Leadership

  • Mr Aubrey Almeida
  • Mr Peter Skillington
  • Dr Andrei Catanchin
  • A/Prof Nicholas Cox
  • Mr Marco Larobina
  • Dr Gary Liew
  • A/Prof Kean Soon
  • Dr Paul Sparks
  • A/Prof Antony Walton
  • Mr Michael Yii

Highlights

  • Designed to enable replacement of a diseased aortic valve without open heart surgery or surgical removal of the native valve, Epworth has seen over 300 transcatheter aortic valve implantation's performed
  • Robotic mitral valve surgery has been performed at Epworth since 2004. The procedure enables complex mitral valve operations to be performed via a small incision on the side of the chest. The rate of success of mitral valve repair procedures has been 99%, amongst the best in the world
  • Epworth Richmond became the first private hospital in Victoria to offer open and endovascular capabilities for neurosurgery, cardiac and vascular procedures with the Siemens Artis Q hybrid biplane theatre. The hybrid technology allows surgeons to perform minimally invasive procedures that result in safer, faster and more efficient treatment of patients
  • Epworth specialist cardiothoracic surgeons are leaders in the Ross procedure, a type of specialised aortic valve surgery where the patient’s diseased aortic valve is replaced with their own pulmonary valve. As it is their own tissue, the valve is not rejected. The pulmonary valve is then replaced with a donor pulmonary valve
  • Epworth has commenced using the Maze IV surgical technique (AtriCure) for the treatment of atrial fibrillation (AF) in cardiac patients. Australasia’s first Maze IV one-day training course was held at Epworth

Our performance

Cardiac surgery

Cardiac surgery is classified into four separate groups for monitoring and comparing information.

1.) Coronary artery bypass grafts (CABG) performed without any other simultaneous procedure

2.) Any valve procedure performed without any other simultaneous procedure (Valve)

3.) A combination of a simultaneous coronary artery bypass AND any valve procedure (CABG and Valve)

4.) ‘Other’ procedures include surgery of the Aorta and heart rhythm abnormalities, and any other procedure in combination with CABG, valve or both (CABG and valve)

Coronary artery bypass grafts are the most common type of cardiac surgery currently performed on adults at Epworth.

To measure our performance, our cardiac surgery results are compared with other hospitals who participate in the Australia and New Zealand Society Cardiac and Thoracic Surgeons (ANZSCTS). Performance is measured by evaluating risk associated with cardiac surgery including mortality, return to theatre for bleeding, deep sternal wound infection, stroke, readmission to hospital etc. Current data indicates a low mortality rate of two percent, lower than average return to theatre for bleeding and stroke, no deep sternal wound infections and a lower rate of readmission to hospital. Other key performance measures include ventilation hours, intensive care stay and hospital length of stay.

Mortality rates following cardiac surgery

Highlight: Mortality rates following cardiac surgery at Epworth are consistently and significantly lower than or similar to the national average.

Other key performance measures – cardiac surgery

Medical ventilation is needed when the patient’s own natural breathing is not sufficient to maintain life. While mechanical ventilation is often a life-saving intervention, it also has the risk of potential complications. For this reason, a lower number of hours on a ventilator is a positive result. Epworth’s average number of hours a patient is on a respiratory ventilator and length of stay in hospital following cardiac surgery is less than half that of other cardiac surgery hospitals.

Cardiology

To measure our performance, our cardiology treatment results are compared with other hospitals that participate in the Victorian Cardiac Outcomes Registry (VCOR) quality of care projects.

The main performance measure used to monitor performance of the care of PCI patients, is mortality within 30 days. This rate varies according to clinical presentation. Patients presenting with cardiogenic shock or out-of-hospital cardiac arrest had the highest mortality rate; these are the most unwell patients. At the other end of the spectrum, patients presenting with low-risk clinical presentations had a much lower in-hospital mortality rate. In-hospital major bleeding is also a recognised performance measure linked with adverse short and long-term outcomes, including increased mortality.

Epworth’s patient mortality rate following PCI (stent procedures) was 0.63% in 2017, comparing favourably with the Victorian benchmark of 1.89%.

Cardiac rehabilitation

Current evidence suggests rehabilitation benefits all cardiac patients by reducing readmission rates, mortality and enhancing recovery. Following discharge from a cardiac procedure, Epworth provides both inpatient and outpatient support services.

Epworth’s HeartSmart Cardiac Rehabilitation Program is designed to benefit and support patients in attempting to regain full functionality following a cardiac episode. Outpatients are offered the choice of four separate session times each week with three of the programs spanning a six-week period (strongly recommended for post-cardiac surgery patients) while a 3-week ‘Fast Track’ program is specifically designed for Angioplasty and Stent patients.

HeartSmart attendance costs are fully covered by most private health funds.

Patient mortality rate

For most elective PCI cases, length of hospital stay is expected to be one day, whereas PCI in patients with acute coronary syndromes are typically associated with a multi-day hospital stay, usually due to the underlying condition rather than the actual procedure.

Activity

The numbers above include more than 1000 procedures for diagnosing and treating the abnormal electrical activities of the heart (includes pacemakers, defibrillators and ablation of pathways), and more than 700 procedures for treating blockages of coronary arteries.

FY2017 Admissions Bed days 
Cardiology  6,487  18,683 
Cardiothoracic surgery  968  7,536 
FY2018 Admissions  Bed days 
 Cardiology 6,670  18,520 
Cardiothoracic surgery  895  6,767 

Epworth performs more than 700 cardiac surgery procedures per year. Procedures performed in cardiac surgery at Epworth from 2011-2017 are highlighted below in their respective groups:

Condition treated

  • Aneurysm
  • Angina
  • Atrial fibrillation
  • Cardiac arrest
  • Coronary artery spasm
  • Coronary heart disease
  • Deep vein thrombosis
  • Familial hypercholesterolaemia
  • Heart attack
  • Heart failure
  • High blood pressure
  • Palpitations
  • Valvular disorders

Services

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