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Becoming a Cardiothoracic Surgeon: An Emerging Profile in the Surgery Theater and through Scientific Publications 

Author and Curator: Aviva Lev-Ari, PhD, RN

Article ID #65: Becoming a Cardiothoracic Surgeon: An Emerging Profile in the Surgery Theater and through Scientific Publications. Published on 7/8/2013

WordCloud Image Produced by Adam Tubman

Two components of an Emerging Profile of a Young Cardiothoracic Surgeon were researched by the Author for the case of  Dr. Isaac George, Assistant Professor of Surgery, Division of Cardiothoracic Surgery, Department of Surgery, New York Presbyterian Hospital/Columbia University Medical Center , New York, NY.

The two components being:

1. the Cardiothoracic Surgery Theater

2. the Scientific Publications

I noted with interest Dr. George’s second publication, to be about a very well known surgeon in the US and Europe, John Benjamin Murphy. written by Dr. George and two other colleagues,  George I, Hardy MA, Widmann WD. published in Curr Surg. 2004 Sep-Oct;61(5):439-41.

Dr. Murphy, is best remembered for the eponymous clinical sign that is used in evaluating patients with acute cholecystitis. His career spanned general surgery, orthopedics, neurosurgery, and cardiothoracic surgery, which helped him to gain international prominence in the surgical profession. Mayo Clinic co-founder William James Mayo called him “the surgical genius of our generation.”

http://en.wikipedia.org/wiki/John_Benjamin_Murphy 

^{[Musana, Kenneth and Steven H. Yale (May 2005). “John Benjamin Murphy (1857–1916)”. Clinical Medicine & Research. Retrieved 2008-05-16.]}

I assume that Dr. Murphy’s contributions to Thoracic surgery were of interest to Dr. George to inspire him to write on the subject and elect that Specialty in Surgery.

Murphy was first in the U.S. to induce (1898) artificial immobilization and collapse of the lung in treatment of pulmonary tuberculosis. He was a pioneer in the use of bone grafting and made contributions to the understanding and management of ankylosis as well as independently proposing artificial pneumothorax to manage unilateral lung disease in tuberculosis.

• • «It is the purpose of every man’s life to do something worthy of the recognition and appreciation of his fellow men. . . . By their superior intellectual qualifications, their fidelity to purpose and above all their indefatigable labour the few become leaders.»

Journal of the American Medical Association, Chicago, 1911, 57: 1.

SOURCE Whonamedit? A dictionary of medical eponyms, John Benjamin Murphy

I came across Dr. Isaac George’s name while researching clinical indications for Inhaled Nitric Oxide in June 2013, upon the recent publication of Leaders in Pharmaceutical Business Intelligence FIRST e-Book on  Amazon (Biomed e-Books) [Kindle  Edition]

Perspectives on Nitric Oxide in  Disease  Mechanisms
http://www.amazon.com/dp/B00DINFFYC

Dr. George’s article on Outcomes After Inhaled Nitric Oxide Therapy was particularly useful in my own research on the topic,

Clinical Indications for Use of Inhaled Nitric Oxide (iNO) in the Adult Patient Market: Clinical Outcomes after Use of iNO in the Institutional Market,  Therapy Demand and Cost of Care vs. Existing Supply Solutions

Being myself in Analytics and quantitative model design, 1976-2004, I found of particular interest the range of quantitative methodologies used in the following article by Isaac George, assuming that his days at MIT, came very handy in 2006:

George, Isaac, Xydas, Steve, Topkara, Veli K., Ferdinando, Corrina, Barnwell, Eileen C., Gableman, Larissa, Sladen, Robert N., Naka, Yoshifumi, Oz, Mehmet C.
Clinical Indication for Use and Outcomes After Inhaled Nitric Oxide Therapy
Ann Thorac Surg 2006 82: 2161-2169

As a result of studying this article, I became aware that it has impacted  favorably my 6/2013, Editorial decision, for  a forthcoming book on Cardiovascular Disease in 2013. The Editorial decision regarding the selection and representation of  prominent Cardiothoracic Surgery Theater in the US, and my personal decision to select a Young Cardiothoracic Surgeon

Dr. Isaac George, Assistant Professor of Surgery, Division of Cardiothoracic Surgery, Department of Surgery, New York Presbyterian Hospital/Columbia University Medical Center, New York, NY

Education Profile and Medical Training of a Cardiac Surgeon

Isaac George, MD Positions and Appointments 2012-present Attending Surgeon, Heart Valve Center NewYork-Presbyterian Hospital/Columbia University Medical Center, New York, NY 2012-present Assistant Professor of Surgery Division of Cardiothoracic Surgery, Department of Surgery, New York Presbyterian Hospital/Columbia University Medical Center , New York, NY Clinical Specialties Adult aortic and mitral valve surgery Transcatheter aortic and mitral valve implantation Hybrid coronary artery bypass surgery Complex aortic surgery Complex valvular surgery Heart failure and transplant surgery Reoperative cardiac surgery Thoracic aortic endograft implantation Research Interests Director, Cardiac Surgery Research Lab 1. Regulation of myostatin signaling in human cardiomyopathy 2. TGFB regulation in non-syndromic aortic aneurysm formation 3. Valve interstitial cell activation mechanisms after surgical and transcatheter valve replacement 4. Clinical outcomes after valve and hybrid surgery Education and Training 2011-2012 Interventional Cardiology/Hybrid Cardiac Surgery Fellowship New York Presbyterian Hospital – Columbia University Medical Center, New York, NY 2011 Ventricular Assist Device/Cardiac Transplant Fellowship, Minimally Invasive, Cardiac Surgery New York Presbyterian Hospital – Columbia University Medical Center, New York, NY 2009-2011 Fellow, Cardiothoracic Surgery New York Presbyterian Hospital – Columbia University Medical Center, New York, NY 2008-2009 Post-Doctoral Clinical Fellow, Cardiothoracic Surgery New York Presbyterian Hospital – Columbia University Medical Center, New York, NY 2006-2008 Resident, General Surgery New York Presbyterian Hospital – Columbia University Medical Center, New York, NY 2004-2006 Research Fellow, Cardiothoracic Surgery New York Presbyterian Hospital – Columbia University Medical Center, New York, NY 2002-2004 Resident, General Surgery New York Presbyterian Hospital – Columbia University Medical Center, New York, NY 2001-2002 Internship, General Surgery New York Presbyterian Hospital – Columbia University Medical Center, New York, NY 1997-2001 MD, Medicine Duke University School of Medicine, Durham, NC 1993-1997 BS, Mechanical Engineering Massachusetts Institute of Technology, Cambridge, MA Board Certifications American Board of Thoracic Surgery, 2012- American Board of Surgery, 2008- Certification, Pediatric Advanced Life Support, 2008- Certification, Advanced Trauma Life Support, 2006- MD, State of New York, 2005- Certification, Advanced Cardiac Life Support/Basic Life Support, 2001- United States Medical Licensing Examination Step 3, 2004 United States Medical Licensing Examination Step 2, 2001 United States Medical Licensing Examination Step 1, 2000 Professional Honors 2008 Blakemore Prize – Best Resident Research Award, Columbia University College of Physicians and Surgeons 2007 Blakemore Award – Best Resident Research Award, Columbia University College of Physicians and Surgeons 2006 Blakemore Award – Best Resident Research Award, Columbia University College of Physicians and Surgeons 2004 New Era Cardiac Surgery Conference Scholarship 1995 Pi Tau Sigma, Mechanical Engineering Honor Society 1993 Duke University Comprehensive Cancer Center Fellowship Professional Societies and Committees 2011 Faculty, Transcatheter Cardiovascular Therapeutics (TCT) Annual Symposium 2010- Candidate Member, Society of Thoracic Surgeons 2010- Fellow-in-Training, American College of Cardiology, Surgeons Council 2005-06 American Society of Artificial Internal Organs 2004- Member, American Heart Association 1997-01 Member, American Medical Association

SOURCE http://asp.cpmc.columbia.edu/facdb/profile_list.asp?uni=ig2006&DepAffil=Surgery

The decision to focus on Cardiothoracic Surgery @Presbeterian as described in Dr. Isaac George’s research had yielded one Sub-Chapter (4.1) in Chapter 4

Cardiac Surgery, Cardiothoracic Surgical Procedures and Percutaneous Coronary Intervention (PCI)/Coronary Angioplasty  – Heart and Cardiovascular Medical Devices in Use in Operating Rooms and in Catheterization Labs in the US

in Volume Three in a forthcoming three volume Series of e-Books on Cardiovascular Diseases

Cardiovascular Diseases: Causes, Risks and Management

This very Sub-Chapter represents milestones in Dr. Isaac George – Becoming a Cardiothoracic Surgeon: An Emerging Profile through Scientific Publications, This profile is now in: 

Volume Three

Management of Cardiovascular Diseases

Justin D. Pearlman MD ME PhD MA FACC, Editor

Leaders in Pharmaceutical Business Intelligence, Los Angeles

Aviva Lev-Ari, PhD, RN

Editor-in-Chief BioMed E-Book Series

Leaders in Pharmaceutical Business Intelligence, Boston

avivalev-ari@alum.berkeley.edu

5.1 Cardiothoracic Surgery 

5.1.1 Becoming a Cardiothoracic Surgeon: An Emerging Profile in the Surgery Theater and through Scientific Publications

Aviva Lev-Ari, PhD, RN

5.2: Catheter Interventions

5.2.2 Survivals Comparison of Coronary Artery Bypass Graft (CABG) and Percutaneous Coronary Intervention (PCI) / Coronary Angioplasty

Larry H Bernstein, MD, FCAP and Aviva Lev-Ari, PhD, RN

5.3: Transcatheter (Percutaneous) Valves

5.3.1 Transcatheter Aortic Valve Replacement (TAVR): Postdilatation to Reduce Paravalvular Regurgitation During TAVR with a Balloon-expandable Valve

Larry H Bernstein, MD, FCAP and Aviva Lev-Ari, PhD, RN

5.3.2 Trans-apical Transcatheter Aortic Valve Replacement in a Patient with Severe and Complex Left Main Coronary Artery Disease (LMCAD)

Larry H Bernstein, MD, FCAP and Aviva Lev-Ari, PhD, RN

5.4.1  Ventricular Assist Device (VAD): Recommended Approach to the Treatment of Intractable Cardiogentic Shock

Larry H Bernstein, MD, FCAP and Aviva Lev-Ari, PhD, RN

5.4.2 Phrenic Nerve Stimulation in Patients with Cheyne-Stokes Respiration and Congestive Heart Failure

Larry H Bernstein, MD, FCAP and Aviva Lev-Ari, PhD, RN

Content Analysis of  Surgeon Isaac George, MD – Publications on PubMed

SOURCE

Original classification by Aviva Lev-Ari, PhD, RN, 7/8/2013

It is the unique combination of Animal Model Research, Biomaterial, Surgical Procedures and Molecular Cardiology, N=33.

Cardiothoracic Surgeon: An Emerging Profile in the Surgery Theater

Isaac George, MD – Clinical Specialties 

• Adult aortic and mitral valve surgery
• Transcatheter aortic and mitral valve implantation
• Hybrid coronary artery bypass surgery
• Complex aortic surgery
• Complex valvular surgery
• Heart failure and transplant surgery
• Reoperative cardiac surgery
• Thoracic aortic endograft implantation

VIDEOS on CardioThoracic Surgery @ Department of Cardiothoracic Surgery at NewYork-Presbyterian Hospital/Weill Cornell Medical Center in New York City

VIEW VIDEO on the new Heart Center @ Presbyterian Hospital

http://videos.nyp.org/videos/introduction-to-the-vivian-and-seymour-milstein-family-heart-center

VIEW VIDEO on the two Hybrid OR with Siemens Artis Zeego Technology

http://videos.nyp.org/videos/tour-a-hybrid-or-with-siemens-artis-zeego-technology

VIEW VIDEO on Mininally Invesive and Conventional Therapy for Aortic Dissection and Aneurysms – Hybrid Surgery Case

http://videos.nyp.org/videos/thoracic-innovations-in-minimally-invasive-and-conventional-therapy-for-aortic-dissection-and-aneurysms

VIEW VIDEO on Mitral Valve Repair and Replacement – Dr. Karl H. Krieger

Dr. Karl H. Krieger, the Vice Chairman of the Department of Cardiothoracic Surgery at NewYork-Presbyterian Hospital/Weill Cornell Medical Center in New York City, discusses treatment for Mitral Valve Disease. Specifically, Dr. Krieger compares the options of Mitral Valve Repair with Mitral Valve Replacement.

This video with Dr. Krieger is from a web cast at the Ronald O. Perelman Heart Institute at NewYork-Presbyterian.

VIEW VIDEO on Left Ventricular Assist Devices (LVADs) – Dr. Jonathan Chen

Dr. Jonathan Chen, the Site Chief for Pediatric Cardiac Surgery at NewYork-Presbyterian Hospital/Weill Cornell Medical Center in New York City, explains how Left Ventricular Assist Devices (LVADs) work and how they can benefit patients with heart failure.

LVADs are implantable devices that help the heart pump blood. They can be used as a temporary therapy, allowing patients’ hearts to rest while they recover from cardiac events such as heart attacks, or while they wait for hearts to become available for transplants. For some patients whose hearts are unlikely to recover and are not candidates for heart transplants, the devices may be used as a permanent therapy. Heart failure, especially in severe forms, can force patients to lead restricted lives because often even very limited physical activity, such as walking from one room to another, will leave them breathless.

Dr. Chen is a pediatric cardiothoracic surgeon, yet the information in the video is applicable to adult patients as well.

VIEW VIDEO on Transcatheter Aortic Valve Implantation @ Presbyterian Hospital

http://videos.nyp.org/videos/chapter-3-transcatheter-aortic-valve-implantation

Heart, Heart-Lung Transplantation @ Presbyterian Hospital

Organ transplantation that prolongs and dramatically improves quality of life is nearly a daily occurrence at Columbia University Medical Center.

The success of solid organ transplantation – with improved surgical techniques, replacement organ procurement, and medical management – is advancing each year. Many of these advances have resulted from scientific and clinical research conducted at Columbia University Medical Center.

A Brief History of Transplantation at Columbia

Transplantation: Where we’ve been, where we’re going

When he transplanted a chimpanzee kidney into a human patient in the late 1960’s, the late Keith Reemtsma, MD, then Department of Surgery Chairman at Tulane University, revolutionized treatment of end-stage organ failure and initiated an era of unprecedented exploration into organ transplantation that would affect the lives of patients around the world.

Transferring to Columbia-Presbyterian Medical Center in 1971, Dr. Reemtsma recruited Mark A. Hardy, MD, who laid another cornerstone of organ transplant medicine by founding the program for dialysis and kidney transplantation. Dr. Hardy based the new program on the principle of collaborative clinical care between surgeons and nephrologists. During a time when renal transplant programs were managed by one or the other discipline but never by both simultaneously, the medical community regarded the concept as folly. Yet the program grew steadily, as did the program’s immune tolerance research initiatives to induce the transplant recipient’s body to accept a donor organ. This multidisciplinary cooperation also led to major contributions in immunogenetics, immunosuppression, and treatment of autoimmune diseases and lymphoma — and it ultimately became the overarching principle for all the NewYork-Presbyterian Hospital transplant services.

Mark A. Hardy, MD

Eric A. Rose, MD

Lloyd E. Ratner, MD

Colleagues universally give credit to Eric A. Rose, MD, who co-founded the heart transplantation program with Dr. Reemtsma, for his successful transformation of the program into the outstanding center it is today. A parade of achievements marks the history of the heart transplant program, including the first mechanical bridge-totransplantation using intra-aortic balloon pumps in the 1970’s, and the first successful pediatric heart transplant, performed by Dr. Rose in 1984. Under the guidance of Dr. Rose and his successors, the program has pioneered research in immunosuppressant medications, mechanical assist devices, and minimally invasive surgical procedures. It currently performs over 100 heart transplants yearly, with among the highest success rates in the nation.

Also in 2004, Lloyd E. Ratner, MD, succeeded Dr. Hardy as director of the renal and pancreas transplant program. One of the first to perform laparoscopic donor operations, Dr. Ratner has found creative solutions to overcome immune barriers to kidney transplantation. The program now routinely uses extended-criteria donor organs, performs transplants among incompatible donors, and is a leader in coordinating “donor swaps” to maximize availability of compatible donor organs. Since Dr. Ratner’s arrival, Columbia has been designated one of ten regional islet resource centers in the U.S. that isolate and transplant pancreatic cells to treat type 1 diabetes as part of a limited protocol controlled by the FDA. Recent progress in visualization of pancreatic islets using PET technology, under the guidance of Paul Harris, PhD, has been recognized by the scientific community as a milestone in this developing field.

NYPH/Columbia received UNOS approval for pancreatic transplantation in January 2008. Our premier kidney transplant program is facilitating rapid growth of the new pancreatic transplantation program, which overlaps both in its patient population and its surgical and medical expertise. The northeast region of the U.S. has been consistently underserved as far as access to pancreatic transplantation, with relatively few centers serving a disproportionately large metropolitan population. The expanding program at NewYork-Presbyterian now provides much-needed access to patients with end-stage pancreatic disease in New York state, particularly those with the most complex medical and surgical challenges.

Transplantation of cells, rather than organs, is emerging as a therapy with enormous potential. Transplantation of either a patient’s own or a foreign donor’s bone marrow cells, for example, offers hope of regenerating the heart so that patients with heart failure may be able to avoid heart transplantation.

In introducing the transplantation programs, it would be remiss to neglect mention of the yet another dimension in which they excel — education. Physician training is a top priority, and NYPH/Columbia has trained many of the greatest transplant surgeons over the last 20 years, including many of the leaders of transplant programs throughout the U.S.

http://columbiasurgery.org/transplant/history.html

Transplant Initiative

At NewYork-Presbyterian Hospital/Columbia University Medical Center, the Transplant Initiative (TI) has been launched to drive the growth of both clinical and research aspects of transplantation. This multi-year undertaking will involve Departments of Medicine, Pathology, Pediatrics, and Surgery and all of the solid organ transplantation programs, both adult and pediatrics. It is led by its Executive Director, Jean C. Emond, MD.

Although NYP/Columbia is already a national leader in clinical transplantation with respect to volume and patient outcomes, this initiative will further leverage the diverse expertise of its transplant scientists and clinicians.

Heart Transplantation

Approximately 2,200 heart transplants are now performed each year in more than 150 heart transplant centers in the United States. The surgeons and cardiologists of Columbia University Medical Center of NYPH have a long and distinguished history of advancing “standards of care” and the survival rates of our patients by using innovative surgical techniques, by applying our basic scientific research in immunosuppression to the clinical setting, and by inventing and perfecting life-sustaining cardiac assist devices that prolong life while waiting for organ availability.

Lung and Heart-Lung Transplantation

Columbia University Medical Center’s lung and heart-lung transplantation program, which began in 1985, is fast approaching its 200th transplant. Performing more than 30 transplants each year, the lung and heart-lung transplant teams have earned a national reputation for excellence. Our world-renowned transplantation researchers have helped lead the way to improvements in care that, nationwide, have increased the long-term survival rate for lung transplantation by 50% over the past seven years. Among those improvements are new immunosuppressive agents, new antibiotics, refined surgical techniques, and a more comprehensive understanding of follow-up care.

http://columbiasurgery.org/transplant/

It is the combination of basic research at the molecular cardiology level, biomaterial, surgical procedures and PUBLICATION of Cases and research results that found me in Dr. George’s territory as a renewed inspiration.

For Author’s training & experience @ MGH – Cardiac Floor – Ellison 11, BWH – CCU, Tower 3 – 12Fl, BIDMC – Acute Surgery, Farr 9, and Texas Heart Institute, Perfusion, Faulkner Hospital – ICU

http://pharmaceuticalintelligence.com/founder/scientific-and-medical-affairs-chronological-cv/

and in Part II, Section IV in

http://pharmaceuticalintelligence.com/2013/07/14/vascular-surgery-position-statement-in-2013-and-contributions-of-a-vascular-surgeon-at-peak-career-richard-paul-cambria-md-chief-division-of-vascular-and-endovascular-surgery-co-director-thoracic/

Surgeon Isaac George, MD – Training in the OR @ Presbyterian Hospital

SOURCE

http://asp.cpmc.columbia.edu/facdb/profile_list.asp?uni=ig2006&DepAffil=Surgery

Surgeon Isaac George, MD – Publications on PubMed