Adena Health

Surgeries & Interventions

Adena Health Pauses Cardiac Surgeries Amid Mounting Controversies

Ohio’s Adena Health System has temporarily stopped performing heart surgeries, after months of growing scrutiny and some troubling deaths.

Adena Health reportedly “parted ways with” two of its cardiac surgeons, and will transfer all scheduled heart surgeries to OSU Wexner Medical Center during its “pause.” 

• However, Adena’s cardiology, and thoracic and vascular surgery operations were not affected, and the system will continue to operate its cath lab and treat all incoming emergent heart attacks.  

Adena’s cardiac surgery pause and surgeon departures follow the recent deaths of two women during coronary artery bypass grafting (CABG) procedures, although problems within Adena’s cardiac surgery department have been mounting for some time.

• Just a few weeks ago one of the surgeons was accused of “propping up” another deceased patient to look “fake alive” and then urging family members to remove her from life support
• Two of the surgeons were allegedly seen watching YouTube videos to prepare for medical procedures they were unfamiliar with, including one procedure that turned fatal and another that led to three follow up procedures
• In May, another Adena cardiac surgeon was accused by 31 sources of performing at least three TAVR procedures without proper credentials, including one where the patient died

The two surgeons both left after less than two years working at Adena Health, while the third apparently remains with the medical center.

Given that Adena is Southern Ohio’s top medical center, the problems with its cardiac surgery department became widely covered by local news outlets.

• However, news of the “propped up” woman earned international headlines and apparently inspired an upcoming People Magazine story, while these latest deaths during CABG procedures prompted Adena Health to take action.

The Takeaway

Cardiac surgery deaths happen at even the best run hospitals, but Adena’s growing list of controversies and the fact that it elected to pause all heart surgeries is a clear sign that there was something seriously wrong there. Let’s hope Adena figures out what’s wrong and fixes these issues before restarting its cardiac surgery operations.

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The Wire

• Yoga’s HF Improvements: Heart failure patients who start practicing yoga realize significant quality of life and cardiovascular function improvements. A study presented at ACC Asia had 35 HF patients practice yoga five days a week and had 40 similar patients continue with standard of care. After 24 and 48 weeks the Yoga group had significantly improved endurance, strength, balance, symptom stability, and quality of life, while echo exams showed biventricular systolic function improvements. The Yoga group also had “substantial” NHYA-based functional improvements.

• Bivalirudin Beats Heparin for NSTEMI PCI: A meta-analysis in Circulation shows the thrombin inhibitor bivalirudin is as effective and safer than heparin for NSTEMI patients undergoing PCI. In the study of five randomized trials with 12k patients, bivalirudin and heparin had similar 30-day mortality rates (1.2% vs. 1.1%), while bivalirudin’s severe bleeding rate was significantly lower (3.3% vs. 5.5%).

• Qure.ai’s CTR AI Cleared: Qure.ai announced the FDA clearance of its qXR-CTR AI algorithm, which analyzes chest X-ray exams to measure cardiothoracic ratio (CTR) and identify patients with future heart failure risks. qXR-CTR automatically measures CTR by calculating the ratio of the maximum transverse diameter of the heart to the minimum inner traverse diameter of the thoracic cavity, “providing the most accurate indicator of cardiomegaly” when using X-ray. Qure.ai now has 12 FDA-cleared algorithms, mostly for non-cardiac indications.

• Statins’ Senior Benefits: A Danish registry study found that people over age 70 benefit from statins just as much as younger folks. The study showed that statins drove a 1.7 mmol/L median LDL-C decline among participants ≥70 years (n=16,035) and aged 50-70 years (49,155). For both age groups, every 1 mmol/L drop in LDL-C meant a 23% lower risk of major vascular events.

• GLP-1 Growth: Trilliant Health shed more light on the massive growth of GLP-1 weight loss drugs (see slides 40-43), which reached 9 million prescriptions during the fourth quarter of 2022 in the U.S. alone. That’s a 300% increase from early 2020. Novo Nordisk’s diabetes drug Ozempic was the most prescribed, accounting for 65% of total prescriptions, while only 53.6% of GLP-1 users acquired the drug via “traditional medical visits,” highlighting the role of off-label usage in the weight loss drug boom.

• Black-Blood CT: A recent European Radiology study highlighted the potential of black-blood CT, a CT image subtraction method in which vascular lumen appears black. Among 110 patients, black-blood CT had high sensitivity and specificity for detecting stenosis >50% (97% and 84%), and an AUC of 0.93. Black-blood CT also assessed plaque burden comparably to vessel wall MRI, while being cheaper and easier to perform.

• ACC Home-Based Cardiac Care Workbook: Home-based care has become one of the biggest trends in cardiology, and the ACC just released a similarly big (28-page) home-based cardiac care workbook to help guide providers through this trend. The ACC Home-Based Care Workbook gives a comprehensive overview of home-based cardiac care’s advantages, challenges, and tactics, making it a solid resource for any provider looking to create or improve their home care program.

• MitraClip’s Real World Evidence: A large real world study evaluating Abbott’s MitraClip transcatheter edge-to-edge repair (TEER) system eased concerns about conflicting data in its previous COAPT and MITRA-FR randomized trials. In the new COAPT post-approval study (n=5k), the MitraClip achieved a 97.7% implant rate – both overall and in subgroups resembling the COAPT and MITRA-FR trials. The overall trial and subgroups also achieved similar one-year rates of mitral regurgitation reduction to ≤2 (90.7%, 89.7%, 86.6%), and similar adverse event rates.

• Angiography-Derived μQFR Measures Up: A new AHA study highlighted the value and simplicity of using a single angiography view to help assess physiology before TAVR procedures. In the study of 198 stenotic coronary arteries in 123 patients, the angiography-derived Murray’s law-based quantitative flow ratio (μQFR) was on par with FFR for stenosis detection (19.2% vs. 19.7%). Although instantaneous wave-free ratio (iFR) detected significantly more stenosis (44.6%), μQFR more accurately predicted pre-TAVI FFR (93.4% vs. 77%). 

• QT Medical Adds $12M: Portable cardiac monitoring device startup QT Medical completed a $12M Series B round to accelerate its global commercial expansion and fund its product development and long-term strategic planning. QT Medical currently leads with its Personal Cardiac Assistant (PCA 500), a FDA and CE-cleared resting 12-lead ECG device for both professional and patient use, although its funding announcement suggests that QT plans to further expand its portfolio.

• Low T3 Signals HCM Risks: A new study advises checking for low levels of the T3 thyroid hormone in patients with hypertrophic cardiomyopathy (HCM) as they could be at risk for major adverse events. In the 52-month study of 782 HCM patients, the 112 patients with low T3 (defined as < 2.43 pmol/L) had significantly higher rates of sudden cardiac death (HR=1.63) and worsening heart failure, including HF death and HF hospitalization (HR=2.62).

PRECISE Trial Rewrites the Patient Pathway

HeartFlow’s landmark PRECISE trial found that their precision approach for evaluating people with stable chest pain avoided unnecessary testing and improved care without putting patients at risk of a missed heart disease diagnosis.

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The Resource Wire

• Looking to optimize your cardiovascular imaging services, but don’t know what to measure? Check out this Change Healthcare report for insights on how to track and evaluate your cardiovascular imaging performance, assess quality, and enhance operational efficiency. Read the full article now and start measuring what matters!

• The ESC has updated its heart failure guidelines, for the first time including a guideline-directed medical therapy for heart failure with preserved ejection fraction (HFpEF). Learn how to use echo AI to find these cases earlier in this video from Us2.ai. 

• Cardiologists are increasingly relying on cardiac CT angiograms as a heart disease diagnostic tool. See what’s driving this trend in this Cleerly report detailing the key attributes of CCTA exams, evidence of its effectiveness, and CCTA’s medical guideline support.

• With the advent of advanced imaging technologies like CCTA come added burdens to technologists and diagnostic imaging centers. See how PIA can relieve the burden of post-processing, saving you time while helping your bottom line.