NON-PROFIT ORG. U.S. POSTAGE UAB Insight on Heart and Vascular Disease PAID PERMIT NO. 1256 410 • 500 22nd Street South BIRMINGHAM, AL Insight 1530 3rd ave S ON HEART AND VASCULAR DISEASE birmingham al 35294-0104 UAB Division of Cardiovascular Disease medicine.uab.edu/cardiovasculardisease UAB Division of Cardiothoracic Surgery medicine.uab.edu/cardiothoracicsurgery UAB Section of Vascular Surgery and Endovascular Therapy medicine.uab.edu/vascularsurgery Combined Therapy UAB Ambassador Program for Peripheral Vascular Disease The Ambassador Program gives referring physicians complete access to patient notes, letters, reports, and other data through a Catheter Ablation of secure Web portal. To join this program, please contact Physician Tachycardia Services at 1.800.822.6478. Minimally Invasive Pulmonary Thromboendarterectomy Clinic Cardiac Surgery welcOme 3 cOnTents Uab inSighT Welcome to the first issue of UAB Insight on Heart and Vascular On hearT and Disease, designed to keep you informed about UAB’s leading role in Cardiothoracic Surgery VaScUlar diSeaSe evaluation and treatment of cardiac and vascular diseases. UAB con- FALL 2009 sistently ranks among the top 30 cardiac programs rated in U.S. News Minimally Invasive Cardiac Surgery ... 2 & World Reports, and is a regional, national, and international referral VOlUme 1, nUmber 1 center for cardiac and vascular disease diagnosis and treatment. Adult Congenital Heart Disease ........ 3 With expertise in every major area of heart and vascular diseases, and James Kirklin, MD E D I T O R I N C H I E F as home to the Southeast’s largest and most technologically advanced Pulmonary Thromboendarterectomy Julius Linn, MD Heart and Vascular Center, we offer innovative, scientifically based Clinic .................................................. 4 treatments, providing patients with better outcomes, improved quality of E X E C U T I V E E D I T O R Advanced Heart Failure Therapy and Emily Delzell life, and access to the latest translational research. UAB is Alabama’s major referral center for complex cardiac and vas- Mechanical Support .......................... 5 M A N A G I N G E D I T O R cular disorders and the only hospital in the state that offers heart trans- Peaches Scribner plantation and long-term mechanical circulatory support. UAB is the state’s only facility for surgery for complex congenital heart diseases, Cardiovascular Disease CONTRIBUTOR S and our clinicians also provide care for adults with congenital heart Suzanne Parker Robert Bourge, MD Sleep Apnea and Resistant Peaches Scribner disease. Our vascular surgeons offer advanced surgical and endovascular Hypertension .................................... 6 CREATIVE DIRECTOR stenting technologies for aortic aneurysms, carotid occlusive disease, Ron Gamble peripheral vascular disease, and venous disease. Cardiac Rehabilitation ...................... 7 UAB also provides comprehensive care for pulmonary hypertension, ART DIRECTOR Catheter Ablation of Ventricular including surgery for chronic pulmonary thromboembolism. One of the Jessica Huffstutler world’s most active clinical and research programs, UAB’s Pulmo- Tachycardia ....................................... 8 2 IllUSTRATION nary Vascular Disease Clinic has participated in the development and Echo Medical Media evaluation of virtually all new therapeutic avenues for pulmonary arter- Vascular Surgery ial hypertension in the last 15 years. William Jordan Jr, MD Our minimally invasive and state-of-the-art robotic surgery programs Vascular Medicine............................. 9 offer minimally invasive treatments for coronary artery disease and valve repair and replacement. Published by the Working collaboratively, cardiothoracic surgeons and cardiologists have developed a variety of hybrid UAB Health System Aneurysm Repair ............................ 10 minimally invasive approaches for ischemic heart disease. Our valve program provides percutaneous 500 22nd Street South balloon valvuloplasty for selected cases of aortic, mitral, pulmonic, and tricuspid valve repair using Combined Therapy for Peripheral birmingham, al 35233 10 intracardiac echocardiography, percutaneous repair of atrial septal defects and patent foramen ovale, Vascular Disease ............................. 11 ©2009 by The board of Trustees and alcohol septal ablation for hypertrophic obstructive cardiomyopathy. UAB’s pioneering cardiac electrophysiology service is a regional referral center for electrodiagnos- of The University of Alabama tic and therapeutic care of patients with common and complex arrhythmias, including radiofrequency Heart and Vascular Faculty for the University of Alabama at ablation for atrial fibrillation. Ablation of ventricular tachycardia is now highly successful in carefully Birmingham. Second class postage 8 selected cases of structural heart disease and idiopathic ventricular tachycardia (VT). Patients with Heart and Vascular Faculty .............12 paid by Uab bulk mail dept. implantable cardioverter-defibrillators who experience repeated shocks can benefit from VT ablation, Postmaster: address changes to: as can patients with idiopathic VT or dilated cardiomyopathy-associated VT. UAB physicians also offer advanced therapies for heart failure, resistant hypertension, and hyper- UAB Insight lipidemias, as well as unique diagnostic echocardiography, cardiographics, and imaging studies. UAB inSighT Online 410 • 500 22nd Street South Our collaborative approach to heart and vascular diseases is designed to provide timely, seamless 1530 3rd ave S care that serves our patients and referring physicians, to everyone’s benefit. We look forward to work- Visit UAB Insight online (uabmedicine.org/insight) to request a second issue of UAB Insight on birmingham al 35294-0104 ing with you. Heart and Vascular Disease, request our other referring physician magazines, or to sign up for Or call the toll-free miST line: electronic delivery. The site also offers breaking news, referring physician resources, and new 1.800.822.6478 faculty announcements. It features videocasts of our physicians discussing the latest procedures [email protected] available at UAB, CME opportunities, information on the Ambassador Program for referring James K. Kirklin, MD Robert C. Bourge, MD William D. Jordan Jr, MD physicians, and more. Cardiothoracic Surgery Cardiothoracic Surgery Robotic-Assisted and Minimally Adult Congenital Heart Disease Clinic Invasive Cardiac Surgeries A Continuum of Multidisciplinary Care Is Crucial Riding the Wave of the Future Approximately 800,000 US adults are enced interventional cardiolo- living with congenital heart disease (CHD). gists, electrophysiologists, surgeons, perfusionists, an- Cardiac procedures comprise a large “Hybrid procedures offer exponential perform all complex repairs with the system, Advances in diagnosis and therapy have esthesiologists, intensivists, portion of ever-increasing options for mini- benefits to patients who may be able to including chordal placement, leaflet resec- substantially reduced CHD mortality rates, obstetricians, operating mally invasive and robotic-assisted surgery avoid multiple surgeries, extended hos- tion, and ring annuloplasty. and large numbers of young people with room and intensive care at UAB, one of five pilot institutions desig- pital stays, and downtime from work. “This totally endoscopic approach al- complex diagnoses, such as tetralogy of unit staff, and social nated to train residents on the da Vinci ro- It is a quality of life issue,” he says. lows patients to return to work in about 2 Fallot, transposition, and single ventricle, services staff. UAB’s bot, a minimally invasive surgical system. “Patients request the robotic approach weeks with much less discomfort, blood survive into adulthood. The number of Adult Congenital Robotic-assisted surgical techniques, because they can return to work in just 2 loss, and morbidity than with traditional adults with CHD has surpassed the number Heart Disease Clinic’s performed at UAB since 2001, offer at- weeks — rather than 8 — with no activity procedures.” He performs aortic valve of children with the condition. Many of synergistic care ad- tractive advantages over traditional ap- restrictions. They appreciate the superior replacement as a minimally invasive proce- these adults have residual heart problems dresses all aspects of proaches. Hybrid surgeries, which address cosmetic effects: no large chest scar and dure using a 1- to 2-inch parasternal inci- requiring ongoing follow-up and treatment CHD. “Mapping out multivessel disease, are the wave of the no scar down their leg.” sion with no sternal incisions. by specialists. an appropriate treatment future, says UAB cardiothoracic surgeon Akins also has begun a program for total Other procedures Akins does robotically As they age, these adults are at risk for course for patients with Christopher W. Akins, MD. endoscopic bypass surgery, or “port access are atrial septal defect repair, tricuspid CHD as well as the same adult illnesses that complex disease requires Compared with traditional open proce- surgery,” which requires one to four very valve repair, combination mitral and tri- affect the general population. Consequently, extensive experience in dures, robotic-assisted surgeries have many small (5-10 mm) incisions in the chest cuspid valve repair, and ablation of atrial comprehensive care must address congenital pediatric and adult cardiol- design. , contributed to this illustration’s advantages: smaller incisions, reduced