A Mission to Ecuador for Pediatric Heart Surgeon

By Meghan Scalea

UMMC Communications Account Leader

Sunjay Kaushal, M.D., Ph.D., associate professor at UM School of Medicine and director of pediatric cardiac surgery at UMMC, recently returned from a medical mission to Ecuador, where he performed life-saving heart surgeries on nearly 20 children who would have died without surgery.

 

Dr. Kaushal, a father of two, is a huge advocate for kids. This medical mission to Guayaquil, Ecuador, was his fifth trip with the International Children’s Heart Foundation (ICHF), a group dedicated to providing supplies, training and surgical resources to care for underprivileged children with heart disease in dozens of countries around the world.

According to the ICHF, 1% of the world’s population is born with heart disease, only about one-third is diagnosed, and even fewer receive life-saving heart surgery. Congenital heart disease is the most common birth defect in the world.

“There is a huge surplus of kids with congenital heart disease,” says Kaushal. “Traveling with this group allows me to provide free health care for children who wouldn’t otherwise be treated.”

Joining him in Ecuadorwas UMMC certified surgical technologist, Nicolette Dupuis, who supports Dr. Kaushal in his pediatric heart surgeries in the OR in Baltimore. This marked Dr. Kaushal and Ms. Dupuis’s third medical mission trip together. During their week inEcuador, they worked with cardiologists and intensivists from hospitals around theU.S. in the sparse operating rooms.

 “Part of our job while we were inEcuadorwas to teach the local medical professionals to do congenital heart surgeries like we do, but on a smaller level,” says Dr. Kaushal. “Our day began at 7:30 am, and we’d operate until 9:00 pm. We staffed the ICU 24/7 during the time we were there to make sure those children had the post-operative care they needed.”

Dr. Kaushal is the only board-certified congenital heart surgeon inMaryland, giving him a unique expertise in performing surgical procedures on babies just a few days old who were born with heart disease, children with congenital and acquired heart disease, and adults living with heart conditions they developed as babies, known as adult congenital heart disease.

Dr. Kaushal performs the most complex pediatric heart surgeries available today, including surgeries for babies with hypoplastic left heart syndrome, Tetralogy of Fallot and ventricular septal defect, and those in need of pulmonary valve replacement. He is also preparing to open a clinical trial that will use a baby’s own stem cells to regenerate the underdeveloped portion of their heart caused by hypoplastic left heart syndrome.

We invite you to learn more about what Dr. Kaushal and the Children’s Heart Program at UMMC are doing for children within the Mid-Atlantic region.

UMMS “Spring Into Good Health” Event Gets Shoppers Dancing in the Center Court at Mondawmin Mall

By Sharon Boston

UMMC Media Relations Manager

Each spring, the University of Medical System (UMMS) hosts “Spring Into Good Health,” a free event attended by hundreds of people who receive medical screenings (such as blood pressure and cholesterol), talk one-on-one with University of Maryland Medical System health professionals and pick up information on men’s and women’s health, child safety, nutrition and more.

This year, the UMMS Community Outreach and Advocacy Committee wanted to put a focus on fitness and hosted a dance party right in the middle of Mondawmin Mall!

Several guests commented that they didn’t realize that fitness could be so fun, and that they plan to try to exercise more and eat better, thanks to the information that they picked up at the UMMS event.

Take a look at the some of the line dancing that got people of all ages up and moving.

 “The dancing was really upbeat and lively, it really got people moving,” said Donna Jacobs, UMMS senior vice president for government relations. “Several people told us that they’d like to see even more fun physical activities next year.”

Five of the 12 hospitals in the University of Maryland Medical System took part in the event — the University of Maryland Medical Center, Maryland General Hospital, Kernan Orthopaedics and Rehabilitation Hospital, University Specialty Hospital and Mt. Washington Pediatric Hospital. The event was also sponsored by Maryland Physicians Care, Total Health Care, Coppin State University School of Nursing and Radio One, Baltimore.

Mitral Valve Repair Lets Marathon Runner Boogie at Son’s Wedding

By Nick Papas

I had just completed the 2011 Pittsburgh Marathon. It was not my best time. There was no personal record that day. It was a day marked by a continued struggle with a chronic heel injury.  But there was something more serious brewing in my body that day. It was a particularly strong flare-up of my mitral valve pain. I was so familiar with the pain. It had been diagnosed and studied throughout my life. I had mitral valve prolapse. 

 So, I brushed off the chest pain as I slogged through the marathon and finished.

Then a couple hours later, as the marathon and half-marathon runners of our family celebrated with extended family and supportive friends, I shared my personal marathon experience with my soon-to-be daughter-in-law, Beth Ann. My tale included the throw-away detail about my old familiar chest pains. No big deal. Or so I thought.

 Beth Ann, a medical student, was not as flippant as I was about the little detail of chest pain.  She pulled out her stethoscope and diagnosed me on the spot as having mitral valve regurgitation. She strongly suggested that I see my PCP. I was stubborn and a bit incredulous. I didn’t rush.

 Eventually my heart acted up in such new and painful ways that I was compelled to go to my doctor. This set into motion the chain of events that lead me to Dr. James Gammie at UMMC.

An initial link in this chain was me doing my homework. I read the scientific papers. I consulted with knowledgeable, trusted people and friends.

 I had to make my decision: Was I, a man who loves to be active by running and biking, going to be happy taking drugs? Would I be satisfied watching my body get weaker and weaker while my heart became more and more sick?

 Ultimately, the decision was a no-brainer.

 I took action right away, partially because I concluded that it was the right thing to do and partially because my son’s wedding was just around the corner. I wanted to be healed enough to dance at my son’s wedding.

My surgery was performed at UMMC on September 6, 2011. Noah and Beth Ann were married October 8, 2011! I am happy to say I danced! I danced quite a bit! My wife, Patty (in the photo with me), and I had a great time.

 I am grateful not only to be alive but to be living. I am optimistic that with my newly repaired, healthy heart I will be able to enjoy the coming years with my family and to live these years actively. 

In the future, look for me in the 2012 Baltimore Half or Full Marathon. I’m the self-proclaimed, 52-year old, poster “child” of UMMC Mitral Valve Repairs!

 

 

Passion for Kids Leads Children’s Heart Director to Keep on Running!

By Dr. Geoffrey Rosenthal, Director, Children’s Heart Program


Running is my passion.  I haven’t skipped a day of running in four years and have been known to run even while injured, powering through a stress fracture or more recently, cracked ribs.  On most weekends, it’s not uncommon to find me running.  Ideally, I’m participating in a marathon or half marathon.

People always ask me what motivates me to run each day.  I do it for the children.  I run because I know we can do more to make life better for those touched by childhood heart disease.

When you’re running for 26 miles, you have a lot time on your hands.  There’s time to reflect and time to talk to other runners.  It’s also a great time to promote my other passion – the University of Maryland Children’s Heart Program.

I always wear my Children’s Heart Program t-shirt on race day, whether I’m at the Baltimore Marathon or the Boston Marathon.  Some of the best conversations begin with a comment about my shirt.  People share stories about how congenital heart disease has touched their lives.  It is a powerful reminder of how many people are impacted.  Congenital heart defects are the most common birth defect, affecting 1 in 110 infants born each year.  Congenital heart disease is also the most common cause of infant mortality from birth defects.

On October 15, 2011, I will run in the Baltimore Running Festival and proudly wear my Children’s Heart Program shirt.  But on this day, I won’t be alone.  140 runners will also be wearing the shirt to help raise awareness and funds for our program.  Our running team has members, ages 4 to 57, participating in a wide range of events, from the Kids Fun Run to the Baltimore Marathon.  They come from not only Maryland, but Virginia, Pennsylvania, Delaware, New Jersey, and New York.

Since last year, the University of Maryland Children’s Heart Program has grown to include a total of seven pediatric cardiologists, a cardiologist who specializes in adult congenital heart disease, and a pediatric heart surgeon.  Together, the team specializes in fetal diagnosis, management of heart rhythm problems, interventional cardiology, management of congenital heart disease in adults, pediatric cardiovascular thoracic surgery, and neonatal heart surgery.  We’re joined by specialists in nursing, quality improvement, nutrition, social work and other fields.  We’re building an expert team whose talents will help children with congenital heart disease live longer and lead more active lives.  We have set out with the goal to ensure that no child will need to leave the state of Maryland to receive needed care for heart problems.

To support the University of Maryland Children’s Heart Program Running Team, visit: www.ummsfoundation.org/pedsteam

UMMC Heart-Liver Transplant Patient Promotes Organ Donation Awareness

By William Benamati
UMMC Heart and Liver Transplant Recipient

Editor’s Note: This post features excerpts from William Benamati’s CaringBridge site, which was created to keep his friends and family updated on his struggle with familial amyloidosis disease and his heart-liver transplant that was done at the University of Maryland Medical Center on February 21, 2011.

I am 42 years old and a married father of three. My family and I live in Curwensville Pa. I have been a funeral director since 1990 and am the location manager at Bennett & Houser Funeral Home in Clearfield and Mohney-Yargar Funeral Chapel in DuBois.

Without the generous gift of a heart and liver from an organ donor, I would be facing certain death. I have been speaking to many clubs and civic organizations about my illness and to promote organ donation awareness. As a funeral director, I have seen firsthand how organ donation has helped families cope with the unexpected loss of a loved one — providing them with some sort of good feeling knowing that their loss was not in vain and has allowed someone else to live.

Many people do not know how I ended up needing a transplant. My dad died in November 2007 and shortly after in the spring of 2008, I noticed that my heart would flutter for no reason at all. Around that same time, I was having gastrointestinal problems that caused me to steadily lose a lot of weight. I went from about 220 pounds to 150 over a period of a few months. At this point I saw doctor after doctor but all of my tests were normal! As soon as they found out I was a funeral director, they said it was all work-related stress and I needed to work on my anxiety. But in my heart I knew there was something physically wrong.

In 2009 I had a bout with kidney stones and the night before my fifth kidney stone procedure, my older brother David died unexpectedly at the age of 42 of a massive heart attack. That summer, the gastrointestinal issues continued and new symptoms developed. My feet hurt as if they were on fire, and my legs were weakening. In late October I contracted the flu, spent a week in ICU and was discharged the night before Thanksgiving. A cardiac catheterization showed that I had a wonderful heart, but I felt like I was slowly dying. How true my assessment was.

I was home for about two weeks and ended up hospitalized for 10 days with pneumonia. I was now using a cane to walk, and it was recommended that I see a neurologist.

In January 2010, I met with a neurologist who informed me that I had early-onset Parkinson’s disease. I was accepting, but my wife however was not. She disagreed with that diagnosis wholeheartedly, and researched the illness for days if not weeks. The pain in my legs had become unbearable, my heart was weakening, and I truly felt that I would not see 2011. She argued with the neurologist who finally agreed to conduct a nerve study — and lo and behold, the doctor realized that I had very severe neuropathy in my legs. My nerves were dying, and whatever I had was affecting my blood pressure and my GI tract.

I had a sural nerve biopsy in April and two days before my daughter’s senior prom, I received a death sentence: amyloidosis. A visit to a local hospital in June accompanied by a genetic test sent to the Mayo Clinic in Minnesota revealed I had hereditary “familial” amyloidosis. This disease has been passed through my father’s family, and we now know my father had it. His symptoms were exactly the same as mine.

It was later determined that my heart was failing because the amyloids, which are produced by the liver, were attacking the heart and the nervous system. The local hospital where I had been treated does not perform multiple organ transplants, so they referred me a few blocks south to University of Maryland Medical Center. I was listed for exactly seven months when a donor was found for me. I would have started my eighth month of waiting on the day I was actually transplanted.

Dr. Erika Feller was my cardiologist and it was through her that we decided to do the heart and liver transplant at the same time. Dr. Rolf Barth did a good portion of the liver transplant and Dr. Bartley Griffith put in the new heart. Everyone worked together; it was seamless. The surgery went very smoothly — I thought it was going to take 12 hours, but they were done in 7-1/2 hours. They kept my wife very well-informed the entire time.

The whole team was wonderful. The doctors and nurses all worked as a team and they all deserve a lot of credit.

After the transplant, I’m feeling pretty good. I’m just happy to be able to get out and go to my son’s ball games. I do plan on returning to work at some point. I just passed the 100-day mark since my transplant, so it’s a good sign things are progressing the way we want them to.

I have many blessings and can’t wait to start my second life. Remember the 3 Fs: Faith, Family, Friends. Without the 3 Fs I would not be here today.

Mitral Valve Surgery: Why We Operate on the Heart from the Right Side

The launch of our new minimally invasive mitral valve surgery print ad, which has appeared in many publications, including The Washington Post Magazine, has generated several e-mails and blog posts from people questioning the accuracy of the image, which features a chest with the incision location – under the right breast – highlighted.

Dr. James Gammie, a UMMC  cardiac surgeon who specializes in mitral valve repair, said patients are surprised to learn the incision site is under the right, and not the left, breast.

So what’s the story? The heart’s mitral valve is located in the center of the chest, and Dr. Gammie said the best way to approach the valve is through the upper chambers of the heart, which are on the right side of the chest.

Dr. Gammie also talks about his passion, and the benefits to patients, of repairing vs. replacing the mitral valve, which UMMC does more than 90 percent of the time. As for the comments about the incision location, he says he encourages patients to ask questions, and that the more informed patients are the better.

UMMC Heart Transplant Recipient Portrayed in New Film

Casey Towers, a young mother of two from Waldorf, Md., received a heart transplant at the University of Maryland Medical Center in 2006 after she was diagnosed with peripartum cardiomyopathy, a rare heart condition related to her pregnancy.  She later learned the identity of her donor — Luke Abbate, a high school athlete who was killed in reckless driving accident.  Four years after her transplant, Casey had the opportunity to meet Luke’s parents,  Steven and Maryanne Abbate.  That’s when they told her that she had become a character in the ‘The 5th Quarter,’ a new film about Luke’s death and the aftermath. Four other patients also received organs from Luke, but Casey was the only one portrayed in the movie.

In this video, Casey talks about her unique experience and how she felt about the care she received at the Medical Center.  In addition, Dr. Erika Feller shares her insights about Casey’s story and talks about the importance of organ donation. Read the full story here.

All About Triglycerides: An Interview with Dr. Michael Miller

Editor’s Note: A scientific statement published today in Circulation: Journal of the American Heart Association found that dietary and lifestyle changes significantly reduce elevated triglycerides, a type of blood fat, which is associated with heart, blood vessel and other diseases.

So what exactly are triglycerides, how significant are this statement’s findings and what specific steps can people take to reduce their triglyceride level and improve their heart health? Dr. Michael Miller, chair of the AHA’s statement committee, a cardiologist at the University of Maryland Medical Center and director of the Center for Preventive Cardiology at the University of Maryland School of Medicine, answers those questions and more to help you improve your triglycerides IQ.

As compared to lowering cholesterol, it sounds like lifestyle changes can go a long way toward lowering cholesterol levels.

Yes, lifestyle changes may only lower cholesterol 5-10% while they can lower triglycerides 30-50% and higher in some cases!

How significant are these findings, and why should people care and take action?

This is the most comprehensive statement on triglycerides and puts into perspective the important role that they serve as a barometer of our “metabolic” health. Optimal triglycerides suggest that fat is being effectively broken down whereas high triglycerides indicate abnormal processing, which may lead to excess fat in other tissues.

For example, excess fat in muscle may lead to insulin resistance and diabetes, excess fat in the liver may produce a fatty liver and excess fat in the belly may produce inflammation and increase risk of heart disease. In fact, a high triglyceride level may predict development of diabetes years down the road. Therefore, it is important that people pay close attention to their triglyceride level, especially because it can often be effectively treated with lifestyle measures.

What are triglycerides, and why are they important?

Triglycerides are simply our fats and high triglyceride levels in our blood tell us that our body is carrying around too much unhealthy fat. Too much unhealthy fat in our blood is associated with an increased risk of diabetes and heart disease.

Talk about the work your committee did, as well as the key findings.

Our committee of 15 men and women physician scientists evaluated more than 500  studies involving triglycerides during the past 30 years. In summary, our findings indicate that triglycerides are an important marker for heart disease risk.  High triglycerides may raise the risk of heart disease 20-50% and double the risk if accompanied by high levels of LDL (the bad cholesterol). High triglycerides are also associated with increased belly fat, high blood pressure, insulin resistance and low levels of HDL (the good cholesterol).

How are and how often should triglycerides be measured?

Screening levels can now be obtained in a non-fasting state and depending on the results will determine whether additional testing should be performed. For example, a normal non-fasting test (less than 200) may not need additional testing for a period of 1 year or greater, whereas high levels (200 or greater) should have a fasting test within a reasonable period such as 2-4 weeks.

It sounds like triglycerides are somewhat similar to cholesterol. Can you talk about that, as well as why the public is so familiar with lowering its cholesterol levels but not its triglycerides?

Cholesterol is a waxy substance whereas triglyceride is fat, but they are both connected by the lipoproteins that transport them to and from various body tissues. For example, triglyceride-rich lipoproteins include chylomicrons (that transfer triglycerides after a fatty meal) and VLDL (very low density lipoprotein) that transfers triglycerides from the liver. The triglycerides are broken down and stored in fat or used as an energy source in muscle. Cholesterol-rich lipoproteins include LDL and HDL and they transfer cholesterol to or from body tissues.

What are the current guidelines for triglyceride levels, and what is the optimal level?

In addition to the previous guidelines that define desirable levels (less than 150), borderline-high (150-199), high (200-499) and very high (500 and greater), we have now added the optimal level of less than 100.

What can people do to lower their triglyceride levels?

High triglycerides are very responsive to lifestyle changes. They include reducing weight if overweight by decreasing the total number of calories eaten daily, reducing simple sugars, especially fructose, decreasing saturated fat and eliminating trans fats. Physical activity, especially aerobic exercise, will also lower triglyceride levels.

Are there specific foods people should eat more of and avoid, and forms of exercise that are better than others?

Omega-3 fats that contain EPA and/or DHA such as found in fatty fish can lower triglycerides. Decreasing simple carbohydrates, saturated and trans fats are also recommended. Aerobic activity is also effective in reducing elevated triglycerides.

 

Aortic Valve Surgery Patient & Great Grandfather’s Moving Update

By Jack Myers

Editor’s Note: Jack Myers wrote a blog post about his successful aortic valve surgery in early January of 2010. Below is an update he recently sent to his surgeon, Dr. Jamie Brown.

Dr. Brown,

It has been a little over a year since my surgery. As you can see my little boys [great grandchildren] are growing fast.

Thanks to you I will watch them grow into young men.

Jack Myers

Other Posts by Jack Myers:

Virginia Woman Shares Story of Her Successful Mitral Valve Repair

Virginia resident Elizabeth Norris never suspected anything was wrong with her heart. However, the results of an echocardiography test and cardiac catheterization indicated she had severe mitral valve regurgitation and needed surgery to correct the problem. Her physician referred her to Dr. James Gammie at the University of Maryland Medical Center, an expert in mitral valve surgery, who was able to successfully repair her leaking valve.  Visit our Web site to read her story.