Home » Uncategorized » Duke Heart Pulse June 11th 2023

Duke Heart Pulse June 11th 2023

By Manesh Patel, M.D. in Uncategorized on June 11, 2023.

Chief’s message:

Several highlights this week to demonstrate and again give pause to the amazing breadth of clinical, research and educational work that we do at Duke Heart. The work among our heart failure and transplant leaders and team to expand the donor pool by studying the use of hearts donated after circulatory death (DCD) was published this week in the NEJM. This work exemplifies the magic of health science that expands and informs heart care. This can only happen when there are the highest caliber clinicians and teams working to improve and study clinical care. We also have continued stories on the excellence of our faculty with Dr. Lefkowitz named one of the top 3 scientist worldwide by research.com. We also have excellence in teaching as recognized by our fellows and faculty, with Dr. Anita Kelsey winning the educational award in cardiology in the Department of Medicine. And finally service, as our multi-specialty team again goes to Honduras to support surgical cases, this time with ability to support pediatric cases with our world-class team. By any measure, our groups continue to have local and worldwide impact on the care of people with heart disease across the entire spectrum.

Highlights of the week:

New Heart Transplant Method May Grow Donor Pool 30%

Study finds new technique is equivalent to current standard of care

For decades, doctors have used hearts donated after brain death as the standard of care for patients awaiting a heart transplant.

A relatively new method of heart transplantation, which allows for the use of hearts donated after circulatory death (DCD), could expand the annual pool of available donor hearts by a projected 30%.

Traditionally, hearts could not be donated after cardiac death. The DCD method in the study uses a machine to keep the heart pumping, making it viable for donation, but also enabling the organ to travel further.

A study led by Duke Health physicians, appearing online June 7 in the New England Journal of Medicine, found that DCD hearts were equivalent to hearts procured through the current standard of care.

“This should eliminate any barriers for transplant centers to offer this to their patients because we now have objective, randomized data showing both types of hearts are equivalent,” said Jacob Schroder, MD, corresponding author and assistant professor in the Department of Surgery at the Duke University School of Medicine. Schroder is the surgical director of Duke’s Heart Transplantation Program.

The study enrolled 180 patients, with half receiving DCD hearts and the other half receiving brain death hearts. It compared risk-adjusted survival at six months and found a survival rate of 94% for those who received a DCD heart and 90% for those who received hearts donated after brain death.

Researchers also looked at serious adverse events 30 days after transplantation, with the mean number of such events at 0.2 for DCD and 0.1 for the standard donated hearts.

Duke Health helped pioneer the use of DCD in the United States, performing the country’s first DCD heart transplant and pediatric DCD heart transplant. The company that developed the technology to keep a DCD heart pumping during transit, TransMedics, sponsored this study.

Duke is now one of around twenty transplant centers in the country that provide DCD heart transplants. Researchers believe the validation from this study should galvanize other centers to consider adopting the method.

“We’ve remained committed to studying the viability of this method out of an aggressive desire to take care of and provide life-saving options for our patients,” said Chetan Patel, MD, study author and associate professor of cardiology in the Department of Medicine.

“Our goal has always been to expand the donor pool to offer heart transplantation to as many patients in need as possible, said Adam DeVore, MD, study author and associate professor of cardiology in the Department of Medicine. DeVore serves as medical director of Duke’s Heart Transplantation Program.

“By finishing and publishing the DCD Heart study, we offer a clear roadmap for other centers to adopt this practice as well,” DeVore said. “Duke has been lucky to be able offer this treatment option to patients since 2019. This has allowed us to offer transplant to more patients in need but also earlier in their disease course – before they become so sick they have difficulty recovering from the surgery. Our goal is to offer transplant to patients at the right time where they can undergo surgery and recover, and still thrive soon after.”

In addition to Schroder, Patel and DeVore, study authors include Benjamin S. Bryner, Sarah Casalinova, Ashish Shah, Jason W. Smith, Amy G. Fiedler, Mani Daneshmand, Scott Silvestry, Arnar Geirsson, Victor Pretorius, David L. Joyce, John Y. Um, Fardad Esmailian, Koji Takeda, Karol Mudy, Yasuhiro Shudo, Christopher T. Salerno, Si M. Pham, Daniel J. Goldstein, Jonathan Philpott, John Dunning, Lucian Lozonschi, Gregory S. Couper, Hari Reddy Mallidi, Michael M. Givertz, Duc Thinh Pham, Andrew W. Shaffer, Masashi Kai, Mohammed A. Quader, Tarek Absi, Tamer S. Attia, Bassam Shukrallah, Ben C. Sun, Maryjane Farr, Mandeep R. Mehra, Joren C. Madsen, Carmelo A. Milano, and David A. D’Alessandro.

Outstanding work – congratulations to the entire team!

Lefkowitz Again Ranked in Top 3 of Scientists Worldwide

Research.com has released their annual rankings of the Top Scientists in the field of Biology and Biochemistry. Robert J. Lefkowitz, PhD, the Chancellor’s Distinguished Professor of Medicine, a professor of cardiology in the Duke Department of Medicine, and a principal investigator with the Duke Cardiovascular Research Center, currently ranks third in the world and second in the United States. He has also been recognized with Research.com’s Biology and Biochemistry Leader Award for 2023.

To see the full summary, please visit: https://research.com/careers/best-biology-and-biochemistry-scientists-2023-report.

Congratulations, Bob!!!

Duke Heart for Honduras – Third Time is the Charm!

More than 20 medical professionals representing Duke Heart and Duke Heart for Honduras are currently on their third trip to the country – this time with the capability of providing surgical interventions to pediatric patients at Hospital Maria.

For those yet unfamiliar with the program, Duke Heart for Honduras is an international cardiovascular surgical outreach partnership program between the Division of Cardiovascular and Thoracic Surgery at Duke and the Instituto Nacional Cardiopulmonar (INCP) in Tegucigalpa, Honduras. Hospital Maria, the pediatric hospital, is also located in Tegucigalpa.

The goal of the program is two-fold. First, the Duke team seeks to help improve survival rates and quality of life for Honduran adults, and now children, with acquired valvular heart disease (often due to rheumatic fever that resulted in rheumatic heart disease). The program was initiated in July 2019 when a surgical team traveled to Honduras and performed surgical procedures for the first time.

The team’s second goal is to provide education and training to local Honduran healthcare providers at all levels to help them better prevent and treat valvular heart disease in that region.

Such a terrific program. We look forward to hearing all about their trip when the team returns!

Cooney End-of-Year Review Focuses on People, Accomplishments, Resiliency

Closing out her fifth year as Chair of the Department of Medicine, Kathleen Cooney, MD, focused on the many accomplishments of the members of the department on the frontlines as they continue to move us forward and advance our tripartite missions. In her End of the Year Review on Friday, June 2, Cooney noted that we are improving the health of our communities locally, regionally, nationally and abroad as a consequence. Cooney also noted the resiliency of the department’s faculty, trainees who achieved these goals while adapting to major change over the last year.

If you missed the event, a copy of the recording is available here.

Dr. Anita Kelsey was also awarded the Department of Medicine Excellence in Teaching award for Cardiology at the end of year Department Recognition Event. This award is provided to the Faculty with highest commitment and excellence to education in the Division of Cardiology. Congratulations Anita – well deserved.

CSRC Think Tank Meeting Held

The Cardiac Safety Research Consortium (CSRC) held their Think Tank meeting on June 7 in Washington, DC on the campus of the Food & Drug Administration (FDA). The event, CSRC Think Tank: Update on Regulatory Status of Hypertension, Biomarkers and Arrhythmia Monitoring in Clinical Trials was very well attended – despite the city having air quality not unlike that found in Beijing (see Canadian wildfires, impact on U.S.), according to Mitch Krucoff, MD. Krucoff, professor of cardiology in Duke’s Department of Medicine, is a member of the CSRC and principal investigator for the FDA-Duke Memo of Understanding founding the critical path Cardiac Safety Research Consortium (CSRC) PPP program.

The event included professionals from FDA Regulatory, EU Regulatory, Japan PMDA, Cardiac Safety Consultants, Ltd., Eli Lilly, Richmond Pharmacology, and academic trialist experts on cardiogenic shock from the University of Connecticut, Stanford University, University of Pennsylvania, Cleveland Clinic, Mass General, DSI, Penn Medicine, and UCSF.

3200/2200 Great Catch Awards to Ameen & Haigh!

The 3200/2200 Cardiology Stepdown team at Duke University Hospital is very proud to recognize Melissa Ameen and Lakyn Haigh for receiving Great Catch Awards!

Melissa Ameen, BSN, RN, PCCN, identified vital signs populating on the EMR for one of her patients that were very different from the patient’s trend. After investigating, she realized that the patient was admitted to a bedside monitor in another location in the hospital and that the vital signs were actually those of another patient, who was currently attached to that monitor. She caught the problem within 15 minutes, which prevented any of the incorrect vital signs from populating into her patient’s chart. This also ensured that the other patient’s vitals were correctly routed to that patient’s EMR, and that both care teams for the patients had the correct clinical information. Melissa is a Charge Nurse & Preceptor and has been a RN on 32/22 for 7.5 years. Great job, Melissa!

Lakyn Haigh, RN, noticed that an IV medication was ordered to be administered IV push by drawing up four full vials of medication. Though the dose on the order was correct, the rate was not specified, and she recognized that this unusual administration method was not appropriate. She escalated her concerns twice, after which the formulation of the medication was changed to an IV bag. Lakyn’s willingness to escalate her concern led to a change to a safer and more appropriate administration method for the medication. Lakyn is a Travel RN who has worked on 32/22 for nearly one year. Nicely handled, Lakyn!

Thank you both for taking excellent care of our patients!

Quick Reminders & Updates

Masking update. Beginning Tuesday, June 13, masking will be optional for patients, visitors, and team members in most circumstances. Guidelines and exceptions are available in Sharepoint.
PG2 tunnel renovation is complete. New flooring was installed in the Duke University Hospital Parking Garage 2 lobby (tunnel level) throughout the walkway to Duke North. The work was completed last week, so the tunnel is once again fully open.
DHIP Updates:

Town Hall Held

On June 7th, DHIP Leadership hosted a community-wide Town Hall covering recent progress within the DHIP transition, Day 1 Expectations, a Training Overview, and Q&A. The recorded session can be found here.

Benefits

The HR team is engaging in targeted follow-up with transitioning personnel who have not yet completed special enrollment or onboarding.
Information regarding Duke Benefits is available on SharePoint.
All benefits related questions can be sent to DHIPBenefits@Duke.edu.
An email was distributed on 5/30 to all faculty eligible to enroll in benefits regarding an extension to the voluntary short term and long-term disability enrollment period through 6/23.

DHIP Trainings

Please see the training site; you can register for upcoming trainings and view recorded sessions at PDC Intranet – Home (sharepoint.com)

Badges

As a reminder, individuals who are DU and DUHS Leased with PDC on the bottom of their badge will be given new badges (rolling basis in July 2023) due to access constraints. DU/DUHS Leased individuals already have horizontal Duke badges which do not need to be replaced.

Reimbursements

If possible, please submit all current reimbursement requests to PDC.AP@duke.edu by June 22nd for processing.

Have news to share?

If you have news to share with the Pulse readership, please contact Tracey Koepke, director of communications for Duke Heart at tracey.koepke@duke.edu. We would love to hear about your latest accomplishments, professional news, cool happenings, and any events or opportunities that may be of interest to our Duke Heart family. Please call with any questions: 919-681-2868. Feedback on Pulse is welcome and encouraged. Submissions by Noon, Wednesdays, to be considered for weekend inclusion.

Duke Heart in the News:

May 28 — Jacob Schroder and Jason Banner

CBS News

New method revolutionizes heart transplants

https://duke.is/bpve5

**this story originally ran in Feb. 2023; it has been updated

May 30 — Stephen Greene

Healio/Cardiology

Early, rapid uptitration of HF therapies after discharge reduces death, readmission risk

https://duke.is/4fdpg

June issue — Geoffrey Ginsburg

Environmental Factor