An Update from the UVA Cardiovascular Surgery Program
As healthcare providers worldwide navigate the unique challenges of effectively treating patients in the midst of a pandemic, the UVA cardiac surgery team remains committed to providing community partners and their patients continued access to the quality care they’ve come to trust. This includes an ongoing focus on timely communication, appropriate triage and surgical protocols, cardiovascular surgery research, as well as the introduction of new programs and initiatives to further enhance their capacity to provide expert multidisciplinary care.
“We strongly believe the best possible outcomes depend on our ability to build strong relationships with referring providers and their patients. We place a premium on listening and communicating clearly, ensuring you and your patients have the information needed in a timely manner,” says John A. Kern, MD, surgical director of the UVA Heart and Vascular Center.
Getting patients the care they need when they need it — this is key to the UVA cardiac surgery team’s tiered system for triage. “We are paying closer attention to patient throughput and appropriate discharge strategies,” says Kern. “Now more than ever, we are partnering with our community hospital partners to ensure patients receive care in the appropriate place at the appropriate time. But we also have systems in place to be sure we can get those tertiary and quaternary patients in to see us when they need us.
“We get a lot of referrals for folks with relatively chronic, stable conditions who don’t need to be seen in a week or 10 days,” he adds. “If a referring provider says a patient needs to be seen in a week, then we do everything we can to remove barriers and make that happen.”
This commitment to ease the referral process is something the entire surgical team has rallied behind, with each specialist providing a direct line of communication via cell phone to those who request it. “Our access associates work very well together to get patients in as soon as possible, but we can all be contacted directly if referring physicians want our cell numbers,” says Kern.
Need an immediate consult with a UVA cardiac surgeon? Contact our Physician Relations Team Manager, Liz Nottingham via email or phone at 434.243.2733 for more information.
The UVA cardiac surgery team is long on experience. In addition to Kern, it includes:
- Leora T. Yarboro, MD, interim chief, Division of Cardiac Surgery
- Nicholas Teman, MD
- Kenan W. Yount, MD
- Irving L. Kron, MD
- Curtis G. Tribble, MD
Together, this team offers the entire scope of cardiac surgeries, including:
- Traditional open surgical approaches for treatment of coronary artery disease, valve disease and complex aortic disease — isolated and in combination
- Hybrid procedures for the treatment of coronary artery disease, valve disease and complex aortic disease, often combining angioplasty or stenting with an open surgical approach
- Minimally invasive surgery for the treatment of both coronary and valve disease
- Transcatheter approaches for the treatment of valve disease
U.S. News & World Report awarded UVA Heart and Vascular Center with the highest possible performance scores in aortic valve surgery, heart bypass surgery and heart failure care. “This can be attributed to the strong collaborative relationships we have established as part of a larger heart team, working with interventional cardiologists, advanced care providers and others to offer multidisciplinary care targeted at providing optimal treatment for each patient in the least invasive way possible,” says Kern.
New Programs and Initiatives
As they look to the future, the cardiac surgery team sees an opportunity to advance patient care even further. For example, they are actively implementing and revising protocols to minimize blood transfusions, limit time on a ventilator and time in the ICU. They are also working to transition patients to home more quickly and safely. Some of these program enhancements and new initiatives include:
- UVA Aortic Center
The center will serve as a multidisciplinary, tertiary referral care center for patients with complex aortic conditions. The priority of the center is to provide comprehensive, multidisciplinary, high-quality care, in addition to research and education efforts that will serve to further advance innovative treatments, according to Co-Director Behzad Farivar, MD.
“We’ve always offered these services, but the formal development of the Aortic Center with our vascular surgery colleagues reinforces our ability to take care of anyone with any type of aortic pathology, from dissection and aneurysm to connective tissue disorders,” says Kern. “A dedicated center will make it more streamlined for patients so they can easily see everyone they need to see and we can more rapidly develop a care plan for them.”
- Hypertrophic Obstructive Cardiomyopathy Program
Virginia’s only designated Hypertrophic Cardiomyopathy Center of Excellence based on outcomes and expertise, UVA’s HCM Program takes a holistic approach to care, providing surgical and medical treatment, genetic testing, as well as cardiopulmonary testing, stress testing and preventive care tailored to athletes to ensure they can continue to compete safely. Recently joining this program and currently accepting new patients is sports cardiologist Michael Ayers, MD.
- Extracorporeal Membrane Oxygenation (ECMO)UVA has used ECMO since 1991, but in recent months, this program has taken on the new challenge of supporting patients with COVID-19. “We’ve had a lot of calls from outside physicians and hospitals with sick COVID patients who are failing standard therapy,” says Kern. This is one of the reasons this program was one of just nine in the country to receive the Platinum Level Center of Excellence Award by the Extracorporeal Life Support Organization. ”This recognition is the result of our successful outcomes, processes and protocols,” adds Kern.
As a member of the Cardiothoracic Trials Network, UVA has multiple clinical trials ongoing at any given time, providing patients access to some of the most advanced surgical treatments available for the treatment of cardiovascular disease. Some of the UVA trials currently enrolling include:
Anticoagulation for New-Onset Post-Operative Atrial Fibrillation after CABG
Multicenter, Prospective, Parallel-Group, Double-Blind, Randomized, Placebo-Controlled, Phase 2 Study of ANG-3777 (formerly BB3) to Assess the Safety and Efficacy of ANG-3777 in Patients Developing Acute Kidney Injury After Cardiac Surgery (NCT 02771509)
Evaluation of Transcatheter Aortic Valve Replacement Compared to Surveillance for Patients with Asymptomatic Severe Aortic Stenosis: EARLY TAVR trial (NCT 03042104)
On-X Prosthetic Heart Valve: 17 mm Aortic & 23 mm Mitral Study (NCT 01812174)
Surgical Implantation of TRAnscatheter valve in native mitral annular calcification (SITRAL) study (NCT 02830204)
Early Feasibility Study of the Edwards EVOQUE Mitral Valve Replacement System For the Treatment of Moderate to Severe Mitral Regurgitation (NCT 02718001)
Clinical Trial to Evaluate the Safety and Effectiveness of Using the Tendyne Mitral Valve System for the Treatment of Symptomatic Mitral Regurgitation (NCT 03433274)
IRB-HSR # 21853
Clinical TRIal to EvaLUate Cardiovascular OutcoMes IN PAtients Treated with the Tricuspid ValvE Repair System Pivotal (TRILUMINATE Pivotal) (NCT 03904147)
Edwards PASCAL TrAnScatheter Valve RePair System Pivotal Clinical Trial (CLASP IID/IIF): A prospective, multicenter, randomized, controlled pivotal trial to evaluate the safety and effectiveness of transcatheter mitral valve repair with the Edwards PASCAL Transcatheter Valve Repair System compared to Abbott MitraClip in patients with mitral regurgitation
Edwards PASCAL TrAnScatheter Valve RePair System Pivotal Clinical Trial (CLASP II TR): A prospective, multicenter, randomized, controlled pivotal trial to evaluate the safety and effectiveness of transcatheter tricuspid valve repair with the Edwards PASCAL Transcatheter Valve Repair System and optimal medical therapy (OMT) compared to OMT alone in patients with tricuspid regurgitation (NCT 04097145)
Edwards Transcatheter Tricuspid Valve Replacement: Investigation of Safety and Clinical Efficacy using a Novel Device (NCT 04221490)
Percutaneous MitraClipTM Device or Surgical Mitral Valve REpair in PAtients with PrImaRy MItral Regurgitation who are Candidates for Surgery (REPAIR-MR) (NCT 04198870)
Transcatheter Mitral Valve Replacement with the Medtronic Intrepid™ TMVR System in patients with severe symptomatic mitral regurgitation – APOLLO Trial (NCT 03242642)
Randomized trial of evolocumab on saphenous vein graft patency following coronary artery bypass surgery (NEWTON-CABG) (NCT 03900026)
To refer a patient to a UVA cardiac surgeon, call UVA Physician Direct at 800.552.3723.