Scholars@Duke
Douglas Overbey

Douglas Overbey

Assistant Professor of Surgery
Surgery, Cardiovascular and Thoracic Surgery

Selected Publications

Kidney transplantation using a pediatric en bloc graft after normothermic regional perfusion and donation after circulatory death procurement.

Journal Article Am J Transplant · December 2025 Kidney transplantation is the ultimate treatment for patients with end stage renal disease. However, with the expanding gap between organ supply and demand, utilization of organs from extended-criteria donors is an important strategy to address this proble ... Full text Link to item Cite

Preoperative ECMO: Building Bridges.

Journal Article Ann Thorac Surg · December 2025 Full text Link to item Cite

Surgical and Anesthesia-Related Concerns forRobot-Assisted Pediatric Cardiac Surgery.

Journal Article J Cardiothorac Vasc Anesth · November 7, 2025 OBJECTIVE: The purpose of this study is to describe a cohort of pediatric patients undergoing robot-assisted cardiac surgery at a single center and to discuss the anesthetic implications and perioperative considerations to optimize outcomes. DESIGN: A retr ... Full text Link to item Cite

First US pediatric heart transplant using XVIVO Heart Assist Transport.

Conference JHLT Open · November 2025 We report the first US pediatric heart transplant utilizing the XVIVO Heart Assist Transport (XHAT) system for donor heart preservation. An 11-year-old recipient successfully received a heart from a 27-year-old donor using hypothermic ex vivo perfusion. Th ... Full text Link to item Cite

Pediatric heart transplant in donation after circulatory death using normothermic regional perfusion.

Journal Article J Thorac Cardiovasc Surg · October 2025 OBJECTIVE: Orthotopic heart transplant is the definitive option for pediatric patients with end-stage heart failure. Unfortunately, the greatest contributor to waitlist mortality has been a shortage of available hearts for transplant. Donation after circul ... Full text Link to item Cite

Partial heart transplant valves demonstrate growth in piglets despite prolonged cold storage.

Journal Article J Thorac Cardiovasc Surg · October 2025 BACKGROUND: Traditional heart valve replacement options lack growth potential, limiting their long-term effectiveness in pediatric patients. Partial heart transplantation is an emerging approach that offers growth-capable valves by transplanting only the v ... Full text Open Access Link to item Cite

Heart Valve Replacement in Children: Homografts to Partial Heart Transplantation.

Journal Article Transplantation · October 1, 2025 Congenital valvular abnormalities in pediatric patients represent a complex surgical problem that carries with it significant morbidity and mortality. Repair of native valves may not always be feasible, leading to requisite surgical intervention. This has ... Full text Link to item Cite

Partial Heart Transplant for Congenital Heart Disease.

Journal Article JAMA · September 23, 2025 IMPORTANCE: Partial heart transplant, or living valve replacement, has the potential to advance surgical management of irreparable valvular disease by providing a viable option with capacity for growth. OBJECTIVES: To describe the early experience and asse ... Full text Open Access Link to item Cite

How I Do It: Donation After Circulatory Death With Normothermic Regional Perfusion in Small Babies

Journal Article Operative Techniques in Thoracic and Cardiovascular Surgery · September 1, 2025 Background: The gold standard for treatment of patients with end-stage heart failure remains heart transplantation. Time spent on the active waiting list, notably for pediatric patients, contributes to alarmingly high mortality. Donation after circulatory ... Full text Cite

The Living Ross Procedure: A New Paradigm in Partial Heart Transplantation.

Journal Article Ann Thorac Surg · August 2025 In the Ross procedure, homograft stenosis and regurgitation have limited the longevity of the right ventricle-to-pulmonary artery (RV-PA) conduit. Partial heart transplantation (PHT) facilitates conduit growth throughout the life of the child. We report th ... Full text Link to item Cite

On-Table Reanimation of a Pediatric Heart from Donation after Circulatory Death.

Journal Article N Engl J Med · July 17, 2025 Cardiac allotransplantation is warranted in children with end-stage heart failure or irreparable congenital heart disease. A dearth of organs for transplantation has contributed to long wait-list times and resultant deaths in this population. Donation afte ... Full text Link to item Cite

Review of Current Normothermic Regional Perfusion Practice in Pediatric Cardiac Donation.

Journal Article Ann Thorac Surg · July 2025 BACKGROUND: Cardiac allotransplantation is the optimal treatment for end-stage heart failure. However, organ supply remains the principal issue affecting patients. Pediatric patients present unique challenges resulting in long wait-list times and increased ... Full text Link to item Cite

Partial Heart Transplantation: Early Experience With Pediatric Heart Valve Replacements That Grow.

Journal Article Circulation · May 20, 2025 Heart valve replacement in children is fraught with long-term morbidity and mortality rates, largely because conventional implants lack the capacity to grow with the child. Partial heart transplantation presents a potential solution by transplanting only s ... Full text Link to item Cite

Early single-center experience with an ex vivo organ care system in pediatric heart transplantation.

Journal Article J Heart Lung Transplant · April 2025 Pediatric heart transplantation (HTx) faces challenges such as limited donor availability and the need for complex reconstructions, particularly in patients with congenital anomalies. Ex vivo perfusion offers a promising approach to minimize graft ischemic ... Full text Link to item Cite

Use of photon-counting CT and three-dimensional printing for an intra-thoracic retained ballistic fragment in a 9-year-old.

Journal Article Pediatr Radiol · April 2025 Retained ballistic fragments from gunshot wounds pose diagnostic and management challenges for radiologists and surgeons alike. Imaging and clinical decision-making regarding removal warrant comprehensive risk/benefit discussions, considering anatomic loca ... Full text Link to item Cite

Perioperative Outcomes After Bioprosthetic Valve Replacement in Patients Sensitized to Alpha-Gal.

Journal Article Ann Thorac Surg Short Rep · March 2025 BACKGROUND: Alpha-gal syndrome from tick bites, due to sensitivity to alpha-gal, can cause severe allergies. Heart valve implants contain alpha-gal, yet alpha-gal syndrome screening is not standard before valve replacement. This study examines perioperativ ... Full text Open Access Link to item Cite

Partial Heart Transplantation Promotes Organ Stewardship: Domino Hearts and Split Roots.

Journal Article Ann Thorac Surg Short Rep · March 2025 BACKGROUND: Partial heart transplantation (PHT) has emerged as a pioneering approach for treating infants with irreparable heart valve dysfunction. However, the scarcity of suitable donors presents a significant bottleneck to its widespread application. Th ... Full text Open Access Link to item Cite

Awareness, Attitudes, and Perceptions Toward Partial Heart Transplantation.

Journal Article Innovations (Phila) · 2025 OBJECTIVE: Partial heart transplantation (PHT) is a new procedure that delivers growing heart valve implants for children. However, awareness, attitudes, and perceptions of health care professionals regarding PHT remain unexplored. METHODS: A national surv ... Full text Link to item Cite

In Vivo Feasibility and Growth of Atrioventricular Partial Heart Transplantation in a Porcine Model.

Journal Article Innovations (Phila) · 2025 OBJECTIVE: Pediatric mitral valve replacement remains a significant challenge due to the lack of growth-capable prostheses, often necessitating multiple reoperations. Partial heart transplantation (PHT) has shown promise in the semilunar position but has n ... Full text Link to item Cite

Textbook Outcome for the Fontan Operation: A Holistic Quality Metric in Congenital Heart Surgery.

Journal Article Innovations (Phila) · 2025 OBJECTIVE: To develop a holistic measure of congenital heart center performance, we created a composite "textbook outcome" (TO) for the Fontan operation using postoperative endpoints. We hypothesized that achieving the TO would have a positive prognostic a ... Full text Link to item Cite

Aberrant right subclavian artery intervention can provide relief of dysphagia.

Journal Article Cardiol Young · December 2024 BACKGROUND: An aberrant right subclavian artery represents the most common aortic arch vascular anomaly. Conventional wisdom states that these anomalies do not result in dysphagia, but rather serve as "red herrings". Clearly, in the vast majority of cases, ... Full text Link to item Cite

Surgical Protocol for Partial Heart Transplantation in Growing Piglets.

Journal Article World J Pediatr Congenit Heart Surg · September 2024 Partial heart transplantation is a new approach to deliver growing heart valve implants. Partial heart transplants differ from heart transplants because only the part of the heart containing the necessary heart valve is transplanted. This allows partial he ... Full text Link to item Cite

Days alive and out of hospital for children born with single-ventricle heart disease.

Journal Article Cardiol Young · July 2024 BACKGROUND: This study describes the illness burden in the first year of life for children with single-ventricle heart disease, using the metric of days alive and out of hospital to characterize morbidity and mortality. METHODS: This is a retrospective sin ... Full text Link to item Cite

Survival after partial heart transplantation in a piglet model.

Journal Article Sci Rep · May 29, 2024 Partial heart transplantation (PHT) is a novel surgical approach that involves transplantation of only the part of the heart containing a valve. The rationale for this approach is to deliver growing heart valve implants that reduce the need for future re-o ... Full text Link to item Cite

Textbook Outcome for Superior Cavopulmonary Connection: A Metric for Single Ventricle Heart Surgery.

Journal Article World J Pediatr Congenit Heart Surg · May 2024 Background: To develop a more holistic measure of congenital heart center performance beyond mortality, we created a composite "textbook outcome" (TO) for the Glenn operation. We hypothesized that meeting TO would have a positive prognostic and financial i ... Full text Link to item Cite

Staged repair of borderline hypoplastic heart disease with early biventricular conversion.

Conference JTCVS Tech · April 2024 OBJECTIVE: In select patients with borderline ventricular hypoplasia, we adopted a strategy of initial single-ventricle palliation followed by staged or direct biventricular conversion by 2 years of age. METHODS: Between 2018 and 2023, 14 newborns with bor ... Full text Link to item Cite

How I Do the Norwood Operation

Journal Article Operative Techniques in Thoracic and Cardiovascular Surgery · March 1, 2024 The Norwood procedure can be performed with several variations including a sustained total all-region (STAR) perfusion technique, introduced at our institution 5 years ago and well described in a prior Operative Techniques article. Regardless of technique ... Full text Cite

Partial Heart Transplant in a Neonate With Irreparable Truncal Valve Dysfunction.

Journal Article JAMA · January 2, 2024 IMPORTANCE: The treatment of neonates with irreparable heart valve dysfunction remains an unsolved problem because there are no heart valve implants that grow. Therefore, neonates with heart valve implants are committed to recurrent implant exchanges until ... Full text Link to item Cite

Partial Heart Transplantation - How to Change the System.

Journal Article Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu · 2024 Partial heart transplantation is the first clinically successful approach to deliver growing heart valve implants. To date, 13 clinical partial heart transplants have been performed. However, turning partial heart transplantation into a routine procedure t ... Full text Link to item Cite

Center-level factors associated with shorter length of stay following stage 1 palliation: An analysis of the national pediatric cardiology quality improvement collaborative registry.

Journal Article Am Heart J · November 2023 BACKGROUND: Stage 1 single ventricle palliation (S1P) has the longest length of stay (LOS) of all benchmark congenital heart operations. Center-level factors contributing to prolonged hospitalization are poorly defined. METHODS: We analyzed data from infan ... Full text Link to item Cite

Use of microaxial flow pumps in adolescents.

Journal Article JTCVS Tech · October 2023 OBJECTIVES: The Impella 5.5 has been successfully used in the adult population; however, safety and efficacy data in patients aged less than 18 years are limited. METHODS: Six pediatric patients, aged 13 to 16 years and weighing 45 to 113 kg, underwent axi ... Full text Link to item Cite

Understanding and Managing Direct Operating Room Supply Costs in Cardiac Surgery.

Journal Article Ann Thorac Surg · June 2023 BACKGROUND: Value-based bundles require surgeons to understand their costs. Current approaches to cost reporting are confusing and difficult to reproduce. Using the Epic surgical receipt function, we describe an intuitive and systematic approach for evalua ... Full text Link to item Cite

Transesophageal Echocardiography-Guided Percutaneous Aspiration of a Large Tricuspid Valve Vegetation in a Patient with Infective Endocarditis.

Journal Article CASE (Phila) · September 2022 • Right-sided IE is associated with IVDU. • Percutaneous debulking of TV vegetations can be a therapeutic option. • TEE can help guide debulking. • TEE can be used to monitor for and prevent complications. ... Full text Link to item Cite

Early identification of patients at risk for delayed recovery of ambulation after elective abdominal surgery.

Journal Article Surg Endosc · July 2022 BACKGROUND: Recovery of preoperative ambulation levels 1 month after surgery represents an important patient-centered outcome. The objective of this study is to identify clinical factors associated with the inability to regain baseline preoperative ambulat ... Full text Link to item Cite

Decreases in daily ambulation forecast post-surgical re-admission.

Journal Article Am J Surg · May 2022 BACKGROUND: Surgical readmissions are clinically and financially problematic. Our purpose is to determine if a decrease in postoperative ambulation (steps/day) is associated with hospital readmission. METHODS: In this prospective cohort study, patients und ... Full text Link to item Cite

Minimally Invasive Approach for Cardiac Hemangioma Resection in a Teenager.

Journal Article Innovations (Phila) · 2022 Cardiac hemangiomas are a rare tumor traditionally resected by median sternotomy. We performed a minimally invasive right ventricular cardiac hemangioma resection via a left anterior mini-incision (LAMI). The procedure was without complication, and the pat ... Full text Link to item Cite

Electromagnetic interference on cardiac pacemakers and implantable cardioverter defibrillators during endoscopy as reported to the US Federal Drug Administration.

Journal Article Surg Endosc · July 2021 INTRODUCTION: More than 3 million patients have a cardiac implanted electronic device (CIED) such as a pacemaker or implanted cardioverter-defibrillator in the USA. These devices are susceptible to electromagnetic interference (EMI) leading to malfunction ... Full text Link to item Cite

Stray energy transfer in single-incision robotic surgery.

Journal Article Surg Endosc · June 2021 INTRODUCTION: Stray energy transfer from surgical monopolar radiofrequency energy instruments can cause unintended thermal injuries during laparoscopic surgery. Single-incision laparoscopic surgery transfers more stray energy than traditional laparoscopic ... Full text Link to item Cite

Monopolar stray energy in robotic surgery.

Journal Article Surg Endosc · May 2021 INTRODUCTION: Stray energy transfer from monopolar radiofrequency energy during laparoscopy can be potentially catastrophic. Robotic surgery is increasing in popularity; however, the risk of stray energy transfer during robotic surgery is unknown. The purp ... Full text Link to item Cite

Postoperative delirium is associated with decreased recovery of ambulation one-month after surgery.

Journal Article Am J Surg · April 2021 BACKGROUND: We hypothesized that postoperative delirium is associated with diminished recovery toward baseline preoperative ambulation levels one-month postoperatively. METHODS: Patients included were ≥60 years old undergoing inpatient operations. Ambulati ... Full text Link to item Cite

Commentary: Malacia got you down? Unwind with a helical stent.

Journal Article J Thorac Cardiovasc Surg · May 1, 2020 Full text Link to item Cite

Is Your Career Hurting You? The Ergonomic Consequences of Surgery in 701 Urologists Worldwide.

Journal Article J Endourol · December 2019 Purpose: Our objective was to seek correlations between the type, volume, and duration of surgical work performed, surgeon habits and characteristics, and the prevalence of neck and back musculoskeletal complaint and intervention across career from trainin ... Full text Link to item Cite

Wearable Technology-A Pilot Study to Define "Normal" Postoperative Recovery Trajectories.

Journal Article J Surg Res · December 2019 BACKGROUND: Emerging wearable technology has the potential to quantify both preoperative and postoperative patient activity. The purpose of this study was to characterize postoperative recovery trajectories for 1 mo after common surgical procedures. MATERI ... Full text Link to item Cite

Use of the consolidated framework for implementation research to guide dissemination and implementation of new technologies in surgery

Journal Article Journal of Thoracic Disease · January 1, 2019 Background: Improving surgical outcomes is important to patients, providers, and healthcare systems. Understanding best methods to ensure evidence based practices are successfully implemented and sustained in clinical practices leads to improved care. Diss ... Full text Cite

Comparison of laparoscopic to open pancreaticoduodenectomy in elderly patients with pancreatic adenocarcinoma.

Journal Article Surg Endosc · May 2018 INTRODUCTION: The purpose of the study is to compare perioperative and survival outcomes in elderly patients undergoing laparoscopic pancreaticoduodenectomy (LPD) to those undergoing open pancreaticoduodenectomy (OPD). METHODS: Patients aged ≥ 75 years wit ... Full text Link to item Cite

Laparoscopic pancreaticoduodenectomy: changing the management of ampullary neoplasms.

Journal Article Surg Endosc · February 2018 BACKGROUND: The purpose of this study is to present the largest reported series comparing open pancreaticoduodenectomy (OPD) to total laparoscopic pancreaticoduodenectomy (TLPD) in patients with ampullary neoplasms. METHODS: Patients undergoing OPD or TLPD ... Full text Link to item Cite

Frailty

Chapter · January 1, 2018 Full text Cite

Acid Peptic Ulcer Disease

Chapter · January 1, 2018 Full text Cite

Post-operative delirium is associated with increased 5-year mortality.

Journal Article Am J Surg · December 2017 BACKGROUND: Post-operative delirium is associated with increased short term morbidity and mortality. Limited data exists on long term outcomes for older adults with postoperative delirium. We hypothesize that postoperative delirium is associated with incre ... Full text Link to item Cite

Hand-to-hand coupling and strategies to minimize unintentional energy transfer during laparoscopic surgery.

Journal Article J Surg Res · November 2017 BACKGROUND: Energy-based devices are used in nearly every laparoscopic operation. Radiofrequency energy can transfer to nearby instruments via antenna and capacitive coupling without direct contact. Previous studies have described inadvertent energy transf ... Full text Link to item Cite

Morbidity of endovascular abdominal aortic aneurysm repair is directly related to diameter.

Conference J Vasc Surg · October 2017 OBJECTIVE: Previous randomized controlled trials have defined specific size thresholds to guide surgical decision-making in patients presenting with an abdominal aortic aneurysm (AAA). With recent advances in endovascular techniques, the anatomic considera ... Full text Link to item Cite

Laparoscopic colectomy in obese patients: a comparison of laparoscopic and hand-assisted laparoscopic techniques.

Journal Article Surg Endosc · October 2017 BACKGROUND: Recent American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP)-based evidence indicates that laparoscopic (LAP) colectomy results in improved outcomes compared to hand-assisted laparoscopic (HAL) colectomy in the ... Full text Link to item Cite

Stray energy transfer during endoscopy.

Journal Article Surg Endosc · October 2017 INTRODUCTION: Endoscopy is the standard tool for the evaluation and treatment of gastrointestinal disorders. While the risk of complication is low, the use of energy devices can increase complications by 100-fold. The mechanism of increased injury and pres ... Full text Link to item Cite

Single-incision laparoscopic surgery increases the risk of unintentional thermal injury from the monopolar "Bovie" instrument in comparison with traditional laparoscopy.

Journal Article Surg Endosc · August 2017 BACKGROUND: Single-incision laparoscopic surgery (SILS) places multiple instruments in close, parallel proximity, an orientation that may have implications in the production of stray current from the monopolar "Bovie" instrument. The purpose of this study ... Full text Link to item Cite

Operating Room Fires and Surgical Skin Preparation.

Journal Article J Am Coll Surg · July 2017 BACKGROUND: Operating room fires are "never events" that remain an under-reported source of devastating complications. One common set-up that promotes fires is the use of surgical skin preparations combined with electrosurgery and oxygen. Limited data exis ... Full text Link to item Cite

Impact of neoadjuvant chemoradiation on perioperative outcomes in patients with rectal cancer.

Journal Article J Surg Oncol · June 2017 BACKGROUND AND OBJECTIVES: Neoadjuvant chemoradiation for rectal cancer is associated with lower local recurrence rates. The objective of this study is to assess the impact of neoadjuvant therapy on perioperative complications in patients with rectal cance ... Full text Link to item Cite

Impact of Facility Type and Surgical Volume on 10-Year Survival in Patients Undergoing Hepatic Resection for Hepatocellular Carcinoma.

Conference J Am Coll Surg · March 2017 BACKGROUND: Previous studies have demonstrated improved in-hospital mortality after hepatic resection for hepatocellular carcinoma (HCC) at teaching hospitals. The objective of this study was to evaluate if resection of HCC at academic cancer programs (ACP ... Full text Link to item Cite

Fecal microbiota transplant in patients with Clostridium difficile infection: A systematic review.

Journal Article J Trauma Acute Care Surg · October 2016 BACKGROUND: Fecal microbiota transplantation (FMT) restores a diverse bacterial profile to the gastrointestinal tract and may effectively treat patients with Clostridium difficile infection (CDI). The objective of this systematic review was to evaluate the ... Full text Link to item Cite

Efficacy of fibrin glue therapy for abscess-associated enteric fistulas.

Journal Article Tech Coloproctol · September 2016 BACKGROUND: Abdominal abscess that result from bowel injury may require treatment with percutaneous drainage. In some cases, an abscess-associated fistula develops between the injured bowel and the drainage catheter. Fistulas that fail to resolve may requi ... Full text Link to item Cite

Surgical Energy-Based Device Injuries and Fatalities Reported to the Food and Drug Administration.

Journal Article J Am Coll Surg · July 2015 BACKGROUND: Energy-based devices are used in virtually every operation. Our purposes were to describe causes of energy-based device complications leading to injury or death, and to determine if common mechanisms leading to injury or death can be identified ... Full text Link to item Cite

How hemostatic agents interact with the coagulation cascade.

Journal Article AORN J · August 2014 Hemostasis is a critical component of the preservation of hemodynamic stability and operative visibility during surgery. Initially, hemostasis is achieved via the careful application of direct pressure to allow time for the coagulation cascade to create a ... Full text Link to item Cite

The impact of academic calendar cycle on coronary artery bypass outcomes: a comparison of teaching and non-teaching hospitals.

Journal Article J Cardiothorac Surg · September 24, 2013 BACKGROUND: The commencement of new academic cycle in July is presumed to be associated with poor patient outcomes, although supportive evidence is limited for cardiac surgery patients. We sought to determine if the new academic cycle affected the outcomes ... Full text Link to item Cite

Radiometallated peptides targeting guanylate cyclase C and the urokinase-type plasminogen activator receptor.

Journal Article Future Oncol · August 2010 Research is currently underway worldwide into the development of receptor-specific radiopharmaceuticals for the imaging and treatment of cancer. The successful clinical development of radiolabeled somatostatin analogs for imaging and treatment of cancers o ... Full text Link to item Cite

Comparative evaluation of three 64Cu-labeled E. coli heat-stable enterotoxin analogues for PET imaging of colorectal cancer.

Journal Article Bioconjug Chem · July 21, 2010 Analogues of the E. coli heat-stable enterotoxin (STh) are currently under study as both imaging and therapeutic agents for colorectal cancer. Studies have shown that the guanylate cyclase C (GC-C) receptor is commonly expressed in colorectal cancers. It h ... Full text Link to item Cite

In vivo imaging of human colorectal cancer using radiolabeled analogs of the uroguanylin peptide hormone.

Journal Article Anticancer Res · October 2009 BACKGROUND: Uroguanylin is an endogenous peptide agonist that binds to the guanylate cyclase C receptor (GC-C). GC-C is overexpressed in human colorectal cancer (CRC), and exposure of GC-C-expressing cells to GC-C agonists results in cell cycle arrest and/ ... Link to item Cite

Synthesis and characterization of an (111)In-labeled peptide for the in vivo localization of human cancers expressing the urokinase-type plasminogen activator receptor (uPAR).

Journal Article Bioconjug Chem · May 20, 2009 This study describes the synthesis and preliminary biologic evaluation of an (111)In-labeled peptide antagonist of the urokinase-type plasminogen activator receptor (uPAR) as a potential probe for assessing metastatic potential of human breast cancer in vi ... Full text Link to item Cite

Partial Heart Transplant Update: Where Are We In 2025?

Journal Article Semin Thorac Cardiovasc Surg Partial heart transplantation (PHT) creates a new and innovative approach to allow for patient and disease tailored intervention with the ability to treat a larger patient base. It offers the growth capacity of a heart transplantation without the need for ... Full text Link to item Cite