Download Vol. 5 Issue 1 - UTSW Medicine

VOL.
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ISSUE
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UT SOUTHWESTERN MED
PHYSICIAN
UPDATE
A UT Southwestern program
offers expert care for adults
with congenital heart disease
When Hearts
Grow Up …
Congenital heart disease (CHD) is the most
common form of birth defect, affecting
approximately 1 in 150 births, and it is often
diagnosed and treated in childhood. Since
the 1970s, open-heart surgery has allowed
repair or partial correction of many defects,
enabling the majority of CHD patients
to survive into adulthood. Many patients
and their physicians, however, mistakenly
believe that a successful childhood surgery
represents a “cure,” so regular cardiology
care in adulthood has not been the norm.
In fact, less than half of adult CHD patients
are thought to receive such care after they
“outgrow” their pediatric cardiologist.
Continued page 2 
Beth Brickner, M.D., (left), and Lisa Forbess, M.D.
Case Study
Adult Congenital Heart
Disease Program
Adult Congenital Heart Disease Program team members (from left): Reina Covarrubias, R.N.; Angela
Chriss, R.N.; Nicole Benjamin, P.A.-C.; Michael Luna, M.D.; Beth Brickner, M.D.; and Lisa Forbess, M.D.
Cardiology
When Hearts Grow Up ...
For CHD patients with more complex defects, care is often provided by pediatric cardiologists—even well into the patient’s adult
years—because many adult cardiologists have
not been trained in the treatment of these patients. A UT Southwestern team—members
of the UTSW Adult Congenital Heart Disease
Program—is a notable exception to this situation, offering a high degree of expertise to
meet adult CHD patients’ cardiac and general
medical needs.
“For most patients, surgery for CHD does
not result in a cure, and patients remain at risk
for a variety of complications in adulthood,
ranging from arrhythmias to heart failure
and even sudden death,” says Beth Brickner,
M.D., Co-Director of the program. “Some of
these problems are preventable with regular
follow-up and surveillance. When caught early,
serious heart issues such as arrhythmias,
ventricular dysfunction, valvular dysfunction,
pulmonary hypertension, and deterioration of
prosthetic materials can be addressed before
irreversible damage is done.”
Pregnancy for CHD patients can be challenging as well and needs subspecialty care,
she notes. Non-cardiac surgery can be complicated for patients with moderate or complex defects and requires careful perioperative
management and anesthesia.
Expert Care for More Than a Decade
In September 2013, the American Board of
Medical Specialties officially recognized Adult
Congenital Heart Disease as a specific subspecialty of cardiology, requiring specific training
and certification. The first certifying exam will
be offered in 2015.
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(Cont. from page 1)
By working in close collaboration with the
Pediatric Cardiology and Pediatric Cardiothoracic Surgery Program at Children’s Medical
Center, the UT Southwestern Adult Congenital Heart Disease Program has already been
providing expert comprehensive care for adult
patients with CHD for more than 10 years,
according to Dr. Brickner.
“Some patients are transitioned from their
pediatric cardiologist at Children’s to the adult
program, but many patients are referred by
outside physicians to help diagnose and manage their congenital heart disease,” she says.
UT Southwestern physicians in the program offer experience in the management
of adult CHD patients (both inpatient and
outpatient), using advanced imaging (echo,
CT, and MRI), diagnostic and interventional
catheter procedures, pacemakers, and arrhythmia management. Cardiac surgery is
performed by pediatric heart surgeons in collaboration with UTSW adult cardiac surgeons.
Patients with moderate or high-risk CHD
requiring non-cardiac surgery are cared for in
a collaborative fashion with the surgical team
and cardiac anesthetist to provide optimal
surgical outcomes.
High-risk pregnancies for mothers with
CHD are treated in collaboration with UTSW
maternal-fetal medicine physicians. “We also
work closely with the pulmonary hypertension
teams and the heart failure/transplant team
to provide the full spectrum of care for these
patients,” Dr. Brickner says.
UT Southwestern Adult Congenital Heart Disease Program team members are available
for consultation with referring physicians.
To schedule an appointment, call 214-645-8300.
Courtney Peets was born a “blue baby.”
Diagnosed with a complex form of congenitally corrected transposition of the
great arteries with a ventricular septal
defect, pulmonary stenosis, and a single coronary artery, she was not offered
surgery in early childhood because of
her complex anatomy. Ultimately, when
she was 17, she did have surgical repair:
Doctors closed her VSD and placed a
pulmonary homograft. Courtney improved, became an active young adult,
and married.
In 2009, Courtney developed arrhythmias. Her pediatric cardiologist
counseled her to avoid pregnancy.
She was seen for a second opinion by
Lisa Forbess, M.D., Co-Director of the
UT Southwestern Adult Congenital
Heart Disease Program.
Courtney and Eric Peets with son, Zakary
Courtney had a comprehensive
evaluation, including consults in electrophysiology and maternal-fetal medicine. After receiving counseling on the
elevated risk of pregnancy, Courtney
and her husband decided to proceed.
Her pregnancy was complicated by
both arrhythmia and congestive heart
failure (CHF), requiring brief hospitalizations. She had recurrent CHF at 37
weeks and remained hospitalized until
labor was induced at 38 weeks. Courtney delivered a healthy boy, and both
mother and son are doing well today.
Transplantation
Satellite clinics extend UTSW
transplant services across Texas
Patients needing evaluation for heart/LVAD, kidney, liver, or lung transplants can be referred to 10 UT Southwestern outpatient clinics located
in five cities across Texas. These clinics are open on select days each
month and are staffed by UT Southwestern transplant specialists.
Clinic Days Each Month
UTSW
(Amarillo)
UTSW
Heart/LVAD
Fort Worth. . . . . . . . . . As scheduled
(Fort Worth)
Kidney
El Paso . . . . . . . . . . . . . 4th Thursday/Friday
Fort Worth. . . . . . . . . . 2nd Tuesday
Lubbock . . . . . . . . . . . . TBD
UTSW
(El Paso)
UTSW
Liver
Austin . . . . . . . . . . . . . . 1st and 3rd Monday
El Paso . . . . . . . . . . . . . 4th Thursday/Friday
Fort Worth. . . . . . . . . . 2nd and 4th Thursday
Lung
Amarillo . . . . . . . . . . . . 3rd Thursday
El Paso . . . . . . . . . . . . . 2nd Thursday
Lubbock . . . . . . . . . . . . 4th Thursday
UTSW
(Lubbock)
(Austin)
To refer a patient to any of the
clinics for evaluation, please call:
(Heart/LVAD, Lung) – 877-391-1528
(Kidney, Liver) – 877-392-1528
Sports Medicine
Sports Medicine Hotline connects you to expert team
When sports injuries happen, time is often of
the essence. UT Southwestern’s 24-hour Sports
Medicine Injury Hotline can help put your patients on the mend by providing immediate
access to a member of the UTSW Sports Medicine team for fast answers to questions and
expedited appointment scheduling, if needed.
UT Southwestern’s Sports Medicine specialists are the official team physicians for the
National Hockey League’s Dallas Stars and
serve other professional and amateur orga-
nizations throughout North Texas, as well as
numerous school-based programs and active
individuals of all ages.
The team’s expertise in highly advanced
arthroscopic and minimally invasive procedures
translates into faster recovery times (often days
versus weeks) for patients. Fellowship trained
in sports medicine and orthopaedics, the
team offers state-of-the-art diagnostic tools
and treatments for conditions such as:
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ACL injuries
Cartilage restoration
Concussion evaluation and management
Fractures
Hamstring strains
Hip dislocations and/or impingements
Joint preservation and reconstruction
Rotator cuff repairs
Shoulder instability and/or separations
Tendonitis and other overuse injuries
Sports Medicine specialists see patients at
UT Southwestern’s main campus in the Southwestern Medical District and at the UT Southwestern Clinical Center Richardson/Plano,
located adjacent to the UT Dallas campus.
Sports Medicine team members include
Katherine Coyner, M.D.; Robert Dimeff, M.D.;
Michael Khazzam, M.D.; and William Robertson, M.D.
Dallas 24/7 Sports Medicine Injury Hotline:
214-645-3363; Richardson/Plano 24/7 Sports
Medicine Injury Hotline: 972-669-7164
Hand Specialists, Too
If an injury is sustained to the hand or wrist,
UTSW orthopaedic specialists Robert Bass,
M.D., and Timothy Schacherer, M.D., are available and work closely with certified hand therapists. Both physicians are fellowship trained
in hand surgery. UTSW physicians treat more
wrist injuries than any other hospital in Texas.
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P H Y S I C I A N
U P D A T E
Oncology
CANCER CENTER EXPANDING
TO NEW LOCATIONS
UT Southwestern’s Harold C. Simmons Cancer
Center is expanding into new locations in the
Dallas-Fort Worth area, making it more convenient for patients and their referring physicians
to receive services from the only NCI-designated
cancer center in North Texas.
Richardson/Plano
New and current Simmons Cancer Center
patients can experience high-quality, specialized cancer care in UTSW’s Richardson/Plano
location near the UT Dallas campus on Waterview Parkway.
Board-certified medical oncologist Klaus
Hollmig, M.D., oversees care at this location as
Medical Director, and he and the experienced
staff seamlessly coordinate with other members of the care team in Dallas. In addition to
appointments with Dr. Hollmig, patients can
receive chemotherapy and imaging at this
location, as well as have labs drawn.
To refer a patient, call 214-645-8300.
Fort Worth – Urologic Cancers
In partnership with our affiliate, Moncrief Cancer Institute, UT Southwestern will soon be offering more services in Fort Worth’s Medical District.
Members of UTSW’s nationally ranked
urology team will provide screening, evaluation,
diagnoses, and care associated with prostate,
bladder, and kidney cancer at Moncrief Cancer Institute on West Magnolia Avenue. If you
have a patient with any of the following signs
or symptoms, consider referring to UTSW’s
urologic specialists who will partner with you
on your patient’s care:
Urologic specialists seeing patients in
Fort Worth include Claus Roehrborn, M.D.,
Yair Lotan, M.D., and Jeffrey Gahan, M.D.
To refer a patient, call 214-645-8300.
Fort Worth – Oncology Rehab
Have a patient who is struggling with mobility
or daily tasks during or after cancer treatment?
Then consider a referral for oncology rehabilitation, already offered in Dallas, and now available at Moncrief Cancer Institute’s new facility.
Oncology rehabilitation encompasses
physical, occupational, and speech therapy
services that include:
 Exercise programs to help restore
range of motion and build strength
and endurance
 Assistance with handling activities
of daily living
 Manual therapy to address scar
adhesions, radiation fibrosis,
and lymphedema
 Techniques for pain management
 Medication management
UTSW’s rehabilitation team will coordinate
with oncologists and primary care physicians
for continuing care and medical releases.
To refer a patient to the Fort Worth location,
call 817-288-9801.
Coming in early 2015, Simmons Cancer Center
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Blood in urine (micro and macro)
Abnormal prostate palpation
Voiding symptoms
PSA issues
Mass identified by imaging in the kidneys
will open a full clinic at Moncrief in Fort Worth,
offering infusion, imaging, lab, and medical
oncology appointments.
Michael A. Choti, M.D., M.B.A.
Surgery
Acclaimed oncologist
is new Chair of Surgery
Michael A. Choti, M.D., M.B.A., an internationally acclaimed surgical oncologist with specific
expertise in liver, pancreatic, and other gastrointestinal cancers, is the new Chair of the
Department of Surgery at UT Southwestern
and Surgeon-in-Chief for the new William
P. Clements Jr. University Hospital, opening
in November 2014. He comes to UTSW from
Johns Hopkins University School of Medicine,
where he spent the past 21 years.
Dr. Choti earned his medical degree at Yale,
did general surgery training at the University
of Pennsylvania, and completed a surgical oncology fellowship at Memorial Sloan Kettering
Cancer Center before joining the Department
of Surgery at Johns Hopkins.
His research interests include experimental
therapeutics, investigative therapy in gastrointestinal malignancies, molecular genetics
related to cancer and cancer biology, clinical
research in outcomes, surgical innovation,
computer-assisted surgery, and robotics in
cancer therapy.
Dr. Choti’s academic work has been
supported by the National Cancer Institute
and the American Cancer Society and has
been presented in more than 300 peerreviewed publications.
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P H Y S I C I A N
U P D A T E
Neurology
Neuro ICU offers region’s largest service, advanced expertise
Critically ill patients with brain injuries and
neurological diseases can receive expert care
from fellowship-trained neurointensivists in
the dedicated Neurological and Neurosurgical
Intensive Care Unit (Neuro ICU) at UT Southwestern’s Zale Lipshy University Hospital.
Serving as one of the nation’s premier
neurological treatment centers, the dedicated
Neuro ICU at Zale Lipshy offers the highest level
of care available to those most in need. With
20 beds, it is the largest service of its kind in
the region and features state-of-the-art technology and a range of innovative treatments.
“For many people suffering from lifethreatening neurological disorders, the presence
of a Neuro ICU staffed by neurointensivists has
been shown to significantly improve outcomes,” says Venkatesh Aiyagari, M.D., Medical
Director of the Neuro ICU and Director of Neurocritical Care at UTSW.
A Critical Difference
According to Dr. Aiyagari, one of the unique
qualities of the program is its multidisciplinary
approach to care that patients receive, which
is different from other programs where the
neurointensivist is more of a consultant than
an active team member.
At Zale Lipshy, Neuro ICU patients receive comprehensive care from a team that
includes six neurointensivists—all of whom
are fellowship trained in neurocritical care—as
well as neurologists, neurosurgeons, interventional neuroradiologists, neuro ICU nurses,
neuro anesthesiologists, pharmacists, respiratory therapists, dietitians, and speech and
rehabilitation specialists.
“Our daily rounds include neurointensivists, the bedside nurse, care coordinator, pharmacist, respiratory therapist, and a dietitian,”
says Dr. Aiyagari. “We have a daily exchange
of information with each other about each patient, right at the bedside. Family members are
encouraged to be present during rounds and
participate in the care of the patient.”
Neurointensivists in the dedicated Neuro ICU at Zale Lipshy University Hospital include (from left):
Julian Yang, M.D.; Robin Novakovic, M.D.; Stephen Figueroa, M.D.; Christiana Hall, M.D.; Michael Rubin, M.D.;
and Venkatesh Aiyagari, M.D.
Patient-Centered Medicine
The neurointensivists specialize in the
treatment of traumatic brain injury, status
epilepticus, aneurysms, arteriovenous malformations, rare cerebrovascular conditions, brain
tumors, spinal cord injury and myelopathies,
complex demyelinating diseases, meningitis, infectious and autoimmune encephalitis,
neuromuscular conditions that may cause
life-threatening issues, ischemic stroke, and
cavernous malformations. Currently, the most
common conditions the neurointensivists
treat are subarachnoid hemorrhage and intracerebral hemorrhage.
UT Southwestern physicians practice
patient-centered medicine, establishing a partnership with the patient and family in selecting
the right course of action to address an
individual’s needs and diagnosis.
Currently, the UT Southwestern Telestroke
Network is enrolling hospitals in need of 24/7
stroke neurology consultation in the emergency room. The stroke consultations are for any
program that may not have neurology support.
The Neuro ICU also accepts hospital-tohospital transfers for critically ill or complex
patients. To arrange a patient transfer, call
877-645-0911.
To refer a patient, call 214-645-8300.
Late-Breaking News
UT Southwestern University Hospitals have been
certified as an Advanced Comprehensive Stroke
Center by The Joint Commission. UTSW becomes the
first Joint Commission-certified comprehensive stroke
center in North Texas and only the second in the state.
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NON PROFIT
US POSTAGE
PAID
TWMS
5323 Harry Hines Boulevard
Dallas, Texas 75390-8519
Facility Update
New hospital set for 2014 opening
In late 2014, the William P. Clements Jr. University Hospital will open its doors on the
UT Southwestern campus, along Harry Hines
Boulevard, between Inwood Road and Mockingbird Lane.
Every aspect of the new hospital has been
carefully considered. One unique feature is its
W-shaped design, which is both distinctive
and functional. This W design will improve patient care and make it easier for patients, staff,
and visitors to navigate the facility.
Here’s just some of what you’ll find inside
the building:
By the Numbers
 12 floors
 1.3 million square feet
 460 all-private patient rooms
 40 emergency department rooms
 24 surgical suites
 18 procedure rooms
 72 adult ICU rooms
 16 labor and delivery rooms
 30 neonatal ICU rooms
 3 Ob specialty surgical suites
 4 CT scan, 2 MRI, and 6 X-ray suites
 2 nuclear medicine rooms
Patient and
Physician
Referral Services
p. 214.645.8300
f. 214.645.7999
William P. Clements Jr. University Hospital
UT Southwestern physicians offer consultations and treatment in more than 60 subspecialties. Recognizing that navigating
through the many programs and resources at UT Southwestern can be challenging, the University established Patient and
Physician Referral Services to assist external physicians and their staff with securing patient appointments. Offices may call
one centralized phone number to schedule a consultation in any clinic or to fax patient records. The UT Southwestern referral
coordinator will work closely with the appropriate physician or clinic to coordinate the patient’s appointment, as well as
contact the patient and referring physician’s office with the appointment details.
UT Southwestern is an Affirmative Action/Equal Opportunity Employer. Women, minorities, veterans, and individuals with disabilities are encouraged to apply.
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© 2014 UT Southwestern Medical Center. MKT 2087