HopkinsNEWS FOR FRIENDS OF THE JOHNS HOPKINS HEARTPulse AND VASCULAR INSTITUTE spring 2015

Roger Girson is a strong supporter of the Johns Hopkins Heart and Vascular Institute as well as Habitat for Humanity. Three Eras of , One Grateful Heart

t 10 years old, Roger Girson struggled to breathe and quickly became weak when he exerted himself. “My fingernails and lips Awould turn blue,” he says. “We lived in a two-story home, and my mother had to carry me up and down the stairs because I couldn’t climb them.” When none of the various doctors near his hometown in Pennsylvania could address the “the research Johns Hopkins does has helped a lot of people over problem, Girson’s aunt, who lived in Maryland at the years. I want that to continue.” the time—it was 1949—recommended he visit The Johns Hopkins Hospital. —roger girson There, he was examined by renowned pediatric cardiologist Helen Taussig, who found that his pulmonary valve was not allowing proper blood story, come back to the studio, run up the stairs, take For more flow from the heart to the lungs. Despite the my film and put it on the processor, and then run than two seriousness of his diagnosis, Girson could not have downstairs.” decades, Girson been in a better place at a better time. Only five years Even so, Girson returned to The Johns Hopkins has made earlier, Taussig had worked with Johns Hopkins Hospital periodically for checkups. In 1962, with annual financial -in-Chief Alfred Blalock and surgical the advent of open-heart surgery, he was referred contributions technician Vivien Thomas to devise the “blue baby” for complete correction of his complex congenital to the Johns operation for tetralogy of Fallot. heart defect. David Sabiston at The Johns Hopkins Hopkins Heart The congenital defect includes a ventricular Hospital performed surgery on Girson that year, and and Vascular septal defect, an enlarged right ventricle, a defective in just three months, Girson was fully recovered. Institute in pulmonary valve that prevents full flow of blood to Six months later, he landed a job at a TV station, recognition of the lungs and blueness caused by a lack of oxygen to and nine months after that, he was married. He had the care he has the blood. two children and became a longtime volunteer with received over the In 1949, Girson had a pulmonary valvotomy to Habitat for Humanity. years and the open his valve, also known as the Brock operation, Years later, at an annual checkup with Johns care he continues by surgeon Russell Brock at The Johns Hopkins Hopkins cardiologist Thomas Traill, Girson to receive from Hospital. Portrait of Helen Taussig by learned that he needed another open-heart surgery, Traill. “The Yousuf Karsh. “Afterward, there was a huge difference,” says but this time for an aneurysm. In 2008, Duke work they do Girson. “My parents taught me how to ride a bicycle. Cameron, director of the Division of Cardiac is wonderful,” I had a normal childhood, and I played outside with Surgery at The Johns Hopkins Hospital, performed says Girson. “Besides the fact that they saved my life friends.” the operation. All went well, and after a successful several times, the research Johns Hopkins does has When Girson got to college, he continued to recovery, Girson went back to supporting not only helped a lot of people over the years. I want that to be active as a broadcasting major. “I would shoot a Habitat for Humanity, but also Johns Hopkins. continue.” n

Explore our new online resource to improve your heart health. Visit bit.ly/jh_heart or scan the QR code. new therapy approach minimally invasive surgery A Less Invasive Cardioverter An Ideal Defibrillator

or people who have a dangerous Candidate for irregular heartbeat and are at high risk of sudden cardiac arrest, an Robotic- implanted cardioverter defibrillator Fcan be lifesaving. Even so, the device has an Achilles’ heel: the possibility Assisted Mitral of infection or a break in the wire or electrodes going to the heart. But Johns Hopkins electrophysiologist Valve Repair Alan Cheng is now providing another option to selected patients: a defibrillator whose wires are placed just under the n 2000, Jim Watkins’ cardiologist told him not to skin instead of into cardiac vessels or the worry about his heart murmur but to have a follow-up heart itself. “The device senses off the lead every three years or so. By 2013, tests showed a related placed under the surface of the chest,” Irupture in his heart’s mitral valve that would require says Cheng. “The main advantage is that surgery to repair. patients will not face the risk of difficult Exploring alternatives to open-heart surgery, lead extractions in the future, but there Watkins learned that minimally invasive robotic repair are some drawbacks.” offered faster recovery and minimal scarring. After The battery needs to be replaced Early repair is vital, says Kaushik Mandal, because valve doing his research, he found Johns Hopkins cardiac leakage can go from mild to severe in a short period of time. after about four years. The device is surgeon Kaushik Mandal, a valve disease specialist also about twice as large as a traditional with expertise in minimally invasive repairs. implanted cardioverter defibrillator, so Mandal informed Watkins that the robotic-assisted not all patients—especially those who mitral valve repair is an option for about 80 percent To further minimize risks during the operation, the are very thin—are eligible. In addition, because the detection algorithm uses an of people but that thorough presurgery tests were Johns Hopkins team monitors oxygen saturation in the electrocardiogram sensed through the essential. “The first priority is having a safe and durable legs and brain during the procedure. wire under the skin, certain patients may repair, which is why we carefully screen every patient to Another critical variable is early referral, Mandal says, not qualify for the device due to their determine the best approach,” he says. because “once a patient develops symptoms, the valve may particular condition. Besides being in be salvageable, but the outcomes While it can be used for rapid good overall health, the are not as great.” heartbeat conditions like ventricular ideal candidate has no “i think of the robot as a Robotic surgery can be used to tachycardia or ventricular fibrillation, it lung disease, Mandal million-dollar scissors.” repair leaky or narrowing valves, does not have standard pacing support explains, because the —kaushik mandal close a defect between the upper for patients with slower-than-normal right lung is collapsed chambers of the heart, remove heart rates. Nevertheless, it is a good repeatedly for several cardiac tumors or treat an irregular option for some people with limited vascular access or other issues placing minutes at a time during heartbeat that is resistant to them at high risk for bloodborne the procedure. treatment by ablation. infections. In addition, the arteries in the arms, hands, legs and “I think of the robot as a million-dollar scissors,” The implantation requires the patient feet must be free of plaque and calcification, because the Mandal says. “The decision to use it and whom to use it to have general anesthesia but not lung-and-heart bypass machine used during the procedure on is mine. Safety is paramount.” fluoroscopy imaging. The device’s pulse can destabilize plaque, increasing risk for a stroke or heart In the end, Watkins was the ideal candidate for the generator is placed right below the attack. This is why, in addition to a stress echocardiogram operation. One week afterward, he was discharged, and armpit. Then, an electrode on the device and a physical, Watkins underwent a CT angiogram to within a couple of months, he was able to travel across is tunneled across the heart above the rib identify calcium deposits. Europe with his wife. n cage and is attached to the connective “Patients with notable calcium deposits on their valve tissue beneath the skin. leaflets should have a traditional open-chest operation,” Watch a video of Jim Watkins telling his story at Cheng says time will tell how effective bit.ly/JimWat or scan the QR code. the new device will be. “We have 30 Mandal says. And since echocardiography is notorious for years of experience with the traditional missing calcifications, a cardiac CT scan is essential, he implantable cardioverter defibrillator adds. versus about one year with the new one,” says Cheng. But, he adds, it does performance matters hold promise for patients who are good candidates. n

The Johns Hopkins Hospital has been recognized by The Joint Johns Hopkins Commission as a Top Performer on Key Quality Measures for: benchmark • Heart Attack • Pneumonia 66 min • Heart Failure • Surgical Care national benchmark

10 min 20 min 30 min 40 min 50 min 60 min 70 min 80 min 90 min Electrophysiologist Alan Cheng [Time between arrival and treatment for heart attack patients]

2 • HOPKINS PULSE • Spring 2015 showing support Honorable Hosts with the Most Thad Shelly, chairman of the Johns Hopkins Cardiovascular Advisory Board, and his wife, Totty, What Will Your hosted more than 40 guests plus Johns Hopkins leadership and faculty for dinner at the Brazilian Legacy Be? Court Hotel in Palm Beach, Florida. The event took A single gift in 1873 from our founding place in January 2015 and included research and benefactor, Johns Hopkins, inspired a program updates. revolution in American medicine. The Johns Hopkins Legacy Society honors Mr. Hopkins and welcomes those who make their own legacy gifts to secure the financial future of Johns Hopkins Medicine. There are many ways to become a member: Include Johns Hopkins in your estate plan, designate us as beneficiary of a retirement plan or life insurance policy, or give in a way that also provides income to you. To learn more about these and other creative ways to give, visit rising.jhu.edu/giving, or contact the Johns Hopkins Office of Gift Planning at 410-516-7954/800-548-1268 or ‡ A Gift from the [email protected]. Auction Block Manheim, a wholesale vehicle auction operation, made a $20,000 contribution to the Heart and Vascular Institute and Johns Cheers for the Stephen C. Achuff Hopkins Kimmel Cancer Lectureship † Center in February 2015. For the Stephen Achuff, left, and benefactor Roy Lessy second year in a row, Manheim has enjoyed a dinner celebration with friends and provided a gift in honor of heart faculty of the Johns Hopkins Heart and Vascular transplant recipient Susan Adcock Institute. The dinner was held in September 2014 and cancer survivor and longtime to commemorate the inaugural Stephen C. Achuff, Manheim employee Randy Derr. M.D., Lectureship that was made possible through generous contributions from people like Lessy.

giving back No Longer Stopped in His Tracks

or someone like Harry thing they did, he says, was rule out and mild exercise can exacerbate a Kingsbery, who loves the lupus. Then he saw a dermatologist; flare-up. Although there is no cure, outdoors, warm weather brings a neurologist; and an ear, nose and a number of medications have been Fopportunities for fresh-air throat specialist. Like the specialists in shown to relieve the symptoms. activities. But when Kingsbery no Virginia, the Johns Hopkins physicians Over the next year, Kingsbery longer enjoyed Virginia’s afternoon were stumped. The difference was they worked closely with Ratchford to try heat, there was a problem. “When didn’t give up. different combinations of medications it got hot, it triggered this pain in “One thing I really appreciate about and ensure he maintained a healthy my face, arms and hands,” says the the Hopkins system is when you come lifestyle. Today, he says, “I am doing so retired military professional. “My pain in, they are going to keep trying until much better. We have found the best was getting too high, and I couldn’t they get you to the right person to see approach to the disease for me.” During a European vacation, Harry function at 100 percent.” what is going on,” says Kingsbery. It’s been six years since Kingsbery Kingsbery visits the Rhine River in To figure out what was causing the Elizabeth Ratchford, the got the answer to what was causing his France. pain, Kingsbery visited his primary director of the Johns Hopkins Center pain and found the right treatment. care doctor, who was unable to find for Vascular Medicine, heard about Now he enjoys hiking the Appalachian Because of his experience, Kingsbery anything. He referred Kingsbery to a Kingsbery through a colleague of Trail with his 11-year-old grandson. makes regular contributions to support specialist, but the specialist could not hers and thought she might be able Even though he feels better, Ratchford’s ongoing vascular research identify the problem either. In a period to help. After meeting with him and Kingsbery continues to keep in and programmatic needs at Johns of about 18 months, Kingsbery saw going over questions for more than contact with Ratchford. “For so long, Hopkins. “The best way to sustain more than a dozen different doctors. an hour, she identified the problem: we couldn’t find anybody to tell me things in today’s world is through Finally, he says, a rheumatologist in erythromelalgia. what was going on. Then, because financial support,” he says. “When you Virginia referred him to The Johns A rare disorder that typically affects of the Johns Hopkins system, we find an institution that is so dedicated Hopkins Hospital. the skin on a person’s feet or hands, found a physician who figured it out. to medicine and taking care of people, In 2008, Kingsbery visited The erythromelalgia causes visible redness, Ever since then, she’s been my go-to you want to preserve whatever the Johns Hopkins Hospital, and the first heat and pain, and warm temperatures doctor,” he says. magic ingredient is.” n

HOPKINS PULSE • Spring 2015 • 3 research update “Obesity is a well-known ‘accomplice’ in the development of heart disease, but our findings suggest it may be a To learn more about the Obesity Fuels solo player that drives heart failure many ways the Heart independently of other risk factors and Vascular Institute that are often found among those with Silent Heart excess weight,” says Chiadi Ndumele. is changing care, visit hopkinsmedicine.org/heart . Damage up, and during the follow-up, 869 people To make a gift to the developed heart failure. Division of Cardiology or Severely obese people with elevated the Division of Cardiac enzyme levels were nine times more Surgery, please call hile it is commonly led by Johns Hopkins cardiologist Chiadi likely to develop heart failure than people 443-287-7384 or email believed that the Ndumele found that obese people with normal weight and undetectable [email protected]. incidence of heart disease experience silent cardiac damage that enzyme levels. The elevated risk persisted To make a gift to the in severely overweight fuels their risk for heart failure down the even when investigators accounted for W other possible causes of heart damage, Division of Vascular people is driven by diabetes and high road. Surgery, please call blood pressure, researchers from Johns For the study, investigators measured including diabetes, hypertension and 443-287-7953. Hopkins and elsewhere are finding body mass index (BMI) and the levels of high cholesterol. otherwise. a heart enzyme released by injured heart Ndumele says the findings should be Using an ultrasensitive blood test muscle cells in 9,500 individuals for more heeded as an alarm bell for clinicians to to detect the presence of a protein that than 12 years. Levels of the injured heart monitor their obese patients rigorously for heralds heart muscle injury, researchers enzyme rose proportionally as BMI went emerging signs of heart disease. n

Non-Profit Org HopkinsPulse U.S. Postage PAID Johns Hopkins Medicine Permit No. 5415 Heart and Vascular Institute Baltimore, MD Marketing and Communications 901 S. Bond St., Suite 550 Baltimore, Maryland 21231 This newsletter is published for the Johns Hopkins Heart and Vascular Institute by Johns Hopkins Medicine Marketing and Communications Heart and Vascular Institute James Black, M.D., Director of Vascular Surgery and Endovascular Therapy Duke Cameron, M.D., Director of Cardiac Surgery Gordon Tomaselli, M.D., Director of Cardiology Fund for Johns Hopkins Medicine Shannon Wollman, Director of Development, Cardiology and Cardiac Surgery Kathleen Hertkorn, Director of Development, Vascular Surgery Marketing and Communications Dalal Haldeman, Ph.D., M.B.A., Senior Vice President Mary Ann Ayd, Managing Editor Ellen Beth Levitt, Ekaterina Pesheva, Lisa Rademakers, Writers Lori Kirkpatrick, Designer; Keith Weller, Photographer Questions or comments about this issue? Call 443-287-2233 or email [email protected]. © 2015 The and The Johns Hopkins Health System Corporation

HopkinsNEWS FOR FRIENDS OF THE JOHNS HOPKINS HEARTPulse AND VASCULAR INSTITUTE Spring 2015

1 2 3 Three Eras of An Ideal Candidate No Longer Cardiac Surgery, for Robotic-Assisted Stopped in His One Grateful Mitral Valve Repair Tracks Inside Heart