Albany Cardiothoracic Surgeons Delivers Expert, Innovative, Compassionate Heart Care

By Elizabeth Landry

Chief of Cardiothoracic Surgery Chris Rokkas, MD (white coat) and Cardiothoracic Surgeon Stephanie Helmer, MD (scrubs) view heart images.

A practice of St. Peter’s Health Partners Medical Associates, Albany Cardiothoracic Surgeons is the sole provider of cardiac surgery at St. Peter’s Hospital in Albany, NY. In operation since 1955, it is the oldest heart surgery practice dedicated to cardiothoracic surgery in the Capital Region. With over seven decades of experience providing expert-level cardiothoracic surgery, Albany Cardiothoracic Surgeons has become a core aspect of cardiac care within the larger St. Peter’s health system, as Nicholas Montalto, MD, Chief Medical Officer, Acute Care at St. Peter’s Health Partners explained.

“Cardiothoracic surgery is a critical component of a comprehensive cardiac program at St. Peter’s Health Partners, ensuring that patients have access to a full spectrum of advanced heart care close to home,” Dr. Montalto said. “Beyond individual procedures, cardiothoracic surgery strengthens the overall quality of our regional cardiac program, which covers a wide area beyond the Capital Region – stretching into southwestern Vermont, western Massachusetts, north toward the Canadian border and south to the Kingston area.”

Dr. Montalto highlighted the practice’s four Board-Certified cardiac surgeons who bring extensive expertise in cardiac services, both surgical and procedural: Chief of Cardiothoracic Surgery Chris Rokkas, MD, Sulaiman Hasan, MD, Stephanie Helmer, MD, and Rebecca Phillip, MD. He pointed to the excellent cardiac care offered by the surgeons and their teams as a primary reason St. Peter’s cardiothoracic program has received several accolades over the years, such as being rated as high performing in several heart surgery areas including aortic valve surgery, heart attack and heart bypass surgery. St. Peter’s was also recently named Best Regional Hospital in the Capital Region by U.S. News & World Report, a title it has maintained for twelve consecutive years.

“The team’s surgical expertise enables them to not only perform traditional CABG (coronary artery bypass graft) procedures, but also virtually any complex cardiac condition,” explained Dr. Montalto. “Our surgeons specialize in repair and replacement of mitral and aortic valves as well as surgery for aortic aneurysms. This expertise is why St. Peter’s cardiac surgery is consistently ranked among the highest quality programs in New York state.”

Wide-Ranging, Complex Heart Surgery to Meet Patients’ Needs

Having held Cardiac Surgery Chief positions at many academic universities, Dr. Rokkas has extensive expertise in complex surgery care, including aortic and mitral valvular replacement and repair, and he specializes in complex aortic surgery. Dr. Rokkas shared why he chose to join St. Peter’s Health Partners in July of 2025.

“I chose St. Peter’s to continue my career because of the great reputation the hospital has and its rich history in cardiac care,” Dr. Rokkas said. “There’s a lot of emphasis on cardiovascular disease, good results, and a good reputation, and that’s why I joined.”

One of the important recent developments with Albany Cardiothoracic Surgeons is the new Aortic Center opening this spring. Dr. Rokkas said this center will directly address the cardiac needs of the community.

“There is a community need for patients with aortic diseases to be followed and treated at a very specialized center. We have the expertise now at St. Peter’s Hospital to treat patients with complex aortic problems. We’re setting up a very specialized and focused clinic that will serve only patients with aortic disease, including aneurysms of the ascending aorta, aortic dissections and other aortopathies,” Dr. Rokkas explained.

Albany Cardiothoracic Surgeons is also focusing on a new heart failure program. A serious disease that kills hundreds of thousands of people each year, heart failure is a major epidemic across the country, Dr. Rokkas said.

“We are developing a specialized program to treat patients who come in for heart surgery for other conditions like coronary artery disease or heart valve issues and have heart failure,” he said. “We’ll have the technology to care for patients with heart failure at the same time when we’re handling coronary vascularization or heart valve replacement.”

Bypass surgery accounts for approximately 60% of the practices’ work, and Dr. Rokkas also highlighted an innovative technique the team uses for patients who need bypass surgery but who are unable to undergo angioplasty of their coronary arteries.

“These patients require the use of grafts from the legs and arms that is now performed endoscopically without large incisions. The result is faster recovery and less pain for patients,” he said.

Convenient, Quality Clinical and Surgical Care

Dr. Montalto described Dr. Phillip, who has been with Albany Cardiothoracic Surgeons for almost three years, as a provider who has “exceptional surgical skills and has interests in treating ischemic heart disease, valvular heart disease and heart failure.” Dr. Phillip explained the need for the recently established Heart Valve Clinic, which offers a oneday clinic experience for patients who are preparing for a traditional AVR (aortic valve replacement), a TAVR (transcatheter aortic valve replacement), or a mitral valve repair, which is also performed at St. Peter’s Hospital.

“The volume of patients needing an aortic valve replacement is increasing because we’re identifying the disease more frequently and also because we have new therapies to treat it,” Dr. Phillip said. “The TAVR valve is a minimally invasive option that has expanded in use over the last decade. Both AVR and TAVR come with a lot of imaging and preparation to plan for, so it’s much easier for patients and their families to come into the valve clinic and have all that preparation done in a streamlined way in one day,” especially benefitting patients who travel a significant distance to come to St. Peter’s, she added.

Dr. Phillip explained how the convenience of the Heart Valve Clinic also better serves referring providers. “It’s nice for primary care or cardiology providers that are elsewhere to send their patients to us,” she said. “It makes it a lot easier and more familiar for them because the surgeons and cardiologists are centralized here.”

Another way Albany Cardiothoracic Surgeons provides expert yet convenient surgical care for patients is through concomitant procedures, as described by Dr. Helmer, a surgeon with more than 20 years of experience and expertise in heart bypass surgery, heart valve surgery, and other conditions. Some of the heart procedures and surgeries at St. Peter’s can be performed in the same surgery – such as the Maze procedure for ablation of atrial fibrillation – bringing another level of convenience for patients.

“The Maze procedure can be done in addition to a mitral valve procedure, for example,” said Dr. Helmer. “If somebody has a history of a mitral valve leaking and a history of atrial fibrillation, we can take care of both of those problems at the same time.” Another example would be adding a clip to the left atrial appendage during a Maze procedure, decreasing the chance of a thrombus forming, which can often lead to a stroke. Many patients are also dependent on a pacemaker to help keep their arrhythmia under control, Dr. Helmer explained, and those patients can sometimes experience an infected or faulty lead in the pacemaker, which requires a lead extraction procedure.

“Over time, the lead can get stuck to the blood vessels and removing them has a little bit of a higher risk of trauma to those blood vessels. So, what we do is called a laser lead extraction. There aren’t many people who do this procedure – it’s kind of a rarity,” said Dr. Helmer.

Innovative Treatment Options for Optimized Outcomes

Speaking of her experience at St. Peter’s, Dr. Helmer specifically highlighted the level of care provided by the nursing staff in the operating room, intensive care unit, and the progressive care unit. “The nursing care in those units is phenomenal. They deserve a lot of credit because they do a really good job taking care of our patients,” she said.

Dr. Hasan, a surgeon with over 35 years of experience in complex cardiac surgery, echoed Dr. Helmer’s praise of the team at St. Peter’s. “It could possibly be the nicest place I’ve ever worked,” he shared. “The reason is many-fold, but we have a brilliant group of nurses, physician’s assistants, and nurse practitioners. We have very good coordination with the administration, and with each other.” One way the providers at Albany Cardiothoracic Surgeons excel at providing optimized patient outcomes is by minimizing the risks associated with blood transfusions, which can sometimes lead to immune reactions and other complications such as infections.

Dr. Hasan explained that cardiac surgeons primarily use circulatory support, or a heart lung machine, during heart surgery, which takes over the work of the heart and lungs. The  patient’s blood mingles with priming fluid in the machine, which causes hemoglobin levels to drop.

“The business of keeping that hemoglobin up and avoiding a transfusion involves several people. Once the heart starts to beat again, and we come off the bypass, the blood left in the machine is given back to the patient. It’s a meticulous technique and an expeditious operation,” Dr. Hasan said, adding that patients can also take iron and folic acid supplements as well as medications to stimulate bone marrow ahead of the procedure to help reduce dilution of the blood. These options are beneficial to all patients, he said, but especially those who may have personal or religious reasons to avoid blood transfusions.

Dr. Hasan also discussed other innovative procedures performed at St. Peter’s that provide better outcomes for patients. The cardiothoracic surgeons offer bypass surgery utilizing the internal mammary artery as opposed to leg veins, which has been shown to prolong survival and reduce re-operations and heart attacks, he said. Additionally, a procedure called valve sparing aortic root replacement allows patients to retain their own valve, rather than use a valve from animal tissue, which deteriorates over time.

Staying at the Cutting Edge of Cardiothoracic Surgery

The need for cardiovascular services in the Capital Region will continue to increase for several reasons, Dr. Montalto emphasized, including both an aging population and patients choosing to wait longer for preventative care compared to pre-pandemic levels. Dr. Montalto said the team at Albany Cardiothoracic Surgeons is preparing to meet this increased need by continuing to focus on minimally invasive techniques as well as the latest technologies.

“Our structural heart cardiac interventionalists are highly trained and experienced in the latest techniques, including TAVR, mitral clip, and Watchmen procedures,” he said. “Our cardiac electrophysiologists are experts at treating abnormal heart rhythms. Additionally, our vascular surgeons are expertly trained and experienced in minimally invasive endovascular surgical repair of aortic aneurysms. Our catheterization labs are stateof- the-art, and our staff is highly trained. We also have an accredited cardiac rehabilitation program to help patients in their recovery.”

For Dr. Montalto, all of this adds up to a skilled team that’s ready to continue providing expert, high-quality and compassionate care patients can depend on. “Our comprehensive cardiovascular program is expanding and fully prepared to meet the needs of patients, both locally and in communities beyond the Capital Region.” 

Referrals can be made to Albany Cardiothoracic Surgeons via Epic, or by calling 518-525-2525. The practice is located at 319 S. Manning Blvd., Suite 110A, Albany, NY 12208.

Bassett Medical Center Performs Network’s First Tambe® Procedure To Treat Aortic Aneurysm

Minimally Invasive Treatment Can Dramatically Reduce Hospitalization and Recovery Time

The vascular surgery team at Bassett Medical Center successfully completed Bassett Healthcare Network’s first GORE® EXCLUDER® Thoracoabdominal Branch Endoprosthesis (TAMBE) procedure in October 2025.

The procedure was made possible through the use of Bassett Medical Center’s state-ofthe- art hybrid operating room (OR). TAMBE, which received FDA approval in 2024, is an innovative development in the treatment of complex aortic aneurysms, which can be potentially life threatening. The aorta is the largest artery in the body, responsible for supplying oxygenated blood to the cardiovascular system. An  aneurysm can form when a weak area or bulge develops in an artery’s wall. If untreated, an aneurysm could burst, leading to internal bleeding, or cause blood clots that can impact the flow of blood.

TAMBE is an all-in-one, branched device that is implanted to treat the aneurysm. After the patient is under anesthesia, it is inserted into the body through a small incision and, through the use of needle punctures and imaging, is guided into place.

Once in place, the vascular surgeon opens its portals so that graft extensions go into vessels to the lungs, intestines, and kidneys. These grafts open the artery and bolster its walls.

“This is a real advancement in the treatment of these types of aneurysms. 20 years ago, these procedures would require large incisions in the chest and abdomen, whichcame with a significant rate of mortality and risk of complications. Patients would typically be hospitalized for approximately two weeks and have rehabilitation after they were discharged. This procedure reduces that time to only a few days and can often remove rehab as a necessity. The patient who underwent this procedure went home after just a couple of days and is doing well.” – Shelby Cooper, MD, MPH, Chief of Vascular Surgery at Bassett Healthcare Network

Bassett Medical Center’s hybrid OR combines a traditional operating room with a complete angiography lab. An angiography lab is a specialized area where tests and procedures are performed to diagnose and treat diseases and conditions impacting the heart, arteries, and veins. It opened in January 2024 and has since expedited care, reduced the need for some patients to be transferred to other hospitals,
 and allowed for more complex procedures to be performed in one place and time, including this TAMBE procedure.

What Private Equity Really Means for Your Medical Practice

Lynn Trentini, CIC, OneGroup, Business Insurance Account Executive

Private equity (PE) investment in healthcare has grown quickly, reshaping how medical practices run day to day. For physicians and practice owners, selling to a PE firm is a complex decision. It can open doors for growth and support, but it also brings challenges. —offering strategic advantages and potential pitfalls. In New York State, strict regulatory constraints add another layer of complexity that need to be understood before moving forward.

The Three-to-Five-Year Plan

Most PE firms typically work on a three-tofive- year investment plan and during that time they focus on raising the value of the practice thru steps such as: Consolidating smaller practices into larger networks

  •  Streamlining administrative functions via Management Services Organizations (MSOs)
  •  Improving billing and coding practices
  •  Introducing performance metrics and   financial targets

While this model can drive short-term profitability, critics argue it may prioritize financial returns over long-term patient care and physician autonomy.

Advantages of PE Ownership

• Capital Infusion: Immediate financial resources for technology upgrades, service expansion, or debt reduction.

• Operational Support: MSOs take time consuming tasks off your plate providing centralized human resources, IT, and compliance services, reducing administrative burdens and letting you focus more on patient care.

• Negotiating Power: Larger networks often secure better rates with insurers and suppliers.

• Exit Strategy: Helpful for physicians planning retirement or a transition with financial upside.

Disadvantages and Risks 

• Loss of Autonomy: Physicians may have less say in clinical decisions and staffing.

• Pressure to Perform: Aggressive financial targets can lead to higher patient volumes and shorter visits.

• Staffing Cuts: Cost-cutting measures may impact morale and the patient experience.

• Regulatory Challenges: In New York, corporate ownership restrictions require creative structuring through MSOs or joint ventures.

MSOs: Navigating Compliance

MSOs handle non-clinical operations while physicians stay in charge of medical decisions. This model lets private equity groups support and influence the business side without violating state rules that limit non-physician ownership.

New York’s Landscape

The state’s corporate practice of medicine doctrine limits direct ownership by nonphysicians. This means PE firms often succeed by focusing on specialties like dermatology and ophthalmology, where economies of scale and centralized services offer clear advantages.

Final Thoughts

Private equity can provide growth, efficiency, and financial stability—but not without trade offs. It can also change how physicians work and make decisions. The best approach is to balance the financial upside with the impact on autonomy and patient care. In regulated environments like New York, success depends on thoughtful structuring and a commitment to patient care.

Thinking about how private equity could impact your risk exposure or insurance needs?

OneGroup’s Risk Management and Insurance team can help you sort through your options and stay compliant as you plan for the future.

OneGroup is uniquely qualified to help physicians and medical practices with all of their business challenges. If you have any questions or would like additional information, please feel free to reach out to Lynn Trentini 518-698-9997, ltrentini@onegroup.com or Brian Hurley at 315-708-3635, bhurley@onegroup.com.

References

Commonwealth Fund. (2023a, November). Private equity’s role in health care. https:// www.commonwealthfund.org/publications/explainer/2023/nov/private-equity-rolehealth-care  

Medical Economics. (2023). Navigating the pros and cons of selling your medical practice to private equity. https://www.medicaleconomics.com/view/navigating-the-pros-and-consof-selling-your-medical-practice-to-privateequity 

American Journal of Medicine. (2023). What happens when private equity firms sell medical practices. https://www.amjmed.com/article/S0002-9343(23)00589-2/fulltext 

Commonwealth Fund. (2025, May). How private equity deals are reshaping your health care [Podcast]. https://www.commonwealthfund.org/publications/podcast/2025/may/how-private-equity-dealsare-reshaping-your-health-care

Harvard Business School Library. (n.d.).What happens when private equity firms sell medical practices. https://www.library.hbs.edu/working-knowledge/what-happens-whenprivate-equity-firms-sell-medical-practices

When the Algorithm Acts Alone: The Risks of and Emerging Standards Regarding Agentic AI in Healthcare.

By: Scott Carroll, Kennedy Farr, and Jennifer Forward

Kennedy A. Farr

Jennifer Forward

Scott V. Carroll

Agentic artificial intelligence (“agentic AI”) refers to systems that can independently plan and execute multi-step tasks without continuous human direction. Today, these systems can analyze charts, labs, imaging, and medication lists, identify concerning trends, and even draft suggested care plans on their own.

This autonomy distinguishes agentic AI from traditional “generative AI,” such as ChatGPT, Microsoft Copilot, or Google Gemini. Generative AI cannot initiate tasks because it waits for human prompts and cannot interact with operational systems to schedule tasks. Once a conversation with a human ends, generative AI does not retain goals or continue working toward them. Agentic AI, by contrast, maintains objectives over time, continuously monitors new information, and adapts its actions to achieve its programmed goals.

While agentic AI promises potential relief from workforce shortages and could automate routine clinical tasks, it also comes with clinical, security, and ethical risks.

Clinically, agentic AI errors in diagnosis or treatment recommendations and orders could lead to patient harm. Agentic AI learns from human-provided data, and biased data can perpetuate health inequities. Further, since such systems by their nature operate autonomously, a single mistake can trigger a chain of incorrect actions that may harm a patient.

Security risks arise because agentic AI requires broad access to sensitive patient information. Weak security could expose data to breaches, and malicious actors could potentially hack an agentic system, allowing it to take harmful actions.

Accountability becomes unclear when an agentic AI system makes a mistake. Responsibility will likely fall on the clinician who used the tool, the facility that deployed it, and the developer who built it. Such a complicated and evolving legal and risk management landscape creates liability concerns. Indeed, MLMIC has issued several publications addressing risk management and the use of AI in clinical settings.

Practitioners should recognize that using agentic AI creates a professional obligation to understand the tools well enough to ensure satisfaction of the medical standard of care and to uphold the duty to do no harm. Errors made by agentic AI can breach these duties, especially when practitioners lack proper knowledge of how to use the system. Use of experimental or novel tools on patients also implicates concerns related to patient disclosure and consent and human subject safety considerations (and potential requirements for Institutional Review Board approvals). Finally, there is also the risk that increased reliance on automated systems could erode the human empathy central to patient care, as agentic AI cannot understand or express compassion.

Agentic AI is moving from pilots to clinical use, but guidance remains varying. Leading health coalitions, including the Coalition for Health AI and the Trustworthy and Responsible AI Network, have advanced methods to assess safety and performance. Additionally, there are some growing sets of guidelines to use when evaluating and validating this new technology. For example, on September 10, 2025, the Consumer Technology Association (CTA), North America’s largest technology trade association, released a new standard for validating AI tools that predict health outcomes. This fifth CTA AI standard offers a structured scheme for testing predictive algorithms in controlled and real-world settings. It emphasizes transparency about training data, encourages developers to ensure models can explain how they arrive at specific predictions, and calls for robust post deployment plans to monitor quality and recalibrate when performance drifts.

The sector has not united around one approach, leaving potential users to navigate a patchwork of frameworks. We expect over time that there will be a consolidated set of standards and guidelines for development and clinical use that developers, hospitals, systems, and clinicians can refer to when implementing AI and machine learning tools, including agentic AI.

Regarding regulation in New York State, there are not yet agentic-AI-specific rules for clinical care, but New York has established guidelines that will shape deployment in health settings. In 2023, the Governor issued an executive order establishing an AI policy and governance framework and directing ethical-use policies for state agencies, followed in 2024–2025 by guidance from the Office of Information Technology Services on responsible use of generative AI.

State medical boards retain their principal role of regulating the practice of medicine and have likewise begun articulating principals for the use of AI in medical practice, emphasizing that agentic systems cannot independently practice medicine, licensed clinicians remain ultimately responsible for diagnosis and treatment decisions assisted by AI, and development should be transparent, documented, and consistent with the standard of care, patient safety, and existing scope-of practice supervisions requirements. Indeed, over the last year, the New York State Board of Medicine has engaged in discussions with technical, legal, and regulatory representatives regarding this topic. However, no formal guidance or advisories have yet been issued by the Board. Additionally, professional specialty boards may develop their own specialty specific guidance for using agentic AI. Providers should closely monitor guidance from the Board of Medicine and their professional societies.

For hospitals and clinicians, professional standards operate alongside Department of Health requirements for the operation of hospitals and clinics, such as quality assurance, credentialing, and risk management, that apply when agentic AI influences diagnosis or treatment. Additionally, regulatory issues arise with agentic AI. Agentic AI systems may require FDA oversight, warranting premarket review and ongoing controls, because when, to a reasonable person, it provides medical treatment or clinical decision support that influences care, it could be considered a medical device warranting oversight. Users of AI and machine learning applications, including agentic AI, should understand the level of oversight by the FDA of their specific application and its current status.

The regulatory and industry guidance discussed in this article do not resolve the legal issues but provide early guidance to practitioners and the industry as agentic AI enters clinical practice. Physicians and medical groups considering any AI tool need to evaluate these tools as they would any new medical device or drug, ensuring they understand the technology, its intended use, and built-in safeguards, and take additional risk management steps that are appropriate based on the nature of the tool. If you have questions about the topics discussed in this article, please contact Lippes Mathias health law team members Scott V. Carroll (scarroll@lippes.com), Kennedy A. Farr (kfarr@lippes.com), or Jennifer Forward (jforward@lippes.com).