Research is an integral part of the Department of Cardiac Surgery. We have one of the few Cardiac Surgery Departments with dedicated basic science research, and many faculty spend a significant amount of time in the research lab.
Researchers in the Department are actively working on prevention, diagnosis and treatment for cardiac disease.
Physicians are involved in every aspect of research from device design to early development and clinical trials and have an international presence in the community of heart failure surgery.
Residents and fellows are exposed to the full scope when they practice here and some elect to spend dedicated time in clinical trials in addition to training in clinical patient care. The basic research team is led by Dr. Eugene Chen, who was recently awarded a $2 million grant for research on vascular tissue engineering. Our Department recruits those with demonstrated research skills, then ensures they have the resources to be successful. Our Department has the greatest number of high impact publications in both congenital and adult areas in the medical school.
Faculty are uniformly asked to speak at major professional meetings, both national and international, and plan the meetings for many of the leading professional societies. Researchers in the lab work hand in hand with those performing surgery on patients, so the surgeon implanting the valve is also exploring how to create a valve out of a patient’s own tissues. This approach facilitates bringing the newest innovations to patients.
Here are just a few areas where researchers in the Department of Cardiac Surgery are making advances.
The Department of Cardiac Surgery has an active team focused on stem cell regenerative medicine comprised of both M.D and Ph.D. scientists who are investigating methods to grow blood vessels and heart valves. The goal for the future is that physicians will be able to change out parts that are no longer functioning well, with tissue engineered organs. Currently, many patients die waiting for a new heart to be transplanted when theirs fails. UofM researchers are at the forefront of taking a small graft of skin cells to grow a heart that is tailor made for a patient who needs one. The team is working to transform stem cells into cardiovascular cells as a way of generating cardiac tissue and vascular grafts that could eventually be used in patients. Once proven successful, this process can begin at the earlier stages, as soon as a problem is diagnosed.
Dr. Frank Pagani led the development of a mechanical pump that assists those in heart failure while they are waiting for a new heart. Surgeons here have access to the newest type of devices to treat heart failure and have one of the highest volume sites for use of implementable heart pumps.
Researchers are looking for genes in bicuspid aortic valve registry that put people at higher risk for cardiac disease. Bicuspid aortic valve is the most common form of congenital heart disease. Researchers have identified some of the genes that cause this problem and research is ongoing to develop breakthroughs in treatment. The Department of Cardiac Surgery is the leading center using pigs and rabbits research models. Instead of relying on the mouse, which doesn't have a cardiovascular system similar enough to humans, pigs and rabbits are considered a better basis for the implications of lab research on humans.
Minimally Invasive Treatments
Our cardiac surgeons are spearheading the first clinical trial in the U.S. for a branched aortic arch endograft, a new option for treating aneurysms through the peripheral blood vessels instead of through complex open heart surgery. The UofM Cardiac Surgery team was the first in the world to implant this type of endograft. Cardiac surgeons here are also exploring the use of catheter-based technology to treat aortic valve and mitral valve problems. By inserting catheters through an artery in the groin or shoulder area in a process called Transcatheter Aortic Valve Replacement (TAVR), surgeons can guide an artificial heart valve attached to a wire frame into the narrowed aortic valve in the heart. This procedure allows valve replacement in a less traumatic way and can be used safely with patients not suitable for open-heart surgery.
The Department of Cardiac Surgery is one of only a few sites to conduct a clinical trial of a new heart valve system. The trial involves assessing the safety and effectiveness of the Edwards Lifesciences Intuity Valve System in patients with aortic valve disease who need valves replaced. It would allow the surgeon to implant the valve with only two stitches, resulting in a significantly decreased time required for surgical intervention. If the trial is successful and the device is approved by the FDA, the Department will be leading the way in using this new system, offering patients an advanced option for treating this disease.
Pioneering the use of treatment for Thoracic Aortic Pathology
Diseases of the thoracic aorta kill over 15,000 Americans annually. Dr. Himanshu J. Patel has been performing Thoracic Endovascular Aortic Repair (TEVAR) for over 19 years as an alternative to open surgery for many patients, far longer than most centers. It’s a life saving option for patients who are not optimal candidates for traditional open repair and can shorten the hospital stay and recovery period.
New Health Research Section Committed to Evaluating and Improving Care
When the Department of Cardiac Surgery became its own, free-standing entity, it wasn’t just focused on better ways to conduct the next operation. Department administrators are constantly evaluating performance in all areas. The Section of Health Services Research and Quality is led by Dr. Donald Likosky, a nationally regarded expert in investigating the source and consequences of variation in the surgical treatment of heart disease. His team is focused on using data from our institution as well as collaborating centers to look at the best practices and how to improve outcomes. Part of Dr. Likosky’s efforts include surgical case videos which display the patient’s physiologic responses to interventions, along with a view of the surgical procedure. Data are linked to a clinical registry to track information on the patient’s postoperative outcomes. This unique approach has led to an 80% reduction in cerebral emboli—the most frequent cause of stroke—following cardiac surgery, transitioning into improved neurologic outcomes following open heart surgery. The initiative to establish this section, which evaluates clinical outcomes and develops new treatments in cardiac care, represents the Department’s goal to set a standard that cardiac teams everywhere will strive to emulate.
A Physical Environment that Fosters Innovation
Researchers pursue tomorrow’s cures in one of the best facilities in the country at the North Campus Research Complex, a voluminous space in which to explore potential new discoveries. This complex of 28 buildings totals 2.1 million square feet of space devoted to bench, research and manufacturing. The setting is designed to be conducive to collaboration. Here, cardiac surgeons sit side-by-side with those in other disciplines, including bioengineers and cell biologists, to encourage cross-pollination, an environment that fosters the greatest breakthroughs. For more information on the North CampusResearch Complex, visit the NCRC website.