The 20 years of experience is the cornerstone of Lancaster General Heart Center’s successful cardiac surgery program. Cardiothoracic Surgeons of Lancaster (CTSL) has been an important part of the program from the beginning and they now provide care exclusively for LGH patients. This collaboration between LGH and CTSL means that only LGH patients have access to some of the most skilled surgeons in the area. Mark W. Burlingame, M.D., Edward F. Lundy, M.D., and Jeffrey Cope, M.D., are the surgeons who make up CTSL. Lawrence I. Bonchek, M.D., a founding member of the group, continues to serve as a Senior Consultant.

The Early Days

When LGH leadership decided to establish a cardiac surgery program that would serve as a model for others, they conducted a rigorous search for a nationally-recognized cardiac surgeon. They found what they were looking for in Dr. Bonchek, whom they recruited from Milwaukee, Wisconsin. Dr. Bonchek accepted the offer to lead this initiative because he says “it was clear that LGH had outstanding resources, leadership and sophistication in cardiology, and an administration that recognized what was necessary to establish a quality program…They wanted a program on par with the best programs in the country.”
 
In order to build a center for excellence in cardiac surgery, Dr. Bonchek looked to one of his best and most talented surgeons, Dr. Burlingame, and asked him to join him in Lancaster. Dr. Burlingame stood out as one of Dr. Bonchek’s most promising cardiac surgery residents and had gone on to establish his own practice in Michigan. When he received Dr. Bonchek’s call, Dr. Burlingame enthusiastically accepted his request to collaborate with him in this exciting opportunity.

In addition, Dr. Bonchek recruited select members of his cardiac team in Milwaukee to join LGH’s talented clinical staff. Both Norma Ferdinand, RN, and Craig Gassman, Perfusionist, accompanied Dr. Bonchek to Lancaster.          

The LGH staff was enthusiastic about the establishment of their own cardiac surgery program. Several LGH team members traveled to Milwaukee to observe Dr. Bonchek and his team perform surgery.

Dr. Bonchek and Dr. Burlingame worked closely with their new team at LGH as they prepared to start the program. Dr. Bonchek vividly recalls the first days of the program. “At first we thought that we would start slowly, and if things went well we’d perform an operation every other day,” he says.

But after the first successes in September 1983, the program literally took off—and hasn’t slowed since.

The Lancaster General Heart Center program consistently receives high ratings when compared to other surgical programs, according to statistical analyses from The Society of Thoracic Surgeons (STS).

In fact, Lancaster General Heart Center’s combined CABG (coronary artery bypass graft) and valve surgery mortality rate of 1.1 percent for calendar year 2002 was more than a full percent lower than the national average of 2.64 percent, and was significantly lower than the Pennsylvania average of 1.95 percent. The severity of each patient’s illness is considered in order to provide a fair comparison among hospitals; therefore these numbers are “risk adjusted.”*

“We always compare our outcomes with the national experience in cardiac surgery,” Dr. Bonchek says. “Our mortality rate has always been less than the national, regional and state average.”

Tim Zellers, MSN, CRNP, Director of Cardiovascular Nursing, also notes that LGH’s program “has a strong history of providing high-quality care at a reasonable cost to patients.” Based on data from the Pennsylvania Health Care Cost Containment Council’s most recent report, LGH’s charge per cardiac patient was significantly below the state average. These factors have helped the program achieve multiple honors, such as being selected as a 100 Top Cardiology Hospital (as selected by Solucient, Inc.). Recently, the cardiac surgery operating room team won the 2003 Best Nursing Team Award from Advance for Nurses magazine.

An Eye on the Future

Dr. Burlingame sees the program’s past successes and 20 years of experience as building blocks for an even brighter future. “We want to continue to capture the enthusiasm and excitement we had at the outset of the program 20 years ago,” he says. “We draw lessons from the past to build strength for the future.”

Dr. Burlingame notes that one of the program’s objectives is to “provide the most current therapies for surgical treatment of cardiac disease in an efficient and caring environment. As surgeons, we want to be sure that any new techniques are clinically proven and truly benefit the patient.”

Heart Failure Advances

Dr. Lundy, who joined the team in 1989, sees exciting advancements on the horizon, including the use of ventricular assist devices (VAD) as therapy for patients with heart failure (HF). HF occurs when the heart cannot pump adequate amounts of blood through the body or when the heart allows blood to accumulate in the lungs. The American Heart Association reports that heart failure affects 5 million Americans, with 550,000 new cases being reported each year. According to the Pennsylvania Department of Health, heart failure has a tremendous impact in Lancaster County.

The left ventricle is the heart chamber that pumps blood throughout the body. Dr. Lundy describes the ventricular assist device as “half of an artificial heart” and says it allows the heart to pump blood more normally, thus extending the life expectancy and improving the quality of life for many HF patients.

“We are able to offer treatments and surgical procedures for HF patients that we weren’t able to offer several years ago,” he says. He explains that other newer treatments involve bypassing blocked arteries, repairing mitral valve leakage and correcting abnormal heart size.

Dr. Lundy also points to the recent establishment of Lancaster General Heart Center’s inpatient Heart Failure Program as an initiative that is benefiting the community. This program’s success is thanks largely to the talents and efforts of the multidisciplinary team.

His associate and the newest member of the cardiac surgery team, Dr. Cope, adds that HF advances are important because “they allow us to help a growing population of very sick people.” He notes that there also have been significant developments in treating atrial fibrillation (abnormal heart rhythms) using radio frequency catheters at the time of surgery.

Dr. Cope joined CTSL in July 2002. A graduate of Hempfield High School and Franklin & Marshall College, he attended medical school at the Pennsylvania State University’s School of Medicine in Hershey. He completed his residency in general surgery and fellowship in cardiothoracic surgery at the prestigious University of Virginia, but knew he would potentially return to the area. “My mentor at the University of Virginia knew Dr. Bonchek and I knew of Lancaster General Heart Center’s national and world-renowned reputation,” Dr. Cope says. “Plus I’m from this area. I was born at LGH and my mom was a nurse here as well.”

He says that working with surgeons the likes of Dr. Burlingame, Dr. Lundy and Dr. Bonchek has been an incredible experience. “The other surgeons are wonderful mentors,” Dr. Cope says. “They’ve helped me to further hone my clinical and operative skills.”

He’s impressed with all team members—from the physicians through the nurses. “Our nurses are both empowered and skilled enough to make critical decisions on their own with guidance from us,” he says.

Dr. Bonchek also holds the cardiac surgery team in the highest regard. Though he no longer performs surgery, he takes pride in having helped develop both the team and the cardiac surgery program. “My key to success is that I surround myself with outstanding people and get out of their way,” he says with a smile.

For the past 20 years, Dr. Bonchek’s approach has proven successful. His efforts have helped to build and maintain a respected and talented cardiac surgery program at Lancaster General Heart Center.

For more information about cardiac care at Lancaster General Heart Center, call 544-4921 or 1-888-221-6244. To learn about upcoming programs, visit www.LancasterGeneral.org.

*The Data Analyses of The Society of Thoracic Surgeons National Adult Cardiac Surgery Database—Spring 2003