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CT Surgery Center for Clinical Research

OVERVIEW

The Cardiothoracic Surgery Center for Clinical Research (CCR) of the Emory University School of Medicine conducts high-impact clinical and translational research and develops and investigates new techniques and technologies in cardiothoracic surgery to inform evidence-based practice.

Cardiothoracic surgeon scientist Dr. John Puskas, who had been an Emory faculty member since 1996, founded the CCR in 2005. Dr. Puskas was an early, notable advocate of various forms of off-pump CT surgery, and had an important role in validating such procedures as off-pump coronary artery bypass surgery. With an impressive cadre of faculty investigators and robust staff support, he developed the CCR into a highly active research center. Dr. Puskas left Emory in March 2014 to chair the Department of Cardiothoracic Surgery, Mount Sinai Beth Israel Hospital, and direct the Coronary Revascularization Reference Center, Mount Sinai Health System. Dr. Michael Halkos then took over as the CCR's scientific director.

The CCR is a member of the Cardiothoracic Surgical Trials Network (CTSN), which is a consortium of adult cardiac surgery centers supported by the NIH's National Heart, Lung, and Blood Institute. As a center in the network, the Emory CCR participates in multi-institutional prospective randomized trials that evaluate new surgical methods, technologies, devices, and innovative pharmaceutical and bioengineered products.

The CCR has served as the national or international PI site for several FDA IDE trials, ranging from innovative transcatheter aortic valve replacements to reduced anticoagulation for mechanical heart valves. CCR scientists have also conducted landmark, investigator-initiated, randomized controlled trials in stroke prevention, endoscopic vein harvest, and off-pump coronary artery bypass grafting, and have enrolled patients into many multicenter clinical trials in cardiac and thoracic surgery.

THE CCR TEAM

Dr. Michael Halkos

SCIENTIFIC DIRECTOR: Michael E. Halkos, MD, MSc

Dr. Halkos is a highly experienced and productive academic cardiac surgeon-scientist with expertise in minimally invasive cardiac surgery, particularly robotic mitral valve surgery, robotic-assisted coronary artery bypass surgery, hybrid coronary revascularization, hybrid atrial fibrillation ablation, and mitral valve repair techniques. Together with Douglas Murphy, MD, he leads one of the largest and most successful robotic cardiac surgical programs in the world. As an accomplished researcher, Dr. Halkos is considered one of the world's leading experts in robotic cardiac surgery, and has published extensively on robotic approaches to mitral valve surgery, mitral valve repair, coronary artery bypass grafting (CABG), and hybrid coronary revascularization. Currently, he is the principal investigator of an NIH-funded trial to reduce stroke after cardiac surgery.

Dr. Robert Guyton

Robert A. Guyton, MD

Dr. Guyton has served as chief of the Division of Cardiothoracic Surgery of the Emory University School of Medicine since 1990. Throughout that time he has been involved in the creation and refinement of numerous cardiothoracic surgical techniques. In 1999, he and Dr. Omar Lattouf (see below) collaborated on the first implantation in the state of Georgia of an Abiomed biventricular assist system to support a patient suffering from heart failure due to postcardiotomy shock. Beginning in 2007, Dr. Guyton joined Emory CT surgeon scientist Dr. Vinod Thourani (see below) and Emory cardiologists Dr. Vasilis Babaliaros and Dr. Peter Block as one of the local surgical co-PIS  of the multi-center PARTNER I trial of transcatheter aortic valve replacement (TAVR). The results of the national trial influenced FDA approval of the SAPIEN transfemoral transcatheter heart valve in 2011. In 2014, Dr. Guyton began directing the Emory Cardiothoracic Research Lab (CTRL).

Dr. Omar Lattouf

Omar M. Lattouf, MD, PhD

Dr. Lattouf has extensive experience in complex cardiac procedures including heart transplantation, laser re-vascularization, left ventricular reduction procedures, thoracoscopic minimally invasive interventional therapy, and Alfieri mitral repair. In addition to having numerous patents, Dr. Lattouf has various patents pending and is involved in developing a variety of cardiac surgery-associated methods and devices for patent consideration. His research focuses on complex coronary revascularization utilizing off-pump vs. on-pump techniques, transmyocardial laser revascularization to improve myocardial perfusion and reduction of angina, the role of stem cells in treating end-stage ischemic or idiopathic cardiomyopathy, and the diagnosis and treatment of heparin induced thrombocytopenia.

Dr. Bradley G. Leshnower

Bradley G. Leshnower, MD

Dr. Leshnower's research interests include diseases of the thoracic aorta, clinical studies of patient outcomes following medical and surgical treatment of aneurysmal disease and aortic dissection, and basic science investigations of the pathophysiology of acute and chronic aortic dissection. In 2016, he was the first recipient of the Thoracic Surgery Foundation (TSF)/Southern Thoracic Surgical Association (STSA) Research Grant, which is funding his pilot study to determine the optimal cerebral protection strategy during aortic arch replacement.

Dr. Vinod Thourani

Vinod H. Thourani, MD

Dr. Thourani's research and clinical work in transcatheter aortic valve replacement (TAVR) and minimally invasive valvular surgery for high-risk patients with severe aortic stenosis has been particularly significant. Using TAVR, teams of interventional cardiologists and cardiothoracic surgeons place the Edwards SAPIEN valve inside the heart without stopping it or opening the chest. Dr. Thourani was a local co-principal investigator of the Emory-based site of the multi-center PARTNER I trial that measured TAVR against traditional open heart surgery, the initial results of which influenced the FDA's 2011 approval of the SAPIEN valve for treatment of high-risk patients with aortic stenosis. Dr. Thourani is also a national co-PI of the SAPIEN 3 cohort of PARTNER II, which is evaluating the use of a smaller device as well as testing TAVR in patients who pose a moderate surgical risk. The safety and outcomes data from both trials was reported at the 2015 Annual Meeting of the American College of Cardiology. Mortality rates between patients who had received TAVR and those who had open-heart surgery were nearly identical, and TAVR patients had no increased risk of stroke.

Dr. J. David Vega

J. David Vega, MD

Dr. Vega is the surgical director of the ventricular assist device (VAD) and heart transplant programs at Emory, and his recent research has concentrated on evaluating the use of mechanical circulatory support devices as a bridge to transplant or for destination therapy. In 2006, Dr. Vega was the first physician in Georgia to implant a VAD as a form of destination therapy in a patient who was ineligible for or are unwilling to undergo a heart transplant, and in 2007 he was the first to implant an even smaller VAD for the same purpose that featured an automatic speed control mode designed to regulate pumping intensity based on different levels of patient or cardiac activity. In 2013, The Joint Commission (TJC) awarded Emory's VAD program Disease Specific Care Certification for Destination Therapy for the third time since 2009. Emory was the first VAD program certified by TJC in Georgia.

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