The Mount Sinai Hospital Receives Highest Honors for Cardiac Surgery

From left: Ismail El-Hamamsy, MD, PhD, Director of Aortic Surgery, Mount Sinai Health System; Ahmed El-Eshmawi, MD, Clinical Director of the Mitral Valve Repair Center at The Mount Sinai Hospital; Percy Boateng, MD, National Director of the Mitral Valve Repair Center at The Mount Sinai Hospital; David H. Adams, MD, Cardiac Surgeon-in-Chief and Chair of Cardiovascular Surgery, Mount Sinai Health System; Anelechi Anyanwu, MD, Surgical Director of Heart Transplantation and Mechanical Circulatory Support, Mount Sinai Health System; Robin Varghese, MD, MS, FRCSC, Director of Cardiovascular Critical Care, Mount Sinai Health System; Zdravka Zafirova, MD, Director of the Cardiovascular Intensive Care Unit, The Mount Sinai Hospital; and Menachem Weiner, MD, Director of Cardiothoracic Anesthesia, The Mount Sinai Hospital.

The Mount Sinai Hospital is world renowned for its expertise in cardiac valve surgery. That legacy continues as it received recent top ratings for patient safety and superior outcomes from the New York State Department of Health and the Society of Thoracic Surgeons, in addition to the 2022 Mitral Valve Repair Reference Center Award from the American Heart Association and the Mitral Foundation.

In  one of the significant outcomes reports, Adult Cardiac Surgery 2016-2018, the New York State Department of Health found that The Mount Sinai Hospital performed better than the state safety average for isolated valve surgeries and combined valve and CABG procedures, while performing more of these procedures—3,108—than any other hospital in the state.

The report also awarded its highest quality rating for cardiac valve surgery to David H. Adams, MD, Cardiac Surgeon-in-Chief, Mount Sinai Health System, and the Marie-Josée and Henry R. Kravis Professor and Chair of Cardiovascular Surgery at the Icahn School of Medicine at Mount Sinai.

During the study period, Dr. Adams’s safety results were significantly better than the state average for isolated valve surgery and combined valve and coronary artery bypass graft (a risk adjusted mortality rate of 0.18 compared to the State average of 2.10), while performing 1,001 of the procedures—more than any other surgeon in New York State.

“It is a real honor to be recognized by the state for our commitment to quality at Mount Sinai,” Dr. Adams said. “Our ability to achieve positive outcomes for our patients and maintain a high degree of safety with a high volume of cases exemplifies the considerable skills, discipline, and dedication of our entire multidisciplinary team—including our anesthesiologists, intensivists, residents, nursing and perfusion staff, clinical coordinators, and the incredible group of cardiologists and sub-specialists that help take care of our patients. I am proud of all of them and of the exacting standards we have set for the care of our patients at Mount Sinai.”

“The health and safety of our patients is our priority, now and always,” said Valentin Fuster, MD, PhD, Director of Mount Sinai Heart and Physician-in-Chief of The Mount Sinai Hospital. “All of us at Mount Sinai are very proud to be recognized for our commitment to quality care and our outcomes in cardiac surgery, and we continue to draw inspiration from that to do even better.”

Recognized by Society of Thoracic Surgeons

The team’s standards have also earned honors from the Society of Thoracic Surgeons (STS), which recognized The Mount Sinai Hospital with its distinguished three-star rating based on Mount Sinai’s commitment to patient care and the outcomes it achieved in three categories: mitral valve repair and replacement (MVRR), coronary bypass surgery (CABG), and aortic valve replacement and CABG (AVR-CABG).

The STS star rating system is one of the most sophisticated and highly regarded overall measures of quality in health care, and Mount Sinai’s performance places it among the elite in all three categories in the United States and Canada. Historically, 20 percent of participating centers have received the three-star rating for CABG, and 4 to 7 percent have received it for AVR and CABG.

“This star rating system is the premier clinical way of rating hospitals based on their performance and it is exciting that STS has named Mount Sinai the best of the best in three categories,” said Julie Swain, MD, Vice Chair and Professor of Cardiovascular Surgery at Icahn Mount Sinai. “There are very few centers that achieve a three-star rating in multiple specialties, which reinforces the fact that we are among the top hospitals in the world when it comes to performing safe, successful mitral valve, coronary bypass, and other cardiac operations.”

Mitral Valve Repair Reference Center Award

The program was also honored to receive the American Heart Association – Mitral Valve Repair Reference Center Award, which recognizes medical centers that have a demonstrated record of superior clinical outcomes and a commitment to reporting and measuring mitral valve repair-related metrics. It also promotes the centers that have received this award to improve access to quality care among patients nationwide.

“This prestigious award is a testament not just to the excellence of our surgeons but also to our comprehensive team approach to all aspects of patient care from first consultation to post-operative follow-ups,” Dr. Swain said. “We have been refining that approach, and the system that supports it, for years through ongoing quality assessments and we are seeing the results of that effort in the honors we receive and, more important, the results we achieve for our patients.”

 

Non-Hispanic Blacks Found Twice as Likely to Have Atherosclerosis as Hispanics in Study of Young Adults in Harlem

A unique Mount Sinai study focused on a multiethnic, underserved community in Harlem found that young non-Hispanic Black adult participants were twice as likely to have atherosclerosis as young Hispanic adults.

The research, published in the Journal of the American College of Cardiology in July 2022, is part of the FAMILIA Project at Mount Sinai Heart, a pioneering trial created by Valentin Fuster, MD, PhD, Director of Mount Sinai Heart and Physician-in-Chief of The Mount Sinai Hospital.

The new study is one of the first to evaluate atherosclerosis—the plaque build-up in the arteries that can lead to a heart attack or stroke—in asymptomatic young populations. Its findings emphasize the importance of early screening and lifestyle interventions in high-risk minority groups to improve their cardiovascular (CV) health.

Valentin Fuster, MD, PhD, Director of Mount Sinai Heart and Physician-in-Chief of The Mount Sinai Hospital.

“What’s interesting about this study is that Black individuals appear to be more vulnerable to atherosclerosis early in life than people of Hispanic origin, even when adjusting for known cardiovascular and lifestyle risk factors such as smoking, unhealthy diet, lack of exercise, high blood pressure, and cholesterol,” Dr. Fuster says. “This can then put them at increased risk of cardiovascular disease, suggesting the existence of emerging or undiscovered cardiovascular risk factors in this population.”

The study is part of a multinational effort to intervene early in the lives of children, their caretakers, and teachers so they can form a lifetime of heart-healthy habits. These new results come after highly successful interventions involving more than 500 preschoolers, caretakers, and educators at 15 Head Start schools in the Harlem section of Manhattan, an urban area that is socioeconomically disadvantaged—a situation commonly linked to higher rates of obesity, heart disease, and other health issues.

The FAMILIA team focused on 436 adults, including preschoolers’ family members, caretakers, teachers, and school staff. Of that group, 147 participants were non-Hispanic Black and 289 were Hispanic, with an average age of 38; 80 percent were women. Non-Hispanic white, Asian, and Native American groups each formed a small proportion of participants (2.3 percent, 2.3 percent, and 0.3 percent respectively) and people in those groups were excluded from the analysis.

Each participant answered a comprehensive questionnaire at the start of the study, addressing their nutrition, physical activity, tobacco use, and alcohol consumption, and whether they had conditions such as heart disease, hypertension, diabetes, or a family history of health problems. They also had their weight recorded, and blood pressure and cholesterol checked.

Overall cardiovascular risk factors were prevalent for both ethnic groups at baseline. Thirty percent of non-Hispanic Black participants had hypertension, almost triple the rate of the Hispanic group, 11 percent. Conversely, non-Hispanic Black participants had lower rates of dyslipidemia—unhealthy levels of lipids/fat in the blood (18 percent) compared to the Hispanic group at 27 percent, and better eating habits, consuming more fruits and vegetables. Researchers used these data to calculate a predicted cardiovascular risk score for each group. They found the overall risk of having a cardiovascular event in 10 years was low for both Blacks and Hispanics—around four percent for both groups.

Participants also had 3D vascular ultrasounds to determine if they had atherosclerosis in their carotid (neck) and femoral (leg) arteries. These vascular ultrasounds pointed to a significant discrepancy between the groups. Overall, nine percent of participants had subclinical atherosclerosis (nearly one in ten participants showed at least one artery with plaque). Also, the rate of plaque build-up in the arteries was two times higher among non-Hispanic Blacks than Hispanics. The results were consistent even after adjusting for classic cardiovascular risk factors including age, sex, body mass index, hypertension, diabetes, and cholesterol; lifestyle factors including diet, physical activity, and tobacco use; and socioeconomic factors such as employment status.

The study noted some limitations and areas for further investigation. “The population included in the study was from a specific area, Harlem, with known intrinsic health disparities compared with other areas in New York City,” the study said. “This could, to some extent, limit our results’ generalizability.” In addition, “Given the heterogeneity among racial and ethnic groups, assessing associations between self-reported racial or ethnic identity and disease is complex and is vulnerable to confounding due to the effects of socioeconomic inequality, environmental disparity, unequal access to care, and other possible emerging or unknown CV risk factors.”

However, the study is one of the first to assess the presence of subclinical atherosclerosis by 3D vascular ultrasounds in an underrepresented younger population, the research team says, and it contributes to the understanding of higher rates of CV disease observed at an early age in disadvantaged communities.

“These findings may in part help to explain the observed differences in cardiovascular disease prevalence between racial and ethnic groups,” Dr. Fuster says. “Until underlying biological factors and other undiscovered cardiovascular risk factors are better understood and can be addressed by precision medicine, affordable noninvasive imaging techniques such as the portable 3D vascular ultrasounds used in this study, which are easily used and affordable, can be an important form of early detection in underserved communities, and provide valuable information about population disparities and increase the precision of health promotion and prevention programs.”

Dr. Fuster and his team will expand the FAMILIA program to schools across the five boroughs of New York City starting in September 2022. This project will also evaluate how family socioeconomic status and teachers’ characteristics may affect the implementation and efficacy of school-based health promotion programs.

The FAMILIA project was funded by a grant from the American Heart Association.

 

Clearing Misconceptions About Gender-Affirming Care for Transgender and Gender-Diverse People

Gender-affirming care for transgender and gender-diverse people has advanced over the past decade, but connecting patients to this care efficiently remains a challenge, hindered by a lack of awareness.

“Patients worry about what they need to know even before being able to speak to a doctor for gender-affirming care,” said Joshua Safer, MD, Executive Director of the Center for Transgender Medicine and Surgery at Mount Sinai.

Even health providers can be unsure of what gender-affirming care entails. Many once believed that they would have to run a series of tests before even being able to refer their transgender patients for specialized care, Dr. Safer said. “It’s a misconception that they have to do anything,” he noted. “There are some tests that they could run that would make their patients’ lives easier, but it is fine to send patients along even without those tests.”

In a conversation with his doctor, Miroslav Djordjevic, MD, Clinical Professor of Urology, patient Kyshane Rowe talks about how life has changed since he began the transition process 10 years ago, and how Mount Sinai’s Center for Transgender Medicine and Surgery helped him along the way. Click here to watch the video.

As part of efforts to raise awareness about transgender care, Dr. Safer weighs in on common misconceptions about gender-affirming care and shares tips for patients and providers on how to make the experience seamless.

For patients

Seeking gender-affirming care can be overwhelming for transgender and gender-diverse patients, Dr. Safer said. With care that can stretch across multiple specialties, including endocrinology, gynecology, urology, and various surgical subspecialties, patients sometimes think they need to do a bunch of research before even speaking with a provider.

However, speaking with your primary care doctor could be part of that care journey, Dr. Safer said: “Providers can help guide patients with what they need to align their bodies with their gender identities.”  

  • It might be helpful for transgender patients to consider their fertility goals when seeking gender-affirming care. That would help outline what medical or surgical options make sense.
  • Letters of support from mental health and primary care providers are required to be eligible for gender-affirming surgery. Obtaining those letters isn’t necessarily complicated, and our Center provides templates for them.
  • Out-of-state patients seeking surgical care in New York City need to be housed within a 90-minute travel distance of the surgery office for at least two weeks. Additionally, the accommodation cannot be a walkup apartment, and a caretaker must be present to assist with cleaning and daily activities.

The Center for Transgender Medicine and Surgery at Mount Sinai has set up a hotline to help patients with appointments, or even direct them to “champion providers” within the Health System—providers trained in gender-affirming care, Dr. Safer said.

For patients, click here to learn more about accessing transgender care

For providers

Gender-affirming care in a primary care setting doesn’t need to be complicated, Dr. Safer said. It is fine to refer transgender patients after initial assessments without needing a bunch of tests.

However, should the provider choose to order baseline testing for patients, it would make the patients’ care experience more convenient. Here are some typical tests a provider can consider:

There is also a misconception that because insurance companies categorize gender-affirming surgery as a treatment for gender dysphoria, patients need to be seen by a mental health provider, Dr. Safer said.

“If there are underlying mental health concerns, do refer those patients for treatment,” he noted. “But there are many transgender patients who have no mental health concerns and are merely seeking gender-affirming care.”

Providers within the Mount Sinai Health System would already be connected within the Epic system for referrals to any needed specialist, expediting the process, Dr. Safer said. For providers outside the Health System, a dedicated hotline team from the Center for Transgender Medicine and Surgery is there to assist, he added.

For providers, click here to learn more about connecting transgender patients to care

Mount Sinai’s Graduating Master’s Students Share Their Experiences and Passions

Why a master’s degree? Here, five graduates at Mount Sinai’s Graduate School of Biomedical Sciences share how they will use their degree to explore new paths and careers.

Mackenzie Langan Receives a Master of Science in Biomedical Science Degree, Immersing Herself in Research and Gaining New Insights into Brain Disorders

“Mount Sinai has completely changed my life. I’ve had a lot of really great mentors and I definitely would not have gotten here without the support of all those people. Everyone is invested in seeing you succeed. And I think that the level of caring is something that has just really blown me away.”

Read her story

Trisha Tagle: A Project Manager in Neurology Plans to Use Her Master of Health Administration Degree To Move Health Care Forward for All Patients

“One of my project proposals focused on how to make health care technology more inclusive. Not every patient has a smartphone, for example. So how can we give more patients access, to make sure they don’t fall through the cracks? I’m a very process-oriented person, so the idea of making sure we capture everyone is very important to me.”

Read her story

How Conducting Research in Artificial Intelligence Through the Master of Science in Clinical Research Program Puts Olivia Cullen on a Physician-Scientist Path 

“For me, the MSCR program was an opportunity to understand the inner workings of clinical research to discover what interested me most. Ultimately, I fell in love with data science research, and now I’m about to begin an MD/PhD program at Mount Sinai with a concentration in Artificial Intelligence and Emerging Technologies in Medicine.”

Read her story

Varsha Venu, MBBS, MPH: How Her Training as a Medical Doctor Revealed a New Passion for Public Health

“Without good public health, the entire community suffers, and that is probably the biggest reason why I chose not to become a practicing doctor, but instead to take on roles that would ensure that I could give the best care to an entire community and not just individual patients. Public health enables me to contribute to society in a more holistic way.”

Read her story

A Unique Set of Resources at Mount Sinai Enables Thomas Dolan To Find a Passion for Biostatistics

“[The faculty’s] passion for biostats stands out, and it really showed in their coursework and even in conversations about their field.”

Read his story

Phillips School of Nursing at Mount Sinai Beth Israel Approved for a Chapter of Sigma Theta Tau International Honor Society of Nursing

The Phillips School of Nursing at Mount Sinai Beth Israel has been approved to charter a chapter of Sigma Theta Tau International Honor Society of Nursing.

Sigma is the global leader in recognizing excellence in education, practice, and research in nursing. This milestone designation will allow the school to charter its own chapter and induct members into the Society from the school as well as nursing leaders in the Mount Sinai Health System.

Laly Joseph, DVM, DNP, CNE, RN, C, MSN, APRN, ANP, FNAP

“We are excited and honored to have received this invitation from Sigma,” said Laly Joseph, DVM, DNP, CNE, RNC, MSN, APRN, ANP, FNAP, Senior Associate Dean at the Phillips School of Nursing and President of the school’s Sigma Chapter. “Sigma members are leaders at all levels of the health care industry, which includes top-notch nursing executives, clinicians, educators, researchers, policymakers, entrepreneurs, and others. Our students and nurse leaders from the Health System will join a distinguished group of nurses who have met or exceeded the rigorous standards required to receive an invitation to join Sigma.”

A chartering and induction ceremony is planned for the fall of 2022 and will include nursing students and nurse leaders from the Mount Sinai Health System.

“Being selected to host a Sigma chapter is a testament to our school’s commitment in nursing education and scholarship. I want to thank Dr. Laly Joseph and the faculty for their hard work in preparing us to gain this honor,” said Dean Todd Ambrosia, DNP, MSN, APRN, FNP-BC, FNAP.

Sigma Theta Tau International Honor Society of Nursing is a nonprofit organization whose mission is to support the learning, knowledge, and professional development of nurses as part of a commitment to making a difference in health worldwide. The society was founded in 1922 by six nurses at the Indiana University Training School for Nurses, now the Indiana University School of Nursing.

Dean Todd Ambrosia, DNP, MSN, APRN, FNP-BC, FNAP

Sigma’s mission is to create a global community of nurses who lead in using knowledge, scholarship, service and learning to improve public health around the world, which aligns with the mission of the Phillips School of Nursing at Mount Sinai Beth Israel.

Membership is by invitation based on scholarly achievement. Baccalaureate and graduate nursing students who demonstrate excellence in scholarship, along with nurse leaders exhibiting exceptional achievements in nursing, are invited to join.

Sigma has more than 130,000 active members in more than 100 countries, and there are 540 chapters at 700 institutions of higher education worldwide. Members have numerous professional development opportunities in the areas of education, leadership, career development, evidence-based nursing, research, and scholarship.

Annual Dubin Breast Center Event Spotlights an Inspiring Patient Story

Eva Andersson-Dubin, MD, at podium, with panelist (left to right), David Anderson, MD, FACs, Anna Barbieri, MD, Jeffery Meckanick, MD, Cardinale Smith, MD, PhD, and Joseph Sparano , MD, FACP.

 

The annual Dubin Breast Center Fact vs. Fiction Luncheon and Symposium is a unique event that provides a forum for Mount Sinai leaders to share key insights about all aspects of breast cancer and healthy living, and to answer questions about emerging trends and the future of women’s health.

More than 130 people attended the event, which was held Wednesday, June 1 at The Harmonie Club in New York City.

The panel discussion was moderated by Elisa Port, MD, FACS, and featured a panel of experts, including David Anderson, MD, FACS; Anna Barbieri, MD; Jeffrey Mechanick, MD; Cardinale Smith, MD, PhD; and Joseph Sparano, MD, FACP. Watch the video here.

In opening remarks, Eva Andersson-Dubin, MD, Trustee of the Mount Sinai Health System and Founder of the Dubin Breast Center, noted how the Center continues to grow.

“Today we see an average of 180 to 200 patients a day, and since the day we opened we have seen 380,000 patients,” she said. “I am so thankful to everyone who works at the Center.”

One patient, Julie McAllister, shared her inspiring story. She was diagnosed with triple-negative breast cancer six years ago when she was 36 years old.

Julie McAllister tells her story of how the Dubin Breast Center helped her overcome triple negative breast cancer.

“I was in complete shock. I was young, very healthy, active a mother of two children–my youngest was just six months at the time,” she said. “There wasn’t any history of breast cancer in my family. Breast cancer wasn’t even a remote part of my reality. I truly didn’t know if and how I was going to survive. I kept thinking about my kids and how much of their life I was going to be around for, not to mention my husband and I wanted more children.“

Immediately after her initial diagnosis, Shari Brasner, MD, her OBGYN doctor, arranged for additional care. Eventually Ms. McAllister chose Mount Sinai for her treatment and surgery, and she was introduced to Hanna Irie, MD, PhD, who would become her oncologist.

“Dr. Irie was the best and felt like my lifeline during my treatment,” she said. “She was straightforward, incredibly smart, kind, and never made me feel like any of my questions and or fears were silly or unwarranted.” The doctor also helped her find a clinical trial to participate in once she completed her standard treatment.

Ms. McAllister would undergo a number of surgeries, five months of chemotherapy, six weeks of radiation, and then years of ongoing surveillance.

“Throughout all that time, I always felt like I was in the best hands and had the best doctors and nurses looking after me and never felt like a generic cancer patient or a statistic,” she said. “The nurses and staff were extremely warm and knowledgeable. The treatment rooms were comfortable, and I never felt alone.”

She added, “Cancer crushes you physically and mentally. It changes you, puts a fear in you that you never knew existed, and alters the way you think and worry for the rest of your life. But knowing that there are places like the Dubin Breast Center, that there are doctors like the ones I was fortunate enough to call mine, who can and will help treat and cure your cancer, is incredible. I am forever grateful for the treatment and care that I received.”

As a result, she was able to have another child, who was born just four months before the event at The Mount Sinai Hospital, two floors above the Dubin Breast Center.

The Dubin Breast Center at The Tisch Cancer Institute of the Icahn School of Medicine at Mount Sinai was created in 2011 to provide integrated care and services for every phase of breast health and care, including prevention, diagnosis, treatment, and survivorship. Clinicians and staff treat each person individually and holistically, with the goal of alleviating anxiety, enriching lives, and supporting emotional and physical well-being. The team works to advance the standard of care with innovative and emerging treatment, while researching life-saving options for the future.

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