Thoracic & Cardiovascular Surgery Volume|Loyola Medicine

Thoracic & Cardiovascular Surgery Residency Clinical Volume

With a very active heart and lung transplant program, as well as its regional leadership in advanced technology such as endovascular grafting, percutaneous valve implantation, and destination therapy circulatory support, Loyola performs cardiovascular and thoracic procedures far in excess of what can be staffed by our complement of categorical residents.  This provides an environment where residents can involve themselves with those cases they believe will most benefit their education, while our surgical assistants cover the remainder.  Similarly, our dedicated Cardiovascular and Thoracic Intensive Care Unit is staffed by Anesthesia residents who carry out the majority of the 'front-line' care with the oversight of our trainees, so that our Thoracic residents are freed to pursue their technical development while building their clinical management skills.  On the wards and in clinic, our team of Nurse Clinicians and Physician Assistants effectively manage inpatient and outpatient care with resident involvement as necessary.

Loyola Thoracic and Adult Cardiovascular Surgery

Thoracic and Cardiac FY 2018 chart

The figure above represents Cardiovascular Surgery volume for Fiscal Year 2018.  2018 shows growth across the board, with exceptional growth in such areas as our Bridge to Transplant/Destination Therapy VAD implantation and in Thoracoabdominal Aortic Surgery.  A substantial amount of our volume is valvular.  Since the time of the early Heartport experience, Loyola has been a leader in minimally invasive valvular surgery, with particular preeminence in advanced mitral repair, and valve sparing aortic root procedures.  The figure below highlights the stability of these volumes, and the extent to which they exceed resident coverage.

Cardiovascular Surgery Volume

Loyola Thoracic Surgery

Loyola Thoracic Surgery has always drawn complex patients from around the Midwest, as has the Cardinal Bernardin Cancer Center, which offers our patients close coordination of our care with multi-disciplinary oncology teams.  The Thoracic Section also features a very busy lung transplant service, as well as experience with robot assisted surgery.  In the first quarter of 2016, Dr. Wickii Vigneswaran joined the faculty as the Chief of the Thoracic Section after several years on the faculty of the University of Chicago.  He brings cutting edge minimally invasive skills and a particular interest in mesothelioma, robotic and esophageal procedures to supplement the traditional strength of the resident's experience. Dr. Lubawski and he have grown the Thoracic volume in 2016 by over 55% from the previous year.

Thoracic Surgery

MItral valve replacement
Mitral Valve Replacement for Endocarditis with Neochord Reconstruction of Subvalvular Apparatus

Morning ICU rounds
Dr. Schwartz leads Morning ICU Rounds on Heartmate 2 Patient

Ventricular assist device
AB5000 Ventricular Assist Device after Salvage CABG

Thoracic team - 3D procedure
The Thoracic team performs a 3-D minimally invasive procedure

Ascending aortic replacement
Dr. Schwartz takes Dr. Amin through an Ascending Aortic Replacement under circulatory arrest using antegrade perfusion through Pruitt catheters

VATS lobectomy
Dr. Beecher performs a VATS lobectomy

Heartmate 2
Explanted Heartmate 2 after Transplant

Marginal donor lung
Marginal Donor Lung for Transplant

Hines Veterans Administration Hospital

Total Thoracic and Cardiovascular Procedures

The Hines VA Hospital, physically contiguous with Loyola University Medical Center, is an invaluable training site for the residency program, and a favorite rotation for our residents, both for the opportunity to care for our nation's veterans, and for the chance to "put together" what they have learned about technique, clinical decision making, and practice management in an environment where they are allowed carefully supervised autonomy.  The yearly volume of 175 to 250 cases is thus almost completely resident covered. The recently renovated operating rooms, intensive care units, and wards handle complex cases, including minimally invasive procedures, referred from throughout VISN 12.  The Hines VA service screens about 450 patients per quarter.  With access to this volume, it is little wonder that they have become the second busiest Robotic Surgery Thoracic program in the Veteran's Administration hospital system.

Robotic lung procedure at the Hines VA Hospital
Dr. Frazier takes Dr. Amin through a Robotic Lung Procedure at the Hines VA Hospital

Dr. Amin at the DaVinci Console
Dr. Amin at the DaVinci Console

Congenital Cardiothoracic Surgery

Congenital Cardiovascular Surgery Volume

Though some congenital cardiothoracic cases are performed at Loyola, the vast majority of the resident experience in this field is acquired at Christ Hospital, where Dr. Ilbawi's team tackles the full spectrum of complex repairs of congenital malformations.  Residents are typically extremely satisfied with the technical education they receive from our faculty there, and though they could satisfy American Board of Thoracic Surgery case requirements in a third of the allotted time, it is strongly agreed that the physiology and decision making can only be appreciated in the course of a three month rotation.