Members of the Mount Sinai Health System’s Mitral Valve Repair team, from left, Julie Swain, MD; Javier G. Castillo, MD; Ahmed El-Eshmawi, MD; Amit A. Pawale, MD; David H. Adams, MD; Percy Boateng, MD; Anelechi Anyanwu, MD; and Ricardo A. Lazala, MD.
The highest quality rating for adult cardiac valve surgery has been awarded to The Mount Sinai Hospital and to David H. Adams, MD, Cardiac Surgeon-in-Chief, Mount Sinai Health System, and Marie-Josée and Henry R. Kravis Professor and Chairman, Department of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai.
In the 2019 annual report by the New York State Department of Health (NYSDOH), Dr. Adams was recognized as the highest-volume valve surgeon in the state, performing 1,055 valve operations from December 1, 2013, to November 30, 2016. The report also noted that The Mount Sinai Hospital’s program overall performed 2,271 valve operations in that period, more than any other hospital in the state.
“I am very proud to lead a multidisciplinary team of professionals who are so committed to quality,” says Dr. Adams, who was one of only six surgeons in the state to achieve the top rating. “Our volume and outcomes are a testament to our team’s outstanding dedication to each and every patient with valvular heart disease whom we are honored to take care of at Mount Sinai.”
The state report, “Adult Cardiac Surgery in New York State 2014-2016,” tracked data for patients discharged from 38 New York State hospitals where cardiac surgery is performed. Using a risk-adjusted mortality rate (RAMR), the state evaluated the quality of care that hospitals and surgeons provided. The NYSDOH has been publishing quality ratings for more than 20 years in reports designed to help patients make better decisions about their care based upon a statistical review of each hospital’s data.
The adult cardiac valve ratings measure the quality of “index” open-heart procedures. These are coronary artery bypass graft. (CABG) surgery, in which a vein or artery from another part of the body is used to bypass a blocked artery in the heart; cardiac valve surgery, in which a malfunctioning heart valve is repaired or replaced; and operations that combine CABG and valve surgery. For index procedures, the report showed The Mount Sinai Hospital to be the best in New York City, and one of the top three in the state.
During the study period, the Department of Health’s report found that The Mount Sinai Hospital achieved a risk-adjusted mortality rate of 2.32 for isolated valve and combined valve and CABG surgery, significantly lower than the state average of 3.12. In the ratings for individual surgeons, Dr. Adams achieved an RAMR of 0.33, significantly lower than the statewide average of 2.24, while performing more of these procedures than any other surgeon.
“Many studies have looked at the correlation between volume of procedures and quality of outcomes, and there is a good correlation,” says Julie Swain, MD, Vice Chair, Department of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai. “Generally the higher the volume, the better the results.” Dr. Swain says the hospital’s superior rating in adult cardiac surgery reflected well on the entire heart team, because nurses, administrative staff, housekeeping, and all members of the team are critically important in successful outcomes.
Valentin Fuster, MD, PhD, Director of Mount Sinai Heart and Physician-in-Chief of The Mount Sinai Hospital, says, “Patient safety is the ultimate goal in cardiac surgery, so this rating makes all of us very proud.”