Division of Pulmonary, Critical Care and Sleep Medicine - January 2017
RANA HEJAL, MD
Division of Pulmonary, Critical Care and Sleep Medicine, University Hospitals Cleveland Medical Center; Associate Professor of Medicine, Case Western Reserve University School of Medicine
JORDAN KAZAKOV, MD
Division of Pulmonary, Critical Care and Sleep Medicine, University Hospitals Cleveland Medical Center; Assistant Professor of Medicine, Case Western Reserve University School of Medicine
CATALINA TEBA, MD
Division of Pulmonary, Critical Care and Sleep Medicine, University Hospitals Cleveland Medical Center; Assistant Professor of Medicine, Case Western Reserve University School of Medicine
Bronchoscopic procedures allow a direct view of the lower respiratory tract using a long, narrow, fiber optic lighted tube, which is inserted through the nose or mouth. These procedures are performed for both diagnostic and therapeutic purposes. Led by a board-certified interventional pulmonologist, one of a few in this recognized subspecialty, the depth of expertise and scope of services at UH Cleveland Medical Center is found only in the largest centers nationwide.
To support a commitment to delivering the highest quality care experience, the newly expanded bronchoscopy suite at UH Cleveland Medical Center offers more patients the very latest in bronchoscopic procedures. Larger than the previous facility and with all-new equipment, the suite became fully functional at the end of 2016. The new rooms are approximate to operating room standards, therefore, some procedures which previously had to be done in an OR are now able to be performed in the bronchoscopy suite, improving patient access and allowing an outpatient-centered approach to patient care.
The suite features a dedicated anesthesia team able to handle needs ranging from deep sedation to general anesthesia. After their procedure, patients are now able to recover in the bronchoscopy suite. “We believe this offers patients better, faster service and an overall enhanced experience,” said Jordan Kazakov, MD, pulmonologist at UH Cleveland Medical Center and Assistant Professor of Medicine at Case Western Reserve University School of Medicine. “We also bring a multidisciplinary approach to our work to deliver the very best patient care.” The bronchoscopy team at UH Cleveland Medical Center also includes pulmonologists, Catalina Teba, MD, Assistant Professor of Medicine at Case Western Reserve University School of Medicine; and Rana Hejal, MD, Associate Professor of Medicine at Case Western Reserve University School of Medicine.
The pulmonary team collaborates closely with the thoracic surgery division to treat primary lung cancer and cancers that have metastasized to the lungs, discussing malignant disease cases with a multispecialty Thoracic Tumor Board. They also help address other diseases with lung complications.
Research projects include participation in multi-center and international trials on navigational bronchoscopy among other procedure-related topics.
The program is working to train the next generation of physicians and researchers in several ways: partnering with Case Western Reserve University medical student training, presenting joint conferences with UH Cleveland Medical Center pathology and radiology divisions to educate residents and fellows, and expanding the number of fellows and faculty in the division’s Pulmonary Critical Care Fellowship. In addition, the team is exploring educational programs for community physicians.
UH Cleveland Medical Center offers essentially all pulmonary related procedures, including treatment of complex airway disease (malignant or non-malignant) and placement of all varieties of stents to keep the airway open. Bronchoscopy is used to diagnose a range of conditions including lung cancer, metastatic cancer, non-malignant airway disease such as bronchomalacia, sarcoidosis, pulmonary infections, interstitial pulmonary disease, evaluation of persistent cough, vocal cord paralysis, tissue biopsy, and collection of other specimens.
Therapeutic uses of bronchoscopy include removal of secretions or blood to clear airways, control of bleeding, removal of foreign objects, laser or argon therapy for bronchial tumors, and stent placement. Diagnostic procedures offered include endobronchial ultrasound, navigational bronchoscopy, and endoscopy to diagnose and stage lung cancer or lung diseases.
The team also performs pleural procedures, such as thoracentesis to sample pleural fluid accumulation, and indwelling drainage placements for malignant or other chronic effusions. Soon the center will expand its range of procedures even further to include bronchial thermoplasty, which can reduce future hospitalizations and improve asthma control for patients with severe asthma. In addition, it will offer medical pleuroscopy, which is a minimally invasive diagnostic or therapeutic procedure.
The division treats patients referred from throughout Ohio and the neighboring region. It is also a referral center for Louis Stokes Cleveland VA Medical Center, the fourth largest hospital in the Department of Veterans Affairs health care system.