Kudos: Drs. Paul J. DiMuzio and Scott D. Goldstein have been promoted to Professor of Surgery, Drs. Scott Cowan and Harish Lavu have been promoted to Associate Professor of Surgery, and Dr. Gurjyot Bajwa has been promoted to Assistant Professor of Surgery.

Michael Weinstein, MD, co-director of the Jefferson Center for Critical Care will be awarded the 2013 Philip J. Wolfson Outstanding Teacher Award by the Association of Surgical Education at the annual meeting in April. The award is posthumously named for Dr. Wolfson, the former Chief of Pediatric Surgery and Director of Undergraduate Medical Education at Jefferson.

Jonathan Brody, PhD, director of the Division of Surgical Research, is the Chair-Elect of the Peer Reviewed Cancer Research Program at the Department of Defense. As the program chair for fiscal years 2014 and 2015, Dr. Brody will co-chair pre-application and programmatic review meetings which serve to allocate congressional funding to scientific research projects.

Cataldo Doria, MD, PhD, FACS has been named a Knight of the Italian Republic by Italian President Giorgio Napolitano. Dr. Doria will be invested into the Order of Merit of the Italian Republic this summer. To mark the 60th anniversary of Dr. Gibbon’s heart-lung machine, Dr. Herbert Cohn will present a historic Grand Rounds lecture entitled “Fond Memories” on Thursday, May 2, 2013 at 7 a.m. in Foerderer Auditorium in the College Building at 1025 Walnut Street.

Save the Date: The John Y. Templeton, III, MD Grand Rounds will be held on May 9, 2013 at 7 a.m. in BLSB 101 at 233 South 10th Street. Dr. Douglas J. Mathisen, Chief of Thoracic Surgery at Massachusetts General Hospital and the Hermes C. Grillo Professor of Surgery at Harvard Medical School, will deliver a presentation entitled “Tracheal Surgery”.

Dr. Golesorkhi’s commitment to the newly established Surgical Alumni for Education Fund will support academic enrichment for a surgical resident each year. “Surgical residency education is dual-faceted,” she says, “One aspect is focused on hands on clinical practice of general surgery and the other aspect is preparing to be credentialed.” Dr. Golesorkhi recalls the challenge of studying for the boards on her own, with assistance from the attendings and her fellow residents. She ultimately decided to take a formal preparatory course and feels strongly that such programs can be very beneficial for some people. “I knew I had the clinical knowledge, but I had to learn how to apply it to a standardized examination. These programs helped me pass my boards, but they are very expensive.” Tuition for preparatory courses can cost several thousand dollars – a significant price to pay on a resident’s salary.

Dr. Golesorkhi decided to contact her former mentors, including Dr. Karen Chojnacki, to express her interest in providing financial support and put the wheels in motion. Dr. Chojnacki, director of the surgical residency program, explains, “Because of Negar’s generosity, we will be able to support residents better in the credentialing process. One of our recent graduates was given the first stipend from the fund to take board review courses in preparation for the American Board of Surgery certifying exam. We are so grateful to Negar for this gift and the great opportunity afforded to our residents.”

Dr. Golesorkhi feels that she has a duty to give back and hopes others will feel the same. “It is a family there – the residents, the attendings, everyone – and I’m so proud of my education at Jefferson. The program has given me so much that I feel that I have to give back in some way.”

For additional information about the Surgical Alumni for Education Fund, or to make a contribution to the Department of Surgery, please contact Lara Goldstein in the Jefferson Foundation at 215-955-8797 or Email Laura Goldstein

When she returned to Jefferson to assume this role in 2006, Altmark brought more than 20 years of experience in nursing – including seven years as a Jefferson OR nurse and experience as an OR manager and business manager for surgical services as well as labor and delivery.

Altmark maintains Jefferson’s ACS NSQIP database by abstracting relevant clinical data from patient charts. With data points spanning pre-op, intra-op and post-op variables, the database enables Jefferson to generate risk-adjusted reports and trend the quality of surgical care. As a participant in this program, Jefferson can benchmark itself against other hospitals in order to evaluate its own performance and cultivate best practices. In addition to maintaining the database, Altmark works closely with Surgeon Champions Herbert E. Cohn, MD, Scott Cowan, MD, and Stacey Milan, MD and other health care providers to develop and execute process improvements.

The NSQIP program enables surgeons, anesthesiologists, nurses and other clinicians to view summaries of patient outcomes based on objective clinical data. Working with others, they can modify their practice to provide improved care to surgical patients. For example, NSQIP data has been used to help drive improvements in rates of surgical site infections.

“It’s rewarding to know that my relatively small but vital contribution can greatly benefit patients receiving surgical care,” Altmark says. “And, I enjoy collaborating with surgeons and clinicians, who all contribute their expertise and unify around a common goal of providing the best-quality care possible for Jefferson patients.”

“Above all, I’m very grateful to work in a collaborative environment with people who recognize that while we’re doing a great job, we can always do better,” she concludes.

A veritable Renaissance woman, Dr. Lal has earned Master’s degrees in both Botany and Computational Biosciences. She holds a two-year diploma in e-commerce and web design, and has more than six years of professional experience in software development, teaching and research. She also studied Molecular Biology techniques at the U.S. Department of Energy’s Joint Genome Institute and explored microarray printing, scanning and hybridization at the University of California, San Francisco.

As a doctoral student at the University of California, Riverside, Dr. Lal studied the molecular mechanism that controls floral specification in the model plant Arabidopsis thaliana. Her goal was to establish the gene regulatory networks (GRNs) that promote flowering and floral specification in Arabidopsis. She applied a variety of approaches – including molecular, genomic and bioinformatics – to understand these networks.

As Dr. Lal explains, plants and animals have a fundamental difference. While human children are essentially miniature versions of human adults, a young plant is not simply a mini-model of an adult plant: “The plant at juvenile stage has leaves and stems, but upon transition to adult stage it initiates new organs such as flowers,” Dr. Lal says. “My doctoral research was focused on understanding what changes occur that drive plants to start producing flowers.”

Despite opportunities to work in the field of plant research, Dr. Lal was eager to apply her skills to studying human disease. That desire led her to Jonathan Brody, PhD, Director of the Division of Surgical Research, who offered Dr. Lal a position focusing on cancer research. While it might not seem like the most logical career move, Dr. Brody explains, “Dr. Lal brings an intense dedication and fresh perspective to my research team that is invaluable.” From the outset, he posed two challenging questions to her: How do pancreatic cancer cells live with genetic mutations, and how do they become resistant to chemotherapies?

Identifying a novel HuR-regulated molecule Jefferson scientists previously identified the RNA binding protein HuR (Human antigen R) as a key molecule in pancreatic cancer cells. More than half of patients with pancreatic cancer express high cytoplasmic levels of HuR and those patients are more likely to respond well to the drug gemcitabine than those with relatively low levels of HuR. While this knowledge is important, understanding exactly how HuR functions in pancreatic cancer cells is critical. This has been the focus of Dr. Lal’s research since joining the Jefferson team in November 2011.

In that time, Dr. Lal has identified the mechanism by which HuR regulates the WEE1 molecule (a gate keeper of cell growth) when cancer cells are exposed to certain chemotherapeutic drugs. “When chemotherapy is used, pancreatic cancer cells with the HuR protein incur some damage but protect themselves by putting themselves on ‘hold,’ and thereby prevent cell death,” Dr. Lal explains. Through the research, Dr. Lal has found that removing the HuR protein impairs WEE1 function and promotes cell death. Thus, Dr. Lal explains, if a chemotherapy drug can be designed to inhibit the interaction between HuR and WEE1, pancreatic cancer cells will be much more likely to die.

With her groundbreaking manuscript currently in review, Dr. Lal’s long-term goal remains clear: “We want to quickly get this information from the bench to the bedside,” she says, noting that pancreatic cancer deaths are rising at an alarming rate, while other types of cancer deaths are steadily declining. “Our objective is to reverse that trend.”

In the following decades, Dr. Cohn’s surgical practice focused on endocrine and thoracic surgery. He earned a reputation as an exceptional educator with high expectations, and an excellent clinician with a gentle bedside manner. Dr. Cohn has made immeasurable contributions to the educational initiatives at Jefferson and trained hundreds of surgeons. He received the Lindback Award for Distinguished Teaching in 1980, was named the first Anthony E. Narducci, MD Professor of Surgery in 1998 and was appointed to the JMC Academy of Distinguished Educators in 2011. He has also been a tireless advocate for patient safety and performance improvement, most recently as Surgeon Champion of the National Surgical Quality Improvement Program (NSQIP) and the Vice Chair for Quality in the Department of Surgery.

Last summer Dr. Cohn initiated a phased retirement with plans to fully retire in 2014. It will be an end of an era, literally and figuratively. Dr. Cohn’s presence has provided today’s young surgeons with one- degree of separation from Dr. John Gibbon, Jr. – a neatly dressed, perfectly polite living connection to a surgical pioneer and a physician who has made his own indelible mark on Jefferson.

A video about Dr. Cohn is available on www.jefferson.edu/SurgeryChairs. The tribute was shown at the Jefferson Awards Gala in 2009 and features several Jefferson colleagues along with his three sons and his wife of 59 years, Natalie. Sadly, she passed away on February 4, 2013.

The multidisciplinary center, launched in July 2009, is co-directed by Paul J. DiMuzio, MD, FACS, the William M. Measey Professor of Surgery and Director of the Division of Vascular and Endovascular Surgery; Geno Merli, MD, Senior Vice President and Chief Medical Officer of Thomas Jefferson University Hospital; and Laurence Needleman, MD, Associate Professor of Radiology and Director of the Division of Abdominal Imaging. In the first few years, the center directors have focused on implementing innovative surgical devices and techniques, building a strong team of specialists, and expanding the service area beyond Jefferson and Methodist Hospital.

As Dr. DiMuzio explains, Jefferson recently became one of the first centers in the United States to implant the new FDA-approved fenestrated aortic graft (Cook Medical, Inc.) to treat juxtarenal aneurysms via a minimally-invasive technique. This type of aneurysm occurs in the abdominal aorta up to and including the area where the renal arteries branch off to supply the kidneys.

“Previously, the surgical approach required a large abdominal or thoracic incision,” Dr. DiMuzio says. “With the new grafts, we’re able to use a minimally invasive – including a totally percutaneous – approach that can result in less pain and scarring and support a faster recovery.” In a percutaneous procedure, the surgeon punctures the skin of the groin area to access a blood vessel through which they insert and place the graft.

In addition to incorporating new devices, the Center has welcomed two new surgeons, Babak Abai, MD, FACS, and Dawn M. Salvatore, MD. The new faculty members are both fellowship-trained vascular surgeons board certified in General Surgery and Vascular Surgery. Both will be practicing in Center City and at satellite locations. Dr. Salvatore is expanding the Center’s reach to Voorhees, NJ, while Dr. Abai will be providing care to patients in Northeast Philadelphia.

On the medical side, Dr. Merli’s vascular medicine team treats many conditions, including deep vein thrombosis, peripheral artery disease and chronic venous insufficiency, and it staffs the Wound Care Program component of the Jefferson Vascular Center. The wound care specialists can diagnose and treat all types of wounds, such as surgical wounds that have not healed properly, radiation injuries and diabetic ulcers. Treatment options include debridement, application of skin substitutes and hyperbaric oxygen treatment, which involves the therapeutic use of oxygen to promote faster, more effective healing. The program has now attained 100 percent certification for hyperbaric wound care, meaning all five physicians have completed a series of tests to become board certified in this technique.

Finally, Dr. DiMuzio says, the Jefferson Vascular Center is anticipating its expansion later this year to a state-of-the-art space on the sixth floor of the Gibbon Building at 111 South 11th Street. In addition to tripling the Center’s footprint, this next phase of development makes the patient experience even more streamlined. The new office will be adjacent to a new multidisciplinary center devoted to angioplasty.

For more information about the Jefferson Vascular Center visit: www.jeffersonhospital.org/JVC

“Laws and institutions must go hand in hand with the progress of the human mind…” – Thomas Jefferson, July 12, 1810

Our American health care system is under pressure to change from many directions: the government, the media, the economists, and others. In a recent Surgical Grand Rounds, I discussed my Baker’s Dozen list of key topics: (1) health care spending is flattening out, (2) physicians and hospitals will be paid less for what they do, (3) payers are getting aggressive on cost and quality, (4) hospitals are targets for cost cuts, (5) cost reduction will entail standardization and elimination of variations, (6) waste control will be crucial, (7) current payment systems are mal-aligned with quality, health and wellness improvement, (8) Accountable Care Organizations exist, (9) the 5-50 rule reigns (the sickest 5% of the population consume 50% of the resources), (10) hospital systems will necessarily morph to Total Care systems, (11) physician elements are under transition, (12) physician integration (and leadership) will be crucial, (13) aspirational items for hospital corporate leaders have evolved.

We have much to do. The mantras will no longer be – “business as usual” or “increase volume to cover expenses”. The focus needs to be on individual health, wellness and population health… We’re working toward a new paradigm – “Livewell Jefferson” – a cooperative venture of Thomas Jefferson University Hospital, Thomas Jefferson University, Jefferson Medical College, the Jefferson Women’s Board, Jefferson Health System and our communities: eliminate unhealthy cafeteria and vending choices, expand our non-smoking perimeter, increase wellness services, institute a maximum 30-minute meeting rule and mandate daily 30-minute on-the-job treadmill walking, freshen our stairways and label them “vertical exercise corridors”, track BMI quarterly, and work with the city to design and maintain safe, measured walking routes around our campus. We have much to do to effect change!

To view Dr. Yeo’s recent mini-Grand Rounds lecture on this topic visit: www.jefferson.edu/surgerylectures

“For example, Jefferson is joining heart centers across the country in learning how to better select patients for the Left Ventricular Assist Device (LVAD). Historically, patients with heart failure had not explored surgical treatments until their condition had progressed significantly. Thus, most patients receiving the LVAD were quite sick.

“Today, we’re discovering that if we can catch some patients earlier in the process, we can obtain better results. For certain patients, the LVAD pump can support a high quality of life. In fact, I’ve had patients who have traveled abroad with the pump and others who have able to get back to work just a few months after surgery.”

John Entwistle, III, MD, PhD Surgical Director, Cardiac Transplantation and Mechanical Circulatory Support, and Associate Professor of Surgery

To learn more visit: www.jeffersonhospital.org/cardiothoracic

As we commemorate the 60th anniversary of Dr. Gibbon’s milestone, patients of the Division of Cardiothoracic Surgery continue to benefit from Jefferson’s commitment to continual innovation under the leadership of James Diehl, MD, FACS, and two highly specialized programs.

State-of-the-art life support

The Adult Extracorporeal Membrane Oxygenation (ECMO) Program boasts survival rates that far exceed reported national rates. Established in 2010 by Nicholas Cavarocchi, MD, FACS, FCCP, Director of the Cardiac and Vascular Intensive Care Unit, the program’s leading-edge equipment provides both cardiac and respiratory support (oxygen) to individuals with severely diseased or damaged heart and lungs.

At present, Jefferson is the only hospital in the area to utilize two transport devices – the SERVO-i ventilator and the CARDIOHELP (portable) ECMO machine. Using these devices, the Jefferson ECMO team (comprised of physicians and mid-level providers in the Cardiac ICU, JeffSTAT medical transportation staff, and respiratory therapists) is able to transport critically ill patients and place patients on ECMO before they are transferred to Jefferson. By placing patients on ECMO earlier than usual, we improve their chances of being successfully weaned from ECMO or having surgery with fewer complications.

Continued innovation in treating advanced heart failure The Cardiac Transplantation and Mechanical Circulatory Support Program, led by director John Entwistle, III, MD, PhD, offers several leading- edge treatment options to patients with advanced heart failure. Options include the latest-generation left ventricular assist devices (LVADs) and the SynCardia temporary Total Artificial Heart (TAH).

In 2012, the program acquired the SynCardia TAH device, which now boasts a mobile software driver (just recently approved by the FDA) to operate the device outside of a hospital setting. This allows some patients awaiting a heart transplant to return home and, in some cases, resume their normal activities.

Treatment options for end-state heart failure are a permanent LVAD, LVAD as a bridge to transplant, or a heart transplant. But LVAD options are viable only for patients with failure of the left side of the heart. For those with failure of the right side or both sides of the heart, and for those with cardiac amyloidosis (“stiff heart syndrome”), there has not been a good option for returning patients home. SynCardia’s portable driver should change that, and Jefferson is working to identify an optimal candidate for the first implant procedure.

“Because of these advanced therapies – from the SynCardia TAH device and our LVAD capabilities to our unique ECMO equipment – Jefferson is able to successfully treat a sicker group of patients who otherwise would have a very poor prognosis,” concludes Dr. Diehl. “We are honored to continue Dr. Gibbon’s legacy of innovative patient care.”

A lecture on May 2nd will highlight the anniversary – see page 4.

John (Trey) Entwistle, III, MD, PhD, has joined the Division of Cardiothoracic Surgery. Dr. Entwistle was a resident in general surgery at the Medical College of Virginia from 1990 – 1998 during which time he also spent three years as a research fellow in cardiac surgery and earned a PhD in Physiology. He completed his training in cardiothoracic surgery at Hahnemann University Hospital in 2001. He comes to Jefferson from Drexel University where he was the surgical director of cardiac transplantation and mechanical circulatory support for the last nine years.

Matthew Rosen, MD, has joined the Division of Acute Care Surgery. Dr. Rosen graduated from Jefferson Medical College in 2005 and completed his residency at Thomas Jefferson University Hospital. In June, Dr. Rosen completed a surgical critical care fellowship at the Beth Israel-Deaconess Medical Center of Harvard Medical School. He will practice in Center City and at the Trauma Center at Paoli Hospital.

Dawn Salvatore, MD, FACS, has joined the Jefferson Vascular Center and Division of Vascular and Endovascular Surgery. Dr. Salvatore completed a combined residency program in medicine and pediatrics at the Cleveland Clinic. After a couple years in practice, she changed specialties and completed a general surgery residency and vascular fellowship at Ohio State University. She will practice in Center City and at Methodist Hospital.

Qiong (John) Yang, MD, has joined the Division of Cardiothoracic Surgery. Dr.Yang completed residency training at the Second Affiliated Hospital of Jiangxi Medical College and received a Master of Science degree from North Dakota University in cardiovascular pharmacology. He will be working as a nocturnist in the Surgical Cardiac Care Unit.

Dr. Donahue was a graduate of La Salle College High School, La Salle College and Jefferson Medical College (class of 1968). After completing his surgical residency and a fellowship in Surgical Gastroenterology at the University of Illinois in Chicago, he extended his interest and expertise in gastric and esophageal diseases to include highly selective vagotomy procedures for peptic ulcer disease.

Dr. Donahue and his colleagues at the University of Illinois developed the principles and techniques of the “floppy Nissen Fundoplication” procedure to cure gastro- esophageal reflux disease without incurring what had been common, and sometimes disabling, side effects. He published more than 200 articles and book chapters devoted to the medical study of the GI tract, especially the esophagus and stomach.

At the time of his death in 2009, Dr. Donahue was Chairman of the Department of General Surgery at Cook County (John H. Stroger Jr.) Hospital in Chicago. He was also Professor Emeritus of Surgery at the University of Illinois College of Medicine at Chicago.

“My husband was very interested in the education of residents and staff,” Susan says, noting that he was repeatedly nominated for and was a three-time recipient of the “Attending Surgeon of the Year” award from his medical students. “I wanted to give to the medical school that helped train him, which he thought was important, as well.”

In accordance with Mrs. Donahue’s wishes, the focus of the lectureship is on detection, diagnosis and/or treatment of benign diseases of gastrointestinal tract – including the stomach, esophagus, small and large intestine, and accessory organs, such as the liver, pancreas or gallbladder – and on such topics as surgical endoscopy, hernia surgery and treatment of achalasia and gastrointestinal bleeding.

The first lecture was held on September 20, 2012, and was given by William Nealon, MD, FACS (JMC Class of 1979) on the topic of pancreatitis.

For additional information about planned giving, or to make a contribu- tion to the Department of Surgery, please contact Lucinda Dautrich in the Jefferson Foundation at 215-955-4126 or lucinda.dautrich@jefferson.edu

Since April 2011, Rowland has been supporting Jefferson’s Division of Cardiothoracic Surgery as an outpatient nurse practitioner. More recently, he assumed additional responsibilities as director of the Smoking Cessation, Counseling and Therapy (SCCT) Program, for which he became a Certified Tobacco Treatment Specialist.

What is the SCCT Program?

The SCCT Program is a relatively new endeavor that began with the progressive ideas and support of Scott Cowan, MD, FACS, one of our thoracic surgeons. The program’s goal is to jumpstart smoking cessation prior to surgery. During the appointment process, we screen all patients for smoking. If the patient agrees, we schedule him or her for a separate appointment for smoking cessation planning.

We’ve designed the SCCT Program to provide one-on-one counseling tailored to individual patient needs. Each smoking cessation plan of care is formulated with patient input. For most patients, the goal is to quit smoking over a period of a few weeks – and then sustain that success over the long term.

What is your philosophy of patient care?

Patients are multidimensional. When they come to us with physical issues, they also bring social, cultural and spiritual dimensions. I believe it’s important to formulate a plan of care that incorporates and adapts to these needs.

What most energizes you about your career?

I’m energized by the ability to help patients navigate through their journey with cardiothoracic surgery and/or smoking cessation, which for most is a very stressful time. I always strive to help patients and their families truly understand what’s happening – from admission through final discharge and even weeks after surgery.

Learn more at: www.jeffersonhospital.org/SCCT

Founded in 1927, LIMR now has a team of 120 – including 20 resident faculty members – working to advance its mission. Those investigators include LIMR President and CEO George C. Prendergast, PhD, who also serves as editor in chief of Cancer Research, the most highly cited journal in the field, and Janet Sawicki, PhD, Professor, whose work focuses on cancer nanotherapy and related technologies.

In recent years, Drs. Prendergast and Sawicki have been collaborating successfully with the Jefferson Department of Surgery on research related to diagnosis and treatment of pancreatic and ovarian cancers. As Jonathan Brody, PhD, Director of the Division of Surgical Research recalls, the relationship took root in 2007, when Dr. Sawicki delivered a presentation on cancer nanotherapy at the monthly Surgical Research Seminar hosted by the Division.

Since then, Jefferson and LIMR have co-authored multiple publications and secured four nationally recognized grants (including from NIH and the American Cancer Society) worth roughly a million dollars.

The grants have funded research on predicting and optimizing the effect of gemcitabine therapy in ovarian and pancreatic cancers; using the HuR stress response gene to enhance Gemcitabine therapy; using HuR to combat chemotherapeutic resistance in ovarian cancer; and IDO2 targeting for pancreatic cancer treatment. Early work seeding the IDO2 collaboration was published initially by the Jefferson-LIMR team in the Journal of the American College of Surgery in 2009.

“Both these collaborations are unique and allow us to attack these tumors with different strategies,” Dr. Brody says. “Drs. Prendergast and Sawicki are the only people in the world I could do this particular work with, and luckily, they are in our backyard.”

The collaboration has been beneficial to the researchers at LIMR, as well: “I met Dr. Brody not long after he moved to Jefferson from Johns Hopkins with Dr. Charlie Yeo’s team, when we were each

just beginning to become interested in how IDO2 may affect cancer,” recalls Dr. Prendergast. “We had discovered this gene as a result of our work in cancer immunotherapy, but its connections to pancreatic cancer would not have been made so soon without Dr. Brody’s initial observation that brought us together.”

Dr. Sawicki feels similarly about the interactions that started with the seminar at Jefferson: “Jonathan and I quickly identified a few high-impact questions of common interest where our research programs could readily benefit from collaborative work,” she said. “We were fortunate that the multidisciplinary

synergies in the work we started were welcomed so readily by the grant review committees who have made its development possible.

“For me, the ability to benefit from access to clinical specimens and linked databases was critical, given that few groups have assembled such a valuable foundation to enable research into the questions I wished to pursue.”

Jefferson and LIMR are currently preparing two grants for roughly $1.25 million each from the NIH Research Project Grant Program (R01). If awarded, these grants will fund research targeting HuR and IDO molecules for the treatment of pancreatic cancer and ovarian cancers – which all three investigators hope will be translated to the clinic within the next few years.

For more information about the Division of Surgical Research visit: www.jefferson.edu/surgery

Please welcome (from left to right):

Adam Strickland, MD, East Carolina University, Danika Giugliano, MD, Drexel University, Adam Johnson, MD, Tulane University, Sami Tannouri, MD, Pennsylvania State University, Deepika Koganti, MD, University of Miami, Talar Tatarian, MD, George Washington University

We are also pleased to welcome back the following Jefferson Medical College 2012 graduates as preliminary interns in general surgery: Lawrence Lee, MD, Andrew Margules, MD, and Jared Meshekow, MD.

Until the last decade, the best surgical treatment was to replace the valve – which traditionally required invasive surgery, a lengthy recovery and a lifetime of anticoagulation therapy. Consequently, patients with mitral valve prolapse often chose to “wait and see” if the condition worsened. In many cases, the delay in treatment led to cardiac compromise and a host of related symptoms, such as swelling of the lower extremities, atrial fibrillation (“palpitations”) and shortness of breath.

“Twenty years ago, mitral valve replacement was really the last and only resort,” explains Jefferson’s Gurjyot Bajwa, MD. “With today’s minimally invasive techniques, there’s no need to take the ‘wait-and-see’ approach, as we know the progression leads to deterioration of cardiac function.”

Indeed, minimally invasive mitral valve repair has become the standard of care – and in September 2011, Dr. Bajwa was the first surgeon in Philadelphia to perform the procedure robotically. Safe and reproducible, repair preserves cardiac function, helping patients maintain their quality of life.

Dr. Bajwa came to Jefferson from the Cleveland Clinic Foundation, where in 2008 she became a clinical associate in complex adult cardiac surgery. In 2009, she remained at the Cleveland Clinic for fellowship training in minimally invasive and robotic cardiac surgery. To date, she has used the robot to perform over 25 minimally invasive mitral valve repairs.

“Most people don’t have the option of taking three months off of work or life,” Dr. Bajwa says, adding that patients also prefer to avoid large, unsightly scars. By using the minimally invasive robotic procedure to perform the mitral valve repair, patients are typically discharged from the hospital in just three or four days. Most are able to resume normal activities within two weeks – with no restrictions on driving because the sternum (breastbone) is untouched.

Dr. Bajwa urges patients with mitral valve prolapse to obtain a surgical evaluation: “If you have mitral valve prolapse, please don’t wait for your heart to deteriorate,” Dr. Bajwa advises. “Come in when you’re diagnosed or as you’re progressing but before you have symptoms. That’s how you can enjoy the best quality of life.”

For more information about robotic cardiac surgery at Jefferson visit: www.jeffersonhospital.org/cardiothoracic

During the autumn of my senior year in medical school I was approaching my 25th birthday (1978) and my father asked if there was anything I “needed” for my birthday. My initial list was met with his comment that I didn’t need the items requested (new car, new stereo system, my own pair of new snow skis.) He was correct – I just wanted them. I then altered my approach, and told him that I really could use a subscription to the NEJM. After he heard my rationale, he started me off with my first issues: a 3 year subscription, at student rates, which I have renewed religiously… this will be my 35th year!

I love reading it. Filled with op-ed pieces on health care or global health issues, landmark original articles, review articles and of course the weekly mysterious clinicopathological conference (CPC) cases, it provides me an hour of broad medical education amidst the usual hectic work week. I recommend it to all physicians, and especially to all surgeons. I can’t tell you how much I have learned from this amazing journal on a year to year basis.

A very belated thanks to my now departed father, for starting me on this weekly tradition.

P.S. The NEJM is celebrating its 200th birthday this year.

Born in Philadelphia in May 2008, Assiah Phinisee spent the first four years of her life battling biliary atresia – a blockage of the ducts that carry bile from the liver to the gallbladder and intestines. By the time Assiah’s mother, Rasheena, visited Stephen P. Dunn, MD, Chair of the Department of Surgery at Nemours/Alfred I. duPont Hospital for Children and Professor of Surgery at Jefferson Medical College, in 2010, Assiah had undergone numerous surgeries and spent hundreds of days in the hospital.

At another area hospital in 2009, Assiah received her first transplant, a full liver from a toddler donor. Despite initial positive signs, that transplant ultimately failed. The team at duPont – with whom Jefferson partners to provide pediatric transplants – re-listed Assiah on the transplant waiting list in March 2011.

After waiting nearly a year and a half, Rasheena got the news that Assiah would receive a partial liver transplant in July. Since then, Rasheena says her daughter has never been healthier.

Read the full story at: www.jeffersonhospital.org/assiah

The South Philadelphia native, known for such hits as “Volare” (1960), “Kissin’ Time” (1959), and “Wild One” (1960), still calls the city home. So, when he needed a lifesaving transplant, he came to Jefferson.

“Mr. Rydell did not have very long to live,” says Cataldo Doria, MD, PhD, FACS, the Nicoletti Family Professor of Transplant Surgery and director of the Division of Transplant Surgery at Jefferson.

Dr. Doria performed the liver transplant on the singer assisted by fellow transplant surgeon Carlo Ramirez, MD, FACS. The two surgeons then reversed their roles for Rydell’s kidney transplant.

The patient had been placed on the transplant waiting list in late spring.

The seriousness of his condition and the rarity of his situation – he needed simultaneous transplants of two organs – placed him close to the top of the list.

“I was at home eating breakfast when the call came from Jefferson that they had both organs,” recalls Rydell. “My wife and I packed up and headed to Jefferson immediately to prepare for surgery.”

In fact, Rydell was not the primary recipient of the liver, rather a child on the waiting list for a new liver at Alfred I. duPont Hospital for Children was the call [see sidebar]. But because a liver can regenerate, surgeons can now perform so-called split-liver transplants, doubling the number of beneficiaries.

In Rydell’s case he would get the larger portion of the liver and a kidney from the

donor, with the smaller part of the donor liver – about 25 percent – going to the pediatric patient.

Warren Maley, MD, director of Jefferson’s Live Donor Liver Transplant Program traveled to the hospital where the deceased donor was to procure the organs. First he split the liver inside the donor’s body before removing the two parts.

Dr. Maley sent the larger portion of the liver and one kidney to Jefferson where Rydell waited in an operating room; he then accompanied the smaller portion of the liver to Alfred I. duPont Hospital for Children in Delaware to assist with the pediatric transplant.

Back in Philadelphia Drs. Doria and Ramirez proceeded with Rydell’s double transplant.

The surgery was a great success. Rydell’s recovery continues to progress on schedule.

“We are thrilled with his results and hope that he will resume his normal life – including a return to the stage,” says Dr. Doria.

With his new lease on life, Rydell advocates for organ donation, telling KYW Newsradio it truly is “the gift of life”.

With the help of his team of transplant surgeons at Jefferson, this American icon of the early days of rock and roll still has “A Lot of Living to Do” (Bye Bye Birdie, 1963).

For more information about the Transplant Program at Jefferson visit: www.jeffersonhospital.org/transplant

Born in Pittsburgh in 1953, Moore received his bachelor’s degree from the University of Virginia, where he stayed on for his medical degree. After completing his internship at Thomas Jefferson University Hospital in 1980, he completed a general surgery residency. He then participated in a fellowship in hand surgery and microsurgery at Jefferson and completed a plastic surgery residency at the Eastern Virginia Graduate School of Medicine.

In 1987, Moore joined the practice of James W. Fox, IV, MD, at Jefferson as an assistant professor of surgery. He was promoted to clinical associate professor in 1994 and clinical professor in 2001. He assumed numerous leadership roles at Jefferson, sitting on the board of directors of the Volunteer Faculty Association and serving on committees such as student affairs; alumni and public affairs; professionalism; patient care services; bylaws; surgical advisory and clinical performance improvement. He was also faculty advisor for the John H. Gibbon Jr. Surgical Society from 1987 to 2005.

As president of the JMC Alumni Association, Moore worked to engage alumni and promote growth at Jefferson. He used his skills to contribute to communities outside of Jefferson, as well. He served as medical director of the Philadelphia Chapter of Operation Smile and led missions to Liberia, Kenya and Nicaragua to treat children with cleft palates. He was awarded the Star of Africa from the Republic of Liberia and was chosen by surgical residents to receive the Francis E. Rosato Teaching Award from the Department of Surgery in June 2011.

“I remember John most fondly as a guy who smiled a lot, who was happy go lucky and who was happiest when he was with the residents and medical students,” said Dr. Fox, director of the Division of Plastic Surgery. “He truly enjoyed helping young people achieve their training goals and will be deeply missed across the Jefferson community.”

Moore is survived by his wife, Jane, and four children: Molly, Lucy, Nancy and Jake.

For information about the John H. Moore Jr., MD Residency Education Fund, please contact Lara Goldstein in the Jefferson Foundation at 215-955-8797 or lara.goldstein@jefferson.edu.

Ehyal Shweiki, MD, FACS, has joined the Division of Acute Care Surgery. Dr. Shweiki is fellowship-trained in both cardiothoracic surgery (University of Louisville) and surgical critical care (Washington University/Barnes Jewish Hospital). He also holds an MS in Bioethics. He will serve patients at our Level I trauma center and surgical intensive care unit in Center City as well as our Level II trauma center at Paoli Hospital.

Theresa Zimmers, PhD, has joined the Division of Cancer Biology with a secondary appointment in the Department of Surgery. Dr. Zimmers is a NIH-funded researcher focusing on cancer cachexia and identifying and addressing cancer outcome disparities in breast and lung cancer. The American Society for Metabolic and Bariatric Surgery (ASMBS) and Surgical Review Corporation (SRC) have approved Jefferson as a Bariatric Surgery Center of Excellence®.

David Tichansky, MD, FACS, director of Jefferson’s Bariatric and Metabolic Surgery Program, was also named a Bariatric Surgery Center of Excellence® designee.

Save the Date

September 20, 2012: The Inaugural Philip E. Donahue, MD Lectureship in Benign Gastrointestinal Diseases. William H. Nealon, MD (JMC ’79), Vice-Chairman, Department of Surgery, Chief of the Division of General Surgery, Vanderbilt University, “Evolution of a Concept: Creating a Framework for Managing the Complications of Pancreatitis.” 7 a.m., Jefferson Alumni Hall, Brent Auditorium.