VADs save lives of heart-failure patients

VADs save lives of heart-failure patients click to enlarge Brian Ainsley received a VAD before getting a new heart. (Photo from UNC Health Care)

UNC has become a leader in use of ventricular assist devices (VAD) to treat patients with heart failure. A VAD is a mechanical circulatory device that provides continuous blood flow, replacing the function of a failing heart. UNC heart surgeon Brett Sheridan, MD, says use of the devices has become more common as their size, reliability and function have improved.  Read about VADs and the experience of UNC patient Brian Ainsley in an article from UNC Health Care’s magazine, Well.

Lung transplant gives CF patient a new lease on life

Lung transplant gives CF patient a new lease on life click to enlarge Wesley Telsrow

A double-lung transplant gives a 22-year-old cystic fibrosis patient a new lease on life. For the first time in his young life, Wesley Telsrow can sleep lying down rather than sitting up and laugh without coughing. Nirmal Veeramachaneni, MD, was his transplant surgeon. Read more in a story written by Elizabeth Swaringen for UNC Health Care.





Drs. Feins and Mill are on Best Doctors in America list for 2011-2012

Congratulations to Dr. Richard H. Feins and Dr. Michael R. Mill of the UNC Division of Cardiothoracic Surgery, who are included in the latest compilation of The Best Doctors in America® database for 2011-2012. 

Dr. Feins specializes in lung and other chest surgery, including treatment of cancers.  Dr. Mill specializes in pediatric heart surgery.

Only 3 to 5 percent of physicians in each country where Best Doctors is present are included in its database. The Best Doctors database contains the names and professional affiliations of approximately 45,000 doctors in the United States, all chosen through an exhaustive peer-review survey that asks: “If you or a loved one needed a doctor in your specialty, to whom would you refer them?” The peer review process as well as additional research conducted by Best Doctors determines selections for each list.

More than 200 doctors at UNC made the latest list.

Lung transplant patient grateful for 2nd chance

Lung transplant patient grateful for 2nd chance click to enlarge Mary Scercy, facing camera, hugs a member of her lung donor's family.

A double-lung transplant at UNC in March 2010 gave Mary Scercy of Lincoln County, N.C., woman a second chance at life, allowing her to witness the birth of her first granddaughter, attend her son’s wedding and to meet the lung donor’s family on Nov. 5 to thank them face-to-face for their selfless generosity.

The transplant team also attended the reunion with the donor’s family. Such meetings between a donor's family and an organ recipient are rare, according to Carolina Donor Services, but after an exchange of letters, both families thought that meeting would help them heal.

“It’s difficult to find the words to describe the meeting,” said Dr. Benjamin Haithcock, surgical director of the UNC Lung Transplant Program, who was Scercy's surgeon. “What a gift to be able to meet and personally thank a family for an organ donation. It’s almost surreal, and it’s certainly been an amazing and unique experience for me.”

Read the story and see the video, part of the SECU Family House Diaries from UNC Health Care.

Project TICKER aims to improve care of pediatric heart patients

Pediatric congenital heart disease patients, a high‐risk group, receive care from many medical teams in a complex system of hospital units. UNC Hospitals provides excellent care of these patients, but is always looking for ways to improve.  A new research study aims to do just that.

Tina Schade Willis, MD, is principal investigator for Project TICKER (Teamwork to Improve Cardiac Kids' End Results), which is funded by a grant from the Agency for Healthcare Research and Quality (AHRQ). Pediatric heart surgeon Michael R. Mill, MD, and pediatric cardiologist Scott Buck, MD, are co-investigators. Karla Brown, RN, MSN, PNP, the nurse practitioner who cares for pediatric heart surgery patients at UNC, is an investigator.

The project will involve a partnership among hospital service units (pediatric intensive care, children's intermediate cardiac care, newborn critical care, and the operating room), ancillary support teams (nutrition, pharmacy, patient- and family-centered care specialists, chaplain), medical teams (cardiothoracic surgery, pediatric cardiac anesthesia, cardiology, pediatric critical care, neonatology) and pediatric congenital heart disease patients and their families.

The aims of Project TICKER are to implement a strong foundation of communication and teamwork for the general care of pediatric congenital heart disease patients using a tailored training program, TeamSTEPPS™ and to design and implement integrated clinical pathways (ICPs) for two of the most common congenital heart disease diagnoses using the specific teamwork tools of TeamSTEPPS and evidence‐based standardized care throughout the patient's entire hospital stay.

TeamSTEPPS is a teamwork training program for health care professionals developed by the Department of Defense and the Agency for Healthcare Research and Quality. All health-care personnel providing care to pediatric cardiac patients will receive training in TeamSTEPPS, and the project will measure teamwork performance using a validated teamwork observation tool.

Project TICKER is funded by a $574,523 grant from AHRQ. Read more about the project.

Heart surgeon Andy C. Kiser joins UNC

Heart surgeon Andy C. Kiser joins UNC click to enlarge Andy C. Kiser, M.D.

The UNC Division of Cardiothoracic Surgery and the UNC Center for Heart & Vascular Care welcome Andy C. Kiser, M.D., a cardiothoracic surgeon who joined UNC as professor of surgery on Nov. 1.

At UNC, Dr. Kiser joins Brett C. Sheridan, MD, in providing heart surgery for adults.  Michael R. Mill, MD, chief of the Division of Cardiothoracic Surgery, provides heart surgery for pediatric patients at UNC.

Dr. Kiser is recognized as an international leader in arrhythmia surgery, having pioneered the paracardioscopic procedures to treat atrial fibrillation. Dr. Kiser has an expertise in minimally invasive valve and coronary artery surgery, performing valve procedures using only a 3-inch incision. He also has extensive experience in the treatment of cancers and other disease processes that involve the lungs, the esophagus, and the chest wall.

Dr. Kiser, a native of Moore County, earned B.S. and M.D. degrees at The University of North Carolina at Chapel Hill and completed his training in both General and Cardiothoracic Surgery at UNC in 2000. He practiced cardiac and thoracic surgery in Pinehurst until he rejoined UNC this fall. He is a Fellow of the American College of Surgeons, the American College of Cardiology, and the American College of Chest Physicians.

For an appointment with Dr. Kiser, please call 919-966-3382.

Early UNC transplant patient celebrates 20 years with good lungs

Early UNC transplant patient celebrates 20 years with good lungs click to enlarge Howell Graham

Twenty years ago, Howell Graham became the first cystic fibrosis patient to undergo a double-lung transplant surgery at UNC Hospitals in Chapel Hill. Lung transplantation was then a very new procedure, but the operation, done by UNC cardiothoracic surgeon Thomas M. Egan, MD, was a success. Now, Graham is believed to be the longest-surviving double-lung transplant patient in the world. In an article about Graham that appeared in the Star-News of Wilmington, UNC thoracic surgeon Benjamin Haithcock comments on how lung transplantation has changed in 20 years. Graham hopes to raise awareness for organ donation and new lung transplant techniques developed by Egan.  Read the article here.

NPR report features Dr. Parsons

Dr. Alden Parsons, a Raleigh thoracic surgeon who completed a cardiothoracic surgery residency at UNC-Chapel Hill in 2009, was featured in a report on National Public Radio on Oct. 14, 2010, about the number of doctors who are working for hospitals instead of being in private practice. To hear the report ("Hospitals go Doctor Shopping to Help Bottom Line"), click here. To read the story on the NPR web site, click here.


Health Sciences Library names room for Dr. Wilcox

Health Sciences Library names room for Dr. Wilcox click to enlarge Dr. Wilcox in January 2010.

The UNC Health Sciences Library plans to rename its Historical Collections Reading Room as “The Benson Reid Wilcox Historical Collections Reading Room” in recognition of Dr. Benson Wilcox.

Dr. Wilcox, a heart surgeon and UNC School of Medicine graduate, served 29 years as chief of the UNC Division of Cardiothoracic Surgery. He died May 11, 2010, after a courageous battle with brain cancer. He had a longtime interest in medical history and rare books, and supported the Health Sciences Library by donating a large collection of rare medical books and supporting the library financially. He had been an active member of the library’s Board of Visitors since 1995.

The renaming was approved by the University of North Carolina at Chapel Hill (UNC-CH) Board of Trustees during their July 22, 2010 meeting. Read more here.


Lung transplant research leaps forward

An article in UNC's Endeavors magazine, a publication about discoveries and creativity at the university, highlights the research of Dr. Thomas Egan and his collaborators.
Lung transplant research leaps forward click to enlarge Dr. Egan and patient Joy Cook, who received a lung transplant in 2006, in her senior year at UNC. (Photo from Endeavors magazine)

They are now testing and perfecting a new technology that could drastically increase the number of lungs suitable for transplant. Egan thinks it could also help surgeons to draw from a new donor pool - people who have died outside the hospital and have not been on life support.

The article also features two of Dr. Egan's lung transplant patients.

To read the Endeavors article, click here.






Benson R. Wilcox, M.D., 1932-2010

Benson R. Wilcox, M.D., 1932-2010 click to enlarge Dr. Wilcox, January 2010.

Benson Reid Wilcox, M.D., a heart surgeon who served 29 years as chief of the Division of Cardiothoracic Surgery at the University of North Carolina at Chapel Hill, died May 11, 2010, at his home after a courageous battle with brain cancer. He was 77.

Dr. Wilcox served as chief of cardiothoracic surgery at UNC from 1969 to 1998. During that period, which was a time of dramatic advances in heart and lung surgery, the UNC hospital began offering coronary artery surgery, heart and lung transplantation, successful surgery for congenital heart defects in newborn infants, and a comprehensive program for the treatment of lung and esophageal cancer.

Dr. Wilcox was primarily a pediatric heart surgeon whose specialties were congenital heart disease, pediatric cardiac morphology, pediatric chest disease, and pulmonary circulation. He was a co-author of three books and an author of numerous medical journal articles and book chapters. He held important leadership posts in national medical organizations and was especially interested in the training of future surgeons.

Dr. Wilcox, known as Ben, was born May 26, 1932, in Charlotte, N.C., the son of James Simpson Wilcox and Louisa Reid Wilcox. He was raised in Charlotte and graduated from the Darlington School in Rome, Ga., in 1949. He was named 1997 Distinguished Alumnus of the Darlington School.

He earned an A.B. in history from the University of North Carolina in 1953 and an M.D. from the UNC School of Medicine in 1957. As an undergraduate at UNC, he was president of Sigma Alpha Epsilon fraternity and Rex of the Order of Gimghoul. At the UNC medical school, he was president of his class and was inducted into the Alpha Omega Alpha medical honor society in 1957.

While a medical student in 1956, Dr. Wilcox helped to conduct laboratory research on the application of newly developed heart-lung machines. A heart-lung machine was first used in the operating room at UNC in April 1957, beginning the era of open heart surgery at North Carolina Memorial Hospital.

After serving as a surgery resident at Barnes Hospital in St. Louis (1957-1959) and North Carolina Memorial Hospital in Chapel Hill (1959-1960), he spent two years as a surgical clinical associate at the National Heart Institute, part of the National Institutes of Health in Bethesda, Md. He then returned to UNC as chief resident in cardiovascular and thoracic surgery (1962-63) and as chief resident in surgery (1963-64).

He joined the UNC Department of Surgery faculty in 1964 and was appointed as chief of the Division of Cardiothoracic Surgery in 1969 and as a full professor in 1971. He was named a Markle Scholar in Academic Medicine in 1967. After he retired as chief of cardiothoracic surgery, Dr. Wilcox remained on the UNC medical school faculty as Professor of Surgery from 1998 until his death.

Dr. Wilcox served the university in a number of other capacities. He was a member of the Selection Committee for the North Carolina Fellows Program; the UNC Faculty Committee on Athletics, serving as chairman from 1977 to 1985; and the Morehead Foundation’s Central Selection Committee, serving as chairman from 1989 to 1992. He was on the university’s Faculty Council and other campus-wide committees. He was a member of the executive committee of the Atlantic Coast Conference from 1978 to 1982 and was its president from 1980 to 1981. He also served on the board of directors of the Ronald McDonald House in Chapel Hill from 1981 to 1999.

He held leadership positions in prestigious professional organizations, including chairman of the American Board of Thoracic Surgery, chairman of the Advisory Council for Cardiothoracic Surgery of the American College of Surgeons, president of the Nathan A. Womack Surgical Society, and president of The Society of Thoracic Surgeons, the largest society of thoracic surgeons in the world. He received the Distinguished Service Award from the Society of Thoracic Surgeons in 2003.

He had a strong interest in graduate medical education, the training of resident physicians. He was instrumental in establishing the Thoracic Surgery Directors Association (TSDA) which was formed to improve cardiothoracic surgery training and education for doctors, and whose members are directors of cardiothoracic surgery residency programs across the United States. From 1985 to 1987, he served as president of TSDA. In 2009, the TSDA honored him by establishing the Benson Wilcox Award for Best Resident Paper, to be presented each year at The Society of Thoracic Surgeons' annual meeting for the best scientific abstract submitted by a cardiothoracic surgery resident.

He also was on the Board of Directors of the National Resident Matching Program from 1998 to 2007, serving as president from 2001 to 2002. He was a member of the Accreditation Council for Graduate Medical Education’s Residency Review Committee for Thoracic Surgery (1999-2005); the American College of Surgeons’ Graduate Medical Education Committee (1993-2001); and a member of the Committee on Graduate Education for the American Association for Thoracic Surgery (1992-2001).

In 1980, Dr. Wilcox spent time during a sabbatical at Royal Brompton National Heart and Lung Hospital in London, beginning a collaboration with Robert H. Anderson, M.D., a pediatric morphologist at Royal Brompton. After that visit, he and Dr. Anderson worked together on many research projects and publications, including the book Surgical Anatomy of the Heart (Raven Press, 3rd edition, 2004). The two physicians established a program that for many years enabled UNC cardiothoracic surgery residents to spend time in London studying with Dr. Anderson and attending rounds with him. Dr. Anderson also visited UNC.

Dr. Wilcox also was co-author of Atlas of the Heart (Gower Medical Publishing, 1988); and a co-editor of Diagnostic Atlas of the Heart (Raven Press, 1994). He was an author of more than 100 scientific and clinical articles that were published in medical journals.

After operating on many ill children, Dr. Wilcox had the idea of starting a support group for families of children who are undergoing heart surgery. The Carolina Parent Network, begun in 1986 and directed by Maggie Morris for many years, enables parents of children who are facing heart surgery at UNC to talk to parents who have already had the experience, and it also educates families about what to expect before, during and after surgery.

Dr. Wilcox loved history, especially medical history. As a medical student at UNC, he helped found the Bullitt Club for the study of the history of medicine. As a faculty member, he began collecting old and rare books about the history of medicine, particularly books about thoracic surgery and the specialties that preceded it. In 1984, he began presenting a rare book to the UNC Health Sciences Library each year in honor of his chief resident. In 1998 and 1999, he donated most of his medical book collection to the library. Since then the Benson Reid Wilcox Collection has grown to more than 1,400 books, journals, reprints and other items. He served on the board of visitors for the UNC Health Sciences Library.

"Dr. Wilcox' contributions to the historical collections at the Health Sciences Library were truly remarkable in both variety and scope. An avid and erudite bibliophile, he thrilled in the hunt for significant texts, and had a deep appreciation for the role of history in the theory and practice of medicine," said Daniel Smith, special collections librarian for the UNC Health Sciences Library.

Dr. Wilcox is survived by his wife, Patsy Davis, and by his four children: Adelaide W. King and her husband, Ruffin, of Charlottesville, Va.; Sandra W. Conway and her husband, Peter, of Charlotte, N.C.; Melissa W. Bond and her husband, Brett, of Charlotte; and Reid Wilcox and his wife, Suzanne, of Greensboro, N.C. He is also survived by 11 grandchildren, Alexandra and Ruffin King; Peter, Ben and Adelaide Conway; Brett, Lucinda and Reid Bond; and Ben, Henry and Ellie Wilcox. He is also survived by two stepdaughters, Harriet Kendall and Julia Klein; a brother, Bob Wilcox; two sisters-in-law, Dede Thompson and Louise Wilcox, and a brother-in-law Allan Davis. He was predeceased by his parents and by his brother Jim Wilcox.

A memorial service was held Friday, May 14, in Gerrard Hall on the campus of the University of North Carolina at Chapel Hill.

In lieu of flowers, the family suggests memorial gifts to the TSDA Benson R. Wilcox Award. Checks can be made to the Thoracic Surgery Directors Association and mailed to Michael R. Mill, M.D., Division of Cardiothoracic Surgery, CB#7065, UNC-CH, Chapel Hill, NC, 27599-7065.



Cardiothoracic surgery simulators

The Center for Cardiothoracic Simulation at the University of North Carolina at Chapel Hill has developed two simulators which allow for a full operative experience with cardiac surgery and with lung surgery (both open and thoracoscopic) without the use of live animals.
Cardiothoracic surgery simulators click to enlarge The lung surgery simulator is used for training in video-assisted surgery (VATS).

The lifelike simulators are used in cardiothoracic surgery education and training at the local and national levels. The simulators use organs that have been re-animated using hydraulics, reperfusion, and computer orchestration, and are then placed in a human equivalent model.

Dr. Richard Feins of the UNC Division of Cardiothoracic Surgery, is director of CCTS.

For more information about the simulators and to see three videos of the simulators in use, click here.


Dr. Bowdish receives faculty development award

Michael E. Bowdish, M.D., of the UNC Division of Cardiothoracic Surgery, has received a $7,500 UNC Junior Faculty Development Award for research. His project, "Evaluation of Partial Task Simulation and a High-Fidelity Cardiac Surgery Simulator in the Training of Cardiac Surgery Residents," is funded from Jan. 1, 2010 to Dec. 31, 2010.
Dr. Bowdish receives faculty development award click to enlarge Michael E. Bowdish, M.D.

Dr. Bowdish is a heart surgeon, specializing in adult cardiac surgery.



He hopes to help more lung patients breathe easier: News story features Dr. Egan and his transplant research

Thomas M. Egan, M.D., of the UNC Division of Cardiothoracic Surgery is featured as the "Tar Heel of the Week" in a News & Observer story about Dr. Egan and his pioneering lung transplant research, which would make more donor lungs usable for transplant by treating the lungs ex-vivo (outside the body) to improve their health before transplant.
He hopes to help more lung patients breathe easier: News story features Dr. Egan and his transplant research click to enlarge Thomas M. Egan

Read the article here.


Gifts of new lungs, great friends: Transplant patient of Dr. Haithcock's talks about her experience.

Kena Sawyers, 46, of Eden, N.C., received a double-lung transplant at UNC Hospitals on Sept. 20, after living 15 years with lungs scarred by pneumonia secondary to adult respiratory distress syndrome (ARDS) that she contracted when pregnant with her daughter, Kayla. Dr. Benjamin Haithcock of the UNC Division of Cardiothoracic Surgery was her transplant surgeon.
Gifts of new lungs, great friends: Transplant patient of Dr. Haithcock's talks about her experience. click to enlarge Kena Sawyers

Since her release from the hospital after her transplant, Sawyers has been living at the SECU Family House in Chapel Hill, a 40-bedroom hospital hospitality house that provides comfortable, convenient and affordable housing for adult patients undergoing treatment for critical illness and trauma and family members of those patients.

Sawyers' new lungs are working well. She is staying in Chapel Hill to undergo physical therapy, additional testing and routine monitoring. To read a story about Sawyers, her transplant and her experience at SECU Family House, click here.



Drs. Egan, Feins and Mill listed in Best Doctors database

Dr. Thomas M. Egan, Richard H. Feins and Michael R. Mill of the UNC Division of Cardiothoracic Surgery are among more than 200 University of North Carolina at Chapel Hill School of Medicine physicians who are included in the latest The Best Doctors in America® database.

These doctors are also listed in the November 2009 issue of Business North Carolina magazine, as part of its annual compilation of the best doctors in North Carolina. In both the national database and the Business North Carolina listing, Drs. Egan, Feins and Mill are listed under Thoracic Surgery. Dr. Egan and Dr. Feins are both lung surgeons.  Dr. Mill a pediatric cardiac surgeon, is also listed under Pediatric Specialist (Best Doctors) and Pediatric Cardiac Surgery (Business North Carolina). (Because of a physical disability that prevents prolonged standing, Dr. Egan no longer performs surgery, but is available for second opinions and advice. He performs bronchoscopy, interventional bronchoscopy, and participates in treatment planning for stereotactic radiosurgery (Cyberknife).)

Only 3 to 5 percent of U.S. physicians are included in the Best Doctors database. The Best Doctors database contains the names and professional affiliations of approximately 45,000 doctors in the United States, all chosen through an exhaustive peer-review survey that asks: “If you or a loved one needed a doctor in your specialty, to whom would you refer them?” The peer review process as well as additional research conducted by Best Doctors determines selections for each list. To read the UNC Health Care release about the listings, click here


Dr. Egan receives $1.47 million NIH grant for lung transplant research

Dr. Egan receives $1.47 million NIH grant for lung transplant research click to enlarge Thomas M. Egan, M.D., M.Sc.

The National Heart, Lung, and Blood Institute has awarded Thomas M. Egan, a professor of surgery at the University of North Carolina, a $1.47 million, two-year grant for research on perfusion and ventilation of lungs outside the body before transplant. The research could lead to a significant increase in the number of lungs available for transplant.

Dr. Egan, a surgeon in the UNC Division of Cardiothoracic Surgery, is internationally known for his research on lung transplantation, which has been under way since he came to UNC in 1989 to start its lung transplant program.

His new grant was awarded under the NHLBI’s Translational Research Implementation Program, a two-stage program designed to translate fundamental research ideas into proof-of-concept efficacy testing in patients. This Stage 1 grant is supported by the American Recovery & Reinvestment Act's Grand Opportunities (GO) grants program, for large-scale research projects that the National Institutes of Health says have “a high likelihood of enabling growth and investment in biomedical research and development, public health, and health care delivery.” NHLBI is part of the National Institutes of Health.

Dr. Egan’s project will perfect a technique to perfuse and ventilate human lungs outside the body (ex vivo) to determine if they are suitable for transplant, and will demonstrate safety of transplanting human lungs after ex-vivo perfusion in a pilot clinical study.

Lung disease is the fourth leading cause of death among Americans. Lung transplantation helps patients with end-stage lung diseases and improves survival, but transplants are critically limited by an inadequate supply of suitable lungs from conventional organ donors – people who have been declared brain-dead after a lethal brain injury and have been on ventilation before a controlled cardiac arrest when organs are retrieved for transplant. Lungs that have been offered for donation frequently cannot be used because lung function in the donor is poor, due to inflammation or infection or fluid build-up (edema) that occur after trauma and emergency treatment.

Even if the lungs are suitable for use, they are still vulnerable to problems. During transplant, the stopping and restarting of circulation to the lungs can cause ischemia-reperfusion injury, which damages cells in the lung and leads to problems with lung function after transplant.

Only about 1,400 lung transplant procedures are performed each year in the United States; since 1995, 6,022 people have died while on the waiting list for lung transplants. This week, 1,867 people were on the national waiting list for lung transplants, according to the Organ Procurement and Transplantation Network, part of the U.S. Department of Health and Human Services.

Dr. Egan has designed an ex-vivo perfusion and ventilation circuit in which lungs are placed for evaluation and possible treatment before transplant. Ex-vivo perfusion and ventilation allow for lung function assessment, and also for possible treatment of lungs to reduce ischemia-reperfusion injury in transplant. Thus, the lungs treated this way could have less graft dysfunction or failure and the transplant recipient could have an improved chance of survival. This would revolutionize lung transplantation, and could have a major impact on other types of organ transplants.

Michael Knowles, M.D., a pulmonologist in the UNC Division of Pulmonary and Critical Care Medicine and a collaborator on Dr. Egan’s project, called the research project “groundbreaking.”

“I have been involved in lung transplantation from its inception at UNC, and have seen, first-hand, the suffering and unnecessary death that results from the shortage of lung donors in the U.S.,” Dr. Knowles said in a letter of support for the research.

The project has support of lung transplant physicians at several other universities in the U.S. and Canada as well as from Carolina Donor Services, the organ procurement organization serving most of North Carolina.

For the Stage 1 project, Dr. Egan’s research team will use lungs from conventional organ donors that have been declined for transplant because of concerns about lung function, as well as lungs from DCD (donation after cardiac death) donors, patients who are not brain dead but whose next-of-kin have decided to withdraw life support because the patient's condition is so poor. The lungs will be assessed and treated in the ex-vivo perfusion and ventilation circuit.

In a Stage 2 study, Dr. Egan’s project will also plan a large multi-center clinical trial to use the ex-vivo lung perfusion/ventilation system to evaluate human lungs retrieved after death from non-heart-beating donors, patients who have died of sudden cardiac arrest outside the hospital or in the emergency room. Using animal models, Dr. Egan was the first scientist to show that lungs could be retrieved from non-heart-beating donors after death and safely transplanted. His research has shown that lungs are viable for substantial periods of time after circulation stops, because lung cells do not rely on perfusion (circulation of blood or other fluids) for cellular respiration.

Widespread use of lungs retrieved from non-heart-beating donors followed by ex-vivo assessment could provide much larger numbers of human lungs for transplant that may function better and last longer than lungs currently being transplanted from conventional brain-dead organ donors.

Investigators for the project, entitled “Ex-vivo perfusion and ventilation of lungs to assess transplant suitability,” are:

Thomas M. Egan, M.D., M.Sc., Professor, Division of Cardiothoracic Surgery, UNC Department of Surgery (Principal Investigator), UNC School of Medicine
Peadar G. Noone, M.D., Associate Professor, Division of Pulmonary and Critical Care Medicine, UNC Department of Medicine, UNC School of Medicine
Paul Stewart, Ph.D., Research Associate Professor, Department of Biostatistics, UNC Gillings School of Global Public Health
Eileen Burker, Ph.D., CRC, Associate Professor, Division of Rehabilitation Counseling and Psychology, Department of Allied Health Sciences, and Adjunct Associate Professor, Department of Psychiatry, UNC School of Medicine
Benjamin E. Haithcock, M.D., Assistant Professor, Division of Cardiothoracic Surgery, UNC Department of Surgery, UNC School of Medicine
William K. Funkhouser, M.D., Ph.D., Professor, Department of Pathology and Lab Medicine, UNC School of Medicine
Katherine Birchard, M.D., Assistant Professor, Department of Radiology, UNC School of Medicine
R. Duane Davis, M.D., Ph.D., Professor, Division of Cardiothoracic Surgery, Department of Surgery, Duke University School of Medicine

For more information, contact Dr. Egan at (919) 966-3383.

 To read the NHLBI release about the grant, click here.

UNC begins new 6-year integrated cardiothoracic surgery residency

In July 2010, the Division of Cardiothoracic Surgery at the University of North Carolina at Chapel Hill will begin a new six-year integrated residency program, which residents will enter directly from medical school. The Residency Review Committee for Thoracic Surgery, the national residency accrediting body, approved the program in July 2009.  UNC is one of just a few institutions in the United States that offer such a program.

Students at North American medical schools may apply for the program through the Electronic Residency Application Service (ERAS). The deadline for applying for the 2010 residency has passed, but students may apply from September 2010 to January 2011 for the six-year residency program that begins in July 2011.

The new program will replace UNC’s traditional three-year cardiothoracic surgery residency program and the general surgery residency that precedes it. UNC’s three-year program will be phased out as residents in the integrated six-year program fill the early years of the program.

The three-year residency program will start its final resident in 2013; that person would complete the three-year program in 2016 (application for this position would be in the fall of 2011, with interviews in winter 2011-2012). For more information on the three-year program, click here.

The six-year curriculum includes rotations in vascular interventional radiology, endoscopy, cardiology, and endovascular surgery, and will provide residents with the background and experience using these new techniques in order to build a career as future “cardiothoracic specialists.” The program has been carefully designed to balance cardiovascular and thoracic care, and includes extensive exposure to fields relevant to thoracic surgery such as GI endoscopy, surgical oncology, and gastrointestinal (foregut) surgery. Completion of the program will lead to certification by the American Board of Thoracic Surgery. At UNC, the new program shortens the current ABTS certification process by two years.

Michael R. Mill, M.D., is chief of the UNC Division of Cardiothoracic Surgery and is director of the residency program.

UNC Division of Cardiothoracic Surgery faculty members believe that this tightly focused, comprehensive curriculum will produce better trained cardiothoracic surgeons and will be gratifying to the resident physicians who complete the program.

The field of cardiothoracic surgery has evolved tremendously over the decades, offering patients many more options for the treatment of intra-thoracic disease. The complexity of cardiothoracic surgery has increased and it has become more dependent upon a multi-disciplinary team approach, involving primary care physicians, cardiologists, pulmonologists, anesthesiologists, intensivists, radiologists, pathologists, cardiac perfusionists, nurses, clinical coordinators, social workers, and others. Hence, the objective of this training program is to provide a more comprehensive and rational immersion in the diagnosis and management of all aspects of cardiovascular and thoracic diseases through multi-disciplinary training. All aspects of the new curriculum are based on proven models of education currently available at the University of North Carolina. The curriculum preserves the significant contribution of general surgery and vascular surgery training to the development of a well-rounded cardiothoracic surgeon.

For more information on the new six-year program, click here.

Heart transplant patient finds new enthusiasm for life

Heart transplant patient finds new enthusiasm for life click to enlarge Lisa and Russell Ford at SECU Family House in Chapel Hill.

Russell Ford received a heart transplant at UNC Hospitals in July 2009 after suffering from congestive heart failure for 10 years. Dr. Michael Bowdish of the UNC Division of Cardiothoracic Surgery was his transplant surgeon.  In "Family House Diaries," written by Elizabeth Swaringen for UNC Health Care, Mr. Ford tells the story of his illness, his surgery and the experience his family had at SECU Family House at UNC Hospitals.  The Family House is a non-profit hospital hospitality house, offering housing and other support services to adult patients and their families.  




UNC team provides heart surgery for 10 more children in Uganda

UNC team provides heart surgery for 10 more children in Uganda click to enlarge Tiny patients at Mulago Hospital recuperate from heart surgery.

Tiny patients recuperate from heart surgery at Mulago Hospital.(Includes information from a blog by Keith Kocis, M.D., team leader for the Uganda mission.)

A UNC medical team provided heart surgery for 10 children with complex congenital heart defects during this year's two-week medical mission to Mulago Hospital, Makerere University, in Kampala, Uganda. All of the children were doing well when the UNC team left Kampala on Wednesday, Oct. 7.

This was the third year that the UNC team had visited Uganda, where they are training health care providers at the Uganda Heart Institute. The missions aim to help the pediatric cardiac surgery program become self sufficient in providing care for children with heart disease. The UNC team includes physicians (a pediatric heart surgeon, a pediatric anesthesiologist, a pediatric cardiologist and pediatric intensive care doctors); a pediatric nurse practitioner and a physician’s assistant who specialize in cardiac surgery; operating room and intensive care unit nurses; respiratory therapists; a perfusionist; and a biomedical engineer.

The team members left North Carolina on Sept. 26, carrying 900 pounds of medical equipment and supplies with them on their flight. When they arrived at the hospital in Uganda, the team quickly set up the operating room, perfusion equipment, and intensive care unit. Team members Karla Brown, Ruben Bocanegra, Katherine Desrochers, and Jennifer Ditto had collected and prepared the supplies and equipment for shipment, a months-long process.

Dr. Michael Mill, a pediatric heart surgeon from UNC, performed two operations a day for the first four days of the visit, with one additional operation on Oct. 3, and one on Oct. 5.  This year, the children receiving surgery were smaller and younger than those who received surgery on past visits, and this year's patients had more complex congenital heart lesions. Seven of the children who received surgery weighed less than 10 kg (about 22 pounds). The team cared for the children 24 hours a day, overcoming challenges such as brief power outages, equipment breakdowns and repairs, and illnesses of team members.

The children who had the surgery are all recuperating well, and their spirits, energy, and appetites have markedly improved, team members reported. Without surgery, the children would have died from their heart defects; now, they can live normal lives.

The Uganda heart program mission has generous support from Samaritan's Purse and the UNC Institute for Global Health & Infectious Diseases. A team from the Children’s National Medical Center in Washington also participates in Uganda missions. After the UNC team's last mission in October 2008, partners from Children's National Medical Center  returned in April 2009 and operated on an additional 10 children while advancing the Uganda program. The Ugandan team in-country has successfully repaired three additional children.

The 2009 UNC team members:
Keith Kocis, MD, UNC pediatric intensive care unit (PICU) physician; team leader
Michael Mill, MD, UNC pediatric heart surgeon
Eugene Freid, MD, anesthesiologist from Nemours Children's Clinic, Jacksonville, Fla.
Stacey Peterson-Carmichael, MD, PICU physician from Duke
Parvin Dorostkar, MD, PICU cardiologist, University of Minnesota
Ruben Bocanegra, PA-C, UNC physician's assistant
Karla Brown, RN, MSN, PNP, UNC pediatric nurse practitioner for cardiothoracic surgery
Greg Griffin, UNC perfusionist
Jennifer Ditto, RN, PNP, UNC surgical scrub nurse
Katherine Desrochers, RN, UNC PICU nurse
Susan Van Fleet, RN, UNC PICU nurse
John Bryson, RN, UNC PICU nurse
Diane Yorke, RN, PhD, UNC School of Nursing faculty
Jeannie Koo, RN, PNP, PICU pediatric nurse practitioner from Duke
Sheila White, RRT, UNC respiratory therapist
Lupe Haynes, RRT, UNC respiratory therapist
Elizabeth Smith, UNC medical engineer, and her husband

Read the blog written by UNC participants in this year’s mission.

The work at Mulago Hospital began after a group of UNC physicians established the Amal Murarka International Pediatric Health Foundation in memory of their colleague, Dr. Amal Murarka, a UNC PICU physician who died in a traffic accident in 2003. The foundation sent a medical team to Kampala to establish the country's first pediatric intensive care unit at Mulago Hospital, where Dr. Murarka had previously conducted research. Subsequent work in 2007, 2008 and 2009 has focused on pediatric cardiac surgery. The teams have established a cardiac ICU and have performed more than 30 life-saving pediatric cardiac surgeries. Team members have trained nurses at the Ugandan hospital in post-surgical care of pediatric heart surgery patients.

In 2008 the Murarka foundation partnered with the Institute for Global Health and Infectious Diseases to establish UNC Project-Uganda.

To make a gift in support of UNC-Uganda, click here.

To read a recent Carolina Alumni Review article about the team's 2008 mission to Mulago Hospital, click here. (To get rid of the black pop-up box, click on the "x" at the top right hand corner of the box.)