Other Medical and Surgical Procedures

Arteriovenous Malformation Surgery:

Arteriovenous malformation (AVM), usually a congenital defect (present at birth), is an abnormal tangle of blood vessels connecting arteries and veins, which disrupts normal blood flow and oxygen circulation. The decision to treat an AVM depends on its location, the risk of future complications, and the risk of neurological deficits that may be associated with its treatment. There is a variety of surgical techniques, which may be used alone or in combination, for the treatment of AVMs. These include:

  • Stereotactic Surgery: Stereotactic radiosurgery (SRS) is a form of radiation therapy used to treat functional abnormalities and small tumors of the brain. It can deliver precisely-targeted radiation in fewer high-dose treatments than traditional therapy, which can help preserve healthy tissue.
  • Endovascular Embolization: This procedure involves the insertion of a catheter (thin, hollow tube) through an artery in your groin. The catheter is guided up to the site of the AVM, where it delivers a liquid “glue" that embolizes (blocks) blood flow to the malformed vessels, thus restoring normal circulation.
  • Microsurgical Resection: Microsurgical resection of an AVM requires removal of part of the skull to gain access to the abnormal vessels, which are then repaired or removed.

AVM surgery will usually take place at the hospital. This procedure will take several hours, depending on your specific health condition. Check with your doctor for further details.

*Procedure offered at all of our 11 facilities

Endovascular Coiling:

Endovascular coiling is performed to block blood flow into an aneurysm (bulging, weak area in an artery wall). Preventing blood from flowing into an aneurysm helps keep it from bursting. In some cases, coiling is also performed even if the aneurysm has already burst. Coiling may also be used to treat a condition called arteriovenous malformation, or AVM.

Coiling does not require surgery and/or opening of the skull. During this procedure, your doctor places a catheter (thin, hollow tube) in an artery in your groin, and then moves it carefully up to the affected artery in your brain. X-rays are used to guide the catheter into the artery. A small medical device called a “coil” is placed in the aneurysm to stop blood from flowing into it.

An endovascular coiling will usually take place at the hospital. This procedure will usually take anywhere between 2 to 4 hours. Check with your doctor for further details.

*Procedure offered at all of our 11 facilities

Heart-lung transplantation:

A heart–lung transplant is performed to replace both heart and lungs in a single operation. Due to a shortage of suitable donors and due to the fact that both heart and lung have to be transplanted together, it is a rare procedure. To learn more about a similar procedure, please visit our heart transplantation page.

*Procedure offered at NBIMC

Implantable Hemodynamic monitor:

An implantable hemodynamic monitor (IHM) provides constant measuring of blood pressure inside your veins, heart and arteries. It also measures blood flow and amount of oxygen in the blood. This monitoring is specially warranted for heart failure patients.

Implantable hemodynamic monitors are implanted during a cardiac catheterization procedure. During this procedure, a catheter (thin, hollow tube) is placed in a large vein in your groin and advanced to the heart under X-ray guidance. The monitor is deployed in a branch of a blood vessel feeding the pulmonary artery. Once in place, it remains in the body indefinitely. Readings are then taken on a daily basis in your home by lying down on a specialized pillow that contains an antenna which can retrieve information from the monitor. Readings are sent from your home electronics module to a central monitoring platform that your doctor or nurse can review.

Implanting a hemodynamic monitor will usually take place at the hospital. This procedure will usually take between 1 to 3 hours. Check with your doctor for further details.

*Procedure offered at CMMC, NBIMC and SBMC

Inferior Vena Cava filter:

The inferior vena cava is a large vein in the abdomen that returns blood from the lower half of the body to the heart. Sometimes, blood clots develop in the veins of the leg or pelvis (deep vein thrombosis) and occasionally break up. When this occurs, large pieces of the clot can travel to the lungs. An IVC filter is a small metal device that traps large clot fragments and prevents them from traveling through the vena cava vein to the heart and lungs, where they could cause severe complications such as pain, difficulty breathing, and shortness of breath or even death.

IVC filter implantation is done by placing a catheter (thin, hollow tube) in an artery in your groin, and advanced to the inferior vena cava abdomen. The IVC filter is then placed through the catheter and into the vein. Once it is placed in the correct position, the filter is released, allowing it to fully expand and attach itself to the walls of the blood vessel.

Implantation of this device will usually take place at the hospital. The procedure will usually take anywhere between 30 minutes to 1 hour to complete. Check with your doctor for further details.

*Procedure offered at all of our 11 facilities

Lymphovenous Anastomosis:

Lymphatic fluid surrounds the cells and tissues of the body and not only keeps the cells healthy, but also helps drain away waste products. Lymph vessels transport lymphatic fluid from the limbs through the lymph nodes to larger lymphatic vessels which in turn join to large veins at the bottom of the neck. When the lymphatic system is not working properly, the lymph fluid builds up and causes swelling, leading to the condition known as lymphedema.

In lymphovenous anastomosis (LVA) surgery, your doctor connects a lymph vessel in the affected limb to a nearby vein to bypass the damaged area and restore the flow of lymph fluid back to the venous system. Several connections are made, with the number depending on the condition of the lymph vessels. The connections are generally made before the damaged area and are performed using a small cut just below the surface of the skin.

This procedure will usually take place at the hospital. The procedure will usually take anywhere between 3 to 5 hours to complete. Check with your doctor for further details.

*Procedure offered at all 11 of our facilities

Pericardial Window:

A fibrous sac called the pericardium surrounds the heart. This sac has two thin layers with a small amount of fluid in between them. The fluid helps reduce friction between the 2 layers as they rub against each other when the heart beats. In some cases, too much fluid builds up between the layers (pericardial effusion) leading to the heart not functioning properly. A pericardial window is one method of draining excess fluid and preventing future fluid buildup.

During this procedure, your doctor will remove part of the pericardium to prevent any further excess fluid buildup. This procedure can be performed several ways: through a cut under the bottom of the breastbone, through a cut between the ribs, or through several small incisions on the side of the chest.

A pericardial window will usually take place at the hospital. This procedure will usually take anywhere from 2 to 3 hours to complete. Check with your doctor for further details

*Procedure offered at NBIMC, JCMC, RWJNB and SBMC

Pericardiocentesis:

A pericardiocentesis is another procedure performed to remove excess fluid buildup in the pericardium.Unlike a pericardial window (in which part of your pericardium is removed), during a pericardiocentesis, your doctor places a catheter (thin, hollow tube) in an artery in your groin, and then moves it carefully to the pericardium. Once in place, the catheter helps by draining some of the excess fluid. However, if this approach does not work and/or your condition is more severe, your doctor will recommend a pericardial window.

A pericardiocentesis will usually take place at the hospital. The procedure will usually last anywhere from 30 minutes to 1 hour to complete. Check with your doctor for further details

*Procedure offered at NBIMC, JCMC, RWJNB and SBMC

Surgical clipping:

A surgical clipping procedure provides another treatment option for aneurysms. However, unlike an endovascular coiling, this procedure requires opening of the skull. During this procedure, your doctor will open the skull and place a tiny clip across the neck of the aneurysm. The aneurysm is thereby sealed off from the blood flow; it cannot burst or spill blood into the brain.

A surgical clipping will usually take place at the hospital. The procedure will usually take anywhere between 3 to 5 hours to complete. Check with your doctor for further details.

*Procedure offered at NBIMC, JCMC, RWJNB and SBMC

Thoracic Outlet Decompression:

The thoracic outlet is the ring formed by the top ribs, just below the collarbone. Thoracic outlet syndrome (TOS) occurs when nerves or blood vessels are compressed by the rib, collarbone or neck muscles at the top of the outlet. There are a number of types of thoracic outlet syndrome. Depending on your specific type, your doctor may recommend one of the following options:

  • Transaxillary approach: Your doctor will make an incision in your chest to access the first rib, divide the muscles in front of the rib and remove a portion of the first rib to relive compression.
  • Supraclavicular approach: Your doctor will make an incision just under the neck to expose your brachial plexus region. Your doctor will then remove the muscles causing the compression and repair the compressed blood vessels.
  • Intraclavicular approach: Your doctor will make an incision under your collarbone and across your chest. This procedure may be used to treat compressed veins that require extensive repair.

A thoracic outlet decompression will take place at the hospital. This procedure will usually take 2 hours to complete. Check with your doctor for further details

*Procedure offered at NBIMC, JCMC, RWJNB and SBMC

Saint Barnabas Medical Center
94 Old Short Hills Road
Livingston, NJ 07039
(973) 322-5000
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Monmouth Medical Center
300 Second Avenue
Long Branch, NJ 07740
(732) 222-5200
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Monmouth Medical Center Southern Campus
600 River Avenue
Lakewood, NJ 08701
(732) 363-1900
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Clara Maass Medical Center
1 Clara Maass Drive
Belleville, NJ 07109
(973) 450-2000
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Community Medical Center
99 Highway 37 West
Toms River, NJ 08755
(732) 557-8000
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Newark Beth Israel Medical Center
201 Lyons Avenue at Osborne Terrace
Newark, NJ 07112
(973) 926-7000
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Jersey City Medical Center
355 Grand Street
Jersey City, NJ 07302
(201) 915-2000
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RWJ University Hospital Hamilton
1 Hamilton Health Place
Hamilton, NJ 08690
(609) 586-7900
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Robert Wood Johnson University Hospital
1 Robert Wood Johnson Place
New Brunswick, NJ 08901
(732) 828-3000
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RWJ University Hospital Rahway
865 Stone Street
Rahway, NJ 07065
(732) 381-4200
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RWJ University Hospital Somerset
110 Rehill Avenue
Somerville, NJ 08876
(908) 685-2200
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