Edwards Lifesciences needed an innovative structural heart team to inspire the thousands of interventional cardiologists gathering for its 2019 think tank at the Transcatheter Cardiovascular Therapeutics (TCT) in San Francisco. The TCT is the world’s largest and most important educational meeting for interventional cardiovascular medicine specialists – physicians who heal the heart’s valves, wall and chambers.
During the think tank, Edwards planned to showcase a community-based heart program that had successfully combined its leading-edge heart valve technology with strategies to significantly improve heart health in their respective community.
What heart program did Edwards choose to use as an example? The James Family Heart Center at Yavapai Regional Medical (YRMC) in Prescott – represented by Structural Heart Program Director Soundos Moualla, M.D., FACC, FSCAI – was the top choice.
“Edwards is interested in the bread-and-butter work that leads to major leaps in delivering appropriate quality valve therapy for patients needing heart valve therapy,” said Dr. Moualla. “They recognized this success in our program.”
Precise ECHO Exams
YRMC’s Structural Heart Program excels in both identifying people with valve disease and in providing them state-of-the-art treatment that’s right for their condition. Nationwide, this is a major health challenge, as only 60 percent of people who are diagnosed with severe aortic valve stenosis receive timely needed therapy.
What happens in the Quad Cities – and other communities served by YRMC’s Heart Program – is similar to what you’ll find with other leading heart programs across the country. It begins with the exceptional quality of the information gathered by YRMC’s cardiac sonographers. These healthcare professionals perform echocardiograms (ECHO), the main test for diagnosing heart valve disease.
“There are four major criteria for diagnosing aortic valve disease with an ECHO exam,” explained James Family Heart Center Patient Navigator Gwen Rhodes, RN. “YRMC’s sonographers capture all four of those criteria 92% of the time. Other programs may capture this necessary diagnostic data approximately 40% of the time.”
This is critical because aortic valve disease – especially aortic stenosis – is often dangerously underestimated. Without appropriate treatment, approximately 50 percent of people with aortic stenosis experience heart failure and possibly death within two years.
“People think, ‘it’s only a heart murmur’ or ‘my valve is just a little narrowed,’” said Moualla. “But when aortic stenosis becomes severe, the situation is very dangerous. It’s as serious as a cancer that has spread, but it involves your heart. That is the challenge we are facing in appreciating the serious implications of severe aortic stenosis.”
Gathering the highest quality information from the ECHO exam is step one in the Heart Center’s exceptional Structural Heart program. The next phase is putting the information to work for patients through YRMC’s “ECHO Alert” program.
The result of every ECHO performed at YRMC – at a physician’s request, any clinical situation – is evaluated by the CardioCare program. There, the anonymous test results are scored using American College of Cardiology classification for heart disease. If a patient’s ECHO score is moderate to critical, their results are flagged when they’re returned to the YRMC Heart Center.
“The system also alerts us if the patient’s cardiologist uses certain words, like ‘moderate’ in their report,” Rhodes said. “We capture critical information using numbers and language.”
Armed with this, she delves into the next phase of the Structural Heart program’s process by:
Informing the patient’s physician of the ECHO results so the information can be shared with the patient.
Collaborating with the physician and Structural Heart team to identify therapy options tailored to the patient’s unique health needs.
Ensuring the patient is in the care of a cardiologist.
Involving the patient in every step of this process.
The Right Therapy for Every Patient
“Our turnaround time – from diagnosis to therapy – is among the fastest in the state because of our streamlined approach,” Moualla said. “Everyone on the team plays a role in ensuring patients receive the therapy that’s best for their individual situation.”
Presenting during the Edwards Lifesciences TCT think tank was recognition of the Structural Heart program’s success, but it’s the individual patient experiences that inspire YRMC’s team.
Heart Healing Stories
Dr. Moualla recalls a patient whose health deteriorated rapidly, going from five-mile hikes and frequent tennis games to needing four liters of oxygen a day. His ECHO exam revealed a damaged heart valve that was caused by a tooth infection. The patient’s severely damaged heart valve was replaced with a prosthetic valve during a Transcatheter Aortic Valve Replacement (TAVR) at the James Family Heart Center.
“A week after his TAVR, we were able to take him off of the oxygen,” Rhodes recalled. “When I see him now, he tells me about his latest golf game or tennis match or hike.”
How does YRMC’s Structural Heart program team feel about the Edwards Lifesciences recognition?
“We are pleased, humbled and delighted with the impact of the Structural Heart program,” said Moualla. “We all understand that everything we accomplish is due to our amazing team. And, of course, it’s inspired by our wonderful patients and their life stories.” QCBN
By Bridget O’Gara
Bridget O’Gara is a writer, communications strategist and project manager who specializes in health care. She works with mission-driven healthcare organizations, including hospitals, other healthcare providers and advocacy organizations.