Overview
The facility is fully equipped to perform studies employing cardiopulmonary bypass (or ECMO) on pigs, dogs, and sheep. The lab offers research possibilities in a number of areas, and given the multiple interests and talents of the entire group, almost any issue pertaining to the treatment of congenital heart disease can potentially be addressed in this environment.
Cerebral Protection of Neonates: This issue has emerged as one of the most important topics in congenital heart surgery. As infant heart repair is performed on an increasing number of neonates and young infants, with impressive success, the long-term outcome for these patients with respect to their neurologic development (quality of life) has taken on renewed importance. Many cardiac surgical procedures on infants are performed using profound hypothermic cardiopulmonary bypass--often with periods of low flow or total circulatory arrest. Our group has become one of the leaders in clinical and laboratory investigation of the response of the neonatal brain to methods of cardiopulmonary bypass and work from this lab has already had an impact on determining the best strategies to limit brain injury during cardiac surgery on infants. These studies are performed by placing neonatal animals on bypass. They overlap nicely with parallel studies performed on patients in the clinical setting and lab fellows are encouraged to become involved in those studies as well. Laboratory work has been presented at the American College of Surgeons, American Association of Thoracic Surgeons, Society of Thoracic Surgeons, World Congress of Pediatric Cardiac Surgery, American Heart Association, American College of Cardiology and others.
Neonatal Myocardial Protection: It seems increasingly clear that the infant heart responds to ischemia differently than the adult heart and the laboratory is dedicated to investigation of optimal methods to protect the infant heart during surgical repair. Most studies are now performed on in vivo animals (as opposed to an isolated heart model) with the animal on CPB since this most closely reflects the clinical situation. These studies employ sophisticated methods of evaluating ventricular function and some studies require substantial surgical skill for creation of the models. Work on this area has been presented at the American College of Cardiology, Society of Thoracic Surgeons and the American Heart Association.
ECMO : The Duke ECMO (ExtraCoporeal Membrane Oxygenation) program is one of the nation's largest and our laboratory serves as the site for all animal training for the ECMO team. We take advantage of this by performing an number of investigations related to current controversies in ECMO. The importance of this laboratory interest is the necessity for those who seek a career in pediatric heart surgery to intimately and thoroughly understand cardiopulmonary bypass physiology and technology. Work from the ECMO lab has been a highly regarded addition to the national ECMO meetings.
Cardiopulmonary Interactions: Exposure to CPB can produce significant effects on the lung--some of which may be mediated by a variety of humoral vasoconstrictors and vasodilators. Ongoing studies are designed to clarify the role of some of these naturally occurring substances in the effects of CPB on the pulmonary vascular system. Other studies have been designed to investigate the effects of CPB on pulmonary compliance and to determine the best methods to ventilate the lungs of patients following CPB, especially when there might be concurrent right ventricular dysfunction. This work has been extremely timely and abstracts are being accepted at many major meetings including the American Heart Association, American College of Cardiology, American Association for Thoracic Surgery and the Society of Thoracic Surgery.
Current Appointments & Affiliations
Adjunct Professor in the Department of Surgery
·
2023 - Present
Surgery, Cardiovascular and Thoracic Surgery,
Surgery
Education, Training & Certifications
Rush University ·
1977
M.D.