Advancing Cardiothoracic Surgery for Patients Around the Globe
We're a national leader in pediatric and congenital heart surgery and research. Learn more about our current projects:
The Cardioprotective Effects of Controlled Hypoxemia Reperfusion
We are conducting a study in collaboration with Dr. Kevin Haworth, Associate Professor at the University of Cincinnati to address the challenges of myocardial infarction. Once the infarction is corrected, reperfusion is standard, but it can paradoxically cause further heart injury. This damage is due to the conversion of oxygen into reactive oxygen species, harming cardiomyocytes. Our research focuses on cardioprotection, aiming to limit reperfusion injury. Previous benchtop studies demonstrated ultrasound activation of an emulsion that reduces available oxygen. Ex vivo research also showed the benefits of temporarily reducing oxygen during reperfusion. This study, however, aims to translate these findings into a clinically feasible approach using ultrasound technology. We are testing this therapy in an in-vivo porcine model of myocardial infarction, conducting two phases. Phase 1 determines the optimal parameters for oxygen scavenging, while Phase 2 assesses the cardioprotective value.
Acute Renal Hemodynamic Changes in Cardiopulmonary Bypass
In collaboration with MediBeacon, we are conducting a study to improve kidney function assessment, especially in the context of cardiothoracic surgery. As the traditional methods, using serum creatinine or Cystatin C, have limitations, a newly developed fluorescent molecule, MB-102 (Relmapirazin, MediBeacon, St. Louis, MO), stands as a potential alternative for measuring the glomerular filtration rate (GFR). MB-102 offers non-invasive and real-time detection through a transdermal signal. Pre-clinical and Phase II studies have shown near-perfect correlation with the gold standard iohexol plasma clearance. Specifically, regarding cardiothoracic surgery, as acute kidney injury is a common issue with cardiopulmonary bypass (CPB), real-time assessment of GFR during surgery is necessary. Therefore, our study aims to utilize MB-102 for transdermal GFR measurements in an ovine model of CPB. We are analyzing the dynamic GFR changes during different surgery phases, correlating them with physiological parameters and renal blood flow. This research is enhancing our understanding of kidney injury during CPB, enabling rapid and targeted interventions to reduce complications.
Cold Ischemia Time of Semilunar Heart Valves Using a Novel Preservation Solution
Our team recognizes the current limitations of evaluating heart valve replacements, especially in infants with congenital heart defects. These include degeneration, leakage, a lifelong need for blood thinning medication, and a lack of growth, leading to multiple operations and/or complications. A promising technique called Partial Heart Transplant (PHT) involves transplanting heart valves from a donor, offering growth potential and avoiding complications. However, a major challenge is the limited time for ischemia, impacting viability. Our study, therefore, aims to understand PHT's transplant biology and its tolerance for a longer ischemia time compared to conventional heart transplants. Using a porcine model, our team simulates the human heart harvest procedure and subjects the tissue to different preservation solutions for analysis, providing insights into ischemia time for PHT and developing new preservation solutions. Success in this study could revolutionize PHT's clinical application, offering new possibilities for children in need of growing heart valve replacements.
Thymectomy in Congenital Heart Disease
Our team is evaluating the connection between congenital heart disease (CHD) and the immune system, specifically focusing on thymic cell education. Recent studies indicate that children with CHD may have a compromised immune response due to thymectomy, leading to an increased risk of infections and severe complications. Therefore, we aim to uncover the relationship between thymectomy consequences (immunosenescence) and CHD, which could have significant clinical implications for managing both acute and long-term complications. We are also determining the relationship between quilty lesions and cardiac allograft vasculopathy (CAV) and the possible consequences of immunosenescence in the development of these issues. Spatial proteomics and transcriptomics are tools for these studies, as are deep sequencing analyses. We recently received the 2023 MACS® Imaging Grant, which will be fundamental for some of our studies. As CHD affects over 15 million children globally, understanding the consequences of common practices during surgical palliation and correction is essential to comprehend the possible role of the immune system on these patients, which could potentially reduce the global burden of morbidity and mortality in children with these conditions.
