heartlungdoc.com

11/09/2025

𝗔 𝗡𝗼𝘁𝗲 𝗧𝗵𝗮𝘁 𝗠𝗮𝗱𝗲 𝗠𝘆 𝗗𝗮𝘆!
Today I received a message that touched me deeply — a simple note from a patient I operated on 𝟯𝟬 𝘆𝗲𝗮𝗿𝘀 𝗮𝗴𝗼 for a congenital heart defect. She wrote just to say hello, to let me know she’s doing well, and to express her appreciation.

Moments like these remind us why we chose this path so many years ago. In healthcare, the road is rarely easy — there are long hours, complex decisions, and emotional challenges that test even the strongest among us. But then, one day, a message arrives from a patient whose life was changed by something you did decades earlier. And suddenly, every challenge feels worth it.

There is no greater reward than knowing that the care we give can impact someone’s entire lifetime.



𝘛𝘩𝘦 𝘷𝘪𝘦𝘸𝘴 𝘦𝘹𝘱𝘳𝘦𝘴𝘴𝘦𝘥 𝘢𝘳𝘦 𝘮𝘺 𝘰𝘸𝘯 𝘢𝘯𝘥 𝘥𝘰 𝘯𝘰𝘵 𝘳𝘦𝘧𝘭𝘦𝘤𝘵 𝘵𝘩𝘦 𝘷𝘪𝘦𝘸𝘴 𝘰𝘧 𝘑𝘦𝘧𝘧𝘦𝘳𝘴𝘰𝘯 𝘏𝘦𝘢𝘭𝘵𝘩.

11/04/2025

𝗪𝗵𝗮𝘁 𝗧𝗿𝘂𝗹𝘆 𝗗𝗲𝗳𝗶𝗻𝗲𝘀 “𝗠𝗶𝗻𝗶𝗺𝗮𝗹𝗹𝘆 𝗜𝗻𝘃𝗮𝘀𝗶𝘃𝗲” 𝗶𝗻 𝗛𝗲𝗮𝗿𝘁 𝗦𝘂𝗿𝗴𝗲𝗿𝘆?

The term “minimally invasive” has become an often misunderstood and overused phrase in cardiac surgery. Many equate it with smaller incisions or robotic approaches. But the reality is that the incision is not always what makes a heart operation “invasive” —to me, it’s operating on the heart that is the invasive part of the procedure.

When performing complex “open-heart” surgery, such as mitral valve repair, the true invasiveness arises from the fact that the heart must be stopped, opened, and supported by a heart-lung machine. Once that step is necessary, the size or location of the incision may become a secondary consideration. 𝗪𝗵𝗮𝘁 𝘁𝗿𝘂𝗹𝘆 𝗺𝗮𝘁𝘁𝗲𝗿𝘀 𝗶𝘀 𝘀𝗮𝗳𝗲𝘁𝘆, 𝗲𝘅𝗽𝗼𝘀𝘂𝗿𝗲, 𝗽𝗿𝗲𝗰𝗶𝘀𝗶𝗼𝗻, 𝗮𝗻𝗱 𝗱𝘂𝗿𝗮𝗯𝗹𝗲 𝗹𝗼𝗻𝗴-𝘁𝗲𝗿𝗺 𝗼𝘂𝘁𝗰𝗼𝗺𝗲𝘀.

Moreover, despite the derisive phrase that refers to the conventional approach as “cracking the chest,” a median sternotomy remains the gold standard for most open-heart operations. It provides consistent exposure, control, and efficiency—and can now be made smaller, with less spreading, and yes, even with minimal or no postoperative pain. I’ve demonstrated this many times in my patient videos that can be found on my website and on social media.

To be clear, I have great respect, support, and admiration for my colleagues who are advancing less invasive and robotic techniques. But my cautionary belief remains that even as the safety and experience for these technologies improve, there are valid indications for offering traditional approaches for many patients. The key is to individualize care. There is not just one procedure fits all patients.

It’s also important to understand that even less invasive procedures have risks. For example, potential risks specific to less-invasive mitral valve repair approaches may include intercostal neuralgia, diaphragm paralysis, liver injury, vascular injury, and retrograde aortic dissection. Lastly, and surprisingly, hospitalization and recovery times are not always significantly faster than traditional approaches.

In my personal experience of more than 𝟱𝟬𝟬 𝗶𝘀𝗼𝗹𝗮𝘁𝗲𝗱 𝗺𝗶𝘁𝗿𝗮𝗹 𝘃𝗮𝗹𝘃𝗲 𝗿𝗲𝗽𝗮𝗶𝗿 𝘀𝘂𝗿𝗴𝗲𝗿𝗶𝗲𝘀 𝘃𝗶𝗮 𝗮 𝘀𝘁𝗲𝗿𝗻𝗼𝘁𝗼𝗺𝘆, I’m pleased to share my results:

• 𝗠𝗼𝗿𝘁𝗮𝗹𝗶𝘁𝘆: 𝟬%
• 𝗔𝘃𝗲𝗿𝗮𝗴𝗲 𝗵𝗼𝘀𝗽𝗶𝘁𝗮𝗹 𝘀𝘁𝗮𝘆: 𝟰.𝟱 𝗱𝗮𝘆𝘀
• 𝗗𝗿𝗶𝘃𝗶𝗻𝗴: ~𝟯–𝟰 𝘄𝗲𝗲𝗸𝘀 𝗽𝗼𝘀𝘁-𝗱𝗶𝘀𝗰𝗵𝗮𝗿𝗴𝗲
• 𝗙𝘂𝗹𝗹 𝗮𝘁𝗵𝗹𝗲𝘁𝗶𝗰 𝗮𝗰𝘁𝗶𝘃𝗶𝘁𝘆: 𝟲–𝟭𝟬 𝘄𝗲𝗲𝗸𝘀 (depending on age, fitness, and preoperative condition)

To complete this discussion, it’s important to recognize that there are indeed 𝘁𝗿𝘂𝗹𝘆 𝗹𝗲𝘀𝘀 𝗶𝗻𝘃𝗮𝘀𝗶𝘃𝗲 𝗵𝗲𝗮𝗿𝘁 𝗽𝗿𝗼𝗰𝗲𝗱𝘂𝗿𝗲𝘀 that are known as “𝗽𝗲𝗿𝗰𝘂𝘁𝗮𝗻𝗲𝗼𝘂𝘀” 𝗼𝗿 “𝗰𝗮𝘁𝗵𝗲𝘁𝗲𝗿-𝗯𝗮𝘀𝗲𝗱” 𝗽𝗿𝗼𝗰𝗲𝗱𝘂𝗿𝗲𝘀 —these do not require stopping the heart or using the heart-lung machine—such as:

• 𝗧𝗿𝗮𝗻𝘀𝗰𝗮𝘁𝗵𝗲𝘁𝗲𝗿 𝗔𝗼𝗿𝘁𝗶𝗰 𝗩𝗮𝗹𝘃𝗲 𝗥𝗲𝗽𝗹𝗮𝗰𝗲𝗺𝗲𝗻𝘁 (𝗧𝗔𝗩𝗥)
• 𝗧𝗿𝗮𝗻𝘀𝗰𝗮𝘁𝗵𝗲𝘁𝗲𝗿 𝗘𝗱𝗴𝗲-𝘁𝗼-𝗘𝗱𝗴𝗲 𝗠𝗶𝘁𝗿𝗮𝗹 𝗥𝗲𝗽𝗮𝗶𝗿 (𝗧𝗘𝗘𝗥 𝗼𝗿 “𝗠𝗶𝘁𝗿𝗮𝗹 𝗖𝗹𝗶𝗽”)
• 𝗣𝗲𝗿𝗰𝘂𝘁𝗮𝗻𝗲𝗼𝘂𝘀 𝗖𝗼𝗿𝗼𝗻𝗮𝗿𝘆 𝗜𝗻𝘁𝗲𝗿𝘃𝗲𝗻𝘁𝗶𝗼𝗻 (𝗣𝗖𝗜) 𝘄𝗶𝘁𝗵 𝗦𝘁𝗲𝗻𝘁𝘀)

These catheter-based procedures represent genuine reductions in physiologic invasiveness.

Ultimately, no operation —conventional, less-invasive/robotic, or catheter-based— should be defined by the size of an incison(s) or by marketing terminology, but by maximal safety, effectiveness, and recovery—achieved through meticulous technique, optimal exposure, and uncompromising outcomes.

The most important thing is for patients to do research, ask questions, and have honest discussions with your doctors regarding your surgeon’s experience and outcomes. Also, it’s important to seek a second opinion whenever feasible. As quickly as technology is expanding, a knowledgeable patient is a safe patient!

——

The views expressed are my own and do not reflect the views of Jefferson Health.



https://heartlungdoc.comr

WELCOME TO HEARTLUNGDOC.COM! My name is Dr. Raymond Singer and this is my personal website. This is not my hospital’s website; all of the views expressed on my personal website are my views only and not the views of my hospital. I’ve created my website with a few purposes in mind: provide inform...

10/26/2025

In a time when our world feels increasingly divided —by politics, race, religion, gender, and ideology— there’s one place where humanity consistently rises above all that: 𝙩𝙝𝙚 𝙝𝙤𝙨𝙥𝙞𝙩𝙖𝙡.

Inside a hospital’s walls, differences fade away. Doctors, nurses, technicians, environmental services, and administrators —people of every faith, background, and identity—come together for a single, sacred purpose: 𝙩𝙤 𝙝𝙚𝙖𝙡.

No one asks about a patient’s political views before rushing to save a life. No one hesitates to lend a hand because of a colleague’s background or personal beliefs. 𝙒𝙝𝙚𝙣 𝙨𝙚𝙘𝙤𝙣𝙙𝙨 𝙘𝙤𝙪𝙣𝙩, 𝙬𝙝𝙖𝙩 𝙢𝙖𝙩𝙩𝙚𝙧𝙨 𝙢𝙤𝙨𝙩 𝙞𝙨 𝙘𝙤𝙢𝙥𝙖𝙨𝙨𝙞𝙤𝙣, 𝙨𝙠𝙞𝙡𝙡, 𝙖𝙣𝙙 𝙩𝙚𝙖𝙢𝙬𝙤𝙧𝙠.

Hospitals remind us that despite our divisions, cooperation is not only possible —it’s happening every single day and night. Hospitals are living examples of how humanity can work together when we focus on what truly matters: 𝙩𝙝𝙚 𝙨𝙝𝙖𝙧𝙚𝙙 𝙙𝙞𝙜𝙣𝙞𝙩𝙮 𝙖𝙣𝙙 𝙬𝙤𝙧𝙩𝙝 𝙤𝙛 𝙚𝙫𝙚𝙧𝙮 𝙝𝙪𝙢𝙖𝙣 𝙗𝙚𝙞𝙣𝙜.

If the world functioned more like a hospital, imagine how much healing we could bring beyond its walls.





(𝘛𝘩𝘦 𝘷𝘪𝘦𝘸𝘴 𝘦𝘹𝘱𝘳𝘦𝘴𝘴𝘦𝘥 𝘪𝘯 𝘵𝘩𝘪𝘴 𝘱𝘰𝘴𝘵 𝘢𝘳𝘦 𝘮𝘺 𝘰𝘸𝘯 𝘢𝘯𝘥 𝘥𝘰 𝘯𝘰𝘵 𝘳𝘦𝘱𝘳𝘦𝘴𝘦𝘯𝘵 𝘵𝘩𝘦 𝘷𝘪𝘦𝘸𝘴 𝘰𝘧 𝘑𝘦𝘧𝘧𝘦𝘳𝘴𝘰𝘯 𝘏𝘦𝘢𝘭𝘵𝘩.)

10/25/2025

With permission from the patient to share, this interview highlights his journey in exploring surgical options for mitral valve repair surgery.

Our discussion emphasizes the significance of patients conducting thorough research, which includes obtaining second opinions, requesting outcomes data, and reviewing publicly available quality report cards on heart programs and surgeons.

The patient is currently on postoperative day three following mitral valve repair surgery performed using conventional open-heart techniques via a sternotomy. He reports no pain or discomfort and is preparing for discharge to home.

10/25/2025

Receiving advanced, compassionate care close to home is essential for our growing suburban Philadelphia communities.

To address this need, 𝗝𝗲𝗳𝗳𝗲𝗿𝘀𝗼𝗻 𝗘𝗶𝗻𝘀𝘁𝗲𝗶𝗻 𝗠𝗼𝗻𝘁𝗴𝗼𝗺𝗲𝗿𝘆 𝗛𝗼𝘀𝗽𝗶𝘁𝗮𝗹 is expanding, blending innovation with humanity every day. While our state-of-the-art facilities showcase our commitment to advanced care, it is our dedicated staff who truly embody this commitment.

We are proud to have achieved the highest 3-Star rating from The Society of Thoracic Surgeons for excellence in mitral valve and multi-procedural surgeries. This distinction is awarded to only the top hospitals in the nation for outstanding surgical quality and outcomes.

Additionally, we are honored to be recognized by Healthgrades as one of the Top 50 Hospitals in the United States for Cardiac Surgery and to be ranked among the Top 10% nationally for patient satisfaction scores —HCAHPS Expertise - The Patient Experience. This recognition reflects our team's commitment to exceptional clinical outcomes and heartfelt patient care.

Every day, we work to advance cardiac care while keeping our focus on what matters most: our patients and our community.

10/24/2025

𝗧𝗵𝗲 𝗡𝗲𝘅𝘁 𝗘𝗿𝗮 𝗼𝗳 𝗖𝗮𝗿𝗱𝗶𝗮𝗰 𝗦𝘂𝗿𝗴𝗲𝗿𝘆: 𝗔𝘂𝗴𝗺𝗲𝗻𝘁𝗶𝗻𝗴 𝗘𝘅𝗽𝗲𝗿𝘁𝗶𝘀𝗲 𝘄𝗶𝘁𝗵 𝗔𝗜
Artificial intelligence (AI) isn’t going to replace surgeons — it’s going to elevate what we can do for our patients.

In cardiac surgery, AI has the potential to transform every stage of care. Preoperatively, AI can analyze imaging and patient data to predict surgical risks with unprecedented accuracy. Intraoperatively, AI-guided visualization and robotic precision can help us navigate complex anatomy and minimize human error. Postoperatively, intelligent monitoring systems can detect subtle signs of complications before they become critical.

The real promise lies in partnership. AI will never replicate the clinical judgment, adaptability, and empathy that define our profession, but it can enhance them. By managing data complexity, standardizing routine decisions, and revealing new insights, AI allows surgeons to focus more deeply on the art of healing.

The future of cardiac surgery is not about automation; it’s about augmentation, combining human intuition with computational intelligence to deliver safer, more personalized, and more effective care.

Together, we can shape a future where every operation benefits from both the wisdom of the surgeon’s experience and the precision of data.

(𝘛𝘩𝘦𝘴𝘦 𝘰𝘱𝘪𝘯𝘪𝘰𝘯𝘴 𝘢𝘳𝘦 𝘮𝘺 𝘰𝘸𝘯 𝘢𝘯𝘥 𝘥𝘰 𝘯𝘰𝘵 𝘳𝘦𝘱𝘳𝘦𝘴𝘦𝘯𝘵 𝘑𝘦𝘧𝘧𝘦𝘳𝘴𝘰𝘯 𝘏𝘦𝘢𝘭𝘵𝘩.)

10/10/2025

𝗔 𝗦𝘁𝗼𝗿𝘆 𝗼𝗳 𝗖𝗼𝘂𝗿𝗮𝗴𝗲, 𝗧𝗲𝗮𝗺𝘄𝗼𝗿𝗸, 𝗮𝗻𝗱 𝘁𝗵𝗲 𝗛𝘂𝗺𝗮𝗻 𝗦𝗽𝗶𝗿𝗶𝘁 —with permission from the patient to post…

Meet Barbara, a remarkable 68-year-old woman who has once again shown what resilience truly looks like.

Five years ago, Barbara underwent a quintuple bypass. Recently, she faced yet another formidable challenge — a double valve operation to correct severe aortic insufficiency and mitral regurgitation.

This was no ordinary surgery. A second-time operation involving five existing bypass grafts, dense scar tissue, and adhesions required meticulous planning and precision. At just over 5 feet tall and 114 pounds, with a history of smoking, cerebrovascular disease, and peripheral arterial disease, Barbara’s case presented significant risks.

The procedure took over six hours, and her recovery demanded three weeks in the hospital, much of it in the ICU. She spent prolonged time on a ventilator, required nutritional support, and received an extraordinary level of multidisciplinary care.

And yet — here she is, less than two weeks after discharge, smiling, energetic, and feeling completely well.

Barbara’s journey is a profound reminder of why we do what we do. 𝗜𝘁’𝘀 𝗮𝗯𝗼𝘂𝘁 𝗵𝗼𝗽𝗲, 𝗽𝗲𝗿𝘀𝗲𝘃𝗲𝗿𝗮𝗻𝗰𝗲, 𝗮𝗻𝗱 𝘁𝗵𝗲 𝗵𝘂𝗺𝗮𝗻 𝘀𝗽𝗶𝗿𝗶𝘁.

I could not be prouder of Barbara and of our entire surgical and critical care team at Jefferson Health for their dedication, collaboration, and compassion in achieving this truly magnificent outcome.

10/04/2025

With permission from the patient to share, a 60-year-old man is heading home five days after undergoing his second open-heart surgery. He reflects on the exceptional care he received at Jefferson Einstein Montgomery Hospital and how this support significantly impacted his recovery.

Jefferson Health
Lehigh Valley Health Network

10/03/2025

𝑻𝒆𝒂𝒎-𝒃𝒖𝒊𝒍𝒅𝒊𝒏𝒈 𝒔𝒕𝒂𝒓𝒕𝒔 𝒘𝒊𝒕𝒉 𝒄𝒆𝒍𝒆𝒃𝒓𝒂𝒕𝒊𝒏𝒈 𝒚𝒐𝒖𝒓 𝒕𝒆𝒂𝒎!

Healthcare is one of the most rewarding careers, but it is also one of the most demanding—especially in today’s environment. Long hours, high stakes, and emotional intensity can take a toll. That’s why creating a culture of collaboration, support, and positivity is not optional—it’s essential.

Today, we celebrated our ICU Nurse Practitioner, Laura Pinou, CRNP, on her birthday 🎂. Taking the time to acknowledge our team’s special occasions, whether it’s a birthday, work anniversary, or personal milestone, is more than just a kind gesture. It’s about:

✅ Building trust and connection
✅ Reminding each other that we’re more than our job titles
✅ Keeping morale high during stressful times
✅ Reinforcing that every person on the team matters

As leaders, we set the tone. A positive vibe is contagious, and when we choose to lead with encouragement and gratitude, our teams are better equipped to handle the challenges of healthcare.

Here’s to celebrating people, not just work—and to remembering that small moments of kindness are the foundation of a strong, resilient team.

09/20/2025

𝗪𝗵𝗮𝘁 𝘆𝗼𝘂 𝗻𝗲𝗲𝗱 𝘁𝗼 𝗸𝗻𝗼𝘄 𝗮𝗯𝗼𝘂𝘁 𝘁𝗵𝗲 𝗻𝗲𝘄 𝟮𝟬𝟮𝟱–𝟮𝟬𝟮𝟲 𝗖𝗢𝗩𝗜𝗗-𝟭𝟵 𝘃𝗮𝗰𝗰𝗶𝗻𝗲.

Last week, CDC’s vaccine advisory committee (ACIP) released updated guidance for this season’s COVID vaccine. Here are the key points:

• No universal recommendation this year. Instead of urging vaccination for everyone, the guidance shifts toward individual, shared decision-making between patients and their healthcare providers.

• No prescription needed. Access remains the same—people can get the shot without a doctor’s prescription.

• Who should consider it most strongly: Adults 65 and older, and individuals 6-months to 64-years-old, with chronic conditions or other risk factors. For these groups, the benefits generally outweigh any risks.

• Insurance coverage remains. Major insurers confirm that COVID (and flu) vaccines will continue to be covered through at least 2026 under ACIP recommendations.

• Variant update: This season’s shot is a monovalent JN.1-lineage–based vaccine (preferably LP.8.1), updated to target currently circulating strains.

As physicians, our role is to guide patients through these nuanced decisions.

𝗧𝗵𝗲 𝘁𝗮𝗸𝗲𝗮𝘄𝗮𝘆: 𝗙𝗼𝗿 𝗵𝗶𝗴𝗵𝗲𝗿-𝗿𝗶𝘀𝗸 𝗽𝗮𝘁𝗶𝗲𝗻𝘁𝘀, 𝘃𝗮𝗰𝗰𝗶𝗻𝗮𝘁𝗶𝗼𝗻 𝗿𝗲𝗺𝗮𝗶𝗻𝘀 𝗮𝗻 𝗶𝗺𝗽𝗼𝗿𝘁𝗮𝗻𝘁 𝘁𝗼𝗼𝗹. 𝗙𝗼𝗿 𝗼𝘁𝗵𝗲𝗿𝘀, 𝘁𝗵𝗲 𝗰𝗼𝗻𝘃𝗲𝗿𝘀𝗮𝘁𝗶𝗼𝗻 𝘀𝗵𝗼𝘂𝗹𝗱 𝗯𝗲 𝗶𝗻𝗱𝗶𝘃𝗶𝗱𝘂𝗮𝗹𝗶𝘇𝗲𝗱.

09/19/2025

Life is a winding road with both high peaks and deep valleys—some days everything falls into place, and other days the skies seem clouded with uncertainty. These moments, both joyful and challenging, shape who we are and remind us of the ever-changing nature of the journey.

What truly carries us through is faith—not just in a specific religion, but in the belief that there is something greater guiding us. No matter the path taken, trusting in a higher purpose, the universe, or simply in the goodness yet to come can light the way out of our darkest times.

“Hope lights the darkest paths,” and when everything feels heavy, faith helps remind us we’re never alone, even if we can’t always see the reason behind each twist and turn.

Embracing both the ups and downs, and believing in a strength beyond ourselves, transforms every setback into a stepping stone. So here’s to holding on, letting faith be our compass, and remembering that the sunrise always follows the night.