Thoracic & Cardiovascular Surgery Volumes and Outcomes

Marc Gillinov, MD, provides an update on volumes and outcomes for the Department of Thoracic and Cardiovascular Surgery at Cleveland Clinic.

Learn more about the Department of Thoracic and Cardiovascular Surgery.

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Transcript

Announcer:

Welcome to Cardiac Consult, brought to you by the Sydell and Arnold Miller Family Heart, Vascular and Thoracic Institute at Cleveland Clinic. This podcast will explore the latest innovations, medical and surgical treatments, diagnostic testing, research, technology and practice improvements.  

Marc Gillinov, MD:

Welcome, everyone, to our annual report for Thoracic and Cardiovascular Surgery. It is inspiring and humbling at the same time to be a part of this team. Today we're going to have a lot of tremendous graphics created by Doctor Blackstone and Brian Kolbacher. And the slides are beautiful. The format is perfect, they're clear slides, and they are all meaningful. 

When I think about us, I think about days like Monday, and the individuals here. I was doing my third case, and I was really thinking this could be the day: three by three. Except it didn't quite go that way. At about 2:45 I noticed a problem at the back of the heart with the mitral valve, a hematoma, a little bit of bleeding, and the heart instead of going like this was going like this - not moving so much. Not the result that anyone was hoping for. It was right about the time when everyone changes, except Alex, who is a scrub nurse, said, “I'll stay,” and everyone on the team stayed. Without all of those people, we would have had a different result, and the result was the next morning the patient was extubated and had no idea that we had had a true life-threatening problem. 

That kind of thing, that kind of instance, that series of events happens here every day. That's what's behind all of these slides and these figures, that when people come here for their surgery they entrust us with a truly sacred obligation. Every single person on the team comes together. There's no such thing as it's just another mitral valve, just another valve spring root LGS. Every single one of these is a person, and there's the possibility of something going awry. But there's the certainty that we've got the right people to fix things. 

Last year, it's hard to believe that we did better than the year before across the board. No matter what you're looking at, whether it's the total number of operations, more than 8,000, or the results of these operations, we did better than we've ever done before, and we did better than anyone has ever done before. In adult cardiac surgery across northeast Ohio, we had nearly 6,000 cases - at main campus 5,254. About 7 or 8 years ago, Dr. Mihaljevic asked me, “Do you think that you can do 5,000 cases?” I said, well, I can't, but, this group of people likely can, and we broke right through that barrier. 

We did it with outstanding results, meaning 98%+ of the people who came here, whether they arrived on foot or by helicopter, more than 98% of them left this hospital alive. That's reflected in our star rankings for the STS across all eight categories. We are three stars, and I believe we may be the only program in the country that has this honor with these rankings. 

General thoracic surgery, same story, truly outstanding. 2,000 or so cases across the entire spectrum of everything general thoracic surgery does. You go in and see the robotic cases that Dr. Murthy is doing, Dr. Raja, I noticed the heart beating, but they're doing everything. I say that the beating thing you can handle, but we'll take care of all the other things in the entire rest of the body, and they do, with outstanding results. 

The patients know their individual results and they know how their experience was, and they rank us well above our target, meaning almost all patients say we are at least nine out of ten. Virtually 100% of patients say after being at Cleveland Clinic I would recommend that anyone with a problem like mine go to the Cleveland Clinic. It turns out that people from all over do go to the Cleveland Clinic. Most hospitals serve their local community. We do that, but we do that plus. Only 16% of our patients come from Cuyahoga County, 31% from the 20 surrounding counties, and 14% from Ohio in general - so people driving from Columbus, Cincinnati, Toledo, Dayton, etc. But more important to us and to the entire country, almost 40% of our patients come from basically every state in the Union, including Alaska and Hawaii, and from 32 other countries for cardiovascular care. We are truly an international resource. With all of these people, this group, thoracic cardiac surgery, congenital surgery, is responsible for about half of all the admissions to this entire building, which is truly tremendous if you think about the fact that each one of our patients is complex, requires a stay in the operating room, ICU, on the floor, and we fill this building with these patients. And now you'll hear from each individual surgeon and a bit more granularity about what we do, how we do it, and how we serve just every single patient who comes from Ohio, the country, and around the world.

Announcer:

Thank you for listening to Cardiac Consult. We hope you enjoyed the podcast. For more information or to refer a patient to Cleveland Clinic, please call 855.751.2469, that’s 855.751.2469. We welcome your comments and feedback. Please contact us at heart@ccf.org. Like what you heard? Subscribe wherever you get your podcasts or listen at clevelandclinic.org/cardiacconsultpodcast.