Michigan Medicine receives national recognition for excellence in mitral valve repair
Michigan Medicine was one of the first five medical centers in the country to recently receive the American Heart Association and Mitral Foundation’s Mitral Valve Repair Reference Center Award.
The award was created as a way to help patients and physicians identify hospitals and surgeons that excel in complex mitral valve reconstruction and deliver high quality outcomes on a consistent basis.
Michigan Medicine has one of the largest and longest-standing mitral valve centers in the country, with more than 30 years of experience, thousands of mitral valve surgeries performed, now with three reference surgeons specializing in mitral valve repair and highly skilled multi-disciplinary teams dedicated to providing the best possible patient care.
Benefits of mitral valve repair
The mitral valve is one of four valves in the heart with a flap that opens and closes with each heartbeat to make sure blood flows in the right direction through your heart and to the rest of your body. In mitral valve disease, the valve does not function properly.
Mitral valve disease and its complications affect tens of thousands of patients each year. Mitral valve repair is preferable to replacement whenever possible. There are numerous repair techniques, such as leaflet reconstruction and resuspension, annular support, chordal augmentation and patch repair, that are utilized to restore valve competency. Having expertise in all aspects of repair techniques offers a higher likelihood of a durable repair to restore a properly functioning mitral valve.
“The benefits of mitral valve repair compared to replacement are well known,” said Matthew Romano, M.D., director of the Michigan Medicine Mitral Valve Clinic and associate professor of cardiac surgery. “Several studies have demonstrated that when you repair a valve, you basically are putting one back on a normal survival curve.
“You pay a price if you replace a valve in certain types of mitral pathology, meaning that your survival is lower,” Romano continued. “Therefore, we do everything we can to repair your valve to give you the best outcome.”
Steven F. Bolling, M.D., professor of cardiac surgery, echoed Romano’s thoughts: “Mitral valve repair is the standard by which we should fix these valves. It basically cures your disease. Your survival is the same as if you didn’t have the problem, and very few things in medicine can do that.”
Quality through quantity
Bolling said it’s important for patients to understand what quality means in mitral valve surgery. He said business schools define quality as a lack of variance, and that the same definition holds true in mitral valve surgery.
“Approximately 4,000 hospitals nationwide offer heart surgery and cardiology, but the variance in outcomes for mitral valve surgery and patient care is widespread,” Bolling said.
In addition to other important performance and measurement criteria for receiving the Mitral Valve Repair Reference Center Award, a hospital must perform a minimum of 50 mitral valve repair surgeries each year, and have at least one surgeon who performs 25 or more such surgeries per year.
“The average surgeon may do 150 mitral valve repair cases in their entire professional career,” said Bolling. “Here, we have surgeons here who have done thousands of cases.”
Bolling himself has performed somewhere between 6,000 and 7,000 mitral valve repairs.
“It really is the volume effect,” he said, “not only for the surgeon but for the center — the ICU, the nursing staff, the referring cardiologist. For everyone who takes care of these patients, it becomes very routine and we become very good at it. That’s what makes Michigan Medicine unique.”
Access to advanced technology and tools
The MATRIx team, which stands for mitral and tricuspid interventions, is an integral part of the mitral valve repair program at Michigan Medicine.
“This is a program that offers trans-catheter repair and replacement options,” said Mary Judd, M.S., B.S.N., R.N., ACNP-BC, nurse practitioner with MATRIx and the Percutaneous Mitral and Tricuspid Valve Program.
Judd said MATRIx program patients are often considered high-risk or prohibitive surgical risk. Many have undergone previous open surgical interventions and are now in need of additional surgery.
“The team, made up of interventional cardiologists, cardiothoracic surgeons, imaging specialists, advance practice providers and nursing, works closely with the clinical research team and our heart failure colleagues,” said Judd. “Each member plays a critical role in developing a care plan, with the patient as an active part of the decision-making process.”
The team meets weekly to develop care plans that are customized and tailored to meet the needs of each individual patient, with the goal of ensuring overall improvement in quality of life, positive outcomes and patient safety.
“As a mitral valve repair reference center, the MATRIx team is able to offer additional trans-catheter tools to aid our surgeons in mitral repair,” Judd said. “This helps offer more opportunities and hope to our patients.”
“We are fortunate at Michigan Medicine to have access to all of the newest technologies, the least invasive technologies, those that you can repair or replace through a catheter, and all the clinical trials,” said Gorav Ailawadi, M.D., M.B.A., Helen F and Marvin M Kirsh Professor of Cardiac Surgery and chair of the Department of Cardiac Surgery. “When patients aren’t eligible for clinical trials, fortunately, we have the ability to offer them very complex mitral valve surgery with excellent outcomes. In addition, we have significant expertise in offering less invasive mitral valve repair that allows patients to return to work or activity more rapidly.”
What the award means for patients and Michigan Medicine
The Mitral Valve Repair Reference Center Award was created to provide patients and referring physicians with information and resources to help them make well-informed decisions about care options.
“Patients have a choice about where they go for surgery and this award helps them find the best hospitals and surgeons for their long-term survival,” said Ailawadi. “The award also helps patients understand the importance of mitral valve repair and the benefits.”
Ailawadi, who joined the organization last September, explained that the expertise at Michigan Medicine goes beyond surgery alone.
“We have a large multidisciplinary team that lives and breathes the mitral valve, and that is so critical in terms of giving patients the best outcomes,” he said. “U-M has one of the largest experiences of mitral valve surgery in the country and world, year over year. The sheer number of patients we treat and the expertise we have here are a huge draw — not just for patients who come here for treatment, but also for experts who want to work in this environment.”
“The Michigan Medicine experience for patients is very unique because we have surgeons who have expertise in repairing the mitral valve but it’s not only that; it’s the whole approach to care and focusing on each patient as an individual and giving them the top priority they deserve,” said Romano.
“The Mitral Valve Repair Reference Center Award is a big rubber stamp of approval from the American Heart Association,” said Ailawadi. “It shows that they recognize the expertise, volume and outcomes that have existed at Michigan Medicine for decades.”
“The award is a recognition to the entire team — the OR team, the nursing team, our coordinators, imagers, cardiologists, and the list goes on and on,” he said. “It really is a testament to how hard they have worked to give patients the best possible outcome and experience in their time of need.”
A recent Short Takes episode focused on the Mitral Valve Repair team and the organization’s recent award. Click here to watch it!