by: Dr. Benjamin Sun
This academic year has been one of the most challenging in recent memory for the Division of Cardiothoracic Surgery. The economic challenges that all of us have faced this year have
affected our division as well. This becomes particularly frustrating when all traditional markers of divisional health, such as increasing clinical volume, lower mortality, high patient satisfaction, increase in research funding, and increased national and international recognition, have all continued to improve for our group. In addition, fewer candidates are interested in entering our challenging field. We are already seeing a shortage in cardiothoracic surgeons in the United States. Despite these challenges, I believe we’ve just passed an inflection point. Our division is poised for continued growth in all of our mission charges: clinical productivity, research productivity, and education.
Clinical Programs
Our division was the first in North America to offer robotic cardiothoracic surgery, beginning in 1999. With the evolution of the newer techniques and instrumentation, our team is able to provide therapies that until recently were only a dream. Our surgeons perform many thoracic and cardiac procedures robotically. In fact, our team is one of only a handful in the world able to provide totally robotically-assisted closed chest, beating heart, coronary bypass grafting.
Dr. John Sirak has developed and published a new version of the thoracoscopic Maze procedure that provides validation for each of the lesion sets. This has great potential for increasing the efficacy of this procedure for our patients in atrial fibrillation. In addition, our team was the first in the world to do this procedure robotically.
Our mechanical circulatory support program continues to grow in volume and national recognition. We performed more than 95 mechanical circulatory support procedures this year, with an additional 21 adult ECMO procedures. Because of the success of our program, we have access to support devices that very few institutions can offer. We can therefore provide a more personalized option for our patients requiring mechanical support.
With the successful recruitment of Dr. Edmund Kassis, who completed his cardiothoracic training at the M.D. Anderson Cancer Center and will join the division July 1, 2009, we are enthusiastic about revitalizing our foregut surgical options.
Research Programs
Dr. Sampath Parthasarathy continues to lead our research program and was successful in acquiring an additional R01 grant from the National Institutes of Health. This year, our group generated 32 published journal articles and abstracts and 43 presentations at national and international meetings. Our division is participating in more than 30 ongoing clinical trials.
Education
The cardiothoracic surgery residency program recently underwent its cycled review and received full accreditation. Two fellows completed the program in June 2009. Dr. Syed Mehmood took a private practice position in Los Angeles, Calif., and Dr. Patrick McConnell took an academic position at Nationwide Children’s Hospital and The Ohio State University Medical Center.
We are beginning to face a shortage in cardiothoracic surgeons, as there are substantially more cardiothoracic surgeons retiring (approximately 133 per year) than are being trained (approximately 100 per year). With a growing and aging population, we are already seeing the results of this discrepancy unfold. We presented our findings on this shortage at the first morning plenary session of the American Association for Thoracic Surgery this year. Our analysis has been validated by other sources, including the Institute of Medicine. Our challenge in the coming years will be to attract the best and the brightest students to our field. Lifestyle and quality of life will be important, as will producing exciting innovations in cardiothoracic surgery.
Faculty
Benjamin C. Sun, M.D.
Associate Professor of Surgery; Chief, Division of Cardiothoracic Surgery; Director, Cardiac Transplantation and Mechanical Support
B.S.: Yale University, New Haven, Conn., 1984
M.D.: State University of New York, Stony Brook, N.Y., 1989
Specialty Training: University of North Carolina Hospitals, Chapel Hill, N.C.; Columbia-Presbyterian Medical Center, New York, N.Y.
Appointment: 2002
Specialty Interests: Heart transplantation
Research Interests: Direct mechanical ventricular actuation
Juan A. Crestanello, M.D.
Assistant Professor of Surgery
M.D.: University of the Republic of Uruguay Medical School, Montevideo, Uruguay
Specialty Training: General surgery residency, University of Maryland Medical System, Baltimore, Md.; cardiothoracic surgery research, Hahnemann University, Philadelphia, Pa., and University of Maryland, Baltimore, Md.
Appointment: 2004
Specialty Interests: Cardiac surgery
Research Interests: Ischemic preconditioning, mitochondrial function during ischemic preconditioning, myocardial ischemia reperfusion injury, cell transplantation, the effect of myocardial oxygen content on survival of transplanted cells
Michael S. Firstenberg, M.D.
Assistant Professor of Surgery
B.A.: University of Chicago, Chicago, Ill., 1990
M.D.: Case Western Reserve University, Cleveland, Ohio, 1996
Specialty Training: Ohio State University Medical Center, Columbus, Ohio; Cleveland Clinic, Cleveland, Ohio; National Heart, Lung, and Blood Institute, Bethesda, Md.; University Hospitals, Cleveland, Ohio
Appointment: 2007
Specialty Interests: Adult acquired and congenital cardiac surgery, cardiothoracic critical care, mechanical assist, heart failure
Research Interests: Cardiac imaging and physiology, mechanical assist
Mark Galantowicz, M.D.
Associate Professor of Clinical Surgery
B.A.: University of Pennsylvania, Philadelphia, Pa., 1982
M.D.: Cornell University Medical College, New York, N.Y., 1987
Specialty Training: Columbia-Presbyterian Medical Center,
New York, N.Y.
Appointment: 2002
Specialty Interests: Pediatric transplantation and surgery
Pawel Kwiatkowski, M.D.
Research Assistant Professor of Surgery
B.A.: ILO Swietochlowice, Poland, 1982
M.D.: Silesian Academy of Medicine, Katowice, Poland, 1988
Specialty Training: Silesian Academy Medical Center, Zabrze, Poland; Columbia University, New York, N.Y.
Appointment: 1998
Research Interests: Transplant immunology, including xenotransplantation and allotransplantation of heart and lung
Louis B. Louis, IV, M.D.
Assistant Professor of Surgery
B.A.: Virginia Military Institute, Lexington, Va., 1994
M.D.: University of Miami, Miami, Fla., 1998
Specialty Training: The Ohio State University, Columbus, Ohio
Appointment: 2008
Specialty Interests: Adult cardiac surgery, surgery for heart failure,
mechanical circulatory support, cardiac transplantation, cardiovascular surgical critical care
Susan D. Moffatt-Bruce, M.D., Ph.D.
Assistant Professor of Surgery
B.A.: McGill University, Montreal, Quebec, Canada, 1990
M.D.: Dalhousie University, Halifax, Nova Scotia, Canada, 1994
Ph.D.: University of Cambridge, Cambridge, United Kingdom, 1999
Specialty Training: Residency in general surgery, Dalhousie University, Halifax, Nova Scotia, Canada; fellowship in cardiothoracic surgery, Stanford University, Palo Alto, Calif.
Appointment: 2006
Specialty Interests: Lung transplant, heart transplant, transplant outcomes, thoracic oncology
Research Interests: Transplant immunology
Sampath Parthasarathy, Ph.D., M.B.A.
The Karl P. Klassen Professor of Surgery; Director of Research, Division of Cardiothoracic Surgery
Ph.D.: Indian Institute of Science, Bangalore, India, 1975
M.B.A.: University of Phoenix, 2004
Specialty Training: Kyoto University, Kyoto, Japan; Duke University, Durham, N.C.; the Hormel Institute, University of Minnesota, Austin, Minn.
Appointment: 2006
Research Interests: Vascular biology and medicine
Alistair B. M. Phillips, M.D.
Assistant Professor of Surgery
B.S.: Johns Hopkins University, Baltimore, Md., 1990
M.D.: Columbia University, New York, N.Y., 1994
Specialty Training: Residency in general and cardiothoracic surgery, New York-Presbyterian Hospital and Weill Cornell Medical Center, New York, N.Y.; fellowship in pediatric cardiac surgery, Columbia University Medical Center, New York, N.Y.
Appointment: 2006
Specialty Interests: Pediatric cardiothoracic surgery
Patrick Ross, Jr., M.D., Ph.D.
Professor of Clinical Surgery
A.B.: Harvard University, Cambridge, Mass., 1977
M.D., Ph.D.: St. Louis University, St. Louis, Mo., 1983
Specialty Training: University of Pennsylvania, Philadelphia, Pa.
Appointment: 1991
Specialty Interests: Lung volume reduction, thoracic surgical oncology, benign noncardiac thoracic disease, lung transplantation
Research Interests: New modality lung cancer therapy
Chittoor B. Sai-Sudhakar, M.B.B.S., F.A.C.S., F.R.C.S.
Assistant Professor of Surgery
B.A.: Loyola College, Madras, India, 1975
B.Sc.: Presidency College, Madras, India, 1976
M.B.B.S.: Stanley Medical College, Madras, India, 1982
Specialty Training: Yale-affiliated residency, St. Mary’s Hospital,
Waterbury, Conn.
Appointment: 2003
Specialty Interests: Aortic surgery, heart failure
Research Interests: Pathways in endothelial cells
John H. Sirak, M.D.
Assistant Professor of Clinical Surgery
B.A.: Amherst College, Amherst, Mass., 1985
M.D.: Case Western Reserve University, Cleveland, Ohio, 1991
Specialty Training: General surgery residency, minimally invasive cardiothoracic surgery fellowship, The Ohio State University, Columbus, Ohio; arrhythmia surgery fellowship, Cleveland Clinic, Cleveland, Ohio
Appointment: 2004
Specialty Interests: Surgery for atrial fibrillation
Research Interests: Transplant immunology
Alexandru M. Vaida, M.D.
Assistant Professor of Surgery
B.A.: St. Sava National College, Bucharest, Romania
M.D.: University of Medicine and Pharmacy, Targu-Mures, Romania, 1995
Specialty Training: Ohio State University Medical Center, Columbus, Ohio; Targu-Mures General Hospital, Targu-Mures, Romania; Veterans Affairs Medical Center, Richmond, Va.; Medical College of Virginia Hospitals, Richmond, Va.
Appointment: 2006
Specialty Interests: Thoracic oncology, lung transplant, esophageal
surgery
Paul A. Vesco, M.D.
Assistant Professor of Surgery
B.A.: Washington and Jefferson College, Washington, Pa., 1993
M.D.: University of Kentucky, Lexington, Ky., 1997
Specialty Training: The Ohio State University, Columbus, Ohio
Appointment: 2008
Specialty Interests: Minimally invasive robotic cardiac and thoracic surgery
Emeritus Faculty
J. Terrance Davis, M.D.
Professor Emeritus of Clinical Surgery
B.A.: Williams College, Williamstown, Mass., 1963
M.D.: University of Pennsylvania, Philadelphia, Pa., 1967
Gerard S. Kakos, M.D.
Clinical Associate Professor Emeritus of Surgery
B.A.: The Ohio State University, Columbus, Ohio, 1964
M.D.: The Ohio State University, Columbus, Ohio, 1967
James W. Kilman, M.D.
Professor Emeritus of Surgery
B.S.: Indiana State University, Terre Haute, Ind., 1956
M.D.: Indiana State University, Indianapolis, Ind., 1960
Charles V. Meckstroth, M.D.
Professor Emeritus of Surgery
B.A.: The Ohio State University, Columbus, Ohio, 1944
M.D.: The Ohio State University, Columbus, Ohio, 1947
M.M.Sc. (Surgery): The Ohio State University, Columbus, Ohio, 1950
Howard D. Sirak, M.D.
Professor Emeritus of Surgery
A.B.: University of Pennsylvania, Philadelphia, Pa., 1943
M.D.: The Ohio State University, Columbus, Ohio, 1947
M.M.Sc. (Surgery): The Ohio State University, Columbus, Ohio, 1953
Clinical Faculty
Thomas E. Williams, Jr., M.D., Ph.D.
Clinical Associate Professor of Surgery
B.A.: Princeton University, Princeton, N.J., 1957
M.S., M.D.: The Ohio State University, Columbus, Ohio, 1963
Ph.D.: Northwestern University, Evanston, Ill., 1969
Resident Staff
Murtaza Dawood, M.D.
PGY-6
B.S.: University of Maryland, College Park, Md., 1997
M.D.: Saba University, Netherlands-Antilles, 2002
Brian Goodman, M.D.
PGY-6
B.S.: University of Miami, Coral Gables, Fla., 1996
M.D.: University of Vermont, Burlington, Vt., 2003
Patrick McConnell, M.D.
PGY-7
B.S.: Creighton University, Omaha, Neb., 1994
M.D.: University of Nebraska, Omaha, Neb., 1999
Syed Mehmood, M.D.
PGY-7
B.S.: University of Michigan, Ann Arbor, Mich., 1997
M.D.: Rosalind Franklin University of Medicine and Science/Chicago Medical School, Chicago, Ill., 2002
Mission
The Division of Cardiothoracic Surgery is dedicated to preserving and improving life for patients with heart and lung disease.
Research Programs
• AB5000 Circulatory Support System Data Registry.
• CardioWest Temporary Total Artificial Heart post-market surveillance study.
• Chronic heart failure model in sheep.
• Chronic unloading therapy with Heartmate II VAD in an ovine ischemic cardiomyopathy model.
• Circulating endothelial cells and thrombosis.
• Clinical trial of the On-X Prosthetic Heart Valve using low-dose anticoagulation.
• Collaborative study of mitochondrial function in ischemia.
• Comparative clinical and pharmacoeconomic study comparing Argatroban IV vs. Desirudin SC for patients with suspected heparin-induced thrombocytopenia (HIT) without clinically evident thrombosis: PREVENT-HIT.
• Comparative mutational profiling as the standard of care in assessing lung lesions.
• C-Pulse implantable counterpulsation pump for treating heart failure.
• Destiny trial: effects of mitral valve annuloplasty with the GeoForm Ring on left ventricular geometry and function in patients with cardiomyopathy.
• Dietary oxidized lipids and atherosclerosis.
• Evaluation of glycemic control in cardiac surgery patients.
• Evaluation of the HeartWare LVAD system for the treatment of advanced heart failure.
• Heartmate II VAD destination therapy.
• Heartmate II VAD imaging study.
• Heartware BTT.
• The immunobiology of insulin resistance: the role of T regulatory cells.
• Immunobiology of photodynamic therapy in lung cancer patients.
• Immunobiology of transplant-related heart failure.
• INTERMACS (Interagency Registry for Mechanically-Assisted Circulatory Support).
• Levitronix CentriMag LVAS for failure to wean CPB.
• Mechanical, cellular, and pharmacological therapy for congestive heart failure.
• Mechanisms of bronchiolitis obliterans in pediatric and adult lung transplants.
• Medtronic Mosaic vs. Carpentier-Edwards Perimount all-cause patient survival.
• Multicenter study comparing thymectomy to no thymectomy in myasthenia gravis patients on prednisone.
• Non-pharmacological dietary modulation of atherosclerosis by sesame oil.
• A novel approach to generate regulatory T cells using CD103 depletion.
• OSU Heart Center biobank.
• Oxidation hypothesis: paradoxes and pitfalls.
• Patient discharge using the AB Portable Driver System.
• Pilot study assessing robotic video-assisted thoracic surgery (RATS) versus standard thoracotomy for malignant lesions.
• Preclinical cardiac device study.
• A prospective, multicenter, randomized, clinical study to evaluate the PleuraSeal Sealant System as an adjunct to standard closure techniques for control of visceral pleural air leaks following elective pulmonary resection via open thoracotomy.
• A randomized, controlled, Phase 3 study of gentamicin-collagen sponge (Collatamp G) in cardiac surgical subjects at higher risk for sternal wound infection.
• A randomized, multicenter, double-blind, group-sequential study to evaluate the efficacy, immunogenicity, and safety of a single dose of Merck 0657nI staphylococcus aureus vaccine V710 in adult patients scheduled for cardiothoracic surgery.
• A randomized study to compare sizing, implant techniques and homodynamic performance between the Mitroflow and the Carpentier-Edwards Magna pericardial tissue valves in the aortic position.
• Impella Recover I 5.0.
• A retrospective and prospective study of patients with atrial fibrillation and the postoperative outcomes, quality of life, and arrhythmia reoccurrence rates after undergoing the total thoracoscopic Maze procedure.
• Role and mechanism of oxygen tension and oxidative stress in regulating the development of intimal hyperplasia in human saphenous veins cultures ex vivo.
• Role of dietary oxidized lipids in atherosclerosis.
• Role of endothelial nitric oxide synthase in local blood pressure regulation in patients with vascular disease.
• Role of macrophages in acute cellular rejection in cardiac transplantation.
• Schering-Plough CABG clinical research study.
• Simultaneous carotid endarterectomy and cardiac surgery.
• STICH protocol for surgical treatment of ischemic heart failure.
• Study of factors that prevent improvement in left ventricular function after surgical revascularization.
• Study to determine the presence of oxidized low density lipoproteins (Ox-LDL) and its degradation products in the blood and left ventricular tissue of patients with heart failure.
• Supravalvular aortic stenosis.
• Thoratec left ventricular assist device congestive heart failure sheep.
• Thrombosis model of heart failure in sheep.
• Tissue/serum repository for cardiac and thoracic surgery.
• VAD watch telehealth monitoring in the residential setting.
• VentrAssist bridge to transplant.
• VentrAssist destination therapy.
Accomplishments in Research
• Dr. Pawel Kwiatkowski was credited with two patents: “Spin Probes and Measurements for Minimally Invasive Monitoring and Imaging of Cardiovascular Events” and “Use of Paramagnetic Particles to Monitor Effectiveness of Cell Transplantation.”
• Dr. Pawel Kwiatkowski was the recipient of the 2009 OSU Undergraduate Enrichment Award for “The Detection of Heart Failure Biomarker Using Sheep-Specific Antibodies: Optimization of the Assay Protocol.”
• Dr. Pawel Kwiatkowski was a judge of scientific abstracts in the Cardiovascular Surgery Section for The Ohio State University Medical Center’s Annual Research Day, on April 2, 2009.
• Dr. Pawel Kwiatkowski was a judge of medical sciences abstracts for The Ohio State University’s Denman Undergraduate Research Forum, on May 13, 2009.
• Dr. Sampath Parthasarathy received the Medical Science Award of the Ranbaxy Foundation, in New Delhi, India.
• Dr. Sampath Parthasarathy was credited with two inventions: “Methods for Making Multi-targeted Methylenedioxyphenol-based Compositions and Uses Thereof” and “Labeling of Liposomes with Cholesteryl-9-carboxynonanoate for Improved Stability and Pharmacokinetics and Using Them as Targeted MRI Probes.”
• Gregory Steinbaugh received a $650 travel award from The Ohio State University’s Office of Postdoctoral Programs.
Active Research Grants
Crestanello J. Are mitochondria-mediated free oxygen radicals mediators of preconditioning? 2007 American College of Surgeons Faculty Research Fellowship, July 1, 2007 – June 30, 2009, $80,000.
Crestanello J. Destiny trial: effects of mitral valve annuloplasty with the GeoForm Ring on left ventricular geometry and function in patients with cardiomyopathy. Edwards Lifesciences, November 3, 2006 – November 3, 2009, $57,190.
Crestanello J. Measurement of free radical generation in the heart. National Institutes of Health,
Minority Supplemental Grant R01, March 1, 2006 – to November 30, 2009, $112,125/year.
Crestanello J. Postconditioning, free oxygen radical generation and mitochondrial function. Thoracic Surgery Foundation for Research and Education, 2008 Research Grant, July 1, 2008 – June 30, 2010, $60,000.
Diaz PT, Ross P Jr. Clinical center for the National Emphysema Treatment Trial (NETT). National Heart, Lung, and Blood Institute, December 20, 1996 – December 31, 2008, $573,871.
Kissel JT, Ross P Jr. Thymectomy in non-thymomatous MG patients on prednisone. University of Alabama at Birmingham, April 1, 2006 – August 31, 2008, $1,500.
Kuppusamy P, Kwiatkowski P. Noninvasive monitoring of in situ oxygenation and cell therapy in infarcted heart. National Institutes of Health, R01, July 1, 2007 – June 30, 2012, $1,250,000.
Moffatt-Bruce S, Astor T. Mechanisms of bronchiolitis obliterans in pediatric and adult lung transplants. 2008–2009 Ohio State University/Nationwide Collaborative Research Award, August 1, 2008 – December 31, 2009, $50,000.
Moffatt-Bruce S, Hadley G. The role of macrophages in acute cellular rejection in cardiac transplant rejection. Clinical and Translational Science Award, K12 Scholars Award 2009–2011, $196,000/year.
Parthasarathy S. Adherent and non-adherent macrophages in cell survival and death. American Heart Association, Great Rivers Affiliate, July 1, 2008 – June 30, 2010, $21,000.
Parthasarathy S. Dietary oxidized lipids and atherosclerosis. National Institutes of Health, R01, July 1, 2000 – February 28, 2009, $225,000/year.
Parthasarathy S. Novel mechanisms by which aspirin might protect against atherosclerosis. National Heart, Lung, and Blood Institute, R01, July 1, 2008 – June 30, 2013, $250,000/year.
Parthasarathy S. Oxidation hypothesis: paradoxes and pitfalls. National Institutes of Health, R01, December 1, 2001 – July 31, 2009, $250,000/year.
Phillips ABM. Cytoskeletal alterations in a porcine model of restrictive ventricular septal defect.
Society of Cardiovascular Anesthesiologists, September 1, 2008 – August 31, 2010, $40,000 for two years.
Sai-Sudhakar CB. Anticoagulation strategy with bioprosthetic valves postoperative event registry (ANSWER). Duke University, August 10, 2007 – August 9, 2008, $8,150.
Sai-Sudhakar CB. Clinical trial of the On-X valve using low dose anticoagulation. Medical Carbon Research Institute, LLC, December 1, 2006 – November 30, 2013, $3,600.
Sai-Sudhakar CB. Investigating the prevalence and role of autoantibodies to endothelial cells in
patients following acute myocardial infarction and in congestive heart failure. Ross Academic Enrichment Grant, 2008–2009, $78,000.
Sai-Sudhakar CB. Potential auto-antibodies to endothelial cells and their role in angiogenesis and neovascularization following acute coronary events. Davis/Bremer Research Grant, 2008–2010, $50,000 annually for two years.
Sai-Sudhakar CB. A randomized, controlled, phase 3 study of gentamicin-collagen sponge (Collatamp G) in cardiac surgical subjects at higher risk for sternal wound infection. Duke University, February 11, 2008 – December 31, 2009, $14,520.
Sidell N, Parthasarathy S. Nuclear antioxidants in the prevention of endometriosis. Emory Consortium, July 1, 2008 – June 30, 2010, $37,500.
Sirak JH. Stentless porcine bioprostheses for aortic valve replacement model NR-200 Plus and model NR-200C Plus No React treated porcine bioprostheses for aortic valve replacement. Shelhigh, Inc., March 10, 2006 – March 10, 2010, $96,000.
Sun B. AB5000 circulatory support system data registry. Abiomed, Inc., April 26, 2005 – December 31, 2008, $12,398.
Sun B. Clinical evaluation of the HeartMate II LVAS study. Thoratec Corp., April 26, 2005 –
December 31, 2008, $200,444.
Sun B. Preclinical cardiac device study. BioVentrix, February 29, 2008 – June 30, 2010, $215,000.
Sun B. SynCardia CardioWest Temporary Total Artificial Heart (TAH-t) post-market surveillance study. SynCardia Systems, Inc., October 27, 2006 – July 24, 2009, $3,300.
Sun B, Binkley PF. Surgical treatment for ischemic heart failure (STICH). Duke University, June 17, 2002 – May 31, 2009, $255,888.
Sun B, Crestanello JA. CentriMag VAS: use as an RVAS following implantation of a commercially-approved LVAS. Levitronix, LLC, September 2, 2005 – September 1, 2008, $10,000.
Sun B, Feldman DS, Sai-Sudhakar C. Levitronix CentriMag short-term ventricular assist system. Levitronix, LLC, April 26, 2005 – December 31, 2008, $6,000.
Clinical Programs
• Adult cardiothoracic surgery.
• Aortic surgery.
• Arrhythmia surgery.
• Heart failure surgery.
• Heart transplantation.
• Heart-lung transplantation.
• Lung transplantation.
• Lung volume reduction surgery.
• Mechanical circulatory support.
• Minimally invasive heart surgery.
• Photodynamic therapy.
• Robotic surgery.
• Thoracic oncology.
• Total artificial heart transplantation.
Accomplishments in Clinical Care
• Dr. Patrick Ross, Jr. was chief of staff-elect of the Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, Ohio, 2007–2009.
Clinical Statistics
OR Procedures
2,682
Outpatient Visits 7,602
Admissions 1,732
Patient Days 18,688
Average Length of Stay
(Days) 9.38
Educational Programs
• Two-year cardiothoracic surgery fellowship accredited by the Accreditation Council for Graduate Medical Education.
• One-year fellowship in mechanical circulatory support.
• Comprehensive rotation in cardiothoracic surgery for fir