Dr. Halkos Receives NHLBI K-23 Award

June 2011

Dr. Michael Halkos was awarded a Mentored Patient-Oriented Research Career Development K-23 Award from the National Heart, Lung, and Blood Institute to fund his study "Operative Strategies to Reduce Cerebral Embolic Events During Coronary Artery Bypass Surgery." This is the first time a grant of this type has been awarded to a faculty member of the Division of Cardiothoracic Surgery. K-23 awards provide support for supervised study and research for clinically trained professionals who have the potential to develop into productive, clinical investigators focusing on patient-oriented research. Dr. John Puskas, Director of the Clinical Research Unit of the Division of Cardiothoracic Surgery, will serve as Dr. Halkos' mentor for the study.

"It is highly unusual for a practicing surgeon to get one of these awards," says Dr. Allan Kirk, Vice Chair of Research for the Department of Surgery, Emory University School of Medicine, "which speaks to the exceptional commitment to academic work in the Department and the Division."

The study will compare different strategies used during coronary artery bypass graft surgery (CABG) to determine which method is associated with the lowest incidence of cerebral embolic events. Outcomes measures will include Transcranial Doppler-detected embolic events, postoperative stroke, and neurocognitive dysfunction. The primary hypothesis of the study is that an off-pump approach using facilitating devices to perform clampless proximal anastomoses will result in the least amount of aortic manipulation and therefore the lowest incidence of TCD-detected cerebral emboli.

"While the use of cardiopulmonary bypass to provide circulatory support while the heart is arrested is the current standard of practice for performing CABG, it also carries the highest risk for cerebral embolic events due to aortic clamping and cannulation," says Dr. Halkos. "However, various components of off-pump coronary artery bypass (OPCAB) enable the surgeon to perform distal coronary anastomoses without the use of cardiopulmonary bypass and to often minimize or completly avoid aortic manipulation during proximal anastomoses. Theoretically, these maneuvers may reduce the incidence of cerebral embolic events by reducing the generation of aortic atheroemboli."