As diagnostic and treatment options continue to evolve, obstructive hypertrophic cardiomyopathy is best managed by a team of experienced clinical specialists, like the multidisciplinary team at the Johns Hopkins Medicine. (Image courtesy of Mina Zaky, M.D.)
“Having people who know how to get exactly the right study for patients with hypertrophic cardiomyopathy, to get the exact answer that we’re looking for, is really quite unique.” — Michael Robich
As the new surgical director of structural heart disease at the Johns Hopkins Heart and Vascular Institute, Michael Robich is building a program to streamline the referral and admission process for physicians from outside of Johns Hopkins so that patients with hypertrophic cardiomyopathy (HCM) can be evaluated, treated and discharged from the hospital as quickly and as safely as possible.
Robich, who trained at the Cleveland Clinic, Mayo Clinic and Tufts Medical Center, brings surgical expertise in performing septal myectomy for HCM. He’s also skilled in developing multidisciplinary teams to produce the best outcomes for patients.
“Our goal is to make it very easy for referring physicians to send their patients here so we can be part of the care team and offer whatever aspect of HCM treatment they need, whether it’s medical management, surgical myectomy, alcohol septal ablation, advanced heart failure management or electrophysiology,” says Robich, who also specializes in treating aortic and mitral valve disease as well as coronary artery disease. “We want one simple phone call to get you connected to our team, and we’ll have that going very soon.”
Patient-Centered Care from a Multidisciplinary Team
Cardiologist Jose Madrazo, director of the Johns Hopkins Hypertrophic Cardiomyopathy Center, who has begun incorporating medical treatment of HCM using the recently FDA-approved drug mavacamten, will join Robich on a multidisciplinary team that includes cardiac surgeon James Gammie, co-director of the Heart and Vascular Institute, cardiologist Edward Kasper and others.
“We provide a hub and spoke model with the ability to see patients in Baltimore and at our satellite locations, including Columbia, Green Spring Station and White Marsh,” says Madrazo. “In addition to medical evaluation and treatment, we provide genetics counseling and testing, advanced imaging and diagnostic modalities, electrophysiology services including arrhythmia risk stratification and management, and both surgical and catheter-based septal modification procedures.”
Imaging plays a significant role in supporting this multidisciplinary team, says Robich. “We’ve got an excellent cardiac MRI program with an excellent echo program, and so the ability to use high-end unique imaging studies is really important,” he says. “Having people who know how to get exactly the right study for patients with HCM, to get the exact answer that we’re looking for, is really quite unique.”
Another important component is Johns Hopkins’ core strength in research, development of bench-to-bedside innovations, and access to clinical trials, including those available through the Cardiothoracic Surgical Trials Network, says Robich.
A Continuous Approach to World-Class Quality Improvement
Robich is also director of cardiac surgery quality improvement for perioperative services, another area of deep interest and expertise. He will work with Glenn Whitman, director of the cardiovascular surgical intensive care unit, in this effort.
“The fact that I get to partner with Glenn, a real pioneer in the field of quality improvement, is very exciting,” he says. “We are already at work on several projects to shorten the length of stay for patients, especially preoperative. Improving how quickly we get patients into an operation, work through it safely and then return home is something we want to continually improve so that Johns Hopkins is providing absolutely world-class cardiac surgical care.”