Photograph by Stephen Seebeck
For patients with complex valve disease, getting treatment used to mean seeing a family physician for a referral to a cardiologist, who would send them to a heart surgeon. But that’s changed with Missouri Baptist Medical Center’s new Heart Valve Clinic, which opened in June. Patients see both an interventional cardiologist and a heart surgeon, allowing for more efficient diagnosis and treatment.
The idea grew out of the medical center’s weekly heart-valve conferences, in which cardiologists and cardiothoracic surgeons discuss complex cases. “We can talk about patients at 7 in the morning every Wednesday,” says Dr. Michael Mauney, a cardiothoracic surgeon and the Heart Valve Clinic’s co-leader, “but to really evaluate a patient to see if these newer therapies or invasive therapies are going to work, you have to meet the patient.”
The clinic is geared toward patients with severe valve disease, often complicated by other chronic illnesses. By having the patient meet with several specialists, the physicians can “instantly have that conversation with another colleague,” says Mauney. “This really is a team effort.”
That’s because with advances in treatment, there’s been “a blurring of the line between what’s an operation and what’s a procedure,” he explains. “It used to be very clear. An operation meant an incision, usually a big one, and now our operations are getting smaller and smaller. And the ability for the cardiologist to do things through a catheter is becoming better and better… So it is truly both the cardiologist and the surgeons scrubbed—each one is key.”
These advances mean “patients who were sicker in the past—who you wouldn’t think about operating on—are now coming to the table,” says Dr. Rafe Connors, a cardiothoracic surgeon and the Heart Valve Clinic’s other co-leader. “Because of the growing success of valvular surgeries and newer catheter-based therapies, they’re living longer.”
The clinic is geared toward these high-risk patients who “otherwise would maybe never have seen a cardiologist, because they would have been considered too high-risk for any sort of intervention,” explains Connors. The goal is not just convenience, but also to evaluate whether cutting-edge procedures are viable options for patients.
While some patients might grow anxious at the sight of a team of white coats, Mauney and Connors believe that’s not a problem at the new center. “These patients have been to a lot of doctors,” says Mauney. “By the time they’re coming here, they’re tired of having to make trips. They’re hoping to find out if there are any other options for them.”
