Interventional Cardiology Update

Podcast Transcript

Announcer:

Welcome to Cleveland Clinic Cardiac Consult, brought to you by the Sydell and Arnold Miller Family Heart, Vascular and Thoracic Institute at Cleveland Clinic.

Amar Krishnaswamy, MD:

We were fortunate and privileged, really, to provide care to more patients than ever before. In the interventional section last year, we saw more than 13,000 patients in the clinic. We did almost 14,000 procedures in the cath lab in the ORS. This was across all domains in the coronary space. Almost 12,000 procedures. Thanks also to the heart failure and clinical groups that help us in that vein. The peripheral section continued really impressive growth in that area. In the structural arena, we continue to have busy TAVR and Mitraclip volumes. But the new things for last year included the commercial approval of tricuspid valve clipping and tricuspid valve replacement, both of which have seen tremendous growth and important opportunities for patients who really couldn't be treated effectively previously.

Despite the busyness of our practices, of course, quality remains paramount. In this regard, with respect to STEMI, [Jacqueline] Tamis-Holland is our STEMI committee chair. In a collaborative effort with caregivers in EMS, the emergency department, critical care transport, the C-ICU, the interventional and general fellowships, as well as, of course, the cath lab staff, she makes sure that our operations are seamless, allowing us to achieve these, and exceed, I should say, these metrics that are set forth for acute MI care.

Grant [Reed] remains as our quality officer. You can see here, through his leadership, that we have been able to achieve far better even than the 90th percentile with regard to PCI outcomes, whether you classify these as the elective cases that we take care of or those patients coming in with an acute MI.

I'd like to highlight our chronic total occlusion program. We've continued to do the same number of CTO cases, in fact, with a higher degree of success than ever before. Just as a benchmark, this complexity of CTO based on the JCT score nationally has a success rate of barely 70%.

The TAVR program is important, to our entire institution. This is a collaborative team across all cardiovascular medicine sections, cardiac surgery, cardiothoracic anesthesia. While we do treat patients at low and intermediate surgical risk levels, the majority of our patients are still considered at a high surgical risk. Despite that, you can see, our results in blue compared to the benchmark national registry results. We continue to exceed all metrics with regard to mortality, stroke and pacemaker rates. This is not only last year. Just looking at the past seven years, out of our total of 18 years of TAVI experience, 4500 cases with very, very consistently low rates of mortality, stroke and pacemaker.

Investigation and innovation are, of course, a priority for our entire department, including our section. Our section members have provided thoughtful perspectives in very important journals, spearheaded various and important guideline statements, collaborated with fellows, not only in our section but in other sections of cardiovascular medicine, provided mentorship to medical students at Case, collaborated across the enterprise in different departments and institutes, as well as collaborated outside of the enterprise itself. Importantly, our group had 162 unique publications in 2024 alone, many of which were in very high-impact journals.

Innovation includes our research nursing group, who screened more than 1200 patients last year, consented around 150 patients and ultimately enrolled just over 100 patients in various areas of innovation and clinical device trials that spanned valvular heart disease, coronary disease and peripheral vascular disease.

Announcer:

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