Cardiothoracic Surgery

Clinical Environment

Spectrum Health offers a wide breadth of cardiology, cardiothoracic and vascular services. Through Spectrum Health’s partnership with MSU, fellows are surrounded by an academic environment including residents and medical students. Fellows will also enjoy opportunities to learn in a state-of-the-art facility providing innovative cardiovascular care. From open heart surgery and transplant to minimally invasive interventions, our physicians and clinical teams are experienced in blending individualized patient plans with a complete dedication to quality outcomes.

Spectrum Health has the highest-volume cardiac surgery program in Michigan. In 2015, we performed nearly 1,500* open heart surgeries.

Our experts use a multidisciplinary, collaborative approach to care. Formal heart team meetings allow our doctors and clinicians to develop treatment plans unique to each patient.

Our mortality rate (1.9 percent*) is below the national average for all cardiac surgeries.

Spectrum Health has reduced the extubation times after cardiac surgery. Our process improvement efforts have allowed us to successfully reduce ventilation times in more than 73 percent of our patients to six hours or less.*

*Volume and quality data from the Society of Thoracic Surgeons (STS Registry)

 

Volumes

As a nationally recognized health care system, Spectrum Health provides high-quality clinical care to thousands of patients each year. Here are some of our clinical volumes from fiscal year 2016.

Total Surgical
i. Cardiac Surgery 1,388
ii. Thoracic Surgery 370
Heart Transplant 25
Lung Transplant 24
Ventricular Assist Device (VAD) 79
ECMO
i. Adult 103
Robotic Procedures
i. Cardiac 37
i. Thoracic 44
Structural Heart
i. TAVR 189
ii. MitraClip 16

Cardiovascular Simulation Center

Spectrum Health is opening a cutting-edge, state-of-the-art dedicated cardiovascular simulation center in July 2017. The simulation center will train and educate future physician leaders and staff by utilizing innovative simulation, applied experiential learning, and hands-on technology to improve patient safety and outcomes. By providing medical education in a supportive, controlled environment, clinicians will master key competencies and skills with zero risk to patients.SH_CV Sim Lab_AERIAL 08-05-16 web

The Spectrum Health Cardiovascular Simulation Center features:

  • 2,700 square feet, with a flexible design for education, training and outreach
  • A simulation operating room (OR) to support complex procedures allowing fellows to practice multidisciplinary patient care transitions
  • An OR procedural monitor room that allows the viewing of fellows, residents and staff, and controlling high-fidelity simulation
  • Technology equipment linked for two-way communication between the hybrid and simulation OR
  • A flexible conference space for:
    • Didactics and training
    • Hosting outside partners
    • Viewing into the hybrid and simulation OR utilizing information system equipment
  • A flexible wet lab space for smaller simulation equipment and potential for “wet tissue” training
  • A dedicated study space for residents and fellows to use throughout their training

Curriculum

The curriculum of the cardiothoracic surgery fellowship training program is designed to meet the goals delineated by the Accreditation Council for Graduate Medical Education (ACGME) and prepares our physicians for certification by the American Board of Thoracic Surgery. The 24-month core curriculum gives exposure to the essential rotations in cardiothoracic surgery.

– 6 months thoracic

– 15 months cardiac surgery

– 3 months pediatric / adult congenital heart

 

Sample Rotation

Fellows participate in outpatient clinics ½ day per week and take call during the entire three years.  Call is Q4 weekdays and Q4 weekends.  The below rotation schedule is a suggested 2-year schedule:

 

First year  Blocks (13 four-week blocks per year)
Thoracic 3
Cardiac 6
Pediatric / Congenital Heart 3
Second Year Blocks (13 four-week blocks per year)
Thoracic 3
Cardiac 9

Didactics

Education has been a long-standing mission of GRMEP/Michigan State University and Spectrum Health/Frederik Meijer Heart and Vascular Institute.  Faculty have designed  a dedicated lecture series designed for fellows addressing basic management of all aspects of cardiology specifically geared towards fellows during their first few months of training.  In addition, the faculty has a list of conferences throughout the year that fellows, attendings and staff are expected to attend.  These include:

  • Morbidity and Mortality (weekly)
  • Heart Team (weekly)
  • Multidisciplinary Lung Conference (weekly)
  • CT ICU Morning Interdisciplinary Rounds (daily)
  • Journal Club (monthly)
  • Fellow Didactic Conference (weekly)
  • Heart and Lung Transplant Selection Meeting (weekly)
  • Cardiothoracic Surgery Quality Committee (monthly)
  • Structural Heart Committee (monthly)
  • Hypertrophic Cardiomyopathy Multidisciplinary Meeting (weekly)

Research

At the Frederik Meijer Heart & Vascular Institute our cardiology faculty is actively involved in innovative clinical research.  Clinical research is a part of our key strategic vision at Spectrum Health and cardiovascular has an active research portfolio that focuses on industry clinical trials, pre-clinical animal studies and investigator-initiated studies.   We have a large cardiovascular research department which provides support to our physicians, and includes research nurses, coordinators, and assistants; statisticians; budget negotiations and financial analysis; and Q&A.  The Heart and Vascular Institute works in collaboration with numerous institutions across the globe, including the Magdi Yacoub Institute, Van Andel Research Institute, Michigan State University, Grand Valley State University and the DeVos Cardiovascular Research Program.

Publications

Here is a sample of selected publications to demonstrate the research focus of our faculty:

The Midterm Impact of Transcatheter Aortic Valve Replacement on Surgical Aortic Valve Replacement in Michigan. Patel HJ, Herbert MA, Paone G, Heiser JC, Shannon FL, Theurer PF, Bell GF, Prager RL; Michigan Society of Thoracic and Cardiovascular Surgeons. Ann Thorac Surg. 2016 Sep;102(3):728-34. doi: 10.1016/j.athoracsur.2016.02.106. Epub 2016 May 4.

Outcomes in the Randomized CoreValve US Pivotal High-risk Trial in Patients With a Society of Thoracic Surgeons Risk Score of 7% or Less. Reardon MJ, Kleiman NS, Adams DH, Yakubov SJ, Coselli JS, Deeb GM, O’Hair D, Gleason TG, Lee JS, Hermiller JB Jr, Chetcuti S, Heiser J, Merhi W, Zorn GL 3rd, Tadros P, Robinson N, Petrossian G, Hughes GC, Harrison JK, Maini B, Mumtaz M, Conte JV, Resar JR, Aharonian V, Pfeffer T, Oh JK, Huang J, Popma JJ.JAMA Cardiol. 2016 Aug 17. doi: 10.1001/jamacardio.2016.2257.

Outcomes in patients undergoing complex cardiac repairs with cross clamp times over 300 minutes. Shultz B, Timek T, Davis AT, Heiser J, Murphy E, Willekes C, Hooker R. J Cardiothorac Surg. 2016 Jul 12;11(1):105. doi: 10.1186/s13019-016-0501-4.

The effect of acute mechanical left ventricular unloading on ovine tricuspid annular size and geometry. Malinowski M, Wilton P, Khaghani A, Brown M, Langholz D, Hooker V, Eberhart L, Hooker RL, Timek TA. Interact Cardiovasc Thorac Surg. 2016 Sep;23(3):391-6. doi: 10.1093/icvts/ivw138. Epub 2016 May 21.

Propensity Matched Analysis of del Nido Cardioplegia in Adult Coronary Artery Bypass Grafting: Initial Experience With 100 Consecutive Patients. Timek T, Willekes C, Hulme O, Himelhoch B, Nadeau D, Borgman A, Clousing J, Kanten D, Wagner J. Ann Thorac Surg. 2016 Jun;101(6):2237-41. doi: 10.1016/j.athoracsur.2015.12.058. Epub 2016 Mar 24.

Son of SAM: Left ventricular outflow tract obstruction with coexistent mitral stenosis and hypertrophic cardiomyopathy. Timek TA. J Thorac Cardiovasc Surg. 2016 Apr;151(4):1049-50. doi: 10.1016/j.jtcvs.2015.12.033. Epub 2015 Dec 22. No abstract available.

Geometric perturbations in multiheaded papillary tip positions associated with acute ovine ischemic mitral regurgitation. Timek TA, Lai DT, Bothe W, Liang D, Daughters GT, Ingels NB, Miller DC.J Thorac Cardiovasc Surg. 2015 Jul;150(1):232-7. doi: 10.1016/j.jtcvs.2015.04.037. Epub 2015 Apr 25.

Heterogeneity of Mitral Leaflet Matrix Composition and Turnover Correlates with Regional Leaflet Strain. Stephens EH, Connell PS, Fahrenholtz MM, Timek TA, Daughters GT, Kuo JJ, Patton AM, Ingels NB, Miller DC, Grande-Allen KJ. Cardiovasc Eng Technol. 2015 Jun;6(2):141-50.

In-hospital mortality in cardiac surgery patients after readmission to the intensive care unit: a single-center experience with 10,992 patients.Litwinowicz R, Bartus K, Drwila R, Kapelak B, Konstanty-Kalandyk J, Sobczynski R, Wierzbicki K, Bartuś M, Chrapusta A, Timek T, Bartus S, Oles K, Sadowski J.J Cardiothorac Vasc Anesth. 2015;29(3):570-5. doi: 10.1053/j.jvca.2015.01.029. Epub 2015 Jan 16.

The effect of pulmonary hypertension on ovine tricuspid annular dynamics. Malinowski M, Wilton P, Khaghani A, Langholz D, Hooker V, Eberhart L, Hooker RL, Timek TA. Eur J Cardiothorac Surg. 2016 Jan;49(1):40-5. doi: 10.1093/ejcts/ezv052. Epub 2015 Mar 8.

Aortic valve replacement in octogenarians with prior cardiac surgery. Timek TA, Turfe Z, Hooker RL, Davis AT, Willekes CL, Murphy ET, Bove TJ, Heiser JC, Patzelt LH. Ann Thorac Surg. 2015 Feb;99(2):518-23. doi: 10.1016/j.athoracsur.2014.08.024. Epub 2014 Sep 6.

Five-year real world outcomes of GeoForm ring implantation in patients with ischemic mitral regurgitation. Timek TA, Hooker RL, Collingwood R, Davis AT, Alguire CT, Willekes CL, Murphy ET,    Heiser JC, Patzelt LH.J Thorac Cardiovasc Surg. 2014 Nov;148(5):1951-6. doi: 10.1016/j.jtcvs.2014.02.051. Epub 2014 Feb 21.

Complete LVOT obstruction following aortic valve replacement after HeartMate II implantation. Davis RP, Kilian A, Timek TA, Cohle SD, Hooker RL. J Card Surg. 2014 May;29 (3):432. doi: 10.1111/jocs.12249. Epub 2013 Dec 4. No abstract available.

Aortic root thrombosis after transhiatal esophagectomy: a case report. Timek TA, Alguire CT, Wolschleger KG, Chung MH. J Thorac Cardiovasc Surg. 2013 Jan;145(1):e14-6. doi: 10.1016/j.jtcvs.2012.10.035. Epub 2012 Nov 7. No abstract available.

Hybrid approach to HeartMate II left ventricular assist device exchange. Timek TA, Hooker RL, Khaghani A, Merhi W.J Thorac Cardiovasc Surg. 2013 Mar;145(3):878-80. doi: 10.1016/j.jtcvs.2012.09.076. Epub 2012 Oct 23. No abstract available.