Billings Clinic


From first to latest, Billings Clinic provides a complete heart program

Posted at 8:19 PM, Sep 15, 2020

From first to latest, Billings Clinic provides a complete heart program

From Montana’s first open-heart surgery in 1972 to the very latest in technologies and procedures, Billings Clinic provides the region’s most comprehensive heart program.

“This is only highlighted by the fact that we’ve been recognized by U.S. News and World Report as the top heart program in Montana for 2020,” said Dr. Brian Rah, interventional cardiologist and chair of the Billings Clinic cardiology department. “We take this seriously because it’s not only about recognition, it’s about always maintaining the level of service, excellence, and patient care that we’ve established over the decades.”

The John R. Burg MD Cardiac Care Center provides comprehensive diagnostic, treatment and rehabilitation care from board-certified cardiologists, advanced practice providers, nurses, technologists and others. This concentration of expertise is coordinated by the patient’s primary cardiologist and allows Billings Clinic to develop the best individual care plan for each patient. Billings Clinic hires only the best trained cardiologists, many with advanced fellowships in structural heart disease, heart failure, interventional cardiology, and electrophysiology.

“Due to our continuing growth, we have just hired four very well-trained cardiologists including one additional advanced heart failure cardiologist and another cardiologist specializing in structural heart disease,” Rah said. “Advanced heart failure is a very complex disease process and our goal is to make sure these patients have an excellent quality of life. Having two fellowship trained advanced heart failure specialists and a dedicated heart failure clinic is something that is usually only found at big major academic centers. This shows our commitment to providing the best possible heart care to the sickest patients in our region.”

Offering minimally invasive, state of the art procedures when possible helps allow patients to heal faster and be home sooner while providing them with some of the latest in care techniques. Billings Clinic offers the region’s most active highest-volume program for transcatheter aortic valve replacement (TAVR), in which a cardiologist and cardiac surgeon work together to place a new aortic valve using a catheter inserted through a small incision typically in the groin without the use of cardiopulmonary bypass. This offers patients a therapeutic option that typically allows them to go home the following day. Billings Clinic uses the Sentinel filter wire to help decrease risk of complications during this procedure. Billings Clinic is the only facility in a multistate area that uses this filter wire.

Billings Clinic is the first hospital in the region to implant the WATCHMAN left atrial appendage closure device. This is a minimally invasive, one-time procedure that reduces the long-term risk of stroke and bleeding in people with atrial fibrillation. They are also the first health care organization in eastern Montana and Wyoming to offer transcatheter mitral valve repair (MitraClip), which helps control mitral valve leakage (regurgitation) for patients who may be too sick for traditional surgery.

Some of the most common cardiac problems include heart rhythm conditions. Atrial fibrillation, specifically, is the most common arrhythmia, especially in the older population. Billings Clinic offers the most comprehensive program for treatment arrhythmias with four board certified arrhythmia specialists, called electrophysiologists.

“There’s almost nothing, other than transplants, that we do not do here,” Rah said. “We want to keep Montanans in Montana and while still providing them some of the best care in the world.”

Critical to the Billings Clinic heart program is the cardiothoracic surgery team. Working in tandem with cardiologists and other team members, they perform a wide range of heart procedures and open heart surgeries including coronary artery bypass graft surgery, valve replacement, aortic aneurysm repair, and repairing heart and vascular trauma.

Resources available through this team include a hybrid operating room for minimally invasive procedures, minimally invasive cardiac surgery, minimally invasive and robot thoracic surgery, a Multi-Disciplinary Thoracic Oncology Clinic and Low Dose CT screening program, ECMO, Wound Care and Vein treatment center.

“Really, the only other places that do all of this for patients in Montana and Wyoming are university hospitals outside of the state,” said Dr. Sasha Kraev, department chair of cardiac, thoracic and vascular surgery.

As an example of the kind of services provided by Billings Clinic, Dr. Kraev recently performed the highly specialized, first-of-its-kind VATS epicardial LV lead placement procedure. When pacemaker electrodes cannot be placed into the heart in the standard method, surgically placing them on the outside of the heart surgically becomes the only option. Kraev’s work is the first time this has been done with a camera in a minimally invasive manner.

With Billings Clinic Heart and Vascular at Community Medical Center in Missoula, cardiology services at Cody Regional Health in Cody, Wy., and outreach clinics throughout Montana and Wyoming, the heart team provides care to patients where they are throughout the region.

The complete spectrum of services and commitment to quality and innovative care has recently earned Billings Clinic’s heart program a number of awards from the American Heart Association in 2020. These include:

· Mission: Lifeline STEMI Receiving Center Gold Quality Achievement Award: Signifying Billings Clinic’s commitment to guideline adherence and quality improvement for the STEMI (heart attack) patient population. Achieving Mission: Lifeline Recognition shows a commitment to high quality systems of care amongst STEMI Receiving Centers, STEMI Referring Hospitals, 911 EMS Agencies, Interfacility Transport Agencies and other supporting system participants through collaborative efforts, including quality improvement priorities outside the doors of your own facility.

· Get With The Guidelines - Heart Failure Silver Plus Quality Achievement Award: Recognizing Billings Clinic’s commitment and success in implementing a high standard of heart failure care by ensuring that their heart failure patients receive treatment that meets nationally accepted, evidence-based standards and recommendations.

For more information on any of the heart programs at Billings Clinic, visit or call (406) 238-2000.