Cardiac Surgery
Valluvan Jeevanandam, MD
Professor of Surgery
Chief, Section of Cardiac Surgery
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From left to right: Viktoriya Kagan, APN and Colleen LaBuhn, APN
A Heart Transplant Patient’s Unique Journey to Recovery
The University of Chicago’s renowned Cardiac Surgery team, led by Valluvan Jeevanandam, MD, has established the largest heart transplantation program in Illinois. Chicago resident Jerry Butts knew this as he searched for a team that could work strategically as a unit to treat his failing heart and carefully handle his fragile state. In early April, Butts was admitted to the University of Chicago Medicine and received a heart transplant, but little did he know his recovery would be interrupted by a nightmarish reality. After a successful heart transplant, Butts was transferred out of the intensive care unit and onto the floor. Ten days later he was diagnosed with COVID-19, which caused his condition to decline significantly.
Butts was rushed to the COVID-19 unit and immediately put on ECMO, or extracorporeal membrane oxygenation. With his vulnerable heart and lungs weakening rapidly due to COVID-19, ECMO did the work for them. ECMO removes carbon dioxide from the blood, resupplies it with oxygen and recirculates it throughout the body. The process takes on the complex functionalities of the heart and lungs—supporting patients so that their bodies can fight infections like COVID-19. ECMO resets the body so that they can recover. Surgical teams are extremely selective when choosing candidates for ECMO, as there is only a 50 percent chance of survival. Although it’s preferable to use noninvasive ventilation, ECMO is used as a last resort for patients who are in danger of dying without it.
Cardiac Surgery Program Manager Colleen LaBuhn, APN, was instrumental in restoring Butts to stable health. “The entire multidisciplinary team had to get very creative with the management of this patient, without being able to physically see him,” said LaBuhn. “For 30 to 40 days at his sickest time, you had a transplant and surgical team managing his heart postoperatively, a mechanical circulatory support team managing his ECMO to keep him alive, ECMO specialists working as the eyes and ears for all of us to tell us how things were going and an ICU team managing the whole picture, all virtually.” After a grueling two and a half months, Butts was cleared of COVID-19 and discharged to rehabilitation.
From left to right: Colleen LaBuhn, APN and Viktoriya Kagan, APN
Colleen LaBuhn, APN
Another aspect that made Butts’s recovery so successful was that LaBuhn and the rest of his care team were so invested in keeping his spirit alive. “There are so many patients who are depressed now, because they don’t have that contact,” said Dr. Jeevanandam, Chief of Cardiac Surgery. “Not only did we have to make sure that his blood pressure and oxygenation were okay, we had to make sure that his spirit was ok.” Because of its highly contagious nature, COVID-19 prevents human interaction, an essential piece in the healing puzzle. Many COVID-19 patients feel as though the path to recovery is being trekked alone with only the illness as company.
“We didn’t want him to think we’d abandoned him,” said LaBuhn. “We had to keep that social interaction going.” Butts wasn’t allowed to have visitors and couldn’t be with his loved ones. “That was very hard, to see your patients mentally suffering,” said LaBuhn. “You just want to go up there and help them.” The team was determined to bridge the gap and offer the same quality care as they would provide face to face. Which is why they contacted the International Programs office to use one of the iPads normally used for translating different languages between physicians and patients. Not only did they provide an iPad for Butts, but they sent a total of 32 to the COVID-19 unit, so that isolated patients could continue to see their families and care teams.
Heart transplant recipient and Covid-19 survivor, Jerry Butts pictured here with from left to right: Karen Meehan, APN, Justin Okray, PA, Shana Creighton, APN, Patti Swistowicz, APN and Viktoriya Kagan, APN.
Colleen LaBuhn, APN
LaBuhn and lead Mechanical Circulatory Support Coordinator Viktoriya Kagan, APN, would FaceTime Butts daily and continuously reassure him that they were all in this together. They even sent him photos so it would feel like they were in the room with him. “This experience taught us what true multidisciplinary teams can do together,” said LaBuhn.
Butts had not been outside in two and a half months. Knowing that, on his last day in the hospital, his care team arranged to let him sit outside in the sunshine for half an hour before getting in the van that would take him to his rehabilitation center. “His treatment pulled the whole critical care team together to be creative and compassionate,” said LaBuhn. “It was a journey for all of us.”
faculty listing
Professor of Surgery
Husam H. Balkhy, MD, Professor of Surgery; Director, Robotic and Minimally Invasive Cardiac Surgery
Mahesh P. Gupta, PhD, Professor of Surgery
Valluvan Jeevanandam, MD, Cynthia Chow Professor of Surgery; Chief, Section of Cardiac Surgery; Director, Heart and Vascular Center
Luca Vricella, MD, Professor of Surgery; Chief, Pediatric Cardiac Surgery
Associate Professor of Surgery
Narutoshi Hibino, MD, PhD, Associate Professor of Surgery
Takeyoshi Ota, MD, PhD, Associate Professor of Surgery; Co-Director, Center for Aortic Diseases
Assistant Professor of Surgery
Tae H. Song, MD, Assistant Professor of Surgery; Surgical Director, Lung Transplant Program; Director, MCS/ECMO Program
Clinical Associate of Surgery
Mahmoud Okash, MD, Clinical Associate of Surgery
David Onsager, MD, Clinical Associate of Surgery
Gianluca Torregrossa, MD, Clinical Associate of Surgery
faculty honors
Husam H. Balkhy, MD, and Gianluca Torregrossa, MD, of the Robotic Cardiac Surgery team made progress on 22 manuscripts for major peer review journals, with four published, eight accepted and in press, six submitted and currently under review, and four in progress.
Husam H. Balkhy, MD, and Valluvan Jeevanandam, MD, were named 2020 Top Doctors by Chicago magazine.
The research team of Mahesh P. Gupta, PhD, won the Huggins Symposium Postdoctoral/PhD Abstract Award for “SIRT6 Protects Heart from Aging Induced Cardiac Hypertrophy by Enhancing Mitochondrial Fitness” (first author Vinod Pillai, PhD).
The research group of Narutoshi Hibino, MD, PhD, had 13 published papers, one paper under review, four papers in progress and five presentations at meetings. The Hibino Lab was selected as one of 10 teams in the country to participate in the NASA Vascular Tissue Challenge Competition. The team was awarded the Huggins Symposium Faculty Research Award for the abstract “Implantation of Patient-Specific 3D Printed Branched Tissue Engineered Vascular Graft in Porcine Models.”
Valluvan Jeevanandam, MD, was named Cynthia Chow Professor in the Department of Surgery. He was invited to present at the 12th International Symposium for Innovations and New Treatment Strategies in Heart Failure in Serbia.
select publications
Abdollahi S, Boktor J, Hibino N. (2019). Bioprinting of freestanding vascular grafts and the regulatory considerations for additively manufactured vascular prostheses. Translational Research: The Journal of Laboratory and Clinical Medicine, 211, 123–138. doi: 10.1016/j.trsl.2019.05.005.
Anyanwu EC, Kagan V, Bhatia A, Tehrani DM, Adatya S, Kim G, Sarswat N, Jeevanandam V, Sayer G, Uriel N. (2019). Home Inotropes in Patients Supported with Left Ventricular Assist Devices. ASAIO Journal (American Society for Artificial Internal Organs: 1992), 65(1), e7–e11. doi: 10.1097/MAT.0000000000000753.
Balkhy HH, Nisivaco S, Kitahara H, McCrorey M, Patel B. (2019). Robotic Multivessel Endoscopic Coronary Bypass: Impact of a Beating-Heart Approach With Connectors. The Annals of Thoracic Surgery, 108(1), 67–73. doi: 10.1016/j.athoracsur.2018.12.044.
Binka E, Baschat A, Jelin AC, Lui C, Hibino N, Vricella L, Sekar P. (2019). Foetal right atrial aneurysm and aortic coarctation with left ventricular dysfunction. Cardiology in the Young, 29(7), 1002–1004. doi: 10.1017/S1047951119001306.
Ebong IA, Sayer G, Kim G, Jeevanandam V, Baker T, Becker Y, Fung J, Charlton M, Te H, Josephson M, Uriel N. (2019). Simultaneous heart, liver and kidney transplantation: A viable option for heart failure patients with multiorgan failure. The Journal of Heart and Lung Transplantation: The Official Publication of the International Society for Heart Transplantation, 38(9), 997–999. doi: 10.1016/j.healun.2019.06.017.
Elliott MB, Ginn B, Fukunishi T, Bedja D, Suresh A, Chen T, Inoue T, Dietz HC, Santhanam L, Mao HQ, Hibino N, Gerecht S. (2019). Regenerative and durable small-diameter graft as an arterial conduit. Proceedings of the National Academy of Sciences of the United States of America, 116(26), 12710–12719. doi: 10.1073/pnas.1905966116.
Fraser, CD 3rd, Hill KD, Wallace A, Chiswell K, Zhou X, Jelin EB, Kays D, Jacobs JP, Hibino N, Jacobs ML, Vricella LA. (2019). The Prevalence and Impact of Congenital Diaphragmatic Hernia Among Patients Undergoing Surgery for Congenital Heart Disease. Seminars in Thoracic and Cardiovascular Surgery, 31(1), 69–77. doi: 10.1053/j.semtcvs.2018.09.014.
Fraser CD 3rd, Liu RH, Zhou X, Patel ND, Lui C, Pierre AS, Jacobs ML, Dietz HC, Habashi J, Hibino N, Cameron DE, Vricella LA. (2019). Valve-sparing aortic root replacement in children: Outcomes from 100 consecutive cases. The Journal of Thoracic and Cardiovascular Surgery, 157(3), 1100–1109. doi: 10.1016/j.jtcvs.2018.09.148.
Fraser CD, Zhou X, Grimm JC, Suarez-Pierre A, Crawford TC, Lui C, Bush E, Hibino N, Jacobs ML, Vricella L, Merlo C. (2019). Size Mismatching Increases Mortality After Lung Transplantation in Preadolescent Patients. Annals of Thoracic Surgery, 108(1), 130-137. doi: 10.1016/j.athoracsur.2019.01.015.
Fukunishi T, Ong CS, Lui C, Pitaktong I, Smoot C, Harris J, Gabriele P, Vricella L, Santhanam L, Lu S, Hibino N. (2019). Formation of Neoarteries with Optimal Remodeling Using Rapidly Degrading Textile Vascular Grafts. Tissue Engineering. Part A, 25(7-8), 632–641. doi: 10.1089/ten.TEA.2018.0167.
Hashimoto M, Balkhy HH. Robotic endoscopic mitral valve repair with the endoballoon in a patient with the right aortic arch. Journal of Cardiac Surgery, vol. 34,12 (2019): 1670-1672. doi: 10.1111/jocs.14260.
Holzhauser L, Imamura T, Bassi N, Fujino T, Nitta D, Kanelidis AJ, Narang N, Kim G, Raikhelkar J, Murks C, Onsager D, Song T, Ota T, Jeevanandam V, Sayer G, Uriel N. (2019). Increasing heart transplant donor pool by liberalization of size matching. The Journal of Heart and Lung Transplantation: The Official Publication of the International Society for Heart Transplantation, 38(11), 1197–1205. doi: 10.1016/j.healun.2019.08.020.
Imamura T, Jeevanandam V, Kim G, Raikhelkar J, Sarswat N, Kalantari S, Smith B, Rodgers D, Besser S, Chung B, Nguyen A, Narang N, Ota T, Song T, Juricek C, Mehra M, Costanzo MR, Jorde UP, Burkhoff D, Sayer G, Uriel N. (2019). Optimal Hemodynamics During Left Ventricular Assist Device Support Are Associated With Reduced Readmission Rates. Circulation. Heart Failure, 12(2), e005094. doi: 10.1161/CIRCHEARTFAILURE.118.005094.
Imamura T, Kim G, Nitta D, Fujino T, Smith B, Kalantari S, Nguyen A, Narang N, Holzhauser L, Grinstein J, Juricek C, Rodgers D, Song T, Ota T, Jeevanandam V, Sayer G, Uriel N. (2019). Aortic Insufficiency and Hemocompatibility-related Adverse Events in Patients with Left Ventricular Assist Devices. Journal of Cardiac Failure, 25(10), 787–794. doi: 10.1016/j.cardfail.2019.08.003.
Imamura T, Narang N, Nnanabu J, et al. Hemodynamics of concomitant tricuspid valve procedures at LVAD implantation. J Card Surg. 2019; 34: 1511– 1518. doi: 10.1111/jocs.14275.
Imamura T, Nguyen A, Chung B, Rodgers D, Sarswat N, Kim G, Raikhelkar J, Adatya S, Ota T, Song T, Juricek C, Estep JD, Burkhoff D, Jeevanandam V, Sayer G, Uriel N. (2019). Association of Inflow Cannula Position with Left Ventricular Unloading and Clinical Outcomes in Patients with HeartMate II Left Ventricular Assist Device. ASAIO Journal (American Society for Artificial Internal Organs: 1992), 65(4), 331–335. doi: 10.1097/MAT.0000000000000823.
Kanwal A, Pillai VB, Samant S, Gupta M, Gupta MP. (2019). The nuclear and mitochondrial sirtuins, Sirt6 and Sirt3, regulate each other’s activity and protect the heart from developing obesity-mediated diabetic cardiomyopathy. FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology, 33(10), 10872–10888. doi: 10.1096/fj.201900767R.
Kitahara H, Hirai T, McCrorey M, Patel B, Nisivaco S, Nathan S, Balkhy, HH. (2019). Hybrid coronary revascularization: Midterm outcomes of robotic multivessel bypass and percutaneous interventions. The Journal of Thoracic and Cardiovascular Surgery, 157(5), 1829–1836.e1. doi: 10.1016/j.jtcvs.2018.08.126.
Kitahara H, Hirai T, Nathan S, Balkhy HH. (2019). First report of a hybrid robotic beating-heart quadruple totally endoscopic coronary artery bypass: toward complete revascularization. European Journal of Cardio-thoracic Surgery: Official Journal of the European Association for Cardio-thoracic Surgery, 56(5), 1011–1013. doi: 10.1093/ejcts/ezz076.
Kitahara H, McCrorey M, Patel B, Nisivaco S, Balkhy HH. (2019). Predictors of blood transfusion use in robotic beating-heart totally endoscopic coronary artery bypass with anastomotic connectors. Journal of Cardiac Surgery, 34(9), 814–820. doi: 10.1111/jocs.14150.
Kitahara H, Raikhelkar J, Kim G, Sarswat N, Sayer G, Uriel N, Song T, Onsager D, Jeevanandam V, Ota T. (2019). A subcostal approach is favorable compared to sternotomy for left ventricular assist device exchange field of research: artificial heart (clinical). Journal of Artificial Organs: The Official Journal of the Japanese Society for Artificial Organs, 22(3), 181–187. doi: 10.1007/s10047-019-01102-w.
Mirzai S, Patel B, Balkhy HH. (2019). Robotic totally endoscopic off-pump unroofing of left anterior descending coronary artery myocardial bridge: A report of two cases. Journal of Cardiac Surgery, 34(8), 735–737. doi: 10.1111/jocs.14094.
Nam LL, Zimmerman SL, Sekar P, Hibino N. (2019). Repair of anomalous origin of left coronary artery without intramural course using an ultrasonic scalpel. Journal of Cardiac Surgery, 34(11), 1380–1382. doi: 10.1111/jocs.14213.
Nelson McMillan K, Hibino N, Brown EE, Wadia R, Hunt EA, Marshall C, Alvarez-Machado M, Alejo D, Coulson JD, Ravekes W, Vricella LA. (2019). HeartWare Ventricular Assist Device Implantation for Pediatric Heart Failure–A Single Center Approach. Artificial Organs, 43(1), 21–29. doi: 10.1111/aor.13344.
Nguyen AB, Imamura T, Besser S, Rodgers D, Chung B, Raikhelkar J, Kalantari S, Smith B, Sarswat N, LaBuhn C, Jeevanandam V, Kim G, Sayer G, Uriel N. (2019). Metabolic Dysfunction in Continuous-Flow Left Ventricular Assist Devices Patients and Outcomes. Journal of the American Heart Association, 8(22), e013278. doi: 10.1161/JAHA.119.013278.
Nisivaco S, Henry M, Ward RP, Balkhy HH. (2019). Totally endoscopic robotic-assisted excision of right ventricular papillary fibroelastoma. Journal of Robotic Surgery, 13(6), 779–782. doi: 10.1007/s11701-018-00913-y.
Nisivaco SM, Patel B, Balkhy HH. (2019). Robotic totally endoscopic excision of aortic valve papillary fibroelastoma: The least invasive approach. Journal of Cardiac Surgery, 34(12), 1492–1497. doi: 10.1111/jocs.14291.
Ozcan C, Li Z, Kim G, Jeevanandam V, Uriel N. (2019). Molecular Mechanism of the Association Between Atrial Fibrillation and Heart Failure Includes Energy Metabolic Dysregulation Due to Mitochondrial Dysfunction. Journal of Cardiac Failure, 25(11), 911–920. doi: 10.1016/j.cardfail.2019.08.005.
Samant SA, Pillai VB, Gupta MP. (2019). Cellular mechanisms promoting cachexia and how they are opposed by sirtuins 1. Canadian Journal of Physiology and Pharmacology, 97(4), 235–245. doi: 10.1139/cjpp-2018-0479.
Spiller R, Symalla T, McCrorey M, Balkhy HH. (2019). Robotic-Assisted Third-Time Redo Mitral Valve Replacement. The Annals of Thoracic Surgery, 108(4), e245–e247. doi: 10.1016/j.athoracsur.2019.02.041.
Torregrossa G, Amabile A, Williams EE, Puskas JD. (2019). Advanced techniques in mitral annular calcification management. Journal of Cardiac Surgery, 34(12), 1632–1634. doi: 10.1111/jocs.14302.
Yang B, Lui C, Yeung E, Matsushita H, Jeyaram A, Pitaktong I, Inoue T, Mohamed Z, Ong CS, DiSilvestre D, Jay SM, Tung L, Tomaselli G, Ma C, Hibino N. (2019). A Net Mold-Based Method of Biomaterial-Free Three-Dimensional Cardiac Tissue Creation. Tissue Engineering. Part C, Methods, 25(4), 243–252. doi: 10.1089/ten.TEC.2019.0003.
Yeung E, Fukunishi T, Bai ., Bedja D, Pitaktong I, Mattson G, Jeyaram A, Lui C, Ong CS, Inoue T, Matsushita H, Abdollahi S, Jay SM, Hibino N. (2019). Cardiac regeneration using human-induced pluripotent stem cell-derived biomaterial-free 3D-bioprinted cardiac patch in vivo. Journal of Tissue Engineering and Regenerative Medicine, 13(11), 2031–2039. doi: 10.1002/term.2954.
residents & fellows
View the Cardiothoracic Residents and Fellows here.