News

"The future of surgery training": At boot camp, residents learn thoracic surgery with simulators

Resident physicians learn from a faculty member at the TSDA boot camp.About 40 first-year thoracic surgery resident physicians Bronchoscopefrom around the United States learned heart and lung surgery skills at a "boot camp" last week at the University of North Carolina at Chapel Hill.

Much of the training was on simulators, which use pig hearts and lungs with mechanical circulation and ventilation. The simulators provide a lifelike setting for the residents to practice basic skills before they begin their training at their hospitals. Residents learn routine thoracic surgery techniques and how to deal with emergencies during surgery.

The boot camp, held July 27-29 at UNC's Friday Center, is sponsored by the Thoracic Surgery Directors Association (TSDA).  Richard Feins, M.D., of the UNC Division of Cardiothoracic Surgery, was a director of the camp. About 30 surgeons from other universities came to UNC to assist with the training.

Reporter Cliff Bellamy of The Herald-Sun wrote about the training in an article published Sunday, July 29, 2012. Read the Herald-Sun story here.

Use of simulators is an efficient and safe way to teach surgical skills. “We really believe this is the future of surgery training,” Feins told the Herald-Sun.

Watch a WRAL video about the training here.

Dr. Feins is principal investigator of an eight-institution study of simulator training for resident physicians as a way to improve patient safety. The study is funded by the Agency for Healthcare Research and Quality.

Read more about the surgery simulation training at UNC  here, in an article published in UNC's research magazine, Endeavors.

Dr. Stansfield joins UNC Cardiothoracic Surgery

Dr. Stansfield joins UNC Cardiothoracic Surgery
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William E. Stansfield, M.D.

William E. Stansfield, M.D., joined the UNC faculty on July 1 as assistant professor of surgery in the UNC Division of Cardiothoracic Surgery. Dr. Stansfield, who specializes in heart surgery for adults, practices as a cardiothoracic surgeon at UNC Hospitals.

Dr. Stansfield earned an M.D. from the medical school at McGill University in Montreal in 2002. He completed a General Surgery residency at UNC in 2009 and his Cardiothoracic Surgery residency at UNC in June 2012. He was a research fellow in the UNC Department of Surgery from 2005 to 2007, studying molecular mechanisms of left ventricular hypertrophy regression and myocardial ischemia-reperfusion injury.

Dr. Stansfield’s surgical interests are advanced therapy for heart failure, heart transplantation, mechanical circulatory support, aortic surgery, surgical treatment for aortic valve disease and mitral valve disease, and coronary artery bypass grafting (CABG). His research interests include heart failure, cardiac remodeling and structural heart disease.

Thoracic Surgery wins Outstanding Service Award

Thoracic Surgery won the 2012 Outstanding Service Award, presented  June 20 at a UNC Department of Surgery ceremony. UNC surgery interns vote each year to choose the winner of the  Outstanding Service Award, which is presented to the UNC Surgery service that best meets the following criteria: teaching on the part of the faculty, clinical opportunities and technical experience. Thoracic Surgery has won the award in seven of the past 12 years.

For a full list of awards presented at the department ceremony, click here.

Dr. Sell wins award

Dr. Sell wins award
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Kristen Sell, M.D.

Kristen Sell, M.D., a resident physician in the UNC Division of Cardiothoracic Surgery, won the 2012  junior level In-Service Award presented by the UNC Department of Surgery. The In-Service Awards, given each year by the department, recognize residents’ specific achievements on the A.B.S.I.T.E. exam (American Board of Surgery In-Training Examination). Dr. Sell was recognized as the junior level resident at UNC with the highest score on the exam and also as the resident who scored above the 90th percentile on the exam.

The A.B.S.I.T.E. exam gauges surgical residents’ knowledge in clinical and basic sciences. The test is intended to serve as an objective measure to determine competency for progression in the program.

Dr. Sell, who earned an M.D. from the University of Michigan, is about to begin the second year of a six-year cardiothoracic surgery residency at UNC.

TAVR heart valve procedure offers new options

TAVR heart valve procedure offers new options
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TAVR, in which a device is inserted to open the aortic valve, was approved by the FDA in late 2011.

Heart specialists at Rex Healthcare, part of UNC Health Care, are offering a new procedure to repair heart valves.

Trans-catheter Aortic Valve Replacement (TAVR) provides an option for people who are unable to undergo traditional valve replacement, which involves open heart surgery.

The aorta is the major blood vessel of the heart. Sometimes the opening of the aortic valve becomes too narrow - aortic stenosis, or aortic valve stenosis - and blood does not flow easily. When the opening is narrow, the heart has to pump harder to push blood throughout the body, and the patient can feel tired or dizzy.

Most patients who have aortic stenosis need to have the valve replaced. While traditional valve replacement surgery is still the best option for fixing the problem, some patients are too weak or sick to undergo open heart surgery. TAVR is a new option for these patients.

In TAVR, a minimally invasive procedure, a stent is threaded through a catheter into the valve to open the valve.

WRAL TV recently broadcast a report about the procedure. To see the WRAL report, click here.

To learn more about the procedure and the UNC Rex Healthcare Heart Valve Center, click here.

A new pool of lung donors

A new pool of lung donors
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Thomas M. Egan, M.D.

Tom Egan, a professor of surgery at UNC, has spent years researching a solution to the shortage of lungs for transplant. He is now studying lungs from a previously-untapped pool of donors - people who have died suddenly, away from the hospital. Use of these lungs could dramatically increase the number of lungs available for transplant and revolutinize standard transplant practice. The lungs to be studied will come from donors in Wake County, from a new collaboration with Wake County Emergency Medical Services, Carolina Donor Services (organ procurement organization), and UNC.  Dr. Egan's research is funded by a grant from the National Institutes of Health (National Heart, Lung, and Blood Institute).

Read Margarite Nathe's story in Endeavors, UNC's research magazine. Watch a video interview with lung transplant patient Joy Cook, a UNC graduate, here.

Egan receives grant for transplant research

Egan receives grant for transplant research
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Thomas M. Egan, M.D.

Thomas M. Egan, M.D., of the UNC Division of Cardiothoracic Surgery, has received a $100,000 grant from the Cystic Fibrosis Foundation for his project "Is there NO solution to IRI? Nitric oxide to improve and expand lung transplant."  The one-year project will explore whether ventilation of lungs after death with nitric oxide reduces ischemia-reperfusion injury (IRI) and results in sustained improvement in function of lungs after transplant.

Dr. Egan, a thoracic surgeon, is exploring whether lungs from non-heart-beating donors (NHBDs) - people who have died of sudden circulatory arrest, away from a hospital - can be used safely for transplant. Using NHBD lungs could increase the number and quality of lungs available for transplant.

Read more about Dr. Egan's research here.

NC teen is grateful for second double-lung transplant at UNC

Ashley McKnight, of Forsyth County, NC, was born with cystic fibrosis. She got new lungs in a double-lung transplant operation in 2009, when she was 14.

However, her body began rejecting the lungs and she went into respiratory failure. Last year, she was placed back on the waiting list for new lungs.  In January, she got the new lungs and she is now doing well.


Ashley is being helped by the Jason Ray Foundation, which has offered to pay for medical equipment that Ashley needs for therapy.

The foundation honors the memory of Jason Ray, a UNC student who was the Tar Heel mascot Rameses. Ray died after a hit-and-run accident while he was walking on a road near the Meadowlands arena in New Jersey during the 2007 NCAA basketball tournament. After his death, Ray's organs were donated. The foundation promotes organ donation.

Dr. Benjamin Haithcock was the surgeon for both of Ashley's lung transplants.

Read more here and here.  Read an ESPN story about Jason Ray here.

Dr. Haithcock discusses esophageal cancer

Dr. Haithcock discusses esophageal cancer
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Benjamin Haithcock, M.D.

Benjamin E. Haithcock, M.D. of the UNC Division of Cardiothoracic Surgery recently was interviewed about diagnosis and treatment of esophageal cancer. He was interviewed on the radio show "Make It Happen" on WAUG-AM.

Read more here. Listen to the interview here.

UNC/Rex Heart Valve Center to offer minimally-invasive aortic valve procedure

Rex Healthcare, part of UNC Health Care, plans to offer transcatheter aortic valve replacement (TAVR), a minimally-invasive procedure to treat patients with severe symptomatic aortic stenosis.

The procedure will be offered to older patients who are not well enough to undergo open-heart surgery for aortic valve replacement. The aorta is the main artery carrying blood out of the heart; blood flows from the heart through the aortic valve into the aorta.  In aortic stenosis, the aortic valve does not open fully, decreasing blood flow from the heart. TAVR is an alternative to open-chest surgery; the TAVR device and procedure have been studied extensively in the United States and have been used successfully in Europe since 2002.

During the TAVR procedure, doctors guide an artificial heart valve through a catheter that has been placed into the femoral artery, between the thigh and the heart. The technology was developed by Edwards Lifesciences.

Dr. Lance Landvater, co-medical director of Rex Cardiothoracic Surgery Specialists, is leading a team of cardiothoracic surgeons, interventional cardiologists, non-invasive cardiologists and other specialists to implant the device and establish a new UNC/Rex Heart Valve Center. The team also includes Dr. Andy Kiser, chief of the UNC Division of Cardiothoracic Surgery; Dr. Christian Gring, Dr. Matthew Hook and Dr. R. Lee Jobe of Wake Heart & Vascular; Dr. Timothy Gruebel of American Anesthesiology of North Carolina; and Dr. James Zidar, president of Rex Heart & Vascular Specialists.

The new heart valve center at Rex plans to perform the first TAVR procedure in May.

To learn more about the procedure, click here.

 

Two cardiothoracic surgeons affiliate with Rex and UNC

Two Raleigh cardiothoracic  surgeons have started a new practice affiliated with Rex Healthcare, part of the UNC Health Care system.  Lance E. Landvater, M.D., and Robert B. Peyton, M.D., are leading Rex Cardiothoracic Surgery Specialists and will be clinical associate professors in the Division of Cardiothoracic Surgery at the University of North Carolina at Chapel Hill.

 

Drs. Landvater and Peyton will work closely with Rex Heart & Vascular Specialists, Rex Heart & Vascular Services, Rex Thoracic Specialists and Rex Vascular Surgery Specialists, providing patients with a wide range of diagnostic tests, surgical procedures and other treatment on the main Rex campus.

 

Both doctors have practiced cardiothoracic surgery in Raleigh since the late 1980s, offering heart bypass surgery, valve replacements and other cardiac procedures.

 

Dr. Landvater is a graduate of Bowman Gray School of Medicine at Wake Forest University and completed his Surgery and Cardiothoracic Surgery residencies at George Washington University Medical Center in Washington, D.C.

 

Dr. Peyton is a graduate of the New York University School of Medicine and completed his Surgery and Cardiothoracic Surgery residences at Duke University Medical Center in Durham.

 

Their office is located at 2800 Blue Ridge Road, Suite 403, Raleigh, NC, 27607. Telephone: 919-784-7110.

Haithcock gets joint faculty appointment in Anesthesiology

Haithcock gets joint faculty appointment in Anesthesiology
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Benjamin E. Haithcock

Benjamin E. Haithcock, M.D., assistant professor in the UNC Division of Cardiothoracic Surgery, holds a joint appointment as assistant professor in the UNC Department of Anesthesiology as of Oct. 15, 2011. Dr. Haithcock also has been appointed assistant professor of surgery on the tenure track as of Oct. 15; since 2007, he had been clinical assistant professor of surgery. He also serves as associate program director for thoracic surgery in the UNC Division of Cardiothoracic Surgery as of September 2011 and as surgical director of the Lung Transplant Program at UNC Hospitals.

Veeramachaneni studies cancer care disparities

Veeramachaneni studies cancer care disparities
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Nirmal Veeramachaneni

Nirmal K. Veeramachaneni, M.D., a thoracic surgeon and assistant professor in the UNC Division of Cardiothoracic Surgery, is co-investigator on a UNC research project funded by the American Cancer Society, “Lung cancer surgery: Decisions against life saving care – the intervention." Samuel Cykert, M.D., is principal investigator on the ACS study, which focuses on an intervention to optimize surgical rates for early stage non-small cell lung cancer and reduce disparities in the care of African American patients with this disease.

Lung cancer is the leading cause of cancer death in the United States. The only reliable treatment is removing tumors when the disease is at an early stage, but patients – especially African Americans - do not always move forward with surgery.

The $1.8 million American Cancer Society grant funds the project from July 1, 2011, to June 30, 2016. To read more about the project, click here.

Sheridan reappointed as FDA consultant

 

Brett C. Sheridan, MD
Brett C. Sheridan

Brett C. Sheridan, M.D., a cardiac surgeon and associate professor in the UNC Division of Cardiothoracic Surgery, has been reappointed by the U.S. Food and Drug Administration as a consultant to the FDA’s Circulatory System Devices Panel. He will also serve as a consultant to other panels of the FDA’s Medical Devices Advisory Committee, and to its Center for Devices and Radiological Health.

As a consultant, Dr. Sheridan reviews and evaluates data on safety and effectiveness of marketed and investigational devices. He has served in this role since 2007, and was recently reappointed to serve until November 2015.

Residents from across the U.S. attend Cardiothoracic Surgery Boot Camp

The Thoracic Surgery Directors Association (TSDA) hosted its fourth annual Cardiothoracic Surgery Boot Camp, July 14-17, 2011, at UNC's Friday Center in Chapel Hill. First-year residents from 24 cardiothoracic surgery residency programs attended the camp to learn surgical techniques and get extensive hands-on practice.

The camp uses life-like simulators for surgical procedures. This year, procedures included cardiopulmonary bypass, aortic valve repair, anastomosis, lung ventilation, and lobectomy. Three UNC cardiothoracic surgeons - Richard Feins, M.D., Andy Kiser, M.D., and Nirmal Veeramachaneni, M.D., were among the faculty members. Read more here.

UNC lung transplant patient featured on NPR broadcast

UNC lung transplant patient featured on NPR broadcast
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Howell Graham

In a conversation broadcast on National Public Radio's "Story Corps" series, Howell Graham remembers getting a double lung transplant at UNC in 1990. He was the first cystic fibrosis patient to undergo a double lung transplant at UNC Hospitals. At that time, lung transplantation was still a very new procedure, but the surgery, performed by Thomas M. Egan, MD, of the UNC Division of Cardiothoracic Surgery, was a success: Graham is now believed to be the longest-surviving double-lung transplant patient in the world.

Read about and listen to the NPR broadcast here.  Read more about Graham here (Wilmington Star-News story) and here (article about Dr. Egan's research in Endeavors, UNC's research magazine).

Second chance for Jakeina: An active teen gets a 2nd heart transplant plus a new kidney

Second chance for Jakeina: An active teen gets a 2nd heart transplant plus a new kidney
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Members of the UNC Women's Volleyball Team visit Jakeina Sutton in her room at UNC Hospitals. Photo by Tom Hughes.

UNC heart surgeon  Andy Kiser, M.D., reflects on the remarkable story of one of his patients, Jakeina Sutton of Rose Hill, N.C., a 16-year-old who recently received a heart and kidney transplant. For Jakeina, this was her second heart transplant. Michael R. Mill, M.D., director of congenital cardiac surgery at UNC, performed her first heart transplant when Jakeina was only four months old. Read her story here.

Dr. Haithcock and Dr. Mill recognized as "Top Regional Doctors"

Congratulations to Dr. Benjamin E. Haithcock and Dr. Michael R. Mill of the UNC Division of Cardiothoracic Surgery, who  have been recognized as “top regional doctors” by Castle Connolly Medical Ltd. Thirty UNC Health Care physicians were on the list, which is based on recommendations of peers and evaluation by a national research panel that includes physicians.

Dr. Kiser is named chief of Cardiothoracic Surgery at UNC

Dr. Kiser is named chief of Cardiothoracic Surgery at UNC
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Andy C. Kiser, M.D.

Andy C. Kiser, M.D., has been named chief of the UNC Division of Cardiothoracic Surgery, effective July 1, 2011.

Dr. Kiser is a cardiothoracic surgeon who joined UNC as professor of surgery on Nov. 1, 2010. He is recognized as an international leader in arrhythmia surgery, having pioneered the paracardioscopic procedures to treat atrial fibrillation. He is a Fellow of the American College of Surgeons, American College of Cardiology, and the American College of Chest Physicians.

Dr. Kiser, a native of Moore County, N.C., earned his M.D. degree at UNC-Chapel Hill and completed his training in both General and Cardiothoracic Surgery at UNC, finishing in 2000. He practiced cardiac and thoracic surgery in Pinehurst until he joined the UNC faculty in November 2010. Since his return to UNC, Dr. Kiser has increased his clinical activity in minimally invasive cardiac and thoracic surgery, heart failure, and transplantation.

He replaces Michael R. Mill, M.D., who led the division as interim chief from 1998 to 1999 and as chief from 2000 to 2011.

Dr. Mill came to UNC in 1988 to be director of the UNC Heart and Heart-Lung Transplant programs. He performed both the first heart-lung transplant and the first pediatric heart-lung transplant in North Carolina. He has served as Director of the UNC Comprehensive Transplant Center since 1994 and has performed 150 heart transplants, including 50 pediatric heart transplants, here. He also started the mechanical cardiac assist device program at UNC. He specializes in pediatric cardiac surgery and will continue to serve as a faculty member and attending physician at UNC.

“The Department of Surgery especially appreciates the 13 years that Dr. Mill has provided strong leadership for the division, and his continued direction of the congenital heart surgery program,” said Anthony Meyer, chairman of the UNC Department of Surgery.

Dr. Mill has been active on regional and national levels with Carolina Donor Services, the United Network for Organ Sharing, the Society of Thoracic Surgeons, the Thoracic Surgery Directors Association, the American Association for Thoracic Surgery, the Congenital Heart Surgeons Society, and the Southern Thoracic Surgical Association. He helped the American Board of Thoracic Surgery develop the requirements for the first specialty certification in congenital cardiac surgery and in 2009 became one of the first physicians to earn that certification.

Dr. Mill was director of the UNC cardiothoracic surgery residency program during his time as chief. He served on the Residency Review Committee for Thoracic Surgery of the Accreditation Council for Graduate Medical Education, and participated in writing the requirements for the six-year integrated residency in cardiothoracic surgery, which enables medical-school graduates to enter a cardiothoracic residency straight from medical school and streamline their surgical training. (Previously, the path to becoming a cardiothoracic surgeon included about eight years of training after medical school.)

While Dr. Mill was chief, UNC added a six-year integrated residency in cardiothoracic surgery, which is now in its second year.

Dr. Mill earned an M.D. at the University of Colorado and did his residency in General Surgery there. He completed a residency in Thoracic Surgery and a fellowship in Heart and Heart-Lung Transplantation at Stanford University, where he trained with pioneering heart surgeon Norman Shumway.

Dr. Meyer said he would work with Dr. Kiser “to continue to further the goals of the Division of Cardiothoracic Surgery.” There are seven surgeons and six physician extenders in the division, which offers advanced treatments for a wide range of diseases and problems.

The division “is committed to caring for patients with complex cardiovascular problems such as aortic dissection, advanced heart failure, chronic atrial fibrillation, and lung or esophageal cancer,” Dr. Kiser said. “Collaboration is important, both within UNC Hospitals and statewide. Our vision is to develop more clinical partnerships with our colleagues.”

The division is part of the UNC Center for Heart and Vascular Care, which now has a one-call referral service (866-862-4327) to enable physicians to arrange consultations as well as admissions and transfers of patients to UNC Hospitals for care.

Bocanegra wins "Star Heels" award

Congratulations to Ruben Bocanegra, a physician's assistant in the UNC Division of Cardiothoracic Surgery, who received a UNC "Star Heels" award at the UNC Department of Surgery's Grand Rounds on June 8, 2011.

Bocanegra, a longtime employee of the division, assists cardiac surgeons in the operating room. He was complimented for being a technically superb surgeon, for having a phenomenal work ethic, and for being an excellent, knowledgeable and patient teacher of residents, nurses and medical students.

The Star Heels program allows university departments to recognize and award excellent employees. Winners receive a Visa gift card and a certificate.