ruptured heart repaired through complex, two
Transcription
ruptured heart repaired through complex, two
Summer 2013 Vol. 27, No. 2 MESSAGE FROM THE PRESIDENT Welcome to the summer issue of Rounds. In this issue, we recognize the truly exciting events and accomplishments at Henry Ford Hospital, including news from the Center for Structural Heart Lawrence Mitchell, M.D. Disease and the achievements of our graduating residents. At the Center for Structural Heart Disease, we welcomed William W. O’Neill, M.D., as its medical director. One of the reasons why Dr. O’Neill was glad to join Henry Ford is our commitment to technological innovations. In this issue, you can read about the successful repair of a ruptured heart and the opening of five blocked blood vessels, a procedure that was led by Drs. O’Neill and Adam Greenbaum. This complex, minimally invasive procedure is one of the innovations that Dr. O’Neill has pioneered throughout his medical career. We also celebrate the achievements of our graduating residents and fellows. You will find a list of graduates as well as the nominees and recipients of the Outstanding Resident Awards. This (Continued on Page 7) What’s Inside Research Spotlight - Page 2 Atrial Fibrillation Center - Page 3 Investigating Stem Cells - Page 4 In Memoriam - Page 6 Alumni Notes - Page 8 Outstanding Resident Awards and 2013 Graduate List - Pages 9-11 For members of the Henry Ford Medical Association, Henry Ford Physicians, Residents and Alumni RUPTURED HEART REPAIRED THROUGH COMPLEX, TWO-STAGE CATHETERIZATION PROCEDURE A team of doctors at Henry Ford Hospital successfully repaired a hole in the heart and opened five blocked blood vessels in a complex, two-stage catheterization procedure. The initial March 13, 2013 procedure used the Impella CP, a left ventricular assist device, to stabilize the patient and allowed the hole in the heart’s ventricle (lower chamber) to be closed. Retired plant engineer Joseph Mehal, 84, hadn’t been feeling well for more than a week. He had no appetite and thought he might have the flu, but he had no chest pain or other classic symptoms to indicate a possible heart attack. An emergency department physician diagnosed a heart attack, and Mehal was rushed to the cardiac catheterization lab. The team was led by Drs. William O’Neill and Adam Greenbaum of the Center for Structural Heart Disease at Henry Ford Hospital. “The Impella CP device was essential in allowing us to enter the heart and successfully close the defect, and it kept the patient alive while catheters were in his heart,” says Dr. Greenbaum. Once the hole was closed, the patient returned to the cath lab 36 hours later and had complex stent therapy to open five blocked blood vessels. “Closing the hole in the ventricle and high-risk angioplasty have been performed successfully before, but never together in one patient who was in cardiogenic shock,” says Dr. O’Neill. Mehal recuperated in the hospital and his doctors are optimistic that he will return to normal activity. Adam Greenbaum, M.D. (left) and William W. O’Neill, M.D. “My liver and kidneys were failing,” says Mehal. “Thanks to fast action and expertise, not only was my life saved, but my kidneys have recovered. My nephrologist said I was one day away from needing dialysis.” Dr. O’Neill is an internationally recognized cardiologist, who was a pioneer in the use of angioplasty for treatment of heart attacks, now the primary therapy used throughout the world. He is the architect of non-invasive heart surgery, performing the first heart valve replacement through a catheter in North America in 2005. A long list of his career accomplishments includes: • First in the U.S. to use a heart-cooling procedure to reduce heart-attack damage. Lowering body temperature up to 9 degrees Fahrenheit through a chilled IV solution has shown promising results in protecting a patient from brain damage after a heart stops. • First in the U.S. to use stem-cell therapy for heart repair. (Continued on Page 7) RESEARCH SPOTLIGHT $12.4 MILLION NIH GRANT FUNDS HYPERTENSION RESEARCH A senior staff scientist and his team at Henry Ford Hospital have been awarded a five-year, $12.4 million grant by the National Institutes of Health for their research into the damaging effects of high blood pressure on various organs in the body. Hypertension is a major public health issue in the United States, with an estimated 75 million Americans with the disease. It can also contribute to other major health problems such as heart attack and stroke. Oscar A. Carretero, M.D., of Henry Ford’s Hypertension and Vascular Research Division, is investigating how autacoids, which are small molecules and hormones produced by various cells in the body, regulate kidney function and blood pressure, leading to hypertension and tissue and organ damage. Although these biological substances and hormones generally affect cells next to or near where they are secreted, they can be transported through the bloodstream. Dr. Carretero’s research is investigating how, when this happens, they can damage distant tissue and organs. In particular, the various projects are examining the mechanisms by which various autacoids either exacerbate or reduce the pro-hypertensive effects of the hormone angiotensin II. “I am very proud and grateful to my research team,” Dr. Carretero said when he learned of the award. “This project took a lot of teamwork and all of the members deserve credit. They worked very hard under a lot of pressure to make this grant possible.” The NIH grant will provide $2,472,318 each year for five years to fund four related projects. Dr. Carretero, who is the principal investigator, also heads two of the projects. Besides Dr. Carretero, key among the 18 people involved in the scientific and administrative Oscar A. Carretero, M.D. functions of the grant are Henry Ford’s Pamela Harding, Ph.D.; Jeff Garvin, Ph.D.; Xiao-Ping Yang, M.D.; Ed Shesely, Ph.D.; and Ed Peterson, Ph.D. This research proposal began in 1982 and will now continue through the end of January 2018, continuing NIH funding for 35 years. CME OPPORTUNITIES SEPT. 16-18 The Detroit Institute of Ophthalmology is hosting the 2013 The Eye, the Brain & the Auto research congress Sept. 16-18, 2013 at The Henry in Dearborn, Mich. OCT. 26 Henry Ford Heart & Vascular Institute is hosting a continuing medical education Conference Saturday, October 26, 2013 at the Atheneum Hotel - Detroit. NOV. 15 The Josephine Ford Cancer Institute and the Henry Ford Department of Dermatology are hosting the 2nd Melanoma Symposium Friday, November 15, 2013 at the Detroit Marriott. For more information about these and other CME opportunities, visit henryford.com/cme 2 ATRIAL FIBRILLATION CENTER Head off complications with a single phone call With a single phone call, physicians who suspect atrial fibrillation can schedule an immediate outpatient appointment for diagnosis, treatment and condition management. The Atrial Fibrillation Center, established in summer 2012, is accepting patients from referring physicians. “Atrial fibrillation is one of the most interesting, puzzling public health problems in the western world,” says Claudio Schuger, M.D., director, Cardiac Electrophysiology. “Today, it affects 3.5 million Americans, but by 2050, a projected 12 million or more will be affected. Atrial fibrillation accounts for 15 to 20 percent of strokes in the U.S., and in patients with an uncontrolled rapid heart rate, there is an increased risk of heart failure due to weakening of the heart muscle. It is pertinent to address and understand the dynamics of the condition.” The Center’s four senior electrophysiologists and three dedicated nurse practitioners are experts in managing rhythm abnormalities. They provide accurate and quick diagnosis and a holistic approach to the management of atrial fibrillation and the prevention of potentially devastating complications. While atrial fibrillation is only an electrocardiographic manifestation, its etiology may be multi-factorial, adding to disease complexity. “Some patients are symptomatic, others are not, and time between detection of abnormalities and referral is valuable. We see patients in different moments in their history of the disease, from origin to long-term complications,” says Dr. Schuger. Treatment options include: Rhythm control: Catheter ablation continues to grow and evolve as a strategy to suppress atrial fibrillation, particularly for those patients unresponsive or intolerant of standard medical therapy. To investigate this technique, Henry Ford Hospital is now participating in the international CABANA trial to study the efficacy of AF ablation. In addition, Henry Ford currently utilizes the most up-to-date technologies for this procedure, including: • 3-D anatomic mapping using the CARTO-3 and CARTO-SOUND mapping systems • Remote magnetic navigation (Stereotaxis) Claudio Schuger, M.D. • Cryoballoon technology Stroke Prevention: Regardless of whether rhythm control is attempted, patients with AF may be at increased risk for stroke. For those unable to take traditional anticoagulant medications, Henry Ford provides a variety of both FDA-approved and investigational invasive procedures aimed at stroke prevention. These modalities include: • The LARIAT epicardial left atrial appendage suture device • The Watchman device, recently approved to endocardially isolate the left atrial appendage (Continued on Page 5) A 3-D reconstruction of the left atrium and pulmonary veins with ablation lesions (red) delivered circumferentially around the antrum of the veins. This electrically isolates the pulmonary veins from the left atrium, which is responsible for the initiation of atrial fibrillation in most cases. 3 INVESTIGATING STEM CELLS TO PRESERVE HEART FUNCTION Retired science teacher and former principal of Cass Tech High School Lenora Ashford, 64, of Detroit, was recovering from a heart attack at Henry Ford Hospital, when her cardiologist asked if she would like to be part of a new national research study. He felt she could be a candidate to participate in a study to investigate treating a recent heart attack with a patient’s own stem cells to preserve heart muscle function. Henry Ford is the first hospital in Michigan to participate in the PreSERVE AMI Phase II research study, for adults who have received a stent to open a blocked artery after an acute heart attack, who also meet other criteria. “As a teacher, I always encouraged my students to participate in science projects,” says Ashford. “Now I could become part of a science project. It was an opportunity to practice what I preached, and I felt it would be beneficial.” It was determined that Ashford was qualified to participate in the study, which has very strict entry criteria for patients. She had marrow harvested from her hip bone to isolate her own stem cells for the procedure. Two days later, following the rules of the study, either the processed stem cells or a placebo were infused through a catheter in the coronary artery to the area of damaged heart muscle. Both the harvesting and the infusion of stem cells are outpatient procedures. “You don’t make progress unless you take chances,” says Ashford. “I have a lot of family members in the medical field and I discussed it with them. They were very supportive, and I thought, why not? Now, I feel so much better. Would I do it again? Absolutely.” “Stem cell therapy offers new potential approaches in the treatment of acute heart attack patients to Gerald Koenig, M.D., Ph.D. prevent further damage to heart muscle and improve function,” says Gerald Koenig, M.D., Ph.D., a cardiologist and researcher at Henry Ford. “Current standard treatment options only limit the weakening of the heart. This is why we are studying stem cell therapy, which looks very promising, but it is still an investigation, not an established treatment.” The body has a way to repair itself. When a heart attack occurs, the heart sends a distress signal to the body, which then sends repair cells to the injury site. In some cases, depending on the severity of damage, the repair is insufficient, with a poor prognosis for the patient. A dead zone of tissue develops in the heart, while the surrounding healthy heart cells are stressed as they work harder to pump blood. (Continued on next page) 4 The American Heart Association, with the assistance of the National Institutes of Health, reports that an average of 16 years of life may be lost due to a heart attack. “Previous studies using adult stem cells to limit heart muscle damage and improve function have had mixed success,” says Dr. Koenig. “Some studies have tried to do this too soon after a heart attack, and some tried the procedure at a later time. “It has been determined that there’s a window of opportunity - one week to 10 days after a heart attack - which is the most effective time for stem cell treatment.” The type of stem cell used to treat heart muscle is critical for success, according to Dr. Koenig, as well as the number of cells infused. When the correct amount of the right cells are used in the specified timeframe, the possibility of preserving heart function is much higher. “We look for a specific stem cell that has the capability to improve the function of the heart, potentially by regenerating tissue, or as in this case, preventing the loss of heart muscle that typically continues for weeks after the heart attack,” he says. “An acute heart attack can severely weaken heart muscle. Today’s therapies, including balloon angioplasty and stents to reopen blocked blood vessels, and medication, have raised the survival rate for patients. However, one third of heart attack survivors has a significant amount of damage to the heart, and is at high risk to develop congestive heart failure over several years.” For more information on the PreSERVE AMI Phase II study, please call (313) 916-1879. ATRIAL FIBRILLATION CENTER (Continued from Page 3) • The Amplatzer Cardiac Plug (ACP), currently being investigated in a nationwide study for endocardial left atrial appendage isolation “We work to prevent the complications that can result from atrial fibrillation,” says Dr. Schuger. “Thromboembolism prevention is achieved mainly by new or traditional anticoagulation agents. Invasive alternatives for patients with strict contraindications for anticoagulation are based in left atrial appendage occlusion strategies such as percutaneous epicardial ligations (LARIAT) or endocardial left atrial appendage closures (Amplatzer).” The Atrial Fibrillation Center staff will also create a database for use in future quality initiative proposals and development of effective treatment strategies for specific cohorts. When calling the hotline, referring physicians will be asked to describe the patient and provide the medical record number, if available. Referrals result in an immediately scheduled outpatient appointment. Inpatients may also be referred. Referring physicians receive ongoing communication regarding diagnosis and condition management of their patient. For more information or to refer a patient, call the Atrial Fibrillation hotline at (313) 916-AFIB (2342). A 3-D reconstruction of the left atrium and pulmonary veins, demonstrating placement of a circular mapping catheter into the Os of the pulmonary vein to help identify pulmonary vein potentials. Elimination of these potentials is part of the goal of the procedure. 5 IN MEMORIAM Peter B. Gram, M.D., a former intern in the Department of Orthopaedic Surgery at Henry Ford Hospital, passed away on December 25, 2011. Following his training at Henry Ford, Dr. Gram practiced in Manchester, Conn. and taught at the University of Connecticut Medical School. During this time he also practiced at the Newington Children’s Hospital and then in Hartford when the hospital was relocated. Dr. Gram was regarded as a man of many talents, and he painted, sculpted, played the guitar and spoke six languages fluently. During his career, Dr. Gram published many books about events in his life and about his family. He received his medical degree from the University of Rochester, and prior to beginning his education in America, Dr. Gram served with the British resistance forces and the Office of Strategic Services (OSS) during World War II. He is survived by his wife of 62 years Marie, six children and eight grandchildren. Charles (Gene) Jackson, M.D., former head of the Third Medical Division and chief of the Clinical Genetics Division at Henry Ford Hospital, passed away on December 30, 2012. During his career at Henry Ford, Dr. Jackson 6 worked as a physician, performed extensive genetics research and served on several National Institutes of Health Study Sections. He was devoted to researching many diseases and conditions, including muscular dystrophies, Alzheimer’s disease and multiple endocrine neoplasias. Dr. Jackson received numerous awards and recognitions, including the Henry Ford Medical Association Distinguished Career Award in 1997, and he published more than 200 medical articles. After retiring to Temple, Texas in 2001, Dr. Jackson continued his genetics research and published more than16 additional journal articles. He fondly remembered his time at Henry Ford and had a great love for his colleagues and patients. Early in his career, Dr. Jackson served as a Major in the Army Reserves and was stationed at Walter Reed General Hospital in Washington, D.C. He is survived by his son, three grandchildren and two greatgrandchildren. Gilbert D. Jay III, M.D., a former General Surgery resident at Henry Ford Hospital, passed away on October 15, 2012 at the age of 92. After completing his residency, Dr. Jay entered private practice in West Memphis, Ark. and was the first surgeon to service the area. He remained in practice for 35 years. In 1952, the West Memphis Chamber of Commerce awarded him their Man of the Year Award. Before finishing his training at Henry Ford, Dr. Jay served two years as a flight surgeon during World War II. He is survived by his beloved wife of 70 years Mary, four children, seven grandchildren and eight great-grandchildren. Raymond C. Mellinger, M.D., former head of the Division of Endocrinology, physician and resident at Henry Ford Hospital, passed away March 4, 2013 in East Lansing, Mich. His career of more than 40 years at Henry Ford began in 1948 when he entered his residency. Dr. Mellinger was named head of the Division of Endocrinology in 1966. During his time at Henry Ford, Dr. Mellinger was involved in the Endocrine Fellowship Program, and he impacted the education and training of many young physicians from around the world. He was well known for his treatment and extensive research of Cushing’s syndrome. Dr. Mellinger was author or co-author of more than 85 medical articles, and he also served as the editor of the Henry Ford Hospital Medical Journal for 10 years. During his residency, Dr. Mellinger left for two years to serve as a regimental surgeon for the U.S. Army’s 35th Infantry in Japan. He is survived by six children, 13 grandchildren and step-grandchildren and one greatgranddaughter. Message from the President (Continued from Front Page) year, the awards banquet was held May 15 at the Detroit Athletic Club, and 25 residents and fellows were honored for their dedication to patient care, research and education. Having been trained at Henry Ford Hospital and serving in the role of an educator, I am very familiar with the excellence of our programs (See Pages 9-11 for a list of awardees, nominees and graduates). George R. Mikhail, M.D., a surgeon at Henry Ford Hospital, passed away on April 5, 2013. Dr. Mikhail’s career at Henry Ford began in 1963, and he worked to become a skilled expert in the Mohs surgery technique. He started the Mohs Surgery Clinic at Henry Ford in 1967, which was one of the first clinics in the country at the time. Dr. Mikhail was a member of many medical organizations, and he held leadership positions in many of these societies, such as president of the Michigan Dermatological Society. Dr. Mikhail published more than 70 medical publications and authored two books on Mohs surgery. He was acknowledged for his achievements with various awards, including the Distinguished Career Award from Henry Ford Medical Association in 1980. Dr. Mikhail received his medical degree from the Cairo School of Medicine in Egypt. He is survived by his wife Elizabeth and daughter Marianne. Kavitha Vanga, M.D., a Henry Ford Medical Group physician, passed away on April 4, 2013. Dr. Vanga’s medical training began when she completed her medical education and internship at Osmania Medical College in India. Following her education in India, she did her residency at Grace Hospital in Detroit. Dr. Vanga began practicing medicine in 1999, and she specialized in hepatology and women’s health. Dr. Vanga worked in the Department of Internal Medicine at Henry Ford Medical Center – Fairlane, where she was highly respected and regarded by her patients. Frank Zeller, Jr., M.D., a former surgical resident at Henry Ford Hospital, passed away July 17, 2012 at the age of 88. Following his residency, Dr. Zeller entered private practice as a vascular surgeon for more than 30 years. He then served as medical director of Lake Wales Medical Centers in Florida until 2001. Dr. Zeller was a member of numerous medical societies and organizations, including the Henry Ford Medical Association. He received his medical degree from Indiana University and honorably served as a captain in the U.S. Air Force for two years, where he was stationed in Korea and Japan. Dr. Zeller is survived by Shirley, his loving wife of 66 years, his daughter and four grandchildren. Henry Ford’s continued medical innovations would not be possible without our talented and energetic workforce. In the future, we look forward to continuing to bring you the news on the latest achievements and advancements at Henry Ford. Best regards, Lawrence C. Mitchell, M.D. President Henry Ford Medical Association (Continued from Front Page) • First in U.S. to implant donor vein stents through a catheter to repair leaking arteries. • The only successful triple heart valve repair through a catheter in pregnancy, allowing the pregnancy to continue, which open-heart surgery would not. “Approximately one quarter of American adults has some type of structural heart defect,” says Dr. O’Neill. “Treating structural heart disease with catheterbased techniques and less-invasive surgeries is the next frontier in cardiology.” For more information, visit henryford.com/StructuralHeart. A memorial donation is a special way to remember a friend or colleague. Making a memorial gift in their honor can be a wonderful tribute to their life, and may be designated to a specific department or program at Henry Ford. For more information, call (313) 876-1031 or visit henryford.com/giving. 7 ALUMNI NOTES Niru Prasad, M.D., currently working at Urgent Care in Livonia, Mich., was invited as a visiting physician to a local hospital in Nairobi, Kenya. On February 23, 2013 she gave a lecture at the hospital on the management of children with burns in the emergency room. Dr. Prasad can be reached via email at niruprasad@ hotmail.com. Elizabeth R. Ransom, M.D., FACS, completed a residency in the Department of Otolaryngology from 1990-1994 at Henry Ford Hospital and served as chair of the Credentials Committee and vicechair of the Board of Governors at Henry Ford until 2006. She was recently appointed executive vice president and clinical leader, North Zone, for Texas Health Resources (THR), and will be leading efforts to redesign and improve care at THR. Dr. Ransom can be reached via email at elizabethransom@ texashealth.org. 8 Henry Ford Medical Group alumnus Dr. Hideaki Takahashi, recently made the long trip from Japan to visit Henry Ford Hospital for the first time in 50 years in celebration of the 50th anniversary of his graduation from the Orthopaedic Surgery Residency Program. Following his residency, Dr. Takahashi completed a research fellowship at Henry Ford Hospital before returning to Japan to continue his medical career. Pictured from left to right is Gary Gibson, Ph.D.; Theodore Parsons, M.D.; Hideaki Takahashi, M.D., Ph.D.; and his wife, Dr. Takako Takahashi. We want to hear from you! henryford.com/alumni Carl Bartecchi, M.D., MACP, was a resident at Henry Ford Hospital. Recently he published a book titled The Bach Mai Hospital Project, which details the improvements made by the Vietnamese hospital and the humanitarian projects that made the improvements possible. Dr. Bartecchi is currently a Distinguished Clinical Professor of Medicine at the University of Colorado. Anas Moureiden, M.D., a fellow in the Department of Rheumatology from 1993-1995 at Henry Ford Hospital, currently works in a private practice in Florida. Dr. Moureiden can be reached via email at amoureiden@yahoo.com. The Alumni Notes section of Rounds is a great way to share a professional accomplishment, personal news or your fondest Henry Ford memory. Send us your update and your information may appear in an upcoming issue. To send your submission, visit henryford.com/ alumni. Updates may also be sent in writing to: Henry Ford Medical Association Attn: Rounds Editor 1 Ford Place, 3B Detroit, MI 48202-3450 OUTSTANDING RESIDENT AWARDS On May 15, 2013, the Outstanding Residents Awards Banquet was held at the Detroit Athletic Club. This year 25 residents and fellows were recognized for their enthusiastic devotion to patient care, research and education. This year’s winners include: Ariella Freidman, M.D., recipient of the Jan Rival Outstanding Resident Award; Brent Griffith, M.D., recipient of the Michael S. Benninger Outstanding Resident Award; Amanda Godfrey, M.D., recipient of the Roger F. Smith Outstanding Resident Award; Joshua Collins, M.D., and Vivek Rai, M.D., recipients of the Peter Coggan Teaching Award. Congratulations to all awardees and nominees! Pictured are many of the 2013 winners and honorees (in alphabetical order): Victor Chang, M.D., Neurosurgery; Joshua Collins, M.D., Internal Medicine; Jeffrey Devitt, M.D., Orthopaedic Surgery; Ariella Freidman, M.D., Urology; Khurshid Ghani, M.D., Urology Minimally Invasive Surgery; Amanda Godfrey, M.D., Pulmonary Critical Care; Brent Griffith, M.D., Diagnostic Radiology; Tamim Hamdi, M.D., Nephrology; Keiko Hendrick, M.D., Family Medicine; Gina Hurst, M.D., Emergency Medicine/Internal Medicine; Anubhav Jagadish, M.D., Orthopaedic Surgery; Randa Jalloul, M.D., OB/GYN; Tarek Khalife, M.D., OB/GYN; Bassel Mahmoud, M.D., Dermatology; Neelima Nadella, M.D., Cardiology; Keyur Patel, M.D., Neurology; Chirag Popat, M.D., Sleep Medicine; Alexis Raftopoulos, M.D., Anesthesiology; Vivek Rai, M.D., Neurology; Jared Robbins, M.D., Radiation Oncology; Michael Romer, M.D., Anesthesiology; Sumit Singla, M.D., Gastroenterology; Julian Suszanski, M.D., Emergency Medicine; Sandeep Walia, M.D., Internal Medicine; Hadeel Zainah, M.D., Infectious Diseases. 9 CONGRATULATIONS TO THE 2013 GRADUATES! Henry Ford Hospital trains more than 600 medical school students, 500 residents and 150 fellows across 46 different specialties every year. Our graduates have been exposed to a rich learning environment with guidance and mentoring in a multidisciplinary setting by world-renowned faculty. We are proud to recognize our 2013 program graduates: Allergy Mary Burnett, M.D. Jennifer Rumpel, M.D. Anesthesiology: Cardiothoracic Maxime Madhere, M.D. Anesthesiology: Pain Medicine Adam Camp, M.D. Sagar A. Patel, M.D. Amir Samir, M.D. Aman Upadhyaya, M.D. Anesthesiology Anjana Dwivedi, M.D. Jennifer Henderson, D.O. Thuan Le, M.D. Carlos Montoya, M.D. Michael Parks, M.D. Paras Patel, M.D. Georgeanne Raftopoulos, D.O. Michael Romer, D.O. Saida Saidova, M.D. Kress Townley, M.D. Cardiac Electrophysiology Neelima Paladugu, M.D. Parthiv Shah, M.D. Cardiology Tara Hrobowski, M.D. Amrish Malhi, M.D. Gurjit Singh, M.D. Paul Vaitkus, M.D. Dee Dee Wang, M.D. Cardiology: Interventional Antonious Attallah, M.D. Joseph Chattahi, M.D. Prasanth Lingam, M.D. Critical Care Medicine Julie John, M.D. Dermatology Julie Iwaski, M.D. Bassel Mahmoud, M.D. Viet Nguyen, M.D. Frank Santoro, M.D. Veena Vanchinathan, M.D. Kara Walton, M.D. 10 Emergency Medicine Bahareh Aslani, M.D. Deborah Fadowole, M.D. Monica Falconer, M.D. Jennifer Hsieh, M.D. Cameron Hypes, M.D. Vinod Kumar, M.D. Emily McLaren, M.D. Thomas Mikulski, D.O. Ankit Nanavati, M.D. Mayura Phadtare, M.D. Andre Porchia, M.D. Julian Suszanski, M.D. Ryan Worley, M.D. Emergency Medicine & Internal Medicine Adam Schlichting, M.D. Emergency Medicine: Ultrasound John Gallien, M.D. Endocrinology Pendar Farahani, M.D. Naveen Kakumanu, M.D. Family Medicine Onma Ameh, M.D. Ahmid Dredar, M.D. Keiko Anne Hendrick, M.D. April Hom, M.D. Elicia Jenkins-Brown, M.D. Ronak Patel, M.D. Israel Tellez Flores, M.D. Gastroenterology Eduardo Castillo del Castillo, M.D. Robert Dempsey, M.D. Humberto Gonzalez, M.D. Rachel Schiesser, M.D. General Surgery Alfredo Cordova Dupreyrat, M.D. Arika Peck, M.D. Yekaterina Polyatskaya, M.D. Brian Rosett, M.D. Nathan Schmoekel, D.O. Emily Smeltzer, M.D. Hematology/Oncology Mirna Farhat-Derwiche, M.D. Steven Gamalski, M.D. Mohamad Younes, M.D. Hospice & Palliative Medicine Rafi Ishaq, M.D. Grace Pagaduan-Oddo, D.O. Infectious Disease Transplantation Marisa Miceli, M.D. Infectious Disease Edemekong Bassey, M.D. Shubhita Bhatnagar, M.D. Hadeel Zainah, M.D. Internal Medicine Mustafa Abas, M.D. Raid Abu-Awwad, M.D. Yathreb Alaai, M.D. Ahmad Aldeiri, M.D. Mohanad Alfaqih, M.D. Mohammad Alhyari, M.D. Mohammad Alqarqaz, M.D. Nikhil Ambulgekar, M.D. Mahmoud Assaad, M.D. Joaquim Barboza, M.D. Eduardo Bazan Lavanda, M.D. Rafael Cabrera Salinas, M.D. Juan Cattoni, M.D. Surbhi Chamaria, M.D. Aalok Dave, M.D. Erics Esppinoza Moscoso, M.D. Edgardo Flores Anticona, M.D. Sami Hayek, M.D. Jennifer Jorge, M.D. Marilyn Karam, M.D. Fatima Khalid, M.D. Abdallah Kobeissy, M.D. Michael Koniuch, M.D. Ericka Li Fuentes, M.D. George Maidaa, M.D. Rosa Michel Ortega, M.D. Karen Olarte- Merida, M.D. Shital Patel, M.D. Julio Pinto, M.D. Waqas Qureshi, M.D. Jatin Rana, M.D. Snigdha Reddy, M.D. Michael Rothberg, M.D. Eiad Sabia, M.D. Ahmad Saeed, M.D. David Sanchez Vasquez, M.D. Jessica Schering, M.D. Sunay Shah, M.D. Rushyal Shyamraj, M.D. Hanish Singh, M.D. Sandeep Walia, M.D. George Yaghmour, M.D. Mohammad Zaidan, M.D. Otolaryngology Brandon Musgrave, M.D. William G. Young, M.D. Nephrology Transplantation Omar Saleh Abu-Romeh, M.D. Pathology David Nowak, M.D. Linda Szymanski, D.O. Ji Yoon Yoon, M.D. Nephrology Noori Al-Waili, M.D. Hilana Hatoum, M.D. Sayed M. Husain, M.D. Adepeju Jinadu, M.D. Felix Perez, M.D. Jagannath Saikumar, M.D. Josephus Sanjorjo, M.D. Clinical Neurophysiology Omar I. Ahmad, M.D. Nawaf Murshed, M.D. Neurology Komal Ashraf, D.O. Omran Kaskar, D.O. Nelson Maldonado, M.D. Sadia Najamuddin, D.O. Keyur Patel, M.D. Neurosurgery Abbas Bahari, M.D. Victor Chang, M.D. Melvin Omodon, M.D. Scott Phillips, M.D. Obstetrics & Gynecology Randa Jalloul, M.D. Laleh Karimi, M.D. Tarek Khalife, M.D. Matthew Palmer, D.O. Ophthalmology David Chin Yee, M.D. Christina Ryu, M.D. Aly Sheraly, M.D. Swapna Vemuri, M.D. Asmaneh Yamagata, M.D. Medical & Surgical Glaucoma Amy Zhang, M.D. Neuro-Ophthalmology Poonam Bansal, M.D. Neurology Vivek Rai, M.D. Orthopaedics Kirk Cleland, M.D. Jeffrey Devitt, M.D. Heather Harrison, M.D. Anubhav Jagadish, M.D. Srinivasu Kusuma, M.D. Orthopaedic Spine Medicine Ritu Zacharias, M.D. Cytopathology Fellow Mohammad Shokouh-Amiri, M.D. Pathology Informatics Mehrvash Haghighi, M.D. Psychiatry Neha Gupta, M.D. Melissa Hendriks, M.D. Tiana Jarrahzadeh, D.O. Abby Johnson, D.O. Katie Keller, D.O. Santosh Pillai, D.O. Sarah Riehl, M.D. Pulmonary: Critical Care Christopher Butler, D.O. Farooq Cheema, M.D. Jennifer Gardner, M.D. Amanda Godfrey, M.D. Haitham Kanneh, M.D. Mahmoud Mahafzah, M.D. Sophia Mehboob, M.D. Davorka Nikolic, M.D. Veronica Ortiz, M.D. Niraj Parikh, M.D. Julio Pinto Corrales, M.D. Akram Shibani, M.D. Akintayo Sokunbi, M.D. Dominik Starosta, M.D. Ahmed Sulieman Daoud, M.D. Interventional Pulmonology Eduardo Celis Valdiviezo, M.D. Haidong Huang, M.D. Radiation Oncology Jared Robbins, M.D. Radiology Peter Barkett, M.D. Jeffrey Birn, M.D. Chiraag Dharia, M.D. Tashfeen Ekram, M.D. Brent Griffith, M.D. Ahmed Hafeez, M.D. Farhaan Mir, M.D. James Morrison, M.D. Sailendra Sunkara, M.D. Radiology: Body Imaging Sherry Aujla, D.O. Kanika Khanna, M.D. Radiology: Breast Imaging Jay Patel, M.D. Radiology: Musculoskeletal Paul Armour, M.D. Randy Balmforth, M.D. Sandra Lee, D.O. Bisher Tarabishy, M.D. Neuro-Radiology Mohamad Saghir, M.D. Gassan Shahin, M.D. Bisher Taribishy, M.D. Vascular Interventional Radiology Ambreen Sattar, M.D. Laurie Vance, M.D. Radiology: Womens Imaging Brandon Behjatnia, D.O. Jessica Kaniowski, M.D. Jenny Wang, D.O. Sleep Medicine Rami Abboud, M.D. Niraj Parikh, M.D. Chirag Popat, M.D. Family Sports Medicine Laura Owczarek, M.D. Gonzalo Samitier Solis, M.D. Colon & Rectal Surgery Gie Na Yu, M.D. Surgical Critical Care Zachary Bauman, D.O. Marika Gassner, D.O. Transplant Surgery Shunji Nagai, M.D. Transitional Residency Tammam Dayyoub, M.D. Ryan Jaber, M.D. Daniel Kim, M.D. Cole Kreofsky, M.D. Stefania Maraka, M.D. Sumul Modi, M.D. Daniel Montenegro, M.D. Imama Naqvi, M.D. Kushal Parikh, M.D. Mihir Patel, M.D. Robert Prinzi, M.D. Swetha Renati, M.D. Steven Saraf, M.D. Prashant Thomas, M.D. Sean Vance, M.D. Urology: Clinical Research Jay Jhaveri, M.D. Fred Muhletaler, M.D. Minimally Invasive Urologic Surgery Wooju Jeong, M.D. Quoc-Dien Trinh, M.D. 11 DETROIT, MI PERMIT #6785 PAID NON-PROFIT ORG U.S. POSTAGE CARDIAC SURGERY Three-Star Rating: Outcomes in Isolated CABG Address Service Requested 1 Ford Place, 3B Detroit, MI 48202 Henry Ford Medical Association The Division of Cardiac Surgery at Henry Ford Hospital and Henry Ford Macomb Hospital have received a three-star rating from the Society of Thoracic Surgeons (STS) for its outcomes in isolated coronary artery bypass surgery (CABG). Rounds is published by the Henry Ford Medical Association for Henry Ford physicians, residents and alumni. Henry Ford Medical Association Executive Committee: Lawrence C. Mitchell, M.D., President Lisa MacLean, M.D., Vice President Jan Rival, M.D., Secretary Dorothy Kahkonen, M.D., Treasurer Eric Scher, M.D., Ex-Officio Members at Large: Mathilda Horst, M.D. Lynn Miller, M.D. Melissa Times, M.D. Managing Editor: Julie Perez (313) 874-5000 henryford.com/alumni Editorial Assistant: Felicia Adamczyk The STS CABG composite score is calculated using a combination of 11 measures of quality, divided into the following four broad categories: 1. Risk-adjusted mortality. 2. Risk-adjusted major morbidity—the percentage of patients who leave the Gaetano Paone, M.D. hospital with none of the five most serious complications of CABG—reoperation, stroke, kidney failure, infection of the chest wound, or prolonged need to be supported by a breathing machine, or ventilator. 3. Percentage of CABG procedures that use at least one internal mammary (or internal thoracic) artery for bypass grafting. 4. How often all of the four medications believed to improve a patient’s immediate outcome and long-term risk of developing more blockages were prescribed. a. Aspirin and beta-blocking drugs prescribed pre-operatively. b. Beta-blockers and cholesterol-lowering medicines prescribed postoperatively. “It is very difficult to attain a three-star rating, so we’re obviously very pleased that our considerable efforts at outcome improvement have been successful in achieving this benchmark,” says Gaetano Paone, M.D., division head of Cardiac Surgery. “However, we have more challenges to overcome, as it will be more difficult to maintain this three-star rating, as even a single additional negative outcome can be the difference between two and three stars. This is the reason the majority of programs are rated two stars and only 10-12 percent of the programs are at three stars.” Each year, approximately 10 to 15 percent of all adult cardiac surgery database participants have been rated three-star, the highest-quality rating, which indicates a 99 percent statistical certainty that a participant’s performance is above average. The Society of Thoracic Surgeons Public Reporting Online lists participants’ scores for each of the four domains and the STS CABG overall composite score, as well as a star rating. The report is available at www.sts.org.