Central Maine Health takes part in key heart treatment study
Courtesy / Central Maine Healthcare
Central Maine Medical Center receives its recognition as a top cardiovascular hospital. From left, Jeff Garrison, service line director for Central Maine Heart and Vascular; David Tupponce, president of Central Maine Medical Center; Andrew Eisenhauer, medical director of CMHVI; Paul Weldner, cardiac surgeon; Arun Thukkani, interventional cardiologist; and Phillip Terrell, client executive with IBM/WatsonHealth.
Central Maine Medical Center’s Central Maine Heart and Valve Institute is one of 71 hospitals in the U.S. that was part of a study that could radically reduce the need for open-heart surgery.
The report of the study, published in this week’s New England Journal of Medicine, comes as representatives for IBM Watson Health visited the Lewiston hospital to present its recognition for being named one of the nation’s “50 Top Cardiovascular Hospitals” by the health data firm.
The Central Maine Heart and Vascular Institute offers advanced cardiac and vascular diagnostic and treatment services.
The Central Maine HVI participated in tests involving 1,000 patients nationwide that studied using trans-catheter aortic valve replacement, a less invasive option for patients too frail to undergo surgery. The study showed the procedure had a lower rate of death, stroke and re-hospitalization than surgery, as well as resulted in shorter hospital stays.
The results of the study were published this week in the New England Journal of Medicine.
'Absolutely going to change things'
The aortic valve study is “absolutely going to change things,” said Dr. Andrew Eisenhauer, medical director of CMHVI.
“Those people familiar with the subject will tell you that this will be the method of choice for most patients who need an aortic valve replacement.”
There are an estimated 5 million adults in the United States with aortic stenosis — a buildup of calcium in the aortic valve that can lead to heart failure. The new study suggests that open-heart surgery may be required for many fewer patients, the release said.
The study found that catheter-guided aortic valve replacements perform better than open-heart surgery in low-risk patients who normally would undergo the more invasive procedure.
The procedure, where doctors thread a catheter through a groin artery in the heart and install a new aortic valve, has become common over the last decade, especially for this subgroup of heart patients. What doctors did not know is how low-risk patients — strong enough for surgery but offered this lower-impact option — would fare with the procedure.
Eisenhauer noted that more long-term studies need to be done — the trial only studied TAVR patients one year out from the procedure — and that it may not be appropriate for patients with congenital deformities of the aortic valve or very young patients. Previous studies looked at outcomes for medium and high-risk patients, he said.
CMHVI, has done 181 TAVR procedures since 2015.
Affiliated with Massachusetts General Hospital and staffed with highly experienced physicians, CMHVI offers advanced heart and vascular care to patients from across Maine and a unique team-based approach, with interventional cardiologists and surgeons working together to treat each case in a comprehensive way.
“The important thing for patients to remember as they are selecting their care team, is that the interventional cardiologists and the surgeons should be working together,” Eisenhauer said. “Together and with the patients, they should be able to determine the best route—surgery, TAVR, or other treatment, for each person.”
The Watson top hospitals report is based on analyses including reviews from the Centers for Medicare and Medicaid Services. Hospitals were scored in key value-based performance areas including mortality, complications and readmission rates.
If all cardiovascular providers in the U.S. performed at the level of this year's winners (based on Medicare patients only), results industry-wide could amount to: over 10,300 additional lives saved, $1.8 billion saved, and 2,800 additional bypass and angioplasty patients could be complication-free, according to a news release about the report
Central Maine Healthcare serves 400,000 people in central, western and Mid-Coast Maine, and besides Central Maine Medical Center, has hospitals in Bridgton and Rumford. CMH also supports Central Maine Medical Group, a primary and specialty care practice organization. Besides the Central Maine Heart and Vascular Institute, it includes a regional trauma program, LifeFlight of Maine's southern Maine base, the Central Maine Comprehensive Cancer Center and other clinical services.
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