'Everything we do should be about the patient,' says Piedmont heart surgeon Vinod Thourani

Atlanta-based Piedmont Healthcare Marcus Chief of Cardiovascular Surgery Vinod H. Thourani, MD, has a fascination with the heart that began when he was a child.  

His father was a cardiologist in South Carolina, and his interest grew as he spent time volunteering in his father's office.

The Heart, a medical textbook by John Willis Hurst, cardiologist of former U.S. President Lyndon B. Johnson, also contributed to Dr. Thourani's interest in the topic. He said he looked through the textbook as a child and ended up going to medical school at Emory University in Atlanta because Mr. Hurst had worked there.

"Then I took gross anatomy for the first time, and interestingly enough, I loved dissections and using my hands, and that led for me to stay with the heart but switch from cardiology to cardiac surgery," said Dr. Thourani.

His career led him to various healthcare leadership positions since then, including chairman of the cardiac surgery department at Columbia, Md.-based MedStar Health, co-director of Emory Healthcare's Structural Heart and Valve Center and chief of cardiothoracic surgery at Emory University Hospital Midtown. 

Most recently, Dr. Thourani joined Piedmont Heart Institute in October as the Marcus chief of cardiovascular surgery for Piedmont Healthcare and the Marcus Heart Valve Center.

Becker's Hospital Review recently caught up with Dr. Thourani to discuss his clinical research, training and advice for other physicians.

Editor's note: Responses were lightly edited for length and clarity.

Question: You are principal national investigator of five clinical trials and on the executive committee of four  other valve-related national trials. Please describe these trials.

Vinod Thourani: The field of transcatheter valve therapies came up around 2005, 2006 in the United States, and I have a big interest in that. I knew how to do the open surgical therapies but then got trained in transcatheter technologies. Over the last 14 years, that training allowed me to participate in open surgeries and transcatheter therapies, and that led me into the trials I'm leading now. For instance, there's the JenaValve transcatheter aortic valve replacement trial. That's a trial that's for leakage of the aortic valve that I'll help lead.  

Q: Why is this research so important to you?

VT: A lot of trials I work on are new technology trials that potentially would benefit the patient. At the end of the day, everything we do should be about the patient, so they get great outcomes with as little impact on their quality of life as possible.  That's why I love the research component of it because it allows us better therapies potentially, but it allows us to thoughtfully look at the technologies. Some new technologies aren't great, and we should know that. We shouldn't just use it without rigorously studying those therapies. I believe research is critically important to tell us what therapies are not good, but also which therapies are great.  

Q: Many cardiac surgeons are trained in one or two of the three heart surgery techniques (traditional, minimally invasive and transcatheter). Why did you decide to receive training in all three?

VT: What I thought when I was younger in my career is if they [patients] went to a cardiologist or surgeon who didn't do newer technologies, then that surgeon always kind of made the traditional surgery the only possible pathway for them. Then I saw some people whose cardiologist did not do the surgical therapies. But what I thought was interesting, and what I thought would be great for patients in my discussions with them, is I would have an equipoise because it didn't matter the type of surgery. Patients could have any of those three, and I could present what I thought was equipoise in making a decision with the patient on what was best for them. I thought learning all three would help the individualized care vs. if I did only one of the three techniques.

Q: You work with and train other cardiologists, including those at Piedmont. What is one piece of advice you pass along to them?

VT: I tell them the primary goal is for the patient to have a great outcome and to rigorously study the processes you use. So, be thoughtful in your analysis of what procedure they're going to have. Always understand what your outcomes are. If you're better at one than the other, you should always do one that is going to provide the best outcome to patients. If you're able to do all three heart surgery techniques, that's great, but if sometimes you're not able to do all three, don't forget there may be an expert who can help with that. Give patients good options for whatever therapies are available to them.

 

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