USC Cardiac and Vascular Institute (CVI) director discusses exceptional options available at USC.
Established in 2006, the USC CVI at Keck Medicine of USC brings together cardiothoracic surgeons, vascular surgeons, cardiologists, anesthesiologists and other health care professionals in a multidisciplinary practice. The CVI has gained a reputation as a leader in both research and clinical care and has been an early adopter of many cutting-edge technologies, including robotic and minimally invasive surgery, percutaneous heart valve replacement, endovascular aortic interventions and ablation therapies for complex arrhythmias, to name a few.
In a conversation with Vaughn Starnes, MD, director of USC CVI and chairman of the Department of Surgery at the Keck School of Medicine of USC, we have learned how an aging population has led to an increase in heart valve surgery, the importance of providing real treatment options to patients and the future of cardiovascular surgery.
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Why does USC CVI place such emphasis on heart valve repair or replacement?
Several factors have changed our practice in recent years. We have seen a big impact from cholesterol-lowering drugs. And many people in Southern California have adopted a healthier lifestyle. What we are seeing now is that, because people are living longer, they are developing valvular heart disease simply because of age. Right now about 80% of the procedures we perform are on heart valves. As the baby boomers age, we expect to see more of this in the future.
When and why did you decide to adopt minimally invasive valve repair procedures?
We decided to become experts in minimally invasive valve repair more than a decade ago. At the time, not many doctors performed it, but we thought it was the future of medicine, and we wanted to be leaders in the field. It is now the standard for valve repair, and a lot of patients come to us because we were early adopters and we have more than 10 years of excellent outcomes in minimally invasive procedures. As a group, we perform about 150 minimally invasive valve procedures every year, which is more than most academic medical institutions. We also strive to repair the valve rather than replace it, which is something we accomplish more than 95% of the time, because we believe it lasts longer if we repair it rather than replace it.
How much of a difference does a minimally invasive procedure make for the patient?
It is a world of difference. The incisions are tiny, just a few centimeters, for a mitral valve repair. It greatly reduces the chance of infection and patients are back to their lives in just a few days. Recovery from valve surgery, before minimally invasive techniques, could have taken weeks or sometimes months.
What is unique about the patient experience at USC CVI?
Once a week, we have what we call a valve clinic, where the CVI doctors see the patients as a group. We don’t exchange emails or phone calls; our discussion takes place literally in the patient’s room. We talk about what we think are the patient’s best options and answer the patient’s questions, too. It is a highly personal approach and one that our patients like.
What else do patients like about the treatment at USC CVI?
At CVI, they have more options. Beyond the devices and techniques customarily available, patients have access to advanced care, such as the Ross procedure and Bentall procedure, which allows us to repair valves that might otherwise have to be replaced. We also have more of the new valves that are used in percutaneous procedures, some of which are only available now to patients who are participating in a clinical trial. Patients have access to clinical trials and the most advanced research, when they come to CVI.
What exciting new breakthrough treatments are on the horizon?
We are pretty excited about offering even less invasive techniques in the future. We started doing percutaneous valve repairs in 2011, but only for patients with severe native aortic stenosis who are too high risk to undergo a surgical replacement. We expect to offer percutaneous techniques to a larger group of patients, not only those people who cannot undergo surgery. We also expect to use percutaneous techniques to fix a wider range of problems, such as fixing leaks in the mitral valve.
by Hope Hamashige
For more information, or to make an appointment with USC CVI physicians, call (800) USC-CARE (800-872-2273) or visit https://cvti.keckmedicine.org/request-an-appointment/.