Structural Heart Program is changing lives of patients and families

STRUCTURAL HEART Groundbreaking program changes lives of patients and families

Celebrating six years of “treating the untreatable”

Baptist Health launched its innovative Structural Heart Program and Valve Clinic in March 2016, where patients with complex valve conditions receive heart testing and consults from multiple specialists in one place, often within one day. Baptist Heart Specialists interventional cardiologist Ruby Satpathy, MD, FACC, FSCAI, was instrumental in launching the Structural Heart Program. Before joining Baptist, Dr. Satpathy performed the first minimally invasive aortic valve replacement and mitral valve repair in Nebraska in 2012 and 2013, respectively, and served as the National Director of Transcatheter Valve Therapy for all Catholic Health Initiative (CHI) hospitals across the country. In her current role as a national expert, she continues to help write the guidelines for mitral regurgitation and minimally invasive valve therapies in collaboration with the American College of Cardiology (ACC), Society for Cardiovascular Angiography & Interventions (SCAI), the Society of Thoracic Surgeons (STS), as well as CMS and the FDA. Siddharth Wayangankar, MD, FACC, FSCAI, RPVI, joined Baptist Health in 2020 and brought his extensive experience from Cleveland Clinic in Cleveland, Ohio, and has added an extra dimension to the Baptist Structural Heart Program. He is an international proctor for minimally invasive valve therapies and a national faculty for training courses for cardiologists and cardiology fellows across the nation. Within the southeastern U.S., he has helped start more than 15 structural heart programs and has more than 200 citations for his research within the cardiovascular field. “I believe innovation is the key to providing expert care to my patients and knew I wanted to join a system that places emphasis on advancing the field of cardiology with research and clinical trials,” said Dr. Wayangankar.

Ruby Satpathy, MD, FACC, FSCAI Interventional Cardiologist Medical Director, Baptist Structural Heart Program, Chair, Cardiology Board Siddharth Wayangankar, MD, FACC, FSCAI, RPVI Interventional Cardiologist; Medical Director, Peripheral Vascular Program Transforming structural heart care through innovation

For years, structural heart disease was treated with conventional open-heart surgery, resulting in lengthy hospital stays and recovery times.

Betty Sanders, 90, always enjoyed an active social life with family and friends. But when mitral regurgitation caused her to easily become out of breath in 2016, she visited the Baptist Valve Clinic, where the team recommended a MitraClip™ procedure. Betty was the first patient at Baptist Health, and first in the region, to receive the MitraClip™ to close her leaking mitral valve. She was thrilled to be actively socializing again within a week after the procedure. Pictured: Sanders at a follow-up visit with Ruby Satpathy, MD, FACC, FSCAI, and Stephanie Hembach, ARNP.

Today, advances in cardiovascular imaging capabilities, catheter-based techniques and the development of innovative devices through clinical trials have transformed the field of structural heart and created minimally invasive treatment options for patients who previously had none. “Now we have the ability to ‘treat the untreatable’ using these minimally invasive procedures, and our patients can start feeling better right away,” said Dr. Satpathy. Baptist Heart Specialists is at the forefront of cardiovascular innovation, offering groundbreaking treatment options including: • Alcohol septal Ablation (HOCM) • Transcatheter closure (ASD/PFO) • Left Atrial Appendage Occlusion (LAAO) (WATCHMAN™/Amulet™) • Transcatheter mitral valve repair (MitraClip™) • PVL closure (Paravalvular leak) • Transcatheter Aortic Valve Replacement (TAVR™) • Transcatheter Mitral Valve Replacement (TMVR®/ Mitral VIV) “Transcatheter therapies have revolutionized clinical medicine and practice in a huge way. We at Baptist are leading this change,” said Dr. Wayangankar.

From left to right: The Structural Heart team includes Shreya Ghetiya, MD; independent physician John Pirris, MD; Siddharth Wayangankar, MD, FACC, FSCAI, RPVI; Praveen Kanaparti, MD, FACC, RPVI; Ruby Satpathy, MD, FACC, FSCAI; Salvatore DiLoreto, MD, FACC and independent physician Nathan Bates, MD. Alejandro Pena, MD (not pictured above; pictured on pg. 9).

Leading the way in high-risk heart valve repair

Baptist Health is often the first and/or only system in the region to offer leading-edge technologies and serves as a national training site for new learners. Some of the cardiovascular “firsts” in our region include: • First to bring transcatheter mitral valve repair (MitraClip™) to the region for high-risk patients with congestive heart failure and mitral regurgitation. • First in Jacksonville to perform a TAVR™ procedure using conscious sedation and no groin incision, which makes recovery easier for patients and reduces their hospital stay to only one or two days. • Only comprehensive LAAO program in the

Jacksonville area to offer both FDA-approved devices for LAAO (WATCHMAN™ and Amulet™). • First Transcatheter Mitral Valve In Ring procedure (TMVIR) in Florida (see sidebar on page 9). • First in the state and second in the country to perform procedures as part of the Amulet IDE and CATALYST trial. • One of the first centers in the Jacksonville area to perform a transcatheter mitral valvein-valve procedure (TMVIV).

Weekly multi-disciplinary valve conference

A key differentiator of the Structural Heart Program is a weekly valve conference where a multi-disciplinary team of interventional cardiologists and cardiothoracic surgeons meet to review the unique aspects of each case and determine the best care plan for the patient. “Our team at Baptist Health consists of talented physicians of many different disciplines who come together to determine the best treatment options for our patients through collaborative conferences,” said Dr. Satpathy.

STRUCTURAL HEART

Since the inception of the Structural Heart Program in 2016, more than 1,000 procedures have been completed at Baptist Health, with better outcomes than national medians. “For successful outcomes, every step from the first clinic visit to post-surgery follow up is important. I am proud that we have the best outcomes in our region because of our team’s collaboration, experience, expertise and skills,” said Dr. Satpathy.

Advancing care locally, nationally and internationally

Drs. Satpathy and Wayangankar are key participants in research studies that lead to the approval of many new devices and are often among the first in the nation to deploy these devices in structural heart procedures. Both cardiologists spread their knowledge and expertise as national and international proctors for TAVR™. Dr. Satpathy is also a proctor for MitraClip™, WATCHMAN™ and Amulet™ . Some of the most recent clinical trials in structural heart diseases at Baptist include: • AMULET™ LAAO vs. NOAC (CATALYST Trial) • Impella® in STEMI – Door-to-Unload • TAVR™ in Moderate AS • TAVR™ and CAD • WATCH-TAVR™ • TMVR (Apollo), anticipated clinical trial “I believe that every life deserves the best care and we at Baptist Health are proud to be able to provide the same for our patients,” said Dr. Wayangankar. “Our team believes in contemporary and innovative medicine, and we have the skills and the belief to provide this to our community.”

Frequently invited as a national speaker on structural heart, Dr. Satpathy recently performed a live case for the Cardiovascular Research Technologies (CRT) conference in Washington, DC, which was broadcast virtually from the Hybrid Structural Lab in Baptist Heart Hospital to teach an international crowd of interventional cardiologists. Pictured: Dr. Satpathy (operator, right) and Dr. Pena (echocardiographer, left).

First TMVIR in Florida

Siddharth Wayangankar, MD, FACC, FSCAI, RPVI (left), and independent physician Nathan Bates, MD (right).

Siddharth Wayangankar, MD, FACC, FSCAI, RPVI, interventional cardiologist, Baptist Heart Specialists, and independent physician Nathan Bates, MD, cardiac and thoracic surgeon and chief of cardiac surgery, Baptist Medical Center Jacksonville, performed the first Transcatheter Mitral Valve In Ring procedure (TMVIR) in Florida following FDA approval of the procedure. TMVIR is used to fix failing mitral valve repairs (prior mitral valve surgical repair with a ring) in patients where a second open-heart surgery is considered too risky. “These procedures require extensive planning, multispecialty, collaborative strategies focused on preprocedural planning, imaging guidance during the procedure and extensive skills,” said Dr. Wayangankar. “We are lucky to have a group that provides all of this and makes such technically challenging cases possible.”