Yale Surgery: A major expansion of clinical expertise and minimally invasive technology
A major expansion of clinical expertise and minimally invasive technology
[April 2009] The expansion of Yale Surgery which began in 2006 has continued at a robust pace with the recruitment of another 10 surgeons. The year 2007 concludes with a revitalized liver, kidney and pancreas transplant program, new surgical options for the congestive heart failure population, minimally invasive skills for thoracic and surgical oncology patients, robotic expertise, and for the first time in the region advanced endovascular procedures which have been developed in Europe.
The cardiac surgery outcome data speak to the superb skill of the surgeons and the overall strength of the surgical teams, making Yale Surgery and Yale-New Haven Hospital Connecticut’s best choice for the most advanced surgical approaches with the greatest survival odds. As in years past, surgeons in the majority of the surgical specialties were named as top surgeons on the 2007 New York Magazine Top Docs list.
Yale has made a $12.5 million investment in its transplant program and has already increased the number of surgeons, hepatologists, nurses and support staff thereby improving every area touched by transplant medicine, including intensive care and diagnostic radiology. To build a best-in-the-nation transplant program requires an extraordinary and accomplished leader, which we’ve found in Dr. Sukru Emre. His mission is to revive the liver transplant program while strengthening Yale’s kidney and pancreatic transplant program. Dr. Emre is previously credited with one of the best programs in the country at Mt. Sinai in New York, we anticipate Yale’s program to achieve a 98 percent one-year survival rate and a 92 percent five-year survival rate among pediatric liver patients. Transplant surgery is a young branch of medicine growing within Yale’s strengths in hepatology, transplant immunology and vascular biology, and now Yale-New Haven Hospital has made an extraordinary commitment of support.
Cardiac Surgery | Otolaryngology | Plastic Surgery | Surgical Oncology | Thoracic Surgery | Transplantation & Immunology | Trauma, Surgical Critical Care & Surgical Emergencies | Vascular Surgery
Cardiac Surgery
Cardiac surgery has expanded its capacity and capabilities significantly in 2007 to offer the most advanced available treatment modalities for the diseased heart. Yale surgeons have an unparalleled safety record in conducting cardiac surgery. For more than ten consecutive years, safety of cardiac procedures at Yale, as measured by the Society of Thoracic Surgeons database, has far exceeded national expectations with mortality just a fraction of that predicted for our population of patients. Data published in 2006 reports Yale’s cardiac surgical volume in the 80th percentile nationally with exceptional survival statistics in the following categories: CABG 96.6 percent, aortic valve replacement 99.0 percent and mitral valve replacement 96.3 percent.
The new surgeons will perform adult heart transplants and minimally invasive cardiac procedures and will soon begin Phase 1 clinical trials at Yale-New Haven Hospital for tissueengineered vascular grafts to replace arteries in children with congenital and acquired cardiothoracic disease— the only grafts capable of growth as the child matures.
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Donald M. Botta, MD, received his medical degree from the University of Alabama. Dr. Botta completed residency in general surgery at the University of Tennessee, followed by a residency in cardiothoracic surgery at Yale-New Haven Hospital. He served as a Naval Flight Surgeon for three years, where he accrued significant combat experience, and comes to Yale from Mid-America Heart and Lung Surgeons, Kansas City, to direct the cardiac transplant and mechanical cardiac assistance service. He performs all types of adult cardiac surgery. His clinical interests include heart transplantation, mechanical support of the circulation, left ventricular assist device (LVAD), right ventricular assist device (RVAD), intra-aortic balloon pump (IABP), coronary artery disease, aortic aneurysm, aortic dissection, and cardiac valve disease. Research interests include vascular biology, inflammation and the systemic inflammatory response, circulatory support devices, heart transplantation, and aortic pathology. He may be reached at (203) 785-7627. |
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Arnar Geirsson, MD, earned his medical degree at the University of Iceland Medical School and completed a residency in general surgery at Yale-New Haven Hospital. This included two years of dedicated basic science research in transplant immunobiology at Yale School of Medicine. Subsequently Dr. Geirsson completed a cardiothoracic surgery fellowship at the Hospital of the University of Pennsylvania. He joins the cardiac surgery team as the Director of Minimally Invasive Cardiac Surgery. His clinical interests include minimally invasive cardiac surgery, valve-sparing approaches to aortic and mitral valvedisease, aortic root surgery, off-pump coronary artery bypass surgery, heart failure and percutaneous approaches to aortic valve disease and aortic aneurysm. His research interests include ischemic cardiac remodeling, heart failure, cardiac regeneration and mitral valve disease. He may be reached at (203) 785-4079. |
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Richard W. Kim, MD, earned his medical degree from the State University of New York. Dr. Kim completed a general surgery residency at Yale-New Haven Hospital and a cardiothoracic surgery residency at the University of Pennsylvania School of Medicine. He also completed a fellowship in pediatric cardiothoracic surgery at the Children’s Hospital of Philadelphia. Dr. Kim completed a research fellowship in vascular biology and transplantation immunology at Yale School of Medicine and is currently an investigator for the Yale Interdepartmental Program in Vascular Biology and Therapeutics. He received the Jackson H. Stuckey award from the State University of New York for his outstanding surgical research.
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Dr. Kim will begin a clinical program in pediatric cardiac transplantation. His clinical interests include adult congenital heart complex procedures such as single ventricle anomalies, valve repair in AV canal defects, complex aortic arch, aortic root replacement, valve-sparing aortic procedures, and pediatric heart and lung transplantation. His research focus is in utero stem cell therapy for congenital heart disease. He may be reached at (203) 785-4079.
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Otolaryngology
Otolaryngology is constantly engaged in initiating new and improved models of patient care, while continuing its leadership position in the investigation of fundamental mechanisms of auditory function, speech and swallowing behaviors, taste and oral pain syndromes, progression of sinonasal inflammatory disease, and head and neck cancer. In response to growing patient volumes we have added a nurse coordinator, Laurie Finta, RN, and welcome Melissa Dziedzic, APRN, who will work with Dr. Douglas Ross. There is more support staff in addition to increasing physician capacity in the Head and Neck Cancer Surgery Program and the Speech and Swallow Center. The addition of a laryngologist experienced in advanced microscopic surgery of the vocal cords coordinates surgery and therapy for patients with voice disorders at the Speech and Swallow Center.
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Nwanmegha Young, MD, earned his medical degree from the University of California at Davis. Dr. Young completed his residency in otolaryngology, head and neck surgery at Washington University Barnes Jewish Medical Center. He then completed a fellowship in laryngology at the New York Center for Voice and Swallowing Disorders. There, he also worked with the medical director of Lincoln Center for the Performing Arts and the Metropolitan Opera in New York. His clinical expertise lies in the medical and surgical treatment of voice disorders and care of the performing voice, including laryngeal framework surgery and microscopic surgery on the vocal cords. Dr. Young is an expert in the diagnosis of neurologic disorders of the larynx and treatment with botulinum toxin. He may be reached at (203) 785-2593. |
Plastic Surgery
Members of this section provide special expertise that encompasses the entire breadth of reconstructive, extirpative and cosmetic plastic surgery. The physicians provide skilled management of skin cancers, maxillofacial and extremity trauma, and traumatic and chronic wound-care problems. In addition, each faculty member has developed specialized foci of interest to complement programmatic efforts in a number of areas within reconstructive and cosmetic plastic surgery. Multiple novel and highly effective cosmetic surgical treatments have been developed. Complementing our innovation, Dr. Michael Matthew offers a new microvascular surgical option to patients undergoing breast reconstruction.
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Michael K. Matthew, MD, earned his medical degree from Case Western Reserve University and completed an integrated plastic surgery residency at the University of Virginia. He also completed a hand fellowship at New York University. His clinical interests include microvascular breast reconstruction, deep inferior epigastric perforator (DIEP) flap for breast reconstruction, congenital hand reconstruction, and brachial plexus reconstruction. His research is focused on bioengineering. Dr. Matthew joins J. Grant Thomson, MD, in the Hand Center and will also work with surgical oncologists offering the perforator flap approach to breast reconstruction when appropriate. He may be reached at (203) 785-2253. |
Surgical Oncology
Yale Oncologic and General Surgery is a group of general surgeons devoted exclusively to the surgical evaluation and management of benign and malignant tumors. Surgeons perform state-of-the-art minimally invasive and traditional operations for the full range of breast, esophageal, gastric, hepatobiliary, pancreatic, liver, and colorectal cancers and tumors. Emphasis is on the most successful surgery with the least pain, trauma, and scarring and shortest recovery time.
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Charles H. Cha, MD, earned his medical degree from the Feinberg School of Medicine at Northwestern University and completed a residency in general surgery at the University of Wisconsin Hospital & Clinics. Dr. Cha completed a fellowship in surgical oncology at Memorial Sloan-Kettering Cancer Center with a particular interest in hepatobiliary and pancreatic malignancy. His surgical interests include benign and malignant disease of the liver, pancreas, stomach and esophagus, as well as minimally invasive surgery for cancer. His research interests include the investigation of angiogenesis in gastrointestinal malignancy using gene silencing techniques and clinical outcomes in surgery for hepatobiliary, pancreatic, gastric and esophageal malignancy. He may be reached at (203) 785-2380. |
Thoracic Surgery
Thoracic oncology is a rapidly changing field with a close interface between the clinical practice and an immense scientific research effort. Yale Thoracic Surgery offers the full spectrum of chest surgical interventions for both benign and malignant conditions, ranging from minimally invasive operations emphasizing the use of muscle-sparing incisions to extended resections. This growing practice covers all aspects of thoracic surgery, including diagnostic procedures as well as curative and palliative resections. Thoracic surgery is also a major component of the Yale Cancer Center Thoracic Oncology Program (TOP), a multidisciplinary program dedicated to providing state-of-the-art evaluation and treatment for patients with thoracic malignancies in an efficient and coordinated manner. The team approach ensures that the treatment choice is optimized for each patient.
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Daniel J. Boffa, MD, earned his medical degree with honors from the University of Chicago. His surgical training includes a residency in general surgery at New York- Presbyterian Hospital and Memorial Sloan-Kettering Cancer Center as well as a fellowship in thoracic surgery at the Cleveland Clinic. Dr. Boffa has received numerous awards for contributions in surgical education, basic science research, and innovation and recently was awarded the Dr. Charles H. Bryan Clinical Excellence Award from the Cleveland Clinic. He joins the growing section of thoracic surgery, focusing on thoracic oncology. His clinical interests include minimally invasive thoracic surgery, esophageal cancer, lung cancer, chest wall tumors, and benign esophageal disorders (achalasia, gastroesophageal reflux disease, hiatal hernias). His research interests include tumor metastasis and early detection of lung cancer. He may be reached at (203) 785-4079. |
Transplantation & Immunology
Swift and decisive changes have occurred at Yale since July 2007. The new section chief, Sukru Emre, MD, has reorganized a large multidisciplinary team of surgeons, anesthesiologists, hepatologists, nephrologists (both in adult and pediatric), transplant nurse coordinators, social workers, financial coordinators and a compliance officer. Dr. Emre is in charge of the tissue typing laboratory and its new database, and has implemented a process for meeting the myriad of regulatory requirements.
In his first four months at Yale, Dr. Emre performed two kidney and 10 liver transplants—four in children and six in adults. A 7-month-old boy with biliary atresia was Connecticut’s first split-liver transplant recipient. We anticipate the use of other innovative techniques such as living donor transplantation in adult and pediatric patients with end-stage liver disease, and domino transplants, in which the liver removed from one patient undergoing transplantation may still serve another patient with a shorter anticipated lifespan. Such innovation comes out of a determination to help every patient on a transplant waiting list. Yale’s list has already grown from five to 30, but it is anticipated the list will be up to 150 within one year. Our goal is to annually perform 80 to 100 liver transplants, double the kidney transplants to 150 and bring pancreas transplants up to 20.
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Sukru H. Emre, MD, FACS, is the new section chief of Transplantation and Immunology, and Director, Yale-New Haven Transplantation Center. Dr. Emre received his medical degree from the University of Istanbul, where he also completed a residency in general surgery. His clinical postdoctoral training includes completion of a hepatobiliary surgery fellowship at the University of Istanbul and a transplant fellowship at Mount Sinai Medical Center, New York. He also completed two transplantation research fellowships, one at SUNY Health Science Center at Brooklyn and another at Mount Sinai Medical Center. He is a Fellow of the American College of Surgeons. Dr. Emre is an expert in adult and pediatric liver transplantation. He has performed more than 2,000 liver transplants in adults and children, of which the youngest patient was 16 days and the oldest was 75 years. His special interests are performing splitliver transplants (dividing a liver between two recipients, thus saving two lives) and living donor transplants. He is also expert in hepatobiliary surgery, including resection for liver cancer, portal hypertension surgery, repair of complex bile duct injuries and the Kasai procedure for biliary atresia. Dr. Emre’s research interests include acute liver failure, biliary atresia and rare cholestatic diseases in children, and transplanting adult patients with hepatitis B and C and liver cancer. He may be reached at his office (203) 785-2565 or 1-866-925-3897 (1-866- YALE-TXP). |
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Antonios Arvelakis, MD, PhD, joins the Yale-New Haven Transplantation Center as an experienced transplant surgeon. Dr. Arvelakis earned his medical degree with honors at the University of Athens, where he also completed a residency in general surgery. During his residency he received European Union Travel Award to do an elective surgery rotation at the Cleveland Clinic. He subsequently trained in intestinal transplantation surgery at Jackson Memorial Hospital in Florida. He finished the American Society of Transplant Surgeons-approved multi-organ transplantation fellowship program at Mount Sinai Medical Center, New York. His clinical interests include adult and pediatric liver transplantation, kidney transplantation, pancreas transplantation, hepatobiliary surgery, and pediatric liver/kidney transplantation. His research interests include split liver transplantation and pediatric transplantation. He may be reached at his office (203) 785-4134 or 1-866-925-3897 (1-866-YALE-TXP). |
Trauma, Critical Care and Surgical Emergencies
The Trauma Service staffs Yale-New Haven Hospital’s Level 1 Trauma Centers—adult and pediatric—for southwestern Connecticut and serves as the regional referral source for the comprehensive management of critically ill and injured patients. An operating room and intensive care unit are always available and a senior Yale surgeon is physically present in the hospital 24 hours a day, 365 days a year, to provide emergency surgery and direct oversight of the Surgical Intensive Care Unit. Ambulance and helicopter transportation is available to transfer patients to New Haven from remote locations. For patient transfers, please call 1-800-285-7775, 24 hours a day, 365 days a year. To contact a trauma surgeon please call (203) 785-2592.
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Linda Maerz, MD, FACS, earned her medical degree from the University of Arizona College of Medicine and completed her residency in general surgery at Oregon Health & Science University. Dr. Maerz completed a fellowship in surgical critical care at Yale School of Medicine. Her 12 years of surgical experience in private and academic practice earned her several academic awards. She has a particular interest in surgical education and served as assistant program director of the general surgery residency at Oregon Health & Science University prior to coming to Yale. Clinical areas of interest focus on surgical critical care and emergency general surgery. Her basic science research interests have included gastrointestinal physiology, in particular gastric emptying. |
Vascular Surgery
Vascular surgery has been reinvented and is a truly independent specialty that can take care of vascular disease with either medical management or interventions with surgical or percutaneous techniques. Vascular surgeons trained in open procedures are acquiring new endovascular skills and a larger proportion of vascular cases are being performed using endovascular technology.
Our new vascular surgeon, Dr. Bart Muhs, MD, PhD, trained and worked in Europe, where endovascular techniques and devices are more advanced than in the US. His expertise in covered-stent technology for vascular aneurysms recently enabled collaboration with a Yale pediatric cardiologist to perform Connecticut’s first non-operative repair of a descending aortic aneurysm associated with aortic co-arctation. These innovative procedures offer patients less pain and shorter recoveries and are likely to become the preferred approach.
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Bart E. Muhs, MD, PhD, earned his medical degree at the University of Chicago Pritzker School of Medicine and completed his surgery residency and fellowship in vascular surgery at New York University. He was selected by the Society for Vascular Surgery as one of two American vascular surgeons to receive specialized endovascular training in Europe as the prestigious Marco Polo Fellow. Dr. Muhs earned his PhD at Utrecht University, the Netherlands, in advanced endovascular procedures including complex minimally invasive aortic aneurysm repair and carotid stenting. His dissertation involved the use of dynamic imaging in the assessment of fenestrated and branched aortic grafts. Dr. Muhs is Co-Director of the Endovascular Program and is clinically active in all areas of vascular and endovascular surgery, including the latest minimally invasive and traditional surgical options. He treats all conditions of the arteries and veins from the neck to the foot and is therefore able to individualize treatment and offer the optimal approach to patients with vascular disease. His research interests include endovascular surgery, dynamic aortic and side branch motion, minimally invasive surgery, vascular imaging, improving vascular outcomes, fenestrated endografts, branched endografts, and stent technology. Dr. Muhs may be reached for consultations at (203) 785-2564. |
