Leadership Series

At Baylor St. Luke’s Medical Center (BSLMC) Texas Heart Institute (THI), we have a long history of innovation and a commitment to drive new technologies and treatments in cardiology and cardiovascular surgery to better serve our patients and community. THI has been at the forefront of treating aortic disease since it became a specialty, with the first aortic replacement therapy being performed at BSLMC. Additionally, THI was one of the first institutions in the world to perform heart transplantation. In an era of decreasing availability of donor organs, we have refined our specialization to take advantage of advances in medical therapy and long-term device support. We are among a handful of centers in the nation that are capable of performing minimally invasive left ventricular assist device implantation and donation after circulatory death heart transplantation using leading-edge “beating-heart-in-a-box” perfusion technology. 

THI was recently recognized for hard work and dedication in cardiology and cardiovascular surgery, being named a high-performing hospital in the U.S. News & World Report for cardiac conditions and procedures including:

• Abdominal aortic aneurysm repair

• Aortic valve surgery

• Heart bypass surgery

• Heart failure

• Myocardial infarction

• Transcatheter aortic valve replacement

What makes this recognition meaningful for our patients and referring providers? Metrics for evaluating the performance of a hospital’s program include patient volume for conditions and procedures, complexity of cases, the spectrum of services offered, hospital length of stay, complications, and morbidity and overall outcomes of patients. For cardiovascular surgery, hospital performance can be reported to a public database maintained by The Society for Thoracic Surgeons (STS). The STS database compares the calculated score to the observed score to evaluate how hospitals are performing for various procedures.

Each patient who undergoes a particular procedure will have an estimated risk score, known as the “calculated score,” of what to expect based on the national average of patients with a similar condition or comorbidities. Following surgery, the patient will have an “observed score,” reflecting that patient’s actual outcome. At a high-performing center, the patients at higher risk for complication have a higher calculated score, just as they would at any other center. However, a more telling comparison is that between a patient’s real survival and profile and their calculated score—if the calculated score is higher than the real observed score, then that hospital is doing better than the national average.

THI’s program is above the national average for these metrics, as evidenced by the program’s recognition. Despite the increasing complexity of our patient population, our consistent quality of care means even high-risk patients can expect low-risk outcomes. Out of challenging circumstances, we yield extraordinary results.

Broad Spectrum Cardiac Expertise, Close to Home

THI employs some of the brightest and most experienced cardiologists and cardiovascular surgeons and strives to deliver positive outcomes surpassing national averages. We are fortunate to be part of an institution that can provide multidisciplinary support for even the most uncommon complications that can occur in a patient with end-stage congestive heart failure or heart disease.

Our experienced surgeons and cardiologists are leaders in their fields, as evidenced by their scientific publications, their outcomes and their use of state-of-the-art technologies to treat heart patients. For example, our cardiac surgeons use robotics to treat heart disease, which is relatively uncommon in the field. We also lead the country in the use of catheter techniques.

Peer review is the process by which other physicians at a hospital routinely evaluate their colleagues to ensure the standard of care, particularly regarding quality of care and patient safety, is being upheld. The old proverb, “two heads are better than one” is part of the BSLMC ethos. We strive to operate on this philosophy without bias to better serve our patients. Right now, we are considered one of the best or most fair organizations across peer-reviewed hospitals to perform such an evaluation. As a result, we continue to deliver quality care beyond the expected outcome.

To illustrate how highly our peers regard us, consider that BSLMC offers a full continuum of cardiac care, including heart transplants, robotic and reoperative cardiac surgery. Of that high-volume program, about 20 percent of our practice consists of cardiac revision procedures referred to us from other hospitals.

Continuing a Legacy of Ingenuity 

Historically, mitral valve disease was treated with replacement, but our approach at BSLMC is to treat with mitral valve repair first, an approach associated with better five-year mortality rates, according to the Journal of Cardiothoracic Surgery. Patients with degenerative mitral valve disease can expect a nearly 100 percent repair rate based on the application of novel therapeutic interventions to treat the disease.

The last two decades have also seen an explosion in percutaneous treatment of coronary artery disease, leaving generally only the most high-risk and complex patients presenting for open surgical intervention. Consequently, our techniques have continued to evolve to provide even these high-risk patients with safe, open surgical alternatives.

For years, BSLMC has been considered a leader in cardiology and cardiovascular surgery, not just for our outcomes but also for our dedication to advancements in the field. We are committed to research—both basic science research and clinical research. We have numerous clinical trials in progress for the different valve technologies, catheter technologies and artificial heart or mechanical circulatory support devices.

In 2016, surgeons BSLMC successfully implanted the 50cc SynCardia Total Artificial Heart (TAH) in a patient with nonreversible biventricular heart failure. Since that time, THI developed and studied a newer TAH device in animals. This device recently received FDA approval for use in humans with biventricular heart dysfunction. It is the next generation of TAH, and its history begins with us.