Vinod Thourani, M.D., Marcus Chief of Cardiovascular Surgery for Piedmont Healthcare and with the Marcus Heart Valve Center, joined Piedmont on Oct. 28, 2019. The renowned heart surgeon currently is principal national investigator of five clinical trials and is on the executive committee of four others. This year, he has given talks during grand rounds at Mass General Hospital, Harvard University Medical School, Yale University School of Medicine, Brown University Medical School and Northwestern University Feinberg School of Medicine on the topic of innovative valve surgery. He is on the board of four surgery and cardiology-related professional societies and is president or president-elect of three of them. Shortly after joining Piedmont, he answered questions about his background and what he hopes to achieve.

Where are you from and where did you grow up?

“I was born in India and I was five years old when we moved to New York. My dad finished a cardiology residency there. After spending a year in New York, we moved to Columbia, S.C., and spent two and a half years there. From the age of 8, we moved to Mullins, S.C., near Myrtle Beach, and I grew up there. From there, I went to Furman University in Greenville for pre-med and finished there in 1990, from which I went to Emory Medical School and graduated from Emory Med School in 1994. I matched into general surgery at Emory for the five years from that time period. In between my five years, I took off time and did three years of cardiac surgery research so my general surgery residency was for eight years. My time in the lab was with Dr. W. Morris Brown the chief of cardiovascular surgery at the Piedmont Heart Institute (PHI), and Dr. John P. Gott (one of our cardiac surgeons at PHI). From 2002 to 2005, I did three years of cardiac surgery clinical training at Emory, which completed my 11-year residency.”

You knew you wanted to do all of that because…?

“I fell in love with the heart when I was around 10 years of age. Even when I was that age, I would go to my dad’s office and see how he was doing echocardiograms and watching him do EKGs. So ever since I was a young boy, I just fell in love with what my dad did. I wanted to be a cardiologist so I came to Emory for cardiology training and then I went to gross anatomy and I fell in love with anatomic dissection so I changed from cardiology to cardiac surgery in my first year of med school. So I’ve known I’ve wanted to be a heart surgeon since my first year of med school in 1991. After my residency in 2005, I joined the practice at Emory. My mission was three-fold:

• Provide personalized, exemplary patient care.
• Equally important, I felt that research and investigation in new and innovative technologies were very important to me. How could we provide the same therapy and the same results, but minimize the deleterious effects to patients? To me, that was critical.
• A third very important aspect to me was education and giving back to my surgical field. I’ve been fortunate to have received multiple national and international teaching awards and now I’m giving back to society and giving back to my surgical societies. I’m now on the board of four societies and president-elect of three of them. As of November, I’m president of the Southern Thoracic Surgical Association, something I share with Piedmont thoracic surgeon, Joseph Miller, Jr., M.D. Starting in February 2020, I’ll be president of the International Heart Valve Society and starting in June 2021. I’ll president of ISMCS, the International Society of Minimally Invasive Cardiothoracic Surgery.

“Regarding research and education, I have co-authored a review text book for residents on cardiothoracic surgery so that was important to me. It is cool when residents tell me that they read that book for their oral boards. Research has been a part of my DNA since I was a medical student. Not only have I been personally stimulated by new investigation, but I believe it has allowed me to find new and innovative treatments for my patients. I am so fortunate to now be in a position to be on the leadership of five national and international trials and on the executive committee of four additional trials

“Academics and research, which ties mainly for me into innovation, is a critically important aspect of my delivery of patient-directed care. With my interest in innovative valve technologies, I am able to offer my patients all three options for aortic, mitral, and tricuspid valve therapies: standard, minimally-invasive and transcatheter. This allows me to have equipoise for patient care management and since I do all three techniques, I can tailor each procedure for each patient needs.”

Can you explain the difference between minimally-invasive and transcatheter?

“In a regular traditional surgery, you open the sternum up, which is the breast bone. This is the well-developed technique and is the standard of care for many patients. Some patients are candidates for less invasive incisions. Minimally-invasive surgery for the aortic valve requires a partial sternal incision (not a full sternotomy) and for the mitral or tricuspid valve includes a small incision under the right breast.  A minimally-invasive procedure still requires stopping the heart and going on the heart-lung machine. The third procedure technique utilizes transcatheter techniques which do not require the heart-lung machine or to stop the heart. Commonly, those are done through the femoral artery or the femoral vein so it’s needle stick and really no incision. Being facile in all three techniques, allows me to provide the most optimal patient care utilizing one or more technique in order to minimize recuperation time and most importantly achieving long-lasting quality results.”

How else do you try to distinguish yourself among heart surgeons?

“One of the other things I do that is a little bit different when it comes to valvular disease is that I follow these patients for life. The nature of valvular disease means I have the privilege of building-lifelong relationships with each patient. All patients referred to me, in addition to referring physicians, join our family of physicians, nurses, assistants and advanced patient providers, or APPs.

“So at the end of the day, my highest priority is providing personalized, exemplary care by giving patients the options for new innovative technologies that are relevant to their diagnosis. And approaching them with traditional, minimally-invasive or transcatheter procedures is what’s important to me.

“One of the things that is paramount for me and for which I give national lectures on is the aspect of working with cardiology as a heart team. Interestingly, this year I have had the distinct privilege to give cardiology/cardiac surgery grand rounds on this topic at Yale, Brown, Harvard, and Northwestern in 2019. In this exchange, most of our discussions revolved around ‘How does a heart team work?’ ‘How to work within the same box within a multitude of disciplines.’ I am so happy to join the PHI family, who I know also believe in the heart team approach and are staunch advocates of such collaboration.

“Maybe what also distinguishes me is that I love to operate and take care of patients, but also I’ve decided to take my practice one step further. I treat the patient, I write about it and I then educate other surgeons or cardiologists about it. It allows me to go full circle, with the patient care as paramount and in the middle. The aspect of teaching other surgeons in this country and internationally allows me to impact patient care beyond just the patients that I personally treat. For instance, I just finished co-chairing my third meeting in Latin America for cardiac surgeons for the Society of Thoracic Surgeons and we are also planning education in Asia.”

What is it about Atlanta that drew you back?

“On a personal level, my wife and I have long roots in Atlanta.  I have been in Atlanta since 1990 and my wife, Marissa was born here. My only brother lives in Atlanta, as does my dad. Marissa’s brother and parents live in Atlanta. Professionally, working at Piedmont provides that balance of the utmost patient quality care, interest in innovative technologies, and education of other physicians allows us to be leaders not only for Atlanta and the Southeast, but also nationally in the treatment of cardiology and cardiovascular disease. I guess I got super lucky, I had both very strong personal and professional reasons for coming back to Atlanta.”

What is you approach with other doctors?

“My approach as a surgeon with other doctors is three-fold:

• First, with local cardiac surgeons and our intensivists. Working as a team of cardiac surgeons, as is here at Piedmont, where we now have seven surgeons on this campus and two surgeons at the Athens office, is to provide constant feedback and consultation for non-surgeons, which allows the surgeon and the patient to benefit from a team approach. So it’s a seamless interaction, which allows for better care for the patient overall.
• When it comes to cardiologists who refer patients us, it’s exquisitely important to me that they get feedback about their patients and we’re providing a service of the highest standards and keeping in contact with them regarding the procedures we’ve performed and the care their patients have received here.
• Thirdly, would be working with cardiologists in our own hospital, which, to me, is what my entire career has been based on. All the trials I’ve been a part of, all the work I do is performed as part of a multi-disciplinary team. And that team is not only nurses, it’s our APPs, it’s with interventional cardiology, it’s with heart failure specialists and it’s also with our imaging cardiologists, who guide us in all these procedures. Working with my own partners, working with our cardiologists, it’s a somewhat seamless pathway in order to take care of patients for the cardiologists who refer to us, this would be for our patients not only from Atlanta, but from the Southeast.

“And with the Piedmont Atlanta Tower set to open in late summer 2020 and our Piedmont Athens Regional, the goal is for us is to carry our vision of taking care of these patients from Atlanta, but also throughout the Southeast and nationally. I would anticipate that Piedmont Healthcare to be a local, regional, and national destination for cardiovascular care.”