Mary Sheridan Bilbao, PA-C, FAPACVS is an advanced practice provider who specializes in Cardiothoracic Surgery. She completed her both her Undergraduate degree and her Masters of Physician Assistant Studies at Marywood University. She has many years of cardiothoracic surgery experience, and joined our team in 2014. She works in both in-patient and out-patient aspects of care, assists in surgery, and participates in multiple studies and laboratory research. She has expertise in open and endoscopic vein harvesting, open and endoscopic radial artery harvesting, and assisting in cases including valve replacements, minimally invasive aortic and mitral valve repair/replacements, ascending aorta/aortic dissection/aortic arch repair/replacements, redo surgeries, coronary artery bypass grafting (off and on-pump), robotic-assisted minimally invasive coronary artery bypass grafting, minimally invasive myocardial bridge unroofing, heart/lung transplants, VADs, ECMO. She frequently participates in training new PAs and NPs, APP fellows, residents and medical students in OR skills, surgical approaches, endoscopic vein harvest, endoscopic radial artery harvest. Also, she has advanced training in assisting in robotic cases for minimally invasive mitral valve surgery. In the clinic, she frequently performs history & physicals, pre-op evaluations, ordering/interpretation of studies & labs, and coordination of in-patient and out-patient care.
Mary has also been a member of Dr. Joseph Woo's Stanford Advanced Cardiovascular Therapeutics and Surgical Biomechanics Translational Research Laboratory
Woo Lab (http://med.stanford.edu/woolab.html), since 2012. She has been involved in many clinical trials and published research.
Board Certification: National Commission on Certification of Physician Assistants, Physician Assistant (2009)
Professional Education: Marywood University (2009) PA
Professional Education: Marywood University (2008) PA
Endoscopic Radial Artery Harvesting During Anesthesia Line Placement Reduces the Time and Cost of Multivessel Coronary Artery Bypass Grafting.
Innovations (Philadelphia, Pa.)
OBJECTIVE: Endoscopic radial artery (RA) harvesting performed concurrently with internal mammary artery (IMA) takedown and endoscopic saphenous vein (SV) harvesting creates a crowded and inefficient operating room environment. We assessed the effect of a presternotomy RA harvest strategy on surgery time and costs.METHODS: A total of 41 patients underwent elective, first-time, isolated multivessel on-pump coronary artery bypass grafting including an IMA, RA, and SV graft. The first 20 patients (Phase I) underwent endoscopic RA harvesting concurrently with IMA takedown and endoscopic SV harvesting after sternotomy, requiring two sets of endoscopic harvesting equipment per case, each used by a separate individual. The final 21 patients (Phase II) underwent endoscopic RA harvesting during anesthesia line placement, completing the procedure before sternotomy, thus requiring only one set of endoscopic harvesting equipment reused by a single individual.RESULTS: There were no differences in baseline patient characteristics, number of bypasses, duration of SV or RA harvest time, or duration of cardiopulmonary bypass or cross-clamp time between the two groups. Total surgery time was reduced by 32 minutes in Phase II (P = 0.044). Relative to a total hospital direct cost of 100.00 units, total surgery costs were reduced from 29.33 units in Phase I to 25.62 units in Phase II (P = 0.001). No anesthesia- or RA harvest-related complications occurred in either group.CONCLUSIONS: Endoscopic RA harvesting can be safely performed during anesthesia line placement prior to sternotomy. Our simple but innovative strategy improves intraoperative workflow, reduces the time and cost of surgery, and advances the delivery of high-quality patient care.
View details for DOI 10.1177/1556984519882014
View details for PubMedID 31903868
Autograft Valve-Sparing Root Replacement for Late Ross Failure during Quadruple-Valve Surgery
ANNALS OF THORACIC AND CARDIOVASCULAR SURGERY
2017; 23 (6): 313–15
Approximately 25% of patients require reoperation within 15 yrs of a Ross procedure. Increasing experience with valve-sparing root replacement (VSRR) has led some surgeons to spare the autograft valve. Here, we demonstrate that all valves can be surgically repaired or replaced safely during autograft VSRR. As more patients are considered for this operation, coexistent mitral, tricuspid, and pulmonic valve dysfunction should not preclude salvage of the autograft valve, nor should autograft leaflet prolapse.
View details for PubMedID 29046487
- Minimally invasive mitral valve repair in situs inveresus totalis Journal of Cardiac Surgery 2016 ; Vol 31 (12): 718-720
- Stanford Health Care/Stanford Medicine, Department of Cardiothoracic Surgery Handbook (2015 & 2017) Stanford Health Care. 2015
Minimally invasive approach provides at least equivalent results for surgical correction of mitral regurgitation: A propensity-matched comparison
38th Annual Meeting of the Western-Thoracic-Surgical-Association
MOSBY-ELSEVIER. 2013: 748–56
Minimally invasive approaches to mitral valve surgery are increasingly used, but the surgical approach must not compromise the clinical outcome for improved cosmesis. We examined the outcomes of mitral repair performed through right minithoracotomy or median sternotomy.Between January 2002 and October 2011, 1011 isolated mitral valve repairs were performed in the University of Pennsylvania health system (455 sternotomies, 556 right minithoracotomies). To account for key differences in preoperative risk profiles, propensity scores identified 201 well-matched patient pairs with mitral regurgitation of any cause and 153 pairs with myxomatous disease.In-hospital mortality was similar between propensity-matched groups (0% vs 0% for the degenerative cohort; 0% vs 0.5%, P = .5 for the overall cohort; in minimally invasive and sternotomy groups, respectively). Incidence of stroke, infection, myocardial infarction, exploration for postoperative hemorrhage, renal failure, and atrial fibrillation also were comparable. Transfusion was less frequent in the minimally invasive groups (11.8% vs 20.3%, P = .04 for the degenerative cohort; 14.0% vs 22.9%, P = .03 for the overall cohort), but time to extubation and discharge was similar. A 99% repair rate was achieved in patients with myxomatous disease, and a minimally invasive approach did not significantly increase the likelihood of a failed repair resulting in mitral valve replacement. Patients undergoing minimally invasive mitral repair were more likely to have no residual post-repair mitral regurgitation (97.4% vs 92.1%, P = .04 for the degenerative cohort; 95.5% vs 89.6%, P = .02 for the overall cohort). In the overall matched cohort, early readmission rates were higher in patients undergoing sternotomies (12.6% vs 4.4%, P = .01). Over 9 years of follow-up, there was no significant difference in long-term survival between groups (P = .8).In appropriate patients with isolated mitral valve disease of any cause, a right minithoracotomy approach may be used without compromising clinical outcome.
View details for DOI 10.1016/j.jtcvs.2012.09.093
View details for Web of Science ID 000314882500024
View details for PubMedID 23414991
Quantitative evaluation of change in coexistent mitral regurgitation after aortic valve replacement
38th Annual Meeting of the Western-Thoracic-Surgical-Association
MOSBY-ELSEVIER. 2013: 341–48
Management of intermediate degrees of mitral regurgitation during aortic valve replacement for aortic stenosis remains controversial. We sought to evaluate the degree of reduction of mitral regurgitation in patients undergoing aortic valve replacement, as well as a mathematical relationship between aortic valve gradient reduction and the degree of mitral regurgitation decrement.We retrospectively analyzed demographic, intraoperative, and echocardiographic data on 802 patients who underwent aortic valve replacement or aortic root replacement between January 2010 and March 2011. A total of 578 patients underwent aortic valve replacement or aortic root replacement without intervention on the mitral valve. We excluded 88 patients with severe aortic insufficiency, 3 patients who underwent ventricular assist device placement, 4 patients who underwent prior mitral valve replacement, and 21 patients with incomplete data, yielding 462 patients for analysis. For each patient, the degree of pre- and postoperative mitral regurgitation was graded on a standard 0 to 4+ scale.Of the 462 patients, 289 patients had at least mild mitral regurgitation. On average, mitral regurgitation decreased 0.24 degrees per patient for this cohort of 289 patients. Of the 56 patients with at least moderate mitral regurgitation, mitral regurgitation decreased 0.54 degrees per patient. Of 62 patients who underwent isolated aortic valve replacements, who had at least mild mitral regurgitation, and who had no evidence of structural mitral valve disease, mitral regurgitation decreased 0.24 degrees per patient. Linear regression analysis revealed no relationship between reduction in mitral regurgitation and gradient reduction across the aortic valve.Reduction in mitral regurgitation after relief of aortic outflow tract obstruction is modest at best. Further, the magnitude of gradient change across the aortic valve has little influence on the degree of reduction in mitral regurgitation. These observations argue at minimum for performing a prospective evaluation of the clinical benefits of addressing moderate mitral regurgitation at the time of aortic valve intervention and may support a more aggressive approach to concomitant mitral surgery.
View details for DOI 10.1016/j.jtcvs.2012.10.043
View details for Web of Science ID 000313634700010
View details for PubMedID 23245347
View details for PubMedCentralID PMC3660734