“Instead of one option, you get 10 options here,” says Mustafa Ahmed, MD, medical director of the new Structural Heart and Valve Center at Princeton Baptist Medical Center.
At a normal heart center, someone with stenosis (tight heart valve) would get one option — replace the valve through open surgery. “But some older or very young people cannot handle that procedure,” Ahmed says. “Here we can either replace or repair that valve. And we can use a robot or a mini-incision or someone like me can go through the leg or some other place without cutting someone open.”
Ahmed, internationally recognized for his research and impact on structural heart disease, is one of the few specialists in the country with expertise in both minimally invasive procedures and advanced cardiac imaging. He was the first at UAB to complete the American Board of Internal Medicine (ABIM) clinician-scientist pathway in cardiology. “It allowed me to develop expertise in research and cardiology, along with key interventional and imaging aspects of structural heart disease,” he says.
Ahmed is also internationally known for handling pulmonary embolisms. “Very few of us can go through the leg to clean the clot out of the lung,” he says. He’s the only surgeon performing this procedure in the state. “It’s just another example of using mini techniques to help life-threatening conditions.”
Clifton Lewis, MD, a cardiac surgeon, comprises the other half of the surgical team at the new Center. He brings a reputation for robotic surgery. “Most mitral valve surgeons will do six in a year,” Ahmed says. “Here, we’re doing over 150 in a year and that’s just mitral valve operations.” Lewis has also performed the largest number of cases of tricuspid robotic valve surgeries in the country.
Rather than stirring competition, combining the two preeminent surgeons has resulted in breakthrough structural heart and valve procedures. “There’s a misconception that cardiac surgeons do not want to work together. But Clifton and I are best friends when it comes to work. We enhance what each other can do,” Ahmed says. The partnership has already sparked a completely new range of options.
Recently the team had a patient with both a leaky mitral and tricuspid valve. “Which is much, much riskier than a single valve problem,” Ahmed says. To make it worse, the patient had a bad heart. “No surgeon in their right mind wants to touch that person.”
But the two surgeons brought their specialties together for a solution. Ahmed went through the leg and fixed the mitral valve with plugs. Then Lewis fixed the tricuspid using the Da Vinci robot. “We came up with a new approach to treat the patient and that’s the kind of thing we’re doing here. It was the first procedure like that in the world,” Ahmed says.
Opened in July, Princeton’s Structural Heart and Valve Center has exceeded in three months the case volume they expected to handle in a year. As a result, they’ve added two more nurses to support their staff of two surgeons and five cardiologists.
“We cover every aspect of structural heart and valve care from imaging, assessment, and surgery to care,” Ahmed says. “We do you cutting edge stuff with a completely new range of options.”
One patient arrived who had been through multiple heart surgeries and was a Jehovah’s Witness, meaning he would not take blood. “Here we had someone too unstable to have surgery, blood count too low, and we came up with a new way to get in through his leg,” Ahmed says. “It was a first-in-the-world procedure.”
That procedure let the patient live, so two months later he could handle regular heart surgery. “Before we came along, there was no option for a patient like him,” Ahmed says. “But we can come up with things here that rival major medical centers.”
The Center, says Ahmed, is not just for patients in dire need of structural heart or valve repair. “What will surprise physicians is that I want to see people with moderate heart disease,” he says. “I want to get them in ahead of time, identify them, and follow them.”
Before the Structural Heart and Valve Center opened in Birmingham, “you had to shop around to find who could do the different imaging, procedures and assessments,” Ahmed says. But the Center works to get imaging and assessment done in one day, while also allowing patients to see both surgeons and schedule any needed procedures. “We do that several days a week, and we all stretch to be available at any given time, so we’re able to take on cases from really far away.”
The equipment and skills available at the Center, he says, put Princeton on a par with world class medical centers, like Mayo Clinic. “This is the only place where we have a team with the expertise to offer you every single option that is available on the planet,” Ahmed says. “Anyone can send their most complicated cases here.”