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Duke Heart Week of April 19th 2020

By Manesh Patel, M.D. in Uncategorized on April 19, 2020.

In Memoriam: Walter G. Wolfe, MD, Professor of Surgery, Former Chief of Surgery & Cardiac Surgery at Durham VAMC

Walter G. Wolfe, MD, emeritus faculty member and a Duke cardiothoracic surgeon, died on Monday, April 13 at his home in Hillsborough, NC, in the comfort of his family and hospice providers. The cause was amyotrophic lateral sclerosis (ALS), often referred to as Lou Gehrig’s disease. He was 83.

Dr. Wolfe’s service to Duke spanned more than four decades during which time he served in a number of leadership roles, including professor of surgery at Duke, associate director of Duke Heart Center (1994-2000), Program Director of the Duke Surgery Thoracic Residency Program (1994-2002) and Chief of Surgery and Cardiac Surgery at the Durham Veterans Administration Medical Center (VAMC).

Wolfe is widely credited as having led the cardiac surgery program at the VA to crown jewel status within the national VA Health System. Wolfe was appointed to the position by David C. Sabiston, MD, then head of surgery at Duke, at a time when the VA system was struggling. He inherited a program with surgical outcomes that were not as good as they needed to be, and a long waiting list of patients needing procedures. One by one, he addressed every challenge he encountered there.

“Walter took this position extremely seriously and kicked the whole system into shape,” recalled Ken Morris, MD, former head of cardiology at the Durham VAMC. “He scrubbed every case for the first year and managed to work through the entire waiting list with zero mortality. He revamped the program and brought a new esprit de corp to the VA.

“The greatest value was to the patients, of course, because they were receiving much better care and support, but it also opened the door to pursuing research clinical trials,” Morris added. “We worked in great collaboration there and had a great time doing it. He was a one-of-a-kind guy and he’d mess with you, but despite all his non-sense we became very good friends.”

Wolfe, a native of Corry, PA, received his MD from Temple University in 1963. He spent his internship year in surgery at Philadelphia General Hospital, then began training at Duke University Medical Center where he completed residency and began fellowship training. He then pursued a research fellowship at the University of California at San Francisco’s Cardiovascular Institute, where he collaborated with J.B. West, MD, who is widely regarded as the father of pulmonary physiology. Wolfe then returned to Duke and completed his training in General and Thoracic Surgery in 1971. He was invited to join the faculty of Duke University as assistant professor in the Department of General and Thoracic Surgery in 1972 and achieved the rank of professor in 1979.

While at Duke, he studied under Sabiston — a luminary in the field of cardiothoracic surgery –and often served as his go-to partner, particularly on surgeries for the treatment of pulmonary embolism.

“Dr. Wolfe was a surgeon’s surgeon, in all regards, both as a general surgeon and as a cardiothoracic surgeon –this gave him bountiful and wide-ranging experience. His clinical acumen and judgment over the years became one of his finest attributes,” said Peter K. Smith, MD, Chief of the Division of Cardiothoracic surgery at Duke. “At the same time, he was completely devoted both to the residents and to his patients. It is really rare to meet somebody where that’s a meaningful statement, and in his case it definitely was. He formed many lasting relationships with residents and fellow faculty members. He was irascible and highly opinionated and he could be demanding, but the demanding aspect of him was always appropriate and he had a moral compass that was directional for everybody around him.”

Wolfe was beloved by his residents and deeply impactful in their lives long beyond their years of training.

“I’ve known him for 40 years. He was my mentor and he taught me how to be a vascular surgeon,” shared Richard McCann, MD, professor of surgery in the division of vascular and endovascular surgery at Duke. “His clinical expertise, dedication, and above all friendship will be missed by all who knew him and especially those who had the privilege of training and working with him.”

Chad Hughes, cardiothoracic surgeon and director of Duke’s Center for Aortic Disease, trained under Wolfe for several years. “He was always one of my main go-to people and he’d never hesitate to help or support me,” said Hughes. “He was a constant source of mentorship and a tremendous person. He saw things to their bare essence and was the model of efficiency – there were no wasted movements or steps on his part, and he had great surgical judgment.”

One of Hughes’ most unforgettable experiences during training was when Wolfe asked him to perform a new technique with him on Wolfe’s patient. “I had just learned how to perform a David procedure during a fellowship year at Penn. It was the first time we performed a valve sparing aortic root replacement at Duke, and it meant a lot to me that he selected me and trusted me to perform this procedure with him.”

Wolfe’s combined research and clinical efforts at Duke contributed to several milestones in cardiothoracic surgery, including the demonstration of preserving the aortic valve by re-suspension, a procedure which prevents the need for a prosthetic valve in patients with aortic dissection and significantly improved patient outcomes. In 2015, Wolfe was honored with the designation “Master Surgeon” by the Duke Department of Surgery.

“Walter wanted to make sure that the number one thing that would happen here at the VA was that veterans would get the best care,” said Sunil Rao, MD, section chief of cardiology at the Durham VA Health System. “He wanted to also make sure the residents were getting appropriate training and the appropriate independence so that, when they finished their training, they would feel confident doing complex surgeries. The VA pays very close attention to surgical outcomes. Any blip toward a negative trend is taken very seriously not just locally, but at the federal level. In that context, Walter established the Durham VA as a flagship cardiac surgery program. He was a really special guy. A lot of the outpouring of affection for him on social media is really well deserved and I think, quite frankly, an underestimation of the impact he had.”

Morris added, “He made a lot of things possible from a research standpoint because we were in a good position to take care of patients. He trained a lot of people and he trained them very well. Most of all, he was a very good partner to me and I appreciated that very much.”

Dr. Wolfe’s obituary can be found on legacy.com. The Wolfe family is in the care of Hall-Wynne; they will hold a memorial service when circumstances allow.

The Duke Department of Surgery has established the Walter G. Wolfe, MD Memorial Fund, which will be used to support resident education. Contributions can be made to this fund in care of Marcy Romary at Duke Health Development, 300 W Morgan Street. Ste. 1200 Durham, NC 27701. Checks should be written to Duke University.

On behalf of the Duke Heart leadership team, we extend our condolences to the Wolfe family and to his many friends and colleagues, as well as to his former residents. His legacy lives on in you.

Mall Elected to AACN Nominating Committee

Anna Mall, clinical lead RN in the adult cardiac catheterization lab, has been elected to Nominating Committee of the American Association of Critical Care Nurses (AACN). Acting on behalf of AACN members, the Nominating Committee is responsible for maintaining a thoughtful, systematic process to evaluate nominee qualifications that ensures each candidate possesses the required competencies to fulfill the role. The committee will vet and select candidates for the AACN Board of Directors, AACN Certification Corporation Board of Directors and the AACN – AACN Certification Corporation Nominating Committee. They will also evaluate the nomination and election process and educate the community about the process and required competencies.

Mall’s one-year term is effective July 1. Congratulations, Anna! Way to represent Duke Heart!

Nazo Receives CVRC’s Staff Appreciation Award

Nour Nazo, lab manager of the Rajagopal Lab in the Cardiovascular Research Center (CVRC), has been named the 2020 recipient of the CVRC Research Staff Appreciation Award.

Nazo, who has worked on Sudarshan Rajagopal’s lab team since 2013, says the award recognition came as a complete surprise to her, especially when so many events have been postponed and priorities have shifted due to the pandemic.

“The announcement really caught me off guard,” said Nazo. “This is a true honor.”

Before joining the CVRC team, Nazo’s research career began with an internship at the National Institute of Environmental and Health Sciences and a job with the Environmental Protection Agency. Since joining the Rajagopal lab, she has developed a range of skills ranging from studies on basic biochemistry and pharmacology to mouse physiology. She is also responsible for training undergraduates on the basics of cell culture, molecular biology experiments including PCR, agarose and polyacrylamide gel electrophoresis and western blotting.

“Nour was my first hire about seven years ago and she initially served as our lab tech,” said Rajagopal. “Slowly she’s become a real jack of all trades. She’s super helpful and super reliable. She essentially runs the lab from a functional standpoint and makes my life a lot easier.”

Nour is shown here in this 2019 photo of the Rajagopal lab team. She is on the far right, back row.

This is well deserved. Congratulations, Nour!

Birthday Surprise via ICU iPad Project

Our Cardiothoracic ICU enabled a virtual birthday gathering for a patient thanks to our ICU “virtual visitation” iPad project. On Monday, our team collaborated with the family of Lee Moore to gather via FaceTime.

When Kristen Cossaart, one of the ICU nurses, logged onto the platform, she says she was astonished that there were three full video chat pages of loved ones attending the party – guests ranged from his youngest grand baby to his oldest friend. Cossaart counted down from three and the family began to sing “Happy Birthday” as she walked into the patient’s room with the iPad.

“Our patient instantly lit up. While everyone on FaceTime continued to sing, all at different lag times, he could not stop smiling and laughing,” said Cossaart. “He went frame by frame and said hello to all of his loved ones and thanked them for this special moment.” The family continued to chat, sharing words of encouragement and celebrating his recovery progress.

“My iPad partner, Annie Jaeger, Pam Porter, and I were so touched and excited to be a part of this unique opportunity during this COVID-19 pandemic. We hope all nurses are able to have these sweet moments with their patients,” Cossaart added.

Many thanks to Kristen Cossaart and Mollie Kettle of our Cardiothoracic ICU for alerting us to this story, and thanks to our ICU “virtual visitation” iPad project team. Happy belated birthday to Mr. Moore!

Shout-out to EP CRNAs!

A big shout-out to the CRNAs from EP who have been serving on the hospital COVID swab team. We really appreciate their help with COVID patients here at Duke. Shown here is one of our CRNAs getting dressed last weekend (Easter morning) for duty. Do you recognize who it is?

Passings: David E. Miller, MD, cardiologist

Many of you knew Ed Miller, a long-time Durham-based cardiologist whose practice eventually merged with others to become Triangle Heart Associates. Miller, 89, died on Wednesday at Duke University Hospital. Our condolences to his family, friends and many colleagues and former patients. His family has requested that memorial contributions be made in his name to Duke Heart Center. The family is in the care of Hall-Wynne; a private interment is planned at Maplewood Cemetery. To see the full obituary, please visit: https://legcy.co/2XLFpVJ.

COVID-19 Updates:

All the latest official DUHS information regarding coronavirus/COVID-19 response at the following locations:

Upcoming Opportunities/Save the Date:

Cardiology Grand Rounds

Cardiology Grand Rounds are cancelled through May, with the exception of internal faculty gatherings to discuss information related to COVID-19. Invitations to those will come via Outlook.

2020 NC Walk for Victory

Save the Date: July 6

The NC Walk for Victory, which was to be held this weekend at Laurel Park in Raleigh, has been reconfigured as a virtual walk due to the pandemic. Please consider joining Dr. Chad Hughes, medical chair of the event, and presenting sponsors: the Duke Center for Aortic Disease and Duke Heart in our effort to celebrate and fundraise on behalf of patients with Marfan syndrome. Proceeds benefit the Marfan Foundation.

We invite all Pulse readers and their families and friends to register as members of the Duke Heart team and join with us on Saturday, July 6 as we gather virtually with teams from Boston, New York, Washington, DC, San Francisco, Portland and Michigan for an afternoon of walking and sharing photos via social media. The Marfan Foundation is planning the event and asks that participants post photos to social media using #WalkforVictory and #MyWalkSavesLives.

To register, please visit https://give.marfan.org/event/2020-north-carolina-walk-for-victory/e247519. Adult registration is $20. Kids under 17 register for free.

This should be a fun opportunity to have our Marfan communities from coast to coast come together virtually in support of the mission of the Marfan Foundation. This celebration will also include a virtual dance party featuring DJ Willy Wow, a well-known DJ/entertainer for children. More details can be found on the website.

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.

Duke Heart in the News:

April 9 — Kyle O’Connor (DCRI) and Eric Velazquez (Yale School of Medicine)

tctMD/the heart beat

CABG Over PCI for Severe HFrEF Patients With Complex CAD: Observational Data

https://www.tctmd.com/news/cabg-over-pci-severe-hfref-patients-complex-cad-observational-data

April 10 — Adrian Hernandez

WFDD.org (88.5 FM/Piedmont Triad)

Duke Leads $50 Million Study On Coronavirus Preventative Drug

https://www.wfdd.org/story/duke-leads-50-million-study-coronavirus-preventative-drug

April 13 — L. Fernando Gonzalez (Neurosurgery)

ABC11.com

Health care workers concerned heart attack, stroke patients may be delaying care in light of COVID-19