In August 2021, Atrium Health Sanger Heart & Vascular Institute launched a new Valve Center that introduces an innovative patient-centered model of care for people suffering from valve disease. As one of the nation’s highest-volume heart valve disease treatment centers, Sanger used its vast experience to figure out a way to bring the multidisciplinary team together to limit the number of times a patient has to travel to see a doctor and reduce their overall referral-to-procedure wait time.
“The solutions we’ve implemented with this redesigned model will dramatically improve the patient experience and outcomes for valve disease patients across the Carolinas, and hopefully, nationwide,” says Michael Rinaldi, M.D., interventional cardiologist and medical director of Sanger’s Structural Heart Program.
Working in partnership with Jonathan Schwartz, M.D., medical director for Sanger’s Interventional Service, the valve center team is already providing immeasurable value to patients needing this level of medical care for valve disease.
What Is Valve Disease?
As the Centers for Disease Control and Prevention (CDC) explains, the heart has four valves that open and close to control or regulate blood flow into and out of the heart. Diseases of the heart valve take many forms, which include:
- Aortic or mitral valve regurgitation, otherwise known as leaky valves
- Aortic or mitral stenosis, also called narrowed valves
- Mitral valve prolapse or the improper closure of this valve
- Complication or failure of surgical valves
- Congenital heart conditions, such as atrial septal defect (ASD) and patent foramen ovale (PFO)
The American Heart Association says that, “heart valve disease has become an increasing problem in recent years due to increased life expectancy.” The National Heart, Lung, and Blood Institute (NHLBI) says valve disease can potentially be prevented by maintaining a heart-healthy lifestyle and diet that includes physical activity.
Depending on the type and condition of their valve disease, patients suffering from this condition are generally treated in one of these ways: traditional surgery, minimally invasive surgery, catheter-based procedures or medical management.
What Will Patients Experience with the New Valve Center?
Health providers can now refer patients with moderate to severe valve disease to the Valve Center, which acts as a single entry-point to a unified multidisciplinary team that determines which of Sanger’s standardized pathways for care is most appropriate for them: surgical, interventional or medical management. With this approach, “we can quickly direct patients to the specialists they need based on their clinical criteria,” says Dr. Rinaldi, without subjecting them to more studies or visits than they need.
What Are Valve Days?
Sanger has designated specific “valve days” each week to allow same-day testing and imaging so that patients can see the interventionalist and surgeon within one or two trips to the clinic, instead of the typical five or six. During valve days, the multidisciplinary team makes real-time decisions about patients’ testing and imaging results and collaborates to determine the best intervention for the patient.
“We have a high level of imaging expertise at our center, and advanced imagers can now complete a study and discuss results immediately on valve days,” says Dr. Rinaldi. “That provides really valuable context for interventional cardiologists and cardiac surgeons so the team can work to match the right therapy to the right patient at the right time.”
The team is also able to collectively discuss any new technology or treatments that might be available through clinical trials, which clinical research nurses will discuss with patients during their valve day visit. Because patients may see multiple specialists on valve days, it limits the number of times that they have to come to the clinic, which significantly reduces the referral-to-procedure time.
What Else Makes the Valve Center Stand Out?
In addition to experiencing a more unified treatment approach that requires fewer trips to the clinic, advanced practice providers and nurse navigators are part of the patient journey from their first visit until they are discharged from care at Sanger’s Valve Center.
“Ultimately, our goal is to improve valve care nationwide,” Dr. Rinaldi says. “We’re part of the American College of Cardiology Advisory Board and we’re sharing our model to help other structural heart programs improve their processes and care for this growing patient population.”
