Research

RESEARCH AND CLINICAL TRIALS

Research in the Division of Cardiothoracic Surgery is facilitated by 12 Physicians and 8 Research scientists, who are involved inclinical, translational and outcomes research, for the development of clinical excellence and support of our academic mission. Our surgeons actively conduct cutting-edge studies that have been published in leading peer- reviewed medical journals that significantly contribute to the science of cardiac health and patient care.

The clinical research in the cardiothoracic division is directed by Dr. James Kirklin. Dr. Kirklin is the principal investigator of INTERMACS, or Interagency Registry for Mechanically Assisted Circulatory Support, an NHLBI-funded, national registry that tracks patients who are receiving mechanical circulatory support device therapy to treat advanced heart failure. The registry is a joint effort of the National Heart Lung and Blood Institute, Centers for Medicare and Medicaid Services, the Food and Drug Administration, clinicians, scientists and industry representatives. Researchers at UAB coordinate data collection and analyses, and the Data Coordinating Center at UAB is responsible for maintaining the database. This registry, established this registry in 2005, is now in its 10th year of robust, collaborative and outcomes focused research, facilitating the introduction of novel devices, refinement of clinical practice, improvements in patient outcomes, and enhancement of quality of life for thousands of patients.

Dr. Kirklin was instrumental in the formation of the Pediatric Heart Transplant Study (PHTS) and in establishing UAB as headquarters for this program. Clinical information on transplant recipients and donors from more than 40 major heart transplant centers in the United States is collected and maintained in PHTS database that is used to conduct research studies to determine and improve the outcomes of heart transplantation, to improve cardiac health, care and maximize long-term quality of life after transplantation.

Dr. Kirklin is presently the Co-Director of the UAB Comprehensive Cardiovascular Center (CCVC). The CCVC provides an important institutional mechanism for promoting basic, translational and outcomes research, as well as for drug and biomarker development in partnership with small business and industry. For more information, visit:https://www.uab.edu/medicine/cardiovascularcenter/

Division of Cardiothoracic Surgery also facilitates an established basic science research of heart failure, transplantation, and vascular disease to determine the detailed molecular mechanisms of cardiac disease and treatments. UAB's cardiovascular research laboratories are primary sites for the development of rodent surgical models to study cause of ischemic injury on cardiac tissue and processes to study one such protein, called Heme- oxygenase-1, that can protect organs from acute injury and vascular damage resulting from immunologic or physical injury.

In addition to our extensive outcomes research program, our surgeons actively participate as PI and co-PIs in randomized prospective industry sponsored clinical trials.

IMPACT

The Division's nearly five decades of experience in cardiothoracic surgery allows surgeons to observe long-term outcomes of various operative procedures, which helps set the standard for best practices in technique and technology throughout Southeastern United States specifically Valve-Replacement Surgeries, and Ventricular Assist Devices which are used to preserve the lives of patients experiencing end-stage heart failure or who are not eligible for transplant.


These research activities extend to other organs in the thorax, especially the Lungs and Esophagus. Dr. Robert Cerfoliois an internationally recognized leader in thoracic surgery related research focusing on improvements in surgical and pharmacological treatments of lung cancer as well as the implementation of robotic thoracic surgical techniques.


ORGANIZATION

1. Basic Research:Free-form basic research helps to improve our understanding of the basic processes of life, including the activities of cells and proteins and the genetic components of disease
2. Translational Research:Our translational research team provides the link between basic science and clinical care, helping to transform scientific discoveries into medical treatments and feeding clinical insights back to the lab for further investigation
3. Outcome Research: Outcomes researchers study the results of medical procedures to determine which ones offer the most benefits for patients and the health care system
4. Clinical Trials:Clinical researchers safely conduct human trials with consenting subjects to ensure the effectiveness and safety of new medical diagnostics, devices and therapeutics


CURRENT RESEARCH ACTIVITY
  1. Robot-Assisted Coronary cardiac surgery
  2. Clinical outcomes after Heart transplantation
  3. Outcome research after surgical treatment of advanced heart failure
  4. Aortic Valve disease Research
  5. Congenital Heart Disease Surgical Treatments/ and Cardiovascular Surgery in Neonates Research
  6. Arrhythmia Research
  7. Mechanical Cardiac Support Devices
  8. Outcomes after various thoracic surgeries and minimally invasive (robotic) lung cancer surgery
  9. Vascular Biology and Transplantation Immunology
ORGANIZATIONAL STRUCTURE
The division's faculty member, Dr. David C. Naftel, is an internationally recognized outcomes researcher who has developed new techniques of statistical analysis of Cardiac Surgery Outcomes. He is also a leader in multi-institutional studies of outcomes in cardiac transplantation and mechanical circulatory support. He was also instrumental in the establishment of the INTERMACS registry and is in charge of the day-to-day administration and management of scientific studies under INTERMACS auspices. Dr. James George is an established investigator in basic science research of heart failure, transplantation, and vascular disease. He has special expertise in the development of animal models of disease that can be modeled to determine the detailed molecular mechanisms of cardiac disease and treatments. He is currently the principal investigator of NIH funded research project to study the mechanisms of vascular disease after transplantation. The skilled micro surgeons at UAB's cardiovascular research laboratories are capable of performing heart, kidney, and aortic transplants in mice, allowing Division investigators to study disease processes using mice that have been genetically engineered to express or not express specific molecules under study. Division scientists have shown that one such protein, called heme oxygenase-1, can protect organs from acute injury and vascular damage resulting from immunologic or physical injury. Dr. Ayesha Bryant is an clinical outcomes researcher with over 100 research publications. Her research interests include include patient quality of life following cardiothoracic surgery, impact of oncologic agents on patient survival, improvement in quality of care, and post-operative outcomes. She also has an avid interest in resident and medical student education. She has mentored CaRES (NCI program) interns for over 5 years.

Drs. Naftel, Kirklin, and George have collaborated for many years and have developed an extensive research enterprise in cardiac surgery. The research program is facilitated through its expert staff of physicians, statisticians, immunologists, IT professionals, along with nurse coordinators, data entry personnel, data managers, post-doctoral fellows, graduate students, and clinical/ laboratory technicians. The cardiothoracic division's statistical resources and research database facilitate new research initiatives by a team of experts (Dr. Ayesha Bryant, Dr.Manisha Kukreja, Robert Brown, Susan Myers, Ryan Cantor, and Elizabeth Pruitt) that perform scientifically and clinically relevant research by engaging the scientific community and providing investigators with the statistical and scientific support necessary to perform studies that adhere to rigorous methodological standards.

EDUCATION AND TRAINING
The divisional research welcomes our fellow physicians and scientists to explore our current research activities regularly to make discoveries that they can translate into clinical care. Led by our faculty surgeons, research programs also include involvement by UAB medical students, residents, and pre- and postdoctoral fellows, and undergraduate student.

NEWS/EVENTS/PUBLICATIONS This links to PubMed list of faculty publications (Link Pending)