2016 Sentara Heart Annual Report

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Cardiothoracic Surgery

Cardiothoracic surgery at Sentara Heart is a highly regarded program with nationally recognized surgeons, superior quality and complex cases. Much like that of an academic center, this is a deep and diverse program that continues to treat increasingly acute cases. It is also a program that can serve the many needs of patients in one place, sometimes in a single visit.

Last year alone, the surgeons from Mid-Atlantic Cardiothoracic Surgeons (MACTS) and Sentara RMH Cardiothoracic Surgery managed more than 1,900 cases at Sentara Heart Hospital, Sentara Virginia Beach General Hospital and Sentara RMH Medical Center. The cardiothoracic program brought innovative procedures new to Sentara Heart such as the five-box thoracoscopic maze, open Cox-Maze IV and WATCHMAN device for atrial fibrillation.

Mid-Atlantic Cardiothoracic Surgeons work closelywith pulmonary medicine, oncology and radiology to provide a multidisciplinary approach to thoracic surgery. Our surgeons lead the regional effort to launch lung cancer screenings, participate in national Society of Thoracic Surgeons (STS) quality metrics, and perform sleeve thoracic surgeries (a highly complex procedure involving the lung). This surgical group is highly regarded for its efforts to advance cardiovascular and thoracic practices. Individually, its members serve on a multitude of national committees.

Procedures performed at Sentara Heart include:

  • Coronary Artery Bypass
  • Ablation Procedures
  • Aortic Root Replacement
  • Aortic Valve Replacement
  • Heart Transplant
  • Minimally Invasive Mitral Valve Surgery
  • Mitral Valve Repair/Replacement
  • Pericardiectomy
  • Repair Aortic Aneurysm/Dissection (Ascending & Descending)
  • Resection of Cardiac Tumor
  • Repair Atrial Septal Defect
  • Repair Patent Foramen Ovale
  • Repair Ventricular Septal Defect
  • Repair Ventricular Aneurysm
  • Total Artificial Heart Implantation
  • Transmyocardial Revascularization
  • Tricuspid Valve Repair/Replacement
  • Ventricular Assist Device Placement

Most common thoracic procedures include:

  • Minimally invasive lung or mediastinal mass resection for diagnostic and therapeutic purposes
  • Metastatectomy for advanced cancers
  • Decortication, manual and chemical pleurodesis and lung volume reduction surgery

Atrial Fibrillation Reduction in the Post-Surgical CABG Patient

Presence of Afib is known to contribute to an extended length of stay and stroke complications for the hospitalized patient. A clinical workgroup sought to address this issue by developing and standardizing a process to implement Afib prophylaxis utilizing an antiarrhythmic medication, Amiodarone, for all CABG patients, perioperatively. The implementation of this clinical initiative resulted in a decreased hospital stay by 3.8 days and an overall decrease in Afib occurrence.

Occurrence of Atrial Fibrillation Post Cardiac Surgery

Source: Sentara Heart



2014-16 Primary Coronary Artery Bypass Graft (CABG) In-Hospital O/E Mortality Ratio

Source: Sentara Heart

What does the O/E mortality ratio mean?

The observed-to-expected mortality outcome (O/E mortality ratio) is a risk-adjusted measure of a hospital’s mortality (death) rate. Risk adjustment takes into account how sick patients are upon entering the hospital.The mortality observed-to-expected measure tells us how we are performing on mortality relative to what is expected for our patients, given a variety of complicating characteristics, including their age, chronic conditions like diabetes or heart failure, or whether the patient was transferred from another hospital or admitted as an emergency. An O/E ratio less than 1.0 indicates better than expected outcomes and an O/E ratio greater than 1.0 indicates poorer than expected outcomes. (For example, an O/E ratio of 0.50 for mortality would mean that mortality was only 50% of the expected value; conversely a mortality ratio of 1.50 means that mortality was 150% of expected or 50% higher than expected.)