Saint Agnes taps Stanford's surgery expertise

September 26, 2006

Saint Agnes Medical Center hopes a new affiliation with Stanford University Medical Center will provide a boost to its cardiac surgery program.

The Stanford Cardiothoracic Surgery Program at Saint Agnes is the name of the new affiliation, hospital officials announced to donors Monday night.

Wanda Holderman, chief operating officer at Saint Agnes, said the program involves Stanford's assigning a physician who brings the cardiac expertise for which the university is known to Fresno.

"We are confident that this affiliation will help us to improve the quality of our cardiac surgery services here at Saint Agnes," she said.

Dr. Hari Mallidi, a Stanford cardiac surgeon, will be working closely with Dr. Paul Stefanacci, a Fresno cardiac surgeon who also is on Stanford's faculty. The two have offices next to the Saint Agnes campus on Herndon Avenue in north Fresno. However, Mallidi's assignment is only temporary; he will eventually be replaced by a permanently assigned Stanford surgeon.

(Update as of October 5, 2007: Dr. Hari Mallidi has left the Fresno team and joined the Stanford Cardiothoracic Surgery Program at San Jose Regional Medical Center. He has been replaced by Dr. Randy Bolton.

Update as of December 15, 2011: Dr. Hari Mallidi has left the Stanford Department of Cardiothoracic Surgery))

Hospital officials said the new affiliation in no way indicates that local cardiac surgeons are lacking. "We just want to take it [the program] to the next level," Holderman said.

They said Stanford's cardiac program has experts and research at its disposal that will provide oversight, quality and protocols and standards for which the highly regarded program is known.

In Fresno, as in most markets, cardiac surgery is competitive, with hospitals vying for lucrative cardiac services.

The local market became even more competitive three years ago when Community Medical Centers opened its Fresno Heart Hospital in partnership with local cardiac doctors.

However, Saint Agnes also has a new cardiac wing. The number of cardiac surgeries performed at the hospital has grown from 376 in its 2005 fiscal year to 447 surgeries in the recently ended 2006 fiscal year.

There are six cardiac surgeons in the Fresno-Clovis area, and nearly all have privileges at each of the local hospitals. With Stanford's Mallidi, there will be seven. Cardiac surgeons — unlike cardiologists — are trained to crack open chests for invasive procedures such as bypass surgery.

No one at Saint Agnes would discuss directly how local doctors have reacted to bringing in out-of-town Stanford surgeons. Local surgeons contacted did not return telephone calls.

Holderman was optimistic that the move wouldn't alienate local surgeons from Saint Agnes.

"As a medical community, we share a common goal to provide our patients the highest quality of care possible," she said. "I'm confident that we can and will continue to work collaboratively in the best interest of our community."

Dr. Robert Robbins, chairman of Stanford's department of cardiothoracic surgery, said there is enough cardiac surgery business in Fresno. However, he said: "For communities like Fresno, it is getting more and more difficult to get surgeons."

Robbins said that often patients will come up to Stanford for procedures. Stanford, for example, has surgeons and experts in identifying patients who might need valve replacement or repair.

Holderman said cardiologists, who refer patients to cardiac surgeons, have been welcoming of the new Stanford affiliation.

Stanford has been named one of the best hospitals in the nation by U.S. News & World Report in its annual America's Best Hospitals issue. The hospital was ranked 13th among all hospitals nationwide.

Each year, more than 5,000 patients from around the world come to Stanford to receive some of the most advanced care for cardiovascular diseases, according to the university's Web site.