News

Surgery resident Mansi Shah, M.D., wins scholarship from Women in Thoracic Surgery

Surgery resident Mansi Shah, M.D., wins scholarship from Women in Thoracic Surgery click to enlarge Mansi Shah, M.D.

Dec. 17, 2014

Mansi Shah, M.D., a resident in general surgery at UNC, this week won a scholarship from Women in Thoracic Surgery.

The scholarship covers meeting registration fees, lodging and up to $500 in travel expenses so that the winner can attend the annual Society of Thoracic Surgeons (STS) meeting, which will take place in San Diego, CA, Jan. 25-28, 2015. The WTS Scholarship Program is open to female medical students, general surgery residents and thoracic surgery residents who are interested in a career in cardiothoracic surgery.

Dr. Shah, a graduate of Boston University School of Medicine, is in her fourth program year and is working in the lab of UNC pediatric surgeon Sean McLean, M.D. Dr. Shah is investigating the mechanism behind pulmonary hypertension in congenital diaphragmatic hernia. She is interested in both pediatric surgery and thoracic surgery and is looking forward to finding out more about the field of thoracic surgery at the STS meeting. She has worked with mentors in the UNC Division of Cardiothoracic Surgery as well as the Division of Pediatric Surgery.

UNC TAVR program successfully performs its first valve procedure

UNC TAVR program successfully performs its first valve procedure click to enlarge Thomas Caranasos, MD, Michael Yeung, MD, and John Vavalle, MD, perform the first TAVR procedure at UNC.

Dec. 15, 2014

In November 2014, James Aspell of Durham became the first patient at UNC to receive a new heart valve using transcatheter aortic valve replacement, or TAVR.

TAVR is a new technology that provides minimally-invasive aortic valve replacement for many patients who previously had no other options or were at high risk for conventional open heart surgery.

Read more about Aspell's procedure here, in an article by Laura Melega of UNC's Center for Heart and Vascular Care.

Medical directors of UNC's TAVR program are Thomas G. Caranasos, MD, assistant professor in the UNC Division of Cardiothoracic Surgery; and John P. Vavalle, MD, and Michael Yeung, MD, both assistant professors of medicine in the UNC Division of Cardiology. Cassie Ramm, RN, is nurse coordinator for the TAVR program. For more information, email unctavr@unchealth.unc.edu or call 1-800-806-1968

Dr. Nelson wins STSA award for paper on Ross Procedure outcomes

Dr. Nelson wins STSA award for paper on Ross Procedure outcomes click to enlarge Jennifer S. Nelson, M.D., left, with STSA President Richard Prager, M.D.

A study by Jennifer S. Nelson, M.D., of outcomes of children who had the Ross Procedure for aortic valve replacement received the Congenital Heart Surgery President’s Award during the annual meeting of the Southern Thoracic Surgical Association,  Nov. 5-8, 2014, in Tucson, AZ.

The paper, “Long-term outcomes after the Ross Procedure in children vary by age at operation,” was the result of the largest single-center study of the Ross operation in children to date and was done in collaboration with the University of Michigan's Congenital Heart Center. The study described outcomes in children ranging from newborns to 18-year-olds. The manuscript is expected to be published in the Annals of Thoracic Surgery in 2015. In the Ross Procedure, a patient's diseased aortic valve is replaced with the patient's own pulmonary valve; the pulmonary valve is then replaced with a donor valve.

The STSA Congenital Heart Surgery President’s Award was established in 2013 to recognize the best congenital surgery scientific paper delivered at the STSA annual meeting. The award is given on the basis of originality, content and presentation.

Dr. Nelson is an assistant professor in the UNC Division of Cardiothoracic Surgery and co-director of the UNC ECMO program. She specializes in congenital cardiac surgery and is a founder of the UNC Children's Heart Collaborative, a multidisciplinary research group that focuses on congenital heart disease.

Dr. Mill was "heaven sent": 3 years after heart transplant, Clayton girl is doing well

Dr. Mill was "heaven sent": 3 years after heart transplant, Clayton girl is doing well click to enlarge Samiya Hicks, now 4, practices ballet.
Dr. Mill was "heaven sent": 3 years after heart transplant, Clayton girl is doing well click to enlarge One year after her transplant surgery, Samiya and her mom participated in the radiothon that raises money for the NC Children's Hospital.

Nov. 25, 2014

Born with a congenital heart defect, Samiya Hicks was diagnosed with congestive heart failure at just 4 months old. Her only hope of survival: a heart transplant. She got the transplant when she was 1 and now is a happy 4-year-old who, back home in Clayton, N.C., loves to play and dance. Samiya's parents are grateful to all the doctors, nurses and other people who took care of Samiya at UNC.  Her heart surgeon was Michael R. Mill, M.D. , of the UNC Division of Cardiothoracic Surgery. Dr. Mill, Samiya's mother said, was "heaven sent" - she was impressed with his kindness to her family as well as his surgical skills.

To read more about Samiya, click here; the story is from the NC Children's Hospital newsletter, CARE.

 

 

Starek Visiting Professorship will honor distinguished cardiac surgeon

Starek Visiting Professorship will honor distinguished cardiac surgeon click to enlarge Peter J.K. Starek, M.D.

Nov. 24, 2014

Peter J.K. Starek, M.D., was a valuable member of the faculty of the UNC Division of Cardiothoracic Surgery from 1971 until his retirement in 2002. He has been an international leader and researcher in the field of valve replacement and repair. At UNC, he was a tireless educator and dependable colleague.

To honor Dr. Starek and his contribution to cardiothoracic surgery, the division is creating the Peter J.K. Starek, MD Visiting Professorship in Cardiothoracic Surgery. The Starek Visiting Professorship will be an annual invited lecture to be delivered by graduates of the UNC Cardiothoracic Surgery residency training program.

Read more here about the visiting professorship and how to donate to support it.

Dr. Kiser speaks at EACTS on new aortic valve replacement procedure

Nov. 18, 2014

Andy C. Kiser, M.D., chief of the UNC Division of Cardiothoracic Surgery, spoke at the recent meeting of the European Association for Cardio-Thoracic Surgery (EACTS) on a suprasternal direct approach TAVR procedure that he developed.  TAVR is transcatheter aortic valve replacement, a less invasive procedure for valve replacement that is aimed at people who are too frail to undergo traditional aortic valve surgery. 

The EACTS meeting was Oct. 11-15, 2014, in Milan, Italy.

The Suprasternal Aortic Access System (SuprAA System, Aegis Surgical Ltd, Dublin, Ireland) is a new minimally invasive approach for replacing the aortic valves of high-risk patients with aortic stenosis. The SuprAA device described at EACTS allows direct access to the aorta and innominate artery without sternal or thoracotomy incisions. It allows direct and precise deployment into the aorta of a transcatheter aortic valve and allows use of large sheaths for delivery of the valve.

Watch an EACTS interview with Dr. Kiser and co-investigator Michael Reardon, M.D., chief of cardiac surgery at Houston Methodist Hospital and professor of surgery at Baylor University. (If the video is not showing on the linked page, go to http://www.eacts.org/annual-meeting/video-highlights-28th-annual-meeting/  and look under Video Highlights for "Acquired cardiac disease" and "Late breaker: Suprasternal approach TAVR FIM.")

UNC's ventricular assist device (VAD) program grew in 2013-14

UNC's ventricular assist device (VAD) program had tremendous growth in 2013-2014. Ventricular assist devices (VAD) are mechanical devices implanted in open heart surgery to provide increased blood flow for heart failure patients, greatly improving their quality of life and survival. The devices may be used as a bridge to heart transplant, or as a destination therapy for patients who are not medically eligible for heart transplant.

The number of VAD devices implanted into UNC patients grew by 206% during the 2013-2014 fiscal year.  Of the 72 mechanical circulatory support devices implanted, 40 were for durable (home) support, including destination therapy and as a bridge to heart transplant.  Thirty-two of the mechanical circulatory support devices were for temporary in-hospital support, with 24 patients receiving extracorporeal membrane oxygenation (ECMO) as well.

Drs. Andy Kiser and Brett Sheridan of the UNC Division of Cardiothoracic Surgery implant VADs.

Read more here, in an article by Laura Melega of the UNC Center for Heart and Vascular Care,

Transcatheter aortic valve replacement (TAVR) is now available at UNC

Transcatheter aortic valve replacement (TAVR) is now available at UNC click to enlarge During a Transcatheter Aortic Valve Replacement (TAVR) procedure, the patient's aortic valve is replaced using a minimally-invasive approach which doesn't require open heart surgery. Image by Edwards Lifesciences, Irvine, CA.

UNC has begun a program to offer transcatheter aortic valve replacement (TAVR) to patients who are too frail or ill to undergo open heart surgery. With TAVR, a new technology, physicians replace the aortic valve via minimally-invasive approaches, including percutaneous procedures (intervention without an incision), which provide outcomes that are as good, or sometimes better than, surgical valve replacement.

The TAVR procedure is well-suited for an academic medical center with a collaborative approach to patient care.  The UNC Center for Heart & Vascular Care is a team of specialists from cardiac surgery, cardiology, interventional radiology and vascular surgery, provides comprehensive and well-coordinated patient care.

Thomas Caranasos, MD, of the UNC Division of Cardiothoracic Surgery, is one of the TAVR program’s medical directors. “We are going to be at the forefront of not just using the technology but developing and advancing the technology,” he said.

John P. Vavalle, MD, and Michael Yeung, MD, of the UNC Division of Cardiology, are the other medical directors. , RN, BSN, is the TAVR program coordinator.

To refer a patient or for more information, email unctavr@unchealth.unc.edu or call 1-800-806-1968.

Read more here, in an article by Laura Melega of the UNC Center for Heart and Vascular Care.

Dr. Long is guest on "Your Health" radio program

Dr. Long is guest on "Your Health" radio program click to enlarge Jason Long, M.D., M.P.H.

Jason Long, M.D., M.P.H., assistant professor of surgery in UNC’s Division of Cardiothoracic Surgery, will be the guest on the "Your Health" radio program - he will discuss "Heart and Lung Surgery: Past, Present and Future."

Please tune in! The show airs on these stations:

WCHL - 97.9 FM
• Saturday, Sept. 27, 9 a.m.
• Sunday, Sept. 28, 9 a.m. and 5 p.m.
• Monday, Sept. 29, 6 p.m. and 10 p.m.
WBNE - 103.7 FM
• Saturday, Sept. 27, 3 p.m.
KKAG Retro Radio -  88.7 FM
• Sunday, Sept. 28, 7 a.m.

Dr. Caranasos, a heart surgeon and TAVR specialist, joins UNC faculty

Dr. Caranasos, a heart surgeon and TAVR specialist, joins UNC faculty click to enlarge Thomas G. Caranasos, M.D.

 We welcome Thomas G. Caranasos M.D., who joined the UNC Division of Cardiothoracic Surgery in July 2014 as assistant professor of surgery.

Dr. Caranasos, a heart and lung surgeon who specializes in adult cardiac surgery, has a special interest in aortic surgery, including the ascending aorta, arch pathology, thoracic aorta and aortic root; transcatheter aortic valve surgery; mitral and aortic valvular surgery; minimally invasive approaches to cardiac surgery; and video assisted thoracic surgery.

“I am passionate about the field of cardiac surgery because it allows me to offer treatment options to patients who often have a debilitating disease and treatment allows them to get back to enjoying life,” Dr. Caranasos said. “I also get to make a wonderful connection to the patient and family as they recover.”

Dr. Caranasos also serves as a director of the new Transcatheter Aortic Valve Replacement (TAVR)  Program at UNC.  John Vavalle, M.D. and Michael Yeung, M.D. of  the UNC Division of Cardiology are also working on the program. 

TAVR is a new technology that provides a treatment option for many patients who are too frail to undergo open heart surgery for aortic valve stenosis.  With TAVR, physicians provide aortic valve replacement via minimally-invasive approaches, including percutaneous procedures (intervention without an incision), which provide outcomes that are as good as surgical valve replacement. 

The TAVR Program is ideally suited for UNC, an academic medical center with a collaborative approach to patient care.  The UNC Center for Heart & Vascular Care joins physicians from cardiac surgery, cardiology, interventional radiology, and vascular surgery who collaborate on patients’ care. 

 “I am excited to be a part of the transcatheter valve program at UNC.  It is great to be able to offer patients in the region a cutting-edge technology that will treat their disease if they are too high-risk to undergo surgery,” said Dr. Caranasos. “I am also excited to be a part of this multidisciplinary team approach to treatment and having UNC be a leader in developing new technologies for treatment.”

Dr. Caranasos, a native of Gainesville, FL, completed a cardiothoracic surgery fellowship at the University of Florida in June 2014.  He completed his general surgery residency at West Virginia University.  He also earned M.D. and B.A. degrees from West Virginia University.

For appointments with Dr. Caranasos, call 919-966-3382 or 919-843-4614.

Laura Melega, UNC Center for Heart and Vascular Care

Cardiac surgery, cardiology at UNC are ranked "high performing" by U.S. News and World Report

The cardiac surgery and cardiology specialties at UNC Hospitals were recently ranked as "high performing" by U.S. News & World Report in its annual "America's Best Hospitals" issue. That means they are among the top 25 percent of hospitals in their specialty nationally in data compiled by U.S. News & World Report. Read more here in a story from the UNC Health Care newsroom.

Cardiac intensive care unit at UNC Hospitals celebrates five straight years of no ventilator-associated pneumonia

The Cardiac Intensive Care Unit (CICU) at UNC Hospitals recently celebrated its fifth straight year of having no cases of ventilator-associated pneumonia (VAP).

Widespread use of mechanical ventilation puts the CICU's critically ill patients at a particularly high risk for developing VAP. In 2008, the CICU began new practices to help reduce cases of VAP and keep their patients safe. CICU staff knew that cases of VAP would be reduced through the changes they implemented. But last year the CICU celebrated four consecutive years without a VAP -- an accomplishment unheard of among CICUs nationwide -- and this year the CICU reached its fifth year of being VAP-free.

Read more here in a story from the UNC Health Care newsroom.

May-June 2014 newsletter from the UNC Division of Cardiothoracic Surgery

Read the division's May-June 2014 newsletter here.  (PDF)

April 2014 newsletter from the UNC Division of Cardiothoracic Surgery

Read the division's April 2014 newsletter here (PDF).

Construction of UNC Health Care's Rex heart tower to begin this fall

Rex Healthcare plans to start construction of its new heart tower this fall. The 115-bed hospital, owned by UNC Health Care, will be home to North Carolina Heart & Vascular. Read more here in a March 31, 2014, story from The News & Observer.

Convergent Procedure fixes serious atrial fibrillation for UNC patient

Convergent Procedure fixes serious atrial fibrillation for UNC patient click to enlarge Craig Wilkins
Convergent Procedure fixes serious atrial fibrillation for UNC patient click to enlarge Andy Kiser and Paul Mounsey

About five years ago, Craig Wilkins was feeling tired and breathless and decided to see his family doctor in Cary, N.C., before going on a trip.

Craig was otherwise healthy and had no history of heart disease, but his doctor discovered he had atrial fibrillation, a condition that can cause the heart to race, sometimes beating hundreds of times in one minute. For some, atrial fibrillation is annoying but not life-threatening. For Craig, the condition had gone undetected for so long that he had developed congestive heart failure.

After several  attempts  to  regulate  the heartbeat  with  cardioversion  and with anti-arrhythmia medication, Craig's heart was still falling out of rhythm. His cardiologist referred him to Paul Mounsey, MD, director of electrophysiology at UNC Hospitals. Dr. Mounsey performed a cardiac ablation on Craig’s heart. In an ablation, doctors use radiofrequency to destroy the damaged heart tissue causing the atrial fibrillation. Ablations are often successful, but in Craig’s case, they were not. Dr. Mounsey then collaborated with Andy Kiser, M.D., chief of the UNC Division of Cardiothoracic Surgery, to perform the Convergent Procedure.

Traditionally, surgeons such as Dr. Kiser have created scar patterns to disrupt the circuitry that causes atrial fibrillation arrhythmia, while electrophysiologists such as  Dr. Mounsey have performed ablations. In the Convergent Procedure, developed by Dr. Kiser, an electrophysiologist and surgeon work together using miniature cameras, small catheters and electrodes to map out an individualized pattern that will work to reestablish normal rhythms in each patient.

Drs. Kiser and Mounsey have completed procedures on more than 100 patients since 2011. They have an 80 percent success rate, very high for complex arrhythmias.

Five years after Craig’s initial atrial fibrillation diagnosis and a year and a half after having the Convergent Procedure, he says his health is excellent. “I can’t believe how bad I used to feel,” says Craig. “I have energy and a desire to do things now.”

Read more here, in a story by Stephanie Soucheray-Grell from UNC Health Care's magazine, Well.

Womack Surgical Society calls for abstracts from residents and medical students

Womack

Residents and medical students at UNC are invited to submit abstracts for the annual meeting of the Nathan A. Womack Surgical Society, to be held at the University of North Carolina at Chapel Hill from May 1 to 3, 2014.  Abstract submissions will be accepted until Friday, April 4, 2014, at 11 p.m. EDT. Four submitted abstracts will be selected for presentation at the annual meeting on Friday, May 2. The George F. Sheldon Research Competition Award will be given for the most outstanding presentation. Abstracts may be on any medical research topic but are often related to surgery.

Please follow these instructions to submit an abstract:

Abstract Limit: There are no restrictions on the number of abstracts you may submit.

Character Limit: There is a limit of 250 words for 
the text of your abstract submission. Title, authors, institutions, tables, and images are not counted in the 250-word limit.

Tables and Images: You may add 1 table and 1 image to your submission.

Abstract Structure:  All abstracts must be structured with the following headings and content:

  • Objectives – A brief statement on the objectives of the study and the current state of 
research in the field. What limitation or problem does this study address?
  • Methods – The methods of study or experimental approach must be defined briefly.
  • Results – A summary of the study results, including sufficient details to support those 
conclusions. A brief table or image may be used.
  • Conclusions – A statement concerning the significance of the work and its implications 
for further research or clinical practice.

George F. Sheldon Research Competition Award

The award is named after the late George F. Sheldon, M.D.,  Zach D. Owens Distinguished Professor of Surgery.  Dr. Sheldon chaired the UNC Department of Surgery from 1984 to 2001 and served as president of the American College of Surgeons from 1998 to 1999.  This award will be awarded to the medical student or resident in training with the most outstanding presentation.  Selection will be based upon the quality of abstract as well as the oral presentation, as judged by a panel of visitors and UNC faculty.  The award includes $500 cash and recognition at the annual Womack Society reception on Friday evening, May 2.

Submission:  All abstracts must be submitted electronically to Andy Kiser, M.D., andy_kiser@med.unc.edu , by 11 p.m. EDT on April 4, 2014.  Questions may be directed to Dr. Kiser or to Debbie Alberti, debbie_alberti@med.unc.edu , at (919) 966-3391.

Read about the Nathan A. Womack Surgical Society here.

Dr. Feins joins with Dr. Alterovitz on project to develop robotic tentacle device that reaches far into lungs or head

Dr. Feins joins with Dr. Alterovitz on project to develop robotic tentacle device that reaches far into lungs or head click to enlarge Richard H. Feins, MD
Dr. Feins joins with Dr. Alterovitz on project to develop robotic tentacle device that reaches far into lungs or head click to enlarge Ron Alterovitz, PhD

Ron Alterovitz, PhD, assistant professor of computer science and head of the Computational Robotics Research Group in the UNC Department of Computer Science, has been investigating new algorithms that can enable robotic tentacles to achieve depth and precision inside the human body.

He has focused on a new surgical device – a robotic set of concentric nested tubes made of nickel titanium. The device can be deployed from the tip of a bronchoscope, allowing physicians to reach farther than ever into the lungs to diagnose abnormal growths. It can also be deployed via the nose to surgically access tumors in the brain or nearby structures in the head. The robotic device has the potential to move through the body so precisely that it can avoid anatomical obstacles and reach its target within a millimeter. Richard H. Feins, MD, of the UNC Division of Cardiothoracic Surgery, has been working with Dr. Alterovitz on the project. Brent Senior, MD, Nathaniel and Sheila Harris Distinguished Professor of Otolaryngology, is interested in Dr. Alterovitz's research for its potential to reach tiny areas of the head.

Read more about their collaboration here, in an article by Zach Read of the UNC Health Care News Team.

Young heart patient has faced tough road with grace, courage and optimism

Young heart patient has faced tough road with grace, courage and optimism click to enlarge Michael R. Mill, M.D.
Young heart patient has faced tough road with grace, courage and optimism click to enlarge Jennifer S. Nelson, M.D.

CourtneyCourtney, a 17-year-old cardiac patient, has been cared for by UNC doctors since she was a baby. She has been treated medically and surgically for her heart problems. Most recently, Michael R. Mill, M.D., repaired her mitral valve  in June 2013 and Jennifer S. Nelson, M.D., implanted  a left ventricular assist device (LVAD) when Courtney's heart was failing in August 2013. The LVAD, which is not often implanted in pediatric patients, will support her heart until she can receive a heart transplant.

Courtney's courage has impressed her doctors.

“The evening of her [LVAD] surgery, she woke up calmly, her breathing tube in place, and asked for a pen and paper,” Dr. Nelson said. “On that paper, the first thing she wrote was, 'Thank you. Courtney'. I still have a picture of that note. Every time I look at it, I am blown away by her bravery.”

In honor of Heart Month, read Courtney's story, from the N.C. Children's Hospital web site, here.

Dr. Kiser, Dr. Zidar talk about heart health on WRAL's "Rex On Call"

Dr. Kiser, Dr. Zidar talk about heart health on WRAL's "Rex On Call" click to enlarge Andy C. Kiser, M.D.
Dr. Kiser, Dr. Zidar talk about heart health on WRAL's "Rex On Call" click to enlarge James P. Zidar, M.D.

Andy Kiser, M.D., chief of the UNC Division of Cardiothoracic Surgery, and James Zidar, M.D., a cardiologist with North Carolina Heart and Vascular, talked about heart health on "Rex On Call" on WRAL TV on Monday, Feb. 17, 2014.

Watch the show here.