Chapters Transcript Video Heart Care Revolution: AI, Robotics & the Future of Medicine We're trying to predict when a patient will have a complication after surgery and I'm actually wearing a whoop. It's a wearable technology and we're involved with a study that has shown that this technology can predict when patients will have a complication before they even realize it. Welcome to Baptist Health Talk, a podcast on all things healthcare, powered by Baptist Health South Florida. Your trusted source for healthcare prevention and wellness. I'm your host, Willard Shepherd. Welcome back to a new episode of Baptist Health Talk where we give you the answers to the questions you searched the most on topics that are trending. Today, we'll explore advancements in cardiac care and how those surgical techniques that haven't been used before are breaking new ground. The developments transforming lives across South Florida, and we're joined today by Doctor Tom Winn. Internationally recognized minimally invasive heart surgeon and chief medical executive at Baptist Health Miami Cardiac and Vascular Institute. Doctor Wen, thanks for being with us today. You and I kind of have a connection. I kinda told you about my history and how, uh, I as a person who, uh, want to educate as many people about being positive with their. Health care. So just in, in big picture before we go specifically to the new technology, what can we as people, patients, the general public do to make sure we protect ourselves? Don't take it the wrong way so we don't see you in the first place. Yeah, well, thanks for having me. I think there are a couple things to know about heart disease. One, there are genetic risk factors, things you can't control, and there are. Uh, modifiable risk factors, things that you can't control and we're talking about earlier, sometimes people have heart disease and they don't even know it. It's so important for them to go see a cardiologist to pick up on heart conditions that could be fatal, but they might not have known it. So, so there are conditions that um we can pick up and treat very effectively, uh, but we just got to go go to your doctor and make sure you don't have these risk factors and. You have something that could be potentially a ticking time bomb and I'm a perfect example of doing that, otherwise I might not be here today to be with you. We talked about that, yes, very much so. OK, let's talk about AI technology currently this is being used in cardiac surgery. I think a lot of people just think that this is being used in the music world and other things like that but uh tell me how you're doing this, how it's helping your patients. Well, uh, there are a few things in medicine as transformative as uh AI and especially in cardiac surgery. So with AI, it allows us to be better at predicting, uh, people who have risk factors and potentially fatal events. It allows us to be better at managing patients after we treat them, uh, uh, with the cardiac or cardiovascular disease. And then lastly, it allows us to better predict complications. Uh, AI allows us to distill millions and millions of data points and then predict and provide really just detailed guidance on what to do next. Looking ahead over the next 5 to 10 years, where do you see this going? Uh, you showed me a picture a short time ago of, uh, one of your patients who's a senior citizen, a 92 year old person, and how this technology is being able to limit the kind of, uh, damage I'll say that a person has to recover from. You know, in heart surgery, we operate um with sutures that are are finer than your hair follicle, and we have to be incredibly incredibly precise. So, so with cardiac surgery um and with the AI AI allows surgeons to be really better surgeons. You can imagine human beings, we have a lot of emotion, but the problem with, you know, with human beings is we can be very subjective, we tire, uh, and sometimes we have miscalculations. Robots are great, right? Because robots don't tire, they could be very precise, but they don't have emotion and don't have the ability to synthesize information as well. So the beauty of AI is merging that human factor and the robotic factor as well, ultimately to allow surgeons to really become the best surgeons that they can be to take care of patients. Educate us about here at Baptist, specifically what's being done with AI in this area. So one of the things that we're doing in in a partnership with FIU is we're trying to predict when a patient will have a complication after surgery and I'm actually wearing a whoop, it's a wearable technology. And we're involved with a study that has shown that this technology can predict when patients will have a complication before they even realize it. So after surgery, if you wear this technology, you can have changes in your heart rate variability that happens before you even realize it into your brain, like, wow, I'm not feeling well. If something happens to your body before all this happens and eventually it trickles to your. To your sensorium we're like, wow, I'm just not feeling I'm feeling kind of crummy and we're able to pick up on that earlier so that we could bring patients into the hospital earlier or treat them earlier so I think it's um potentially a very transformative way of of managing patients after surgery. Now you're saying you have one of these on as one of these so hold that out there for us so we can have a good picture of and show what that's like now. That's giving you and your team data, live data of what's going on with the individual. Right, so, so this is 24/7, and it gives uh live data that we can track and then get sent back and then record, and we'll figure out, OK, well, something's Something's not right here maybe you should go to the to the doctor's office to figure out what's going on. But again, we're focusing more on the after surgery side patients who have surgery and we're in this technology try to predict to see if we can really predict uh whether or not they're gonna have a complication or not. So far the data seems very promising. um, this study is sponsored by the National Institutes of Health in collaboration uh with uh many centers across the country, one of them being in Boston one of the Harvard hospitals in Boston. Before we move forward, is it possible with that? Do you see down the road where your team could look to see because of the data you're gathering, hey, a person's about to have an event, and then you can interject yourself before that event transpires? Is that what the vision is that's the vision that's the goal. So the goal is anticipating an event before it happens so we can intervene sooner and either minimize it or prevent it from happening altogether. So that's the the concept behind um behind this technology, but again, using AI using mass data to really put lots of information together to allow us to make these predictions. You talk some about FIU, big fan of FIU. That's my law school, so you know we have the highest bar passage rate in the state of Florida, and we always brag about that. Tell us about the collaboration with my alma mater here in South Florida and uh how that's just gonna help our entire community. It's uh in some ways, uh, I described it as almost a perfect marriage because FIU has things. That we don't have and we have things that FIU doesn't have. So for example, FIU is a university with great research scientists, but they don't have as much exposure to the clinical side because they're not walking the hallways of the of the hospital and and dealing directly with patient care, but they know the basic science and a lot of the clinical and translational science very well. On the other hand, we have physicians who have. their entire life to taking care of patients, but they might not know a lot of the basic science, uh, or even the computer science that's out there. So we bring our groups together and we're able to think, OK, what are the problems out there in medicine and use what FIU has and what we have together to really solve really important problems. So that's, that's kind of the potential of bringing together a top rated university and a and a. Large health care system like ourselves ultimately take care of patients and, and, uh, answer important questions. It's gonna be fantastic for our community there. Uh, we talked some about robotics. Uh, how are robotics played in what you do now in terms of these, uh, procedures that are being done to really try to limit, I use the word in lay terms, damage to the patient that they have to recover from. We are one of the few programs in the state of Florida and really in the country that's using robotic heart surgery to uh perform complex operations. You can imagine that typically when we operate, we use our eyes and we use our hands, but the problem with our hands is our hands has only so many degrees of articulation because of the joints. If it's a robot, you can have almost an infinite number of uh of articulation points. So you can, I can only move move my hand. I'm pretty good. I'm pretty flexible with my hand this way, but with a robot you can imagine you could spin it 360 degrees, you can bend it backwards in a lot of different angles and with my eyes I can only see so much with a robot, it's almost like you're sitting right in front of whether it be the coronary artery or the mitral valve or whatever vessel you're looking at, at 10 fold magnification. So you bring this magnification, you bring the ergonomics, and then now you're bringing the power of AI as well. So with a lot of the newer technologies, robotic surgery. We're able to look and see what we're supposed to do and anticipate, well, you know, if the surgeon is doing something that's not in the right sequence, maybe a red light flashes up. Uh, if, uh, if a surgeon is shaking too much during a critical part, then the robot can stabilize that hand and make it more precise. So ultimately it's again it's, it's a fascinating, uh, opportunity, ultimately to allow surgeons to be better surgeons and more precise surgeons when taking care of patients. I'll also add that with robots. Uh, we're able to make incisions really 2 centimeters to do complex heart operations. Typically, we'll make an incision through the front of the chest. Now with robotic heart surgery, we could do surgery through an incision about maybe 2 centimeters, uh, to do really complex operations. Recently we operated on a patient who was 92 years old, very high risk, and a couple of days after surgery, he's asking when he can hit the golf course again. So, so that's what we're able to do and this is the new chapter of medicine that we're trying to pioneer and push the envelope, uh, and lead. The merging of robotics and the AI technology, what do you see that in terms of its ultimate ability to do? Uh, one, it allows us to be a lot more precise with uh taking care of patients being better surgeons, but I also imagine this idea of being able to scale and and allow this technology to reach other, other parts of our, our, our community as well. For example, uh, when we're doing robotic heart surgery, the surgeon is at a console across the room from the patient. So let's say if you're a patient. Typically when I do heart surgery, I'm by your chest and I'm operating right in front of you. With robotic heart surgery, I'm actually in the across your room and the robotic arms are in there operating on you. So you can imagine if I'm across the room, I can be across the city, I could be across the state, I could be across the country and this technology is as good as we think it is, then. Why can't everybody have access to this? The problem is not everybody can do robotic heart surgery. It's tough. It's tough to learn. There's a learning curve, so only about 5% of surgeons out there, heart surgeons, do robotic heart surgery. But I would say a lot more patients out there really want to have robotic heart surgery done to them. It's just not enough surgeons out there doing it. So we can scale this and potentially have the option of doing tele surgery. It's something that we're, we're pushing and trying to see if there are creative ways to try to, try to do this. It's not FDA approved as a disclaimer yet, but again we are trying to think to the future and do what we can to be innovative and try to help as many patients as possible. Now how is your team getting its training and learning how to be able to do this hopefully on a daily basis? Right, so, um, I'm a big believer in preparation and um and pre-training beforehand so we launched our robotic heart surgery program we had to be very thoughtful about it we had to. Uh, get everybody in the room to go through the, the sequence of events of what we're gonna do. Uh, we had, uh, we flew to different sites around the country to see how their best practices were after a case we debriefed to see what we could have done better, make sure the debriefing debriefing process is very open and transparent so people have the opportunity to voice there. Their opinions one way or the other. So, so you bring a good point because, because this is a complex technology, but to do it right, we have to prepare beforehand to make sure that it's done right and, and, and the consequences if we don't do it right, our patient lives. So, so we are very purposeful and thoughtful about making sure that we do every step beforehand to make sure when it's game time, we're ready to do it. I'm sure this is something that as you work through this technology that uh you think a lot about, about using it as a tool, but not losing your surgical skills and those people that you are training to be able to manually step in and do these tasks when required. That's a great question, and we, we talked about this a lot as well. Uh, you're right, ultimately, it's very important for, for Traineees and physicians to be able to do the operation the traditional way in the event that the robot can't fix it or in the event that something happens where the surgeon has to come in. So the most important thing is that surgeons know how to be real surgeons and use your hands, but if the opportunity arises to be able to use a robot to come in and make us become even better surgeons. But so important square one, you have to be a surgeon, be able to use your hands and do complex operations first with your hands. Tell us about the Ross procedure. The Ross procedure is an interesting procedure. The aortic valve is the last valve. Blood goes through before it reaches the rest of your body, and sometimes bad things can happen to the aortic valve. It can leak or it can become tight called auric stenosis. The traditional way to address this is really to replace a valve and replace the valve with either a tissue or a mechanical valve. The Ross procedure has been around for a while, but has recently gained in favor because of very promising results where we take the pulmonary valve, and we move it into the aortic position. So we're taking your native valve, your own valve from the pulmonary artery, and we move it to the aortic position. But why is that important? It's important because you don't need to be on a blood thinner the rest of your life. The blood thinner is called Coumadin, also known as rat poisoning. That's what Coumadin is back in the day. And if we replace it with a tissue valve, we know that tissue valves only last 10 to 15 years. So the data suggests that in patients with aortic disease, aortic valve disease, the Ross procedure can be used where it will last almost their entire life and the patients don't need to be on a blood thinner. That's the exciting thing. The tricky thing is it's a complex operation because you move the pulmonary valve over to the aortic position and what we do is we put a a homograft, a cadaveric valve in the pulmonary position. It's a hard operation, and not very many centers really in the country know how to do the Rosswell, and we're one of them, we're pioneering that the Ross procedure here at Baptist. Tell me how you picked this area of medicine, and why you think these advancements in technology that you're at the forefront on, uh, are so important, uh, not just here in South Florida, obviously people across the country and beyond that, uh, you know, across the globe are watching your work, uh, about this and the kind of impact that can have on people whose families like mine have this type of heart disease. And families like mine, so, so, uh, a little bit selfish. The reason for my push for innovation is I have a very strong family history of heart diseases. Well, my dad passed away suddenly when he was 65, and I want to build a heart surgery center, cardiovascular center where I am comfortable getting care of myself or for my family, and I think that's really important. The second is just innovation. I think the way we make progress is to continue to innovate, push the envelope, doing things that other people aren't doing, leading and not following, uh, and I think that's so important. So that's, that's a big push for us to why we, why we do what we do. OK, uh, since you mentioned that, uh, I will say to you, and you mentioned your own situation, uh, what message, uh, do you have and we can use you an example as me an example because I think you would look at us in the general population and we're not generally obese, we do the right thing how that this can happen to anybody. So, a lot of people have this uh misconception that when you have a heart attack, you have this elephant sitting in your chest, you have pain radiating to your left arm, you have jaw pain, and that happens some of the time, and that's classic symptoms of a heart attack. Most people who have have heart attacks don't have those symptoms and most people who have heart attacks don't even have chest pain at all and it's very subtle so it's a, but it can be fatal. So it's important to recognize potential signs of heart disease and recognize that sometimes you might not have classic symptoms. So that's why it's so important to go to your doctor, go make sure you're being followed up closely because a lot of these things can be very preventable and very treatable. And I think that's probably what happened to my dad, and that's very luckily for you, you were followed very closely with the cardiologist and he, he intervened pretty quickly and we're having this conversation here, but it could have ended very differently if you didn't have follow up with the cardiologist and they pick up on some of these things that showed up on. You know, on either lab tests or a CT scan or an angiogram, um, that, um, that, you know, most people wouldn't have known about if they didn't have it done. And that's why I always say, go every year. I mean, I'm an unusual situation because of my flying and my other athletics when I'm doing these tests on an annual basis, but I just tell everybody I meet, go, go every year. But, but, but not only that, I think it's, it's not like going somewhere, it's going to the right place. So I think it's important. to go to a place where we live and breathe this stuff and we want to try to make it better and a place like Baptist is where we are we are experts in this disease process, but not we're we're not only treating it, we're trying to look in the future and how can we make it better and how can we lead and take this, this treatment to to the next level. So it's not only where you go, it's not, you know, it's not only just going, I think it's just as important where you go. For the people that are being trained here and interns coming up behind you now with your leadership, what message do you have for them about the advancements, the leaps that I presume will be taking place in this area? You know, for, I worked with, I've worked with students my entire 20 plus careers, whether it be medical students, residents, or fellows, or even even young surgeons who want to come and learn, uh. Like everything in life, I encourage them to stay hungry, to stay inquisitive, and, and really continue to try to push the envelope because we're always constantly learning you know I've been doing this for 20 plus years. I'm always asking questions. I'm always open to feedback and I'm always trying to learn as much as I can and for the students out there, I would encourage them to be the same if you do that, I think you'll be OK. Last quick question for you, uh, in terms of this technology, how far of a leap is this? You know, uh, we didn't have the wheel, then we had the wheel, and then we came up with, you know, an assembly line that was a gigantic leap forward in terms of manufacturing technology. How would you compare that or where would you say we are and where we'll be here shortly? You know, I think we're in an exciting time. In the past, the advancements in cardiovascular medicine and surgery has been relatively stagnant. It's been growing, growing, but not really at a rate that to write home about. Within the past 567 years, we've seen transformative growth. In technologies that can really change patient care. So we're an exciting time in medicine where we're doing a lot of really neat stuff out there, um, and I think it's really only the tip of the iceberg. I think the future looks really, really bright. Um, I'll add that, um, cardiovascular disease remains the number one killer worldwide, 18 million people per year, 1 in 5 people will die of cardiovascular disease. And as surgeons, we, we're very competitive souls, creatures, but we're OK by not being number one. We're OK if some other entity takes number one. That's my goal to not be number one anymore uh killer across, across not only the US but across the globe. That's our mission. If, if one day I wake up, I don't have to operate and I have to treat patients with cardiovascular disease anymore, I'll be fine. I'll be on a boat somewhere and, and, and be happy that people aren't dying of cardiovascular disease, but that's not gonna happen anytime soon. Well, since you are now here with us in South Florida, there are a lot of places that you can go out and take your boat and, uh, enjoy that all the South Florida and the warm water has to offer. Thank you, Doctor, thank you for all your work here in our community and here at Baptist, and we certainly. We appreciate, uh, you educating us and uh we'll do our very best to get the message out, uh, about health, heart care, and this new technology. Great conversation and, uh, again, thanks for sharing this insight with our audience. Remember viewers, be sure to hit that subscribe button on our channel here to keep up with the very latest health and wellness information and these expert tips from our experts. Thanks for being with us. Find additional valuable health and wellness information on our resource blog at baptisthealth.net/news, and be sure to interact with us on our social media channels for live and upcoming events. Baptist Health Talk is brought to you by Baptist Health, the warmer side of care. Created by
