Via Christi Structural Heart Program Brings Leading-Edge Treatments Close to Home

Friday, June 23, 2017

A team of Wichita-based physicians are at the forefront of cardiac procedures.

Via Christi Structural Heart program team members include (from left) Richard Steckley, MD; Sanjay Khicha, MD; Bassem Chehab, MD; Brett Grizzell, MD; and Richard Allenbach, PA-C.

Via Christi’s Structural Heart program was borne out of a conversation among hospital leadership and community physicians in early 2012 about the need to bring transcatheter aortic valve replacement (TAVR) procedures and other emerging life-saving structural heart procedures to South Central Kansas.

“I trained in TAVR and saw it as the future,” says surgeon Brett Grizzell, MD, who at the time had recently returned to Wichita after completing his cardiothoracic surgical fellowship at Barnes-Jewish Hospital at Washington University Medical Center, in St. Louis.

Based on input from Dr. Grizzell and the other physicians, Bassem Chehab, MD, was recruited to Wichita to serve as the program’s medical director. Chehab made regular trips from Kansas City, where he was completing his structural heart fellowship, to work with the team to design what today is the area’s only technologically advanced hybrid OR and structural heart program. Less than a year later, the hybrid OR was ready for use at St. Francis and the first TAVR was performed.

The program has continued to grow and mature beyond the introduction of a new procedure that since October 2013 has helped extend and improve the quality of life for more than 400 patients with severe aortic stenosis.

“Today, we’re a comprehensive program — one that offers a vast spectrum of therapies in order to match patients’ needs and desire to receive leading-edge treatment close to home and family,” says Dr. Chehab, who works closely with a core team that includes surgeons Dr. Grizzell and Sanjay Khicha, MD, both with Wichita Surgical Specialists; cardiologist Richard Steckley, MD, Cardiovascular Consultants of Kansas; and physician assistant Richard Allenbach, who serves as Director of the Via Christi Heart Valve Clinic.

“We’ve been able to mature as a program largely because of the team approach we’ve employed from the start,” says Dr. Grizzell.

Dr. Khicha agrees, noting that over the course of almost four years of doing both TAVR and MitraClip, the team has remained very stable.

“With our cumulative experience, we have gained the judgment to know what procedure will best benefit our patients, whether that’s surgical or structural heart,” Dr. Khicha says. “Doing the procedure itself has become routine. Good outcomes are really based on the proper screening and decision-making before you get to the procedure, and with our experience we’re able to do a good job of that.”

That’s led to successful outcomes with TAVR and, later, MitraClip — which to date has benefited more than 100 patients with mitral valve regurgitation — and other less-invasive structural heart procedures.

As a result, the program has been selected as a site for a growing number of pivotal clinical trials. Among the trials being conducted by the team at St. Francis:

  • The recently FDA-approved EARLY-TAVR Trial, which will evaluate patients diagnosed with severe aortic stenosis who have not yet developed symptoms. “Participation in highly specialized trials involving low-risk patients such as this one is generally outcome-based and limited to major academic centers,” Dr. Chehab says. “The outcomes we’ve seen in our Structural Heart program are putting us on the map and allowing patients to access this therapy before the damage is done, rather than wait,” he says. “This is truly a landmark trial and speaks to the value of the work our team continues to perform.”
  • The PARTNER III Trial, which is designed to evaluate the safety and efficacy of implanting Edwards’ SAPIEN 3 in low-risk patients suffering from severe, symptomatic aortic stenosis.
  • The Portico Trial, which is designed to evaluate the safety and efficacy of Abbott’s Portico, a TAVR device not yet commercially available.
  • The COAPT Trial, which is designed to study the safety and efficacy of the MitraClip device in heart failure patients who have functional mitral regurgitation and are not appropriate for mitral value surgery. “We are the No. 1 site in the nation for enrollment in this highly coveted clinical trial,” Dr. Chehab says.
  • The Amulet Trial, which is designed to evaluate the safety and efficacy of the Amulet device in patients with non-valvular atrial fibrillation as compared to the commercially available WATCHMAN left atrial appendage closure device.
  • The Shield II Trial, designed to evaluate the safety and effectiveness of HeartMatePHP in supporting patients with severe symptomatic coronary artery disease with diminished but stable cardiovascular function as compared to the Impella® 2.5.

As research continues to find new ways to treat those patients who have traditionally been at higher risk from cardiac conditions, Via Christi’s Structural Heart program is prepared with a team of talented physicians and the infrastructure ready to bring the latest in heart care to the region.

“We’ve pioneered a trail in Wichita, and in doing so have benefited patients throughout Kansas,” Dr. Chehab says. “Being a site for clinical trials, we’re now helping break new ground in the field of structural heart care.”

The Via Christi Structural Heart team

Based at the Heart Valve Clinic at Via Christi Hospital St. Francis, our team of structural cardiologists and cardiovascular surgeons is equipped to work with patients who have cardiac valve disease, especially patients with complicating conditions such as advanced age, comorbidities or a prior history. St. Francis’ specially constructed hybrid operating room includes cath lab equipment, anesthesia, special lighting, a video and monitoring system, and a CT scan that provides a 3-D image of the heart and its vessels to allow fixed imaging in the sterile environment of the OR.

Treatment options include:

  • Traditional open-heart surgery
  • Minimally invasive surgery options for high-risk patients
  • Balloon valvuloplasty
  • Transcatheter aortic valve replacement
  • MitraClip for repairing mitral valve regurgitation
  • Lariat for soft-tissue closure
  • Hybrid procedures that combine minimally invasive surgery with a simultaneous percutaneous procedure
  • WATCHMAN for left atrial appendage closure

If you have a patient who has been diagnosed with any of the following conditions, he or she may be a good candidate to be seen by the Structural Heart program’s multispecialty team:

  • Patent foramen ovale, atrial or ventricular septal defect
  • Aortic valve stenosis
  • Moderate or severe mitral stenosis
  • Severe mitral valve regurgitation
  • Pulmonary valve stenosis

To refer a patient for evaluation by the Via Christi Structural Heart program team, call 316-268-8650.