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Elevating Cardiac Surgery Care

April 17, 2019
Elevating Cardiac Surgery Care

TriHealth Heart Institute sees 90,000 heart patients annually at its hospitals, outpatient centers and physician practices across greater Cincinnati. Of that large number, only a small percentage require surgery.

TriHealth is the region’s largest provider of minimally invasive and open-heart surgery, performing more than 800 procedures each year. In 2017, 452 procedures were done at TriHealth’s Bethesda North Hospital and 388 at TriHealth’s Good Samaritan Hospital.

Consolidating TriHealth’s two heart- surgery programs into one location at Bethesda North Hospital is the first step toward creating the region’s destination cardiac surgery center of excellence.

“The move allows us to consolidate two medium-sized great programs into one large extraordinary program,” says Stephen Lewis, MD, System Chief and Medical Director of Cardiovascular Care, TriHealth Heart Institute.

Only the surgery programs are being combined—interventional cardiology and non-surgical cardiology services are still available at both Good Samaritan Hospital and Bethesda North Hospital.

Leading the Way

TriHealth has long been a leader in cardiac innovation. Its surgeons were among the first in the United States to treat patients with transcatheter aortic valve replacement (TAVR). They offer deep expertise in robotic-assisted techniques for coronary artery bypass graft (CABG) surgery and valve repair and replacement.

“With Good Samaritan and Bethesda North surgeons under one roof, our minimally invasive program will expand,” says Dr. Lewis. “We can take on more complex cardiac surgeries that require

a large team effort, including advanced heart failure interventions such as LVAD (left ventricular assist device), surgery for patients with end-stage heart failure, and Maze surgery for atrial fibrillation.”

One Focused Team

Cardiothoracic surgeon is a demanding profession, requiring years of additional training, long hours in the OR and an intense on-call schedule. The field is facing a national shortage as surgeons retire and medical school graduates opt for less taxing specialties.

“By combining our surgical programs into one site, we’re ensuring high-quality patient care and fostering a better work environment for our surgeons,” explains Dr. Lewis.

“In addition,” he says, “having surgeons at one location means help is readily available if there’s a difficult surgery that needs an extra set of hands. That’s hard to do when surgeons are across town.”

Positive Change

According to Dr. Lewis, trepidation quickly turned to excitement when Good Samaritan’s cardiac surgery staff moved to Bethesda North.

“We retained a large portion of our Good Sam team during the transfer,” he says. “We doubled the size of our cardiac intensive care unit team. There’s been a lot of renewed energy.”

Two exceptional cardiothoracic surgeons—R. Douglas Adams, MD, and Louis Brunsting, III, MD, recently came to TriHealth from other institutions. Other members of this robust cardiothoracic surgery team include noted surgeons Kathryn O’Keefe, MD, Loren Hiratzka, MD, and Steven Park, MD.

More Cases Mean Better Outcomes

Uniting TriHealth’s cardiac surgery sites under a single roof increases heart-surgery volume, which translates to even more experience for surgeons and the best possible outcomes for patients.

“Medical evidence shows a clear correlation between cardiac surgery site volumes and clinical outcomes,” says Dr. Lewis. Hospitals with higher patient volumes have lower mortality and complication rates. For example, a recent study in The Annals of Thoracic Surgery showed mortality rates for aortic valve replacement patients were 2.41 percent at high-volume hospitals, compared to 4.34 percent at low-volume hospitals.

Combining Resources for Better Care

Creating a single, highly specialized surgical team and center qualifies Bethesda North Hospital to become a Center of Excellence for payers, enabling patients to stay within the network rather than being forced to find surgical care elsewhere.

“When Good Samaritan and Bethesda came together to form TriHealth, they envisioned a truly integrated health system that utilized its broad resources to provide patients the best possible care—at the best cost,” says Mark C. Clement, TriHealth President and CEO. The decision to combine cardiac surgery sites is another step in TriHealth’s journey as the only truly integrated health system in Cincinnati.

“By bringing these two excellent program sites together,” says Clement, “we’re confident we can build a cardiac surgery program that will be second to none in the region when it comes to service, clinical expertise and patient outcomes.”

Advanced Cardiac Surgical Procedures

The expert surgeons at TriHealth Heart Institute perform a wide range of lifesaving procedures including:

Coronary artery bypass graft surgery (CABG) CABG is an open-heart operation (sternotomy) that uses blood vessels to bypass clogged heart arteries and restore circulation.

Left Ventricular Assist Device (LVAD) LVAD is an implanted mechanical heart pump for patients who have reached end-stage heart failure.

Maze Surgery This procedure creates scars to restore normal rhythm for atrial fibrillation (AFib) through open-heart surgery or robotic-assisted surgery (called mini-maze).

Transcatheter Aortic Valve Replacement (TAVR) TAVR is a minimally invasive procedure to replace a diseased aortic valve that doesn’t open properly (aortic stenosis).