Cardiothoracic Surgery
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Cardiothoracic Surgery

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Cardiothoracic Surgery Document Transcript

  • 1. The Section’s experience and expertise continues to grow in minimally invasive cardiac and thoracic surgery, including robotic-assisted surgery and minimally invasive treatment for atrial fibrillation, lung cancer and other disorders.The increased referral of patients from throughout the country for the spe- cialized care offered at the University of Cincinnati has resulted Walter H. Merrill, MD in the ongoing growth in clinical programs involved in treating John B. Flege, Jr. Professor tumors of the mediastinum, minimally invasive removal of lung tumors, and specialized treatment of heart disease. Chief, Section of Cardiothoracic Surgery Collaborative relationships with the Division of Pediatric Walter.Merrill@uc.edu Cardiothoracic Surgery at Cincinnati Children’s Hospital 513.584.3278 Medical Center and the Divisions of Cardiology, Pulmonary Medicine, and Oncology of the Department of Internal Medicine offer both young and adult patients a multidisci- plinary approach to cardiac and thoracic disease.The Section of In 2004 the ACGME granted accreditation for a residency train-Cardiothoracic Surgery ing program in cardiothoracic surgery. The first resident in the program, Dr. John Mehall, began his training on July 1, 2004. Dr. Mehall was elected President of the Thoracic SurgeryThe Section of Cardiothoracic Surgery, comprising the Division Residents Association (TSRA) and was a director for the TSRA-of Cardiac Surgery and the Division of Thoracic Surgery, contin- sponsored Resident Cardiothoracic Technology Symposiumues on the forefront of advances in the treatment of patients which has been held each spring since 2006 at the Universitywith cardiothoracic diseases, including the application of mini- of Cincinnati (see the website at www.ctsymposium.org).mally invasive techniques for cardiac and thoracic disorders Dr. Mehall completed his training in cardiothoracic surgerysuch as atrial fibrillation and lung cancers. June 30, 2007. Our second cardiothoracic surgery resident, Dr. Jeffrey Garrett, has recently completed his training. Our current residents are Dr. Julian Guitron and Dr. Lynn Huffman. The Section of Cardiothoracic Surgery | Page 58
  • 2. The residency training program provides three continuousyears of clinical training in cardiothoracic surgery, with onenew resident starting each year. Residents rotate on adultcardiac surgery at University Hospital and at the GoodSamaritan Hospital, on general thoracic surgery atUniversity Hospital, and on pediatric cardiac surgery atCincinnati Children’s Hospital Medical Center.The Division ofCardiac SurgeryThe Division of Cardiac Surgery leads the region in thediscovery and advancement of innovative treatment forpatients with cardiac disease. Programs in robotic-assistedand minimally invasive surgical techniques, as well as thedevelopment and application of bio-tech advances such asthe growth of new blood vessels, have made the cardiac conducted by Harvard confirm improved patient care,program at the University of Cincinnati a state-of-the-art outcomes and satisfaction.referral center for both standard and complex cases. As part of the collaborative effort, the CICU nurses have collaborated with the diabetes specialists at UniversityPatient Care Hospital and with the cardiac anesthesiologists to develop patient care protocols that are aimed at controlling bloodClinical services are performed at University Hospital, the glucose levels in patients undergoing cardiac surgicalVeterans Affairs Medical Center, and the Cincinnati procedures. This multidisciplinary team approach has ledChildren’s Hospital Medical Center. The Division performs a to improvement in blood glucose values, and there iswide variety of operative procedures in patients with evidence to suggest that this will lead to better overallcardiac and vascular diseases, including off-pump coronary outcomes and especially a lowered risk of infection. Anrevascularization, modified MAZE procedure for atrial fibril- outgrowth of the effort to control blood glucose levelslation without the need for a sternal incision, left ventricu- perioperatively has been an increased focus on postopera-lar assist device (LVAD) insertion, as well as all-arterial tive follow-up and care of diabetic patients once they leavemyocardial revascularization and mitral valve repair. The the hospital.Division is alone in the Tristate in offering chronic long-term LVAD support for heart failure, and it serves as a hubcenter for referral of patients requiring specialized cardiac Educationcare. An additional focus is the treatment of adults withcongenital heart disease. PGY-1 residents and mid-level residents are offered one- and two-month rotations, respectively, on the service.ThirdSurgeons and physicians at the UC Heart & Vascular Center year medical students rotate on the service as part of theircontinue their innovative treatment of heart patients surgery clerkship, and a month-long clerkship is offered towith a growth factor protein (FGF1) in an attempt to grow 4th-year medical students.new myocardial blood vessels (angiogenesis). The proce-dure involves injecting the growth factor directly into the Members of the Division actively collaborate with col-heart to trigger new blood vessel growth to increase blood leagues in adult cardiology and pediatric cardiac surgeryflow around blocked arteries and to relieve the chest pain and offer a broad array of educational conferences andassociated with coronary artery disease. The UC Heart & laboratory research opportunities. Dr. Peter Manning andVascular Center is one of a small number of U.S. medical his colleagues from Cincinnati Children’s Hospital Medicalcenters involved in an early-stage clinical trial to test Center teach pediatric cardiothoracic surgery to residentsmyocardial injection of FGF1 as a method to relieve chest both at that institution and at the University of Cincinnatipain. College of Medicine.The collaborative rounds program established in 2005 All the faculty participate in weekly cardiothoracic teach-continues to be highly successful in raising the standard of ing conferences, cardiac catheterization conference, andpatient care in the cardiac intensive care unit at University roundtable discussions with the residents.Hospital.The collaborative round brings together everyoneinvolved in the treatment and recovery of heart surgery The mandatory reduction in resident work-hours led to thepatients including the patient, surgeons, nurses, pharma- recruitment of physician assistants to reduce the clinicalcists, nutritionists, rehabilitation providers, social workers, workload of faculty and residents, allowing additional timeclergy, and family in one place at the same time. Studies for research and other academic pursuits. The Division of Cardiac Surgery | Page 59
  • 3. physicians and nurse practitioners, with a focus on high- lighting heart and vascular health and describing new technology and therapies to treat various heart and vascu- lar conditions. The Division of Pediatric Cardiothoracic Surgery The Division of Pediatric Cardiothoracic Surgery is dedicat- ed to the surgical care of children with cardiac problems. Based at Cincinnati Children’s Hospital Medical Center (CCHMC), the Division has formed a strong collaborative relationship with the Section of Cardiothoracic Surgery. As an integrated component of The Heart Institute, a multi- disciplinary business unit within CCHMC, the Division has enjoyed a continually higher profile nationally as a leader in the management of cardiac problems in children. TheThe Section of Cardiothoracic Surgery and the University clinical programs of the Division continue to provideof Cincinnati College of Medicine offer a course called excellent care, with morbidity and mortality rates rivaling“Summer Surgery Experience at UC.”This two-week immer- any program nationwide.sion program teaches undergraduates from variouscolleges the art and science of surgery. Participants are Members of the Division of Cardiothoracic Surgery func-exposed to cardiac anatomy and physiology, learning tion as key faculty of the Pediatric Cardiology and Pediatriccardiac diagnostic techniques, receiving hands-on experi- Critical Care fellowship training programs at CCHMC. Closeence in the clinical skills lab, learning about the DaVinci interaction with these fellows occurs on a daily basis,robot, and shadowing in the operating room. The students primarily in the Cardiac Intensive Care Unit, in addition to aalso perform library research on several clinical cases and number of weekly teaching conferences in which the facul-give a presentation at the close of the program. John Flege ty participates. The Division serves as one of the primaryJr., MD, serves as director of the program. rotations of the Cardiothoracic Surgery training program based at UC. The clinical programs in The Division of PediatricResearch Cardiothoracic Surgery focus on surgical management ofDavid Melvin, MD, PhD, continues to apply his advanced cardiac problems from birth through adolescence. Thetraining in Biomedical Engineering to discover break- Division also has become more involved in the Fetalthroughs in ventricular performance and its enhancement Cardiology program, participating in prenatal counselingand support with various mechanical techniques. Dr. of families with children with congenital heart defects. TheMelvin was chosen to serve on UC’s Intellectual Property focus is on complete correction of cardiac defects in theCommittee which will provide advice to the vice president newborn, management of complex single ventricle cardiacfor research in numerous areas related to intellectual prop- anomalies, and techniques to limit transfusion exposures.erty and the administration of the university’s patent andcopyright policies.Community ConnectionsDr. Flege continues as the Associate Editor of the journalINNOVATIONS in Cardiothoracic Surgery, which is the officialjournal of the International Society for Minimally InvasiveCardiac Surgery.Dr. Merrill continues as chair of the Society of ThoracicSurgeons Workforce on Graduate Medical Education andResident Issues. He also serves as a member of the JointCouncil on Thoracic Surgical Education, and he was recent-ly appointed to the Residency Review Committee forThoracic Surgery.The UC Heart & Vascular Center hosted a number of freeeducational lecture series for the lay public and for local The Division of Cardiac Surgery | Page 60
  • 4. The program has the capability of performing all levelsof open and closed heart operations, including cardiactransplantation and the ability to perform ECMO support.The annual review of state-wide data for pediatric cardiacprograms recently revealed that Cincinnati Children’sHospital continues to perform the highest volume of new-born open heart procedures in Ohio.Research continues to be actively pursued in the Divisionof Pediatric Cardiothoracic Surgery. Dr. Duffy’s research labhas focused on mechanisms underlying reperfusion andreoxygenation injury in the immature cardiopulmonarysystem. Dr. Eghtesady’s lab has been productive and con-tinues research in the field of experimental fetal open-heart surgery in order to correct congenital malformationsin the womb. Research on fetal cardiopulmonary bypasswas accepted for oral presentation at four prestigious inter-national meetings this year and included presentation ofthe first ever successful fetal intracardiac surgery while oncardiopulmonary bypass support.The lab also continues its Faculty - Division of Pediatriccollaborative efforts with Professor Kenneth Clark from the Cardiothoracic SurgeryUC Department of Obstetrics and Gynecology. Peter B. Manning, MD, FACS Professor of Clinical SurgeryFaculty Director, Pediatric Cardiothoracic SurgeryWalter H. Merrill, MD, FACS Dr. Manning specializes in complete correction of newbornJohn B. Flege, Jr. Professor cardiac diseases and blood conservation in cardiac surgery.Chief, Section of Cardiothoracic Surgery He is certified by the American Board of Surgery (General Surgery, Pediatric Surgery, and Surgical Critical Care) andDr. Merrill specializes in adult heart surgery and congenital the American Board of Thoracic Surgery.heart disease in adults. He is certified by the AmericanBoard of Surgery and the American Board of Thoracic Pirooz Eghtesady, MD, PhDSurgery. Assistant Professor of SurgeryJohn B. Flege, Jr, MD, FACS Dr. Eghtesady specializes in congenital heart surgery andProfessor of Surgery fetal heart surgery. He is certified by the American Board of Surgery and the American Board of Thoracic Surgery.Dr. Flege specializes in adult heart surgery. He is certified bythe American Board of Surgery and the American Board of Jodie Y. Duffy, PhDThoracic Surgery. Associate Professor of Surgery and PediatricsDwight E. Hand, MD, PhD Dr. Duffy’s research is focused on the cellular and molecularAssistant Professor of Surgery pathways that regulate reoxygenation and reperfusion injury in the immature cardiopulmonary system.Dr. Hand specializes in adult heart surgery, including mini-mally invasive approaches and robotic-assisted cardiac Further information on the Division of Cardiac Surgery cansurgery. He is certified by the American Board of Thoracic be viewed on our website http://surgery.uc.edu.Surgery.David B. Melvin, MD, PhDAssociate Professor of SurgeryProfessor of Biomedical EngineeringDr. Melvin specializes in heart transplantation and mechan-ical support of the failing heart. He is certified by theAmerican Board of Surgery and the American Board ofThoracic Surgery. The Division of Cardiac Surgery | Page 61