Mount Sinai announces new global center focused on heart valve disease
The Mount Sinai Health System is launching a global center dedicated to advancing care and surgical techniques for heart valve patients. While focused on advanced heart surgery and complex disease, leaders hope to also offer healthcare policy advocacy and a world-class educational resource.
The new Adams Valve Institute is named after David H. Adams, MD, chair of the department of cardiovascular surgery at the Icahn School of Medicine at Mount Sinai and cardiac surgeon-in-chief for the Mount Sinai Health System. Adams is credited with building up the system's surgical program, which performs more mitral and tricuspid valve repairs and advanced aortic root operations than any other facility in the state of New York.
Mount Sinai Fuster Heart Hospital is also already a noted leader in cardiology, which helps facilitate this next step. It was recently ranked No. 2 in the country for cardiology, heart and vascular surgery by U.S. News & World Report. It also ranks No. 1 in New York and No. 6 globally according to Newsweek’s “The World’s Best Specialized Hospitals.”
“Dr. Adams is internationally recognized for revolutionizing reconstructive strategies that restore a patient’s own valve. The Adams Valve Institute will build on this legacy to set a global standard for techniques, education, research, and equitable access in reconstructive valve surgery for all valves and for patients of all ages, from infancy through advanced adulthood,” Ismail El-Hamamsy, MD, PhD, director of aortic surgery for the Mount Sinai Health System, said in a statement. He will serve as the inaugural director of the Adams Valve Institute.
Creating new centers of excellence in heart valve care
The plan is for the institute to create specialized centers of excellence to focus on the most complex and underserved areas of valvular heart disease. Serving as the model for these centers is the Mount Sinai Mitral Valve Repair Reference Center, which is already a world leader in mitral valve management, outcomes research and reconstructive standards. Mount Sinai said the new centers will apply similar principle-based management approaches to aortic valve disease, the Ross procedure, Marfan syndrome and other connective tissue disorders, arrhythmic mitral valve prolapse, radiation-induced heart disease, adult congenital heart disease and complex reoperative valve surgery. Each of the centers will focus on team-based approach to care.
“Our new institute will expand our efforts across the full spectrum of valvular heart disease,” Adams said in the same statement. “Collaboration has been the foundation of our success, bringing together cardiologists, imaging specialists, anesthesiologists, critical care teams, and scientists with a shared mission to advance best practices in heart valve disease care."
He said the aim of the centers of excellence is to offer a new option to patients with rare or very complex conditions, where expertise is usually not available at most hospitals.
Addressing broader concerns about brain drain in cardiac surgery
There are growing concerns across cardiology that as new transcatheter valve repair and replacement procedures continue to rapidly expand volume and are increasing used in younger patients, surgical volumes will decrease. These lower volumes could result in clinicians gaining less experience with complex procedures. Some cardiac surgeons have called for the creation of centers of excellence like this one to aggregate these complex cases among a specialized pool of high-volume surgeons.
As an example of the current trends, aortic valve replacements were 100% surgical prior to 2012 when transcatheter aortic valve replacement (TAVR) first gained approval by the U.S. Food and Drug Administration. TAVR now makes up more than 80% of aortic valve replacement procedures, and surgical aortic valve replacement (SAVR) makes up less than 20%. However, there are still many patients who cannot undergo TAVR. There are concerns as more younger patients get TAVR valves, they will eventually require surgical explants and valve reconstruction when there TAVR valves wear out in the decades that follow.
Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: [email protected]