February 1, 2008

VHVI debuts clinic devoted to heart valve care

Featured Image

VHVI debuts clinic devoted to heart valve care

Vanderbilt Heart & Vascular Institute cardiac surgeons and cardiologists are teaming up to see patients with valve conditions in order to expedite their care, decrease the number of doctor visits needed and help determine optimal treatment.

The Vanderbilt Heart Valve Clinic, which opens next week, will be held on Wednesday afternoons on the fifth floor of Medical Center East. Consolidating valve visits on one day serves the best interests of the patients, said John Byrne, M.D., chair of the Department of Cardiac Surgery.

“We offer this clinic because valve disease is often complex conditions, and the proper treatment sometimes can encompass the entire spectrum of medical care, interventional procedures and surgery. As patient conditions become more complex, a multidisciplinary approach is needed to arrive at an optimal treatment plan for each patient,” he said.

According to the American Heart Association, valve disease most often strikes either the mitral valve, which controls blood flow into the heart, or the aortic valve, which controls blood flow out of the heart. Valvular heart disease causes about 20,000 deaths per year in the United States. An estimated 95,000 inpatient valve procedures are performed per year in the United States.

Most valve conditions can be managed medically with follow up for a period of time. Eventually, however, they most likely will require surgical correction.

Valve surgery is performed for two major conditions: leaking valves and blocked valves. Both conditions can lead to heart failure.

Valve surgery typically involves either valve replacement or valve repair.

Valve replacement involves removing the native valve and replacing it with an artificial valve made of either mechanical parts or biological tissues. Valve repair involves using the patient's own native valve tissue to reconstruct the valve. Valve repair has been referred to as “plastic surgery of the valve.”

At Vanderbilt, both isolated aortic valve and isolated mitral valve surgeries are performed using minimally invasive techniques. However, when patients have accompanying coronary artery disease, opening the chest has been typically required in order to perform coronary bypass and valve surgery together.

However, Vanderbilt's hybrid operating suite allows the team to perform minimally invasive valve surgery with angioplasty and stenting instead of coronary artery bypass surgery, thereby lowering the risk of surgery.

When patients arrive at the Vanderbilt Valve Clinic on Wednesdays, they will see a cardiologist and a cardiac surgeon to determine if their valve disease should be treated medically, minimally invasively or surgically.

They will also undergo appropriate imaging studies, if needed. Their cases, where appropriate, will then be presented at the Vanderbilt Valve Conference, which is held on Thursday mornings, and reviewed by the entire team of cardiologists and surgeons in attendance.

“We'll get back to the patient and referring physician that Thursday afternoon with the opinion of the group,” Byrne said.

“The Vanderbilt Heart Valve Clinic is a medical-surgical clinic whereby the patient can be evaluated by both disciplines acting in a concerted fashion to arrive at a best recommendation for each individual patient,” said Joseph Fredi, M.D., assistant clinical professor of Medicine.

“I believe the Vanderbilt Heart Valve Clinic is the only valvular heart disease clinic in Tennessee that houses both specialties in the same physical location so patients can receive this type of expert consultative care. The complexity of some types of valvular heart disease really demands this approach for best patient care.”

Michael Petracek, M.D., professor of Clinical Cardiac Surgery, moved his practice to Vanderbilt in 2006, in part, to develop a heart valve referral center he hoped would become one of the nation's finest. The opening of the Vanderbilt Valve Clinic moves VHVI closer to that goal.

“I look forward to working closely with my colleagues to establish a nationally recognized Heart Valve Clinic,” Petracek said.