From minimally invasive procedures to leading-edge genetic testing, Providence’s cardiovascular care provides revolutionary and accessible options to patients.
If the human body were a song, then the heart would supply the drumbeat — rhythmically pumping blood, oxygen and nutrients to every corner of the cardiovascular system.
A healthy heart is a very good drummer, too; we often keep tempo without even noticing the body is hard at work. But, sometimes, the heart needs a little extra support when it loses a beat, falls out of time or struggles to keep pace.
When this occurs, you can turn to the expert team of Providence cardiologists and specialists who sit at the heart of innovation, employing minimally invasive procedures, leading-edge technology and breakthrough research to care for you and improve your health.
Minimally invasive procedures and techniques
According to Dana Asato, executive director of Providence’s Cardiovascular and Digestive Health Clinical Institutes, advances in cardiac research and techniques have reduced or, in some cases, eliminated the need for many patients to undergo open-heart surgery when faced with coronary artery disease or heart failure.
“The use of surgical valves is steadily declining year-over-year with minimally invasive technologies improving. The same is true for protective PCIs (percutaneous coronary intervention) for patients with cardiovascular disease and heart failure,” she said. “There are more advances now, making it possible for patients to no longer need a surgical option.”
Many procedures are now performed in a cardiac catheterization lab, also known as a cardiac cath lab, where physicians perform minimally invasive tests and procedures and provide emergency care to patients. Across Providence California, several hospitals have recently modernized their cath labs to hold state-of-the-art imaging equipment and accommodate additional patients.
Procedures performed in the cath lab utilize catheters — tiny, flexible tubes that physicians insert through a vein in the groin or arm to access the heart and blood vessels throughout the body. Providence has led the way on many of these minimally invasive procedures, testing and pioneering new approaches that can repair blocked arteries, damaged heart valves and new holes in the heart, such as:
- Impella: Often implanted when patients are unstable or a section of their arteries is blocked, the Impella heart pump temporarily supports the heart and assists with pumping blood through the organ. The procedure helps many patients avoid surgery and gives their heart time to heal.
- MitraClip: Guided by an ultrasound and X-ray imaging, a MitraClip is a small device placed on a patient’s mitral valve that helps blood flow in the correct direction of your heart to prevent leaking, heart failure and sudden death. The procedure has reduced the need for open-heart surgery.
- Transcatheter valve replacement (TAVR): A procedure that replaces a thickened aortic valve that can’t fully open (aortic valve stenosis) with a manufactured valve to restore adequate blood flow to the body. Patients who undergo the procedure are put under light anesthesia and can return home the next day.
- Watchman: Inserted through a vein in the leg, the Watchman is placed in a patient’s left atrial appendage to reduce the risk of stroke for those with atrial fibrillation (A-fib), an irregular heartbeat that can cause blood clots in the heart. Patients often return home the same day of the procedure and may no longer need to take blood thinners.
In addition to these treatments, several Providence hospitals are using a catheter-directed thrombolysis system to quickly treat and provide relief to patients experiencing a pulmonary embolism (PE). The condition, which typically occurs when a blood clot travels to the lung, can cause patients to feel short of breath or like they are suffocating.
Asato said that, in the past, patients were placed in the ICU on several medications for days as they waited for relief. But now, rapid response teams can quickly diagnosis patients and provide them with immediate treatment.
“We have many facilities launching PE response teams to rapidly assess patients and evaluate their candidacy for intervention. If they are a candidate for intervention, a team of interventional providers are mobilized in the cath lab and use a device to take the clot out,” Asato said. “Patients get an immediate return of ease of breathing and their length of stay shortens by about 50%. The outcomes and quality of life are really good for patients.”
On the forefront of cardiogenetic research and innovation
Throughout Providence, physicians are spearheading clinical trials and new treatment options that are advancing the ways cardiologists across the world address advanced heart failure, structural heart issues, A-fib and more.
“We have many physicians that serve as principal investigators on research studies that are funded by the NIH, CDC or industry sponsors,” Asato noted.
Providence is also working to make cardiogenetic testing more affordable and accessible for patients across the state who may be at risk for cardiovascular disorders and diseases. Since its founding in 2019, Providence Southern California’s Cardiogenetic Program has seen a steady increase in the number of individuals served.
“I think that just really speaks to the gap that Providence is really trying to fill,” said Carol Ko, a licensed, certified genetic counselor. “Genetic testing as part of cardiac care has been mentioned in different guidelines for a couple decades now, but access continues to be an issue outside of large academic institutions. I am very proud to be at Providence and to be pushing this type of cutting-edge test and access to care within the community setting for all patients.”
The test, which costs around $250 without insurance, uses a cheek swab or saliva sample to test for several cardiovascular related genetic mutations. According to Ko, results can help care teams understand the causes for conditions, such as high cholesterol, beyond lifestyle habits and reveal what medications patients should or should not take, as well as specific treatments they may need in the future.
Ko added that in some cases of sudden cardiac arrest or death, genetic testing can help bring closure to grieving families looking for answers. For some, it may help shed light on what happened and how to possibly prevent a similar medical event from happening to family members in the future
“Not everyone qualifies for genetic testing right now and cardiogenetic testing is still developing. However, it is helping us move toward personalized medicine where we treat each patient as an individual based off their own risk factors,” Ko said. “I always tell my patients that, no matter the test results, positive or negative, genetic testing is going to help us learn how to take the best care of you possible.”
Promoting a collaborative cardiovascular care model
Beyond its approach to clinical treatments, Providence has an established a Heart Institute which, through its collaboration and thought partnership, is committed to addressing care gaps through access to relevant and timely data.
The institute’s aim is to provide a seamless patient experience by leveraging innovative technologies and evidence-based research. The team is dedicated to delivering high-quality care close to home through an integrated delivery network and virtual care programs, which offers patient-centered care at each person’s convenience. Overall, the institute’s multidisciplinary approach to cardiology ensures that Providence is at the forefront of innovation and care.
“The lens that the institute takes is looking at care across the continuum — from preventive care before a patient ever needs to be hospitalized to optimizing care during hospitalization and then easing the patient’s way through that care model post-discharge so they can manage a chronic illness, stay out of the hospital and access supportive care services,” Asato said.
The Heart Institute also acts as a strategic thought partner for local hospitals, providing data and expertise that promotes information sharing, training and mentoring. Physicians regularly attend conferences and specialty committee meetings to discuss evidence-based care, research and complex cases. The collaboration enables Providence to standardize care and achieve superior outcomes, all while treating complex heart conditions through a personalized, patient-centered approach.
“We have care, in many cases, that is close to home, but we are part of a greater network where patients can get academic-level care within our health system,” Asato said.