Making the Rounds with Dr. Andrew Leventhal

Cardiologist Dr. Andrew Leventhal helps a unique group of patients

Making the RoundsIn this week’s Making the Rounds interview, we caught up with Dr. Andrew Leventhal, director of the Kentucky Adult Congenital Heart Program at the UK Gill Heart & Vascular Institute. Dr. Leventhal is one of the nation’s few adult congenital heart disease specialists, helping a unique set of patients who are born with heart defects and who require specialized care as they become adults.

Why is adult congenital heart disease a challenging specialty?

Patients born with heart defects face unique challenges as they get older. They outgrow their pediatric cardiologists, but their heart problems can be very different from cardiac conditions that begin during adulthood.

One of the problems with this specialty is, because they have had good care in the past, many of my patients feel well and don’t necessarily think they need follow-up care. That’s why we make such a great effort to go out into the community and make sure these patients understand that they do need to see doctors for the rest of their lives.

What can a patient expect during their first appointment with you?

Many of my patients had surgery when they were children, so we talk a lot about their past. Even though they may be young, they actually have a fairly extensive medical history.

We really start at the beginning and go through their lives to make sure we have a very accurate perception of what they’ve had done in the past and where they are now.

What inspires you?

When I get up in the morning and I see my patients and see what they’re going through, that’s very inspiring. And the work ethic of my colleagues here at UK is quite inspiring, too.

If you weren’t a doctor, what would you be doing?

I’d be coaching baseball somewhere.

What do you enjoy most about living in Lexington?

I like that fact that it’s a city, but it has a small-town feel. I think it’s the most beautiful place in the world.

My wife and I very commonly will go out on the weekends into farm country just to drive around and really wonder at how nice of a place it is here.

Check out our video interview with Dr. Leventhal, where he explains how exciting new treatment options are helping patients feel better faster.

Next steps:

Are you at risk for deep vein thrombosis?

Dr. Nathan Orr

Dr. Nathan Orr

Written by Dr. Nathan Orr, a vascular surgeon at UK HealthCare.

Deep vein thrombosis (DVT) is a dangerous condition where a blood clot forms in the larger veins of our body due to slow blood flow, blood vessel damage or increased tendency to clot.

What is deep vein thrombosis?

When we cut or scrape our skin, the clotting process creates a scab. When that process begins inside our bodies – typically in the blood vessels in our legs or thighs – the resulting clot, also known as a thrombus, can break off and travel through the blood stream to an artery in the lungs, blocking blood flow and causing life-threatening complications such as a pulmonary embolism.

According to the Centers for Disease Control and Prevention, up to 100,000 Americans die each year from DVT/pulmonary embolism – more than deaths from breast cancer, motor vehicle accidents and HIV combined.

Symptoms of DVT

Only about half of the people who have DVT have noticeable symptoms. Symptoms include:

  • Swelling of the legs or arms.
  • Severe pain when standing or walking.
  • Warmer skin in the affected area.
  • Enlarged veins.
  • Bluish or reddish skin.

Risk factors

Although DVT can occur at any age, it is more common in people over 50. Risk factors for DVT include:

  • A family history of DVT.
  • Cancer.
  • Undergoing hormone therapy or taking birth control pills.
  • Pregnancy.
  • Injury to a deep vein caused by surgery or trauma.
  • Having a catheter placed in a vein.
  • Prolonged bed rest that leads to slow blood flow in deep veins.
  • Being overweight or obese.
  • Smoking.

Some people may not realize they have DVT until they are affected by a pulmonary embolism, which leads to low blood oxygen levels, lung damage, heart failure and death.

Signs of this pulmonary embolism are sudden shortness of breath, chest pain, coughing up blood, dizziness, rapid pulse and fever.  If you have any of these symptoms, especially if you are at risk for DVT, seek immediate medical attention.

Treatment for DVT

DVT can be treated with medicines and other devices that reduce the chance of blood clots, stop them from getting bigger, and/or prevent them from breaking off and traveling to vital organs of our body.

The most common medicines to treat DVT are anticoagulants, also called blood thinners, that prevent the formation of new blood clots.

Other treatments include filters implanted in a large vein to catch blood clots before they travel into the bloodstream. Graduated compression stockings are also used to reduce leg swelling caused by blood clots.

If you are at risk for DVT or pulmonary embolism, it is important to take preventive measures. Have regular medical checkups, take your prescribed medicine and exercise regularly – especially your lower leg muscles – after surgery and during long trips.

Next steps:

UK begins Pediatric Heart Surgery Program with Cincy Children’s

Last month, UK HealthCare and Cincinnati Children’s Hospital Medical Center completed the first heart surgery as part of a new partnership to provide outstanding pediatric cardiac services for patients in Kentucky and beyond.

The Joint Pediatric Heart Surgery Program is the culmination of three years of work by the two organizations and was announced on Friday. The “one program, two sites” model combines the strengths of UK HealthCare’s advanced subspecialty care with one of the country’s leaders in children’s healthcare, Cincinnati Children’s.

Dr. James Quintessenza, a renowned pediatric cardiothoracic surgeon, was recruited to lead the program. Quintessenza arrived in the Bluegrass last December after having built a reputation as one of the leading cardiothoracic surgeons in the U.S.  He had served at All Children’s Hospital (later named All Children’s Hospital Johns Hopkins) in St. Petersburg, Fla., for 26 years, including 19 years as medical director and chief of pediatric cardiac surgery.

“I’ve found that in Lexington, we have a team of people who are dedicated, caring, experienced and striving to provide the highest-quality care possible for these patients and their families,” said Quintessenza, who is often referred to as “Dr. Q” by patients and staff.

“Pediatric open-heart surgeries, heart catheterizations and electrophysiology procedures are underway at Kentucky Children’s Hospital. The patients and families have been so supportive and thankful for the care we are providing that allows them to receive care closer to their home, their families and their support system.”

Successful surgery

On July 5, Quintessenza performed a complex open-heart surgery on Magdalen Wilson, an infant from Nicholasville, Ky., born with several congenital heart defects.

Magdalen’s surgery was completed at KCH as part of the joint program with Cincinnati Children’s. After Magdalen’s parents, Lauren and Thom Wilson, met with UK pediatric cardiologist Dr. Majd Makhoul and Dr. Q, they felt comfortable and confident in receiving their care at KCH.

“We were impressed that several of Dr. Q’s support staff followed him from his previous location because of his leadership and surgical outcomes,” Thom Wilson said. “At this point, through much prayer and discernment, we decided to pursue Magdalen’s surgery with the joint program at UK.”

With the institution of the “one program, two sites” model, patients from Kentucky now have the opportunity to have surgical procedures, diagnostics and therapeutic interventions performed in Lexington. At all times, recommendations for care are based on what is best for patient safety and quality, allowing families to stay closer to home when appropriate.

“Every member of the joint heart program team – which includes more than 100 physicians, nurses, technicians and other specially trained staff – has one main goal and one agenda, and that is to provide the best care possible to our patients,” said Bo Cofield, UK HealthCare’s chief clinical operations officer. “It was very important for our patients and their families that we do everything we can to provide the highest-quality services and care, and we are confident we have that ability with this program.”

Building a world-class program

UK HealthCare officials voluntarily made the decision to pause pediatric cardiothoracic services in 2012, and a task force was charged with providing recommendations regarding the future of the program. Eventually a Letter of Intent was signed with Cincinnati Children’s in 2015, and an agreement was finalized in September 2016.

While UK HealthCare was working toward the goal of restarting a program to perform complex surgical procedures for pediatric heart patients, it was paramount to be able to deliver the highest-quality services. These standards led to the decision to partner with Cincinnati Children’s, recently ranked third among the nation’s pediatric hospitals by U.S. News and World Report.

Other key components vital in resuming pediatric heart surgeries have been the recruitment and hiring of a world-class team including pediatric cardiac anesthesia, pediatric cardiac critical care, pediatric perfusion, specialized physician assistants and advanced practice nurse practitioners, among others. UK HealthCare has invested in infrastructure enabling success through telehealth and other technologies, specialized equipment and supplies, while staff and faculty have participated in intense on-site training at Cincinnati Children’s.

“Today, this program represents the culmination of three years of work between Cincinnati Children’s and the University of Kentucky to reopen the pediatric cardiac surgical program in Lexington,” said Dr. Andrew Redington, executive co-director of the Heart Institute and chief of the Division of Pediatric Cardiology at Cincinnati Children’s. “By establishing a ‘one program, two sites’ collaboration, we ensure that children will get the right operation, in the right place and at the right time. We are all delighted that the first cases have done well, and anticipate ongoing success in the years to come.”

For the Wilsons, everyone in the family is able to breathe a little easier these days, and Magdalen is enjoying her freedom and health, her mother said. She is being cared for locally by Makhoul since being discharged after her surgery.

“Great love has been shown to Magdalen and our family along this journey,” Lauren Wilson said. “Magdalen’s life is a blessing, and one day she will know about the many hands and hearts at Kentucky Children’s Hospital and beyond that God used to restore her to health. We are truly grateful.”

Next steps:

  • The Joint Pediatric Heart Program provides the full spectrum of high-quality heart care – from assessment and diagnosis to complex surgery and post-surgical care. Learn more about the partnership.
  • Mackenzee Walters was diagnosed with hereditary pancreatitis, a painful condition that had taken the lives of several of her loved ones. Specialists at KCH and Cincinnati Children’s teamed up to help Mackenzee find relief from her painful disease. Read her story.
Adrianne Rogers

Gill gives Lexington woman, 23, new heart and new life

Growing up, Adrianne Rogers was an active athlete, pursuing interests in basketball, football, skateboarding and motocross racing. She was skilled enough to play up on a varsity softball team as a middle-schooler.

But at age 13, she began to experience an inexplicable decline in performance and endurance. She chalked it up to “being out of shape” and tried harder. But her decline persisted. At Rogers’ annual well visit two years later, her pediatrician heard a heart murmur. Rogers was referred to a cardiologist, and after an EKG, and echocardiogram and a heart catheterization, she received a one-in-a-million diagnosis: restrictive cardiomyopathy.

Restrictive cardiomyopathy occurs when the walls of the lower chambers of the heart become rigid, making it harder for them to pump blood out to the body properly. While many cases are mild, some are severe enough to cause heart failure – a sometimes-fatal condition resolved only by a heart transplant. Restrictive cardiomyopathy is usually diagnosed in the elderly. It’s an extremely rare diagnosis in teens.

Rogers was benched from sports of any kind. Diuretics and blood pressure medicine helped control her condition. But by the time she was a senior at UK, she began having episodes of atrial fibrillation. Her atria – the upper chambers of the heart – were struggling to keep a normal rhythm.

Atrial fibrillation, or Afib, is associated with higher risks of stroke and heart failure, so Rogers went to see Dr. Andrew Leventhal, director of the Kentucky Adult Congenital Heart Program at the UK Gill Heart & Vascular Institute. Leventhal is among an elite group of cardiologists with special training to recognize and treat the issues that affect adults with congenital heart defects.

Rogers instantly bonded with Leventhal.

“I just fell in love with him,” Rogers said. “It was clear that he knew a lot about my condition and was committed to keeping a close eye on me.”

In need of a transplant

People like Rogers who are diagnosed with heart defects as children face unique challenges as they become adults, Leventhal says.

“It wasn’t that long ago that children with heart defects didn’t survive to adulthood,” he explained. “Technical advances in cardiac surgery have improved outcomes dramatically, but that presents a new issue: Patients who reach adulthood have outgrown their pediatric cardiologists and the facilities that provide treatment – typically children’s hospitals. Simply transitioning to an adult cardiologist isn’t the best fit either, since their heart problems can be very different from cardiac conditions that begin during adulthood.”

Leventhal followed Rogers carefully as she slipped in and out of Afib three times in a year. Medications and cardioversions (a procedure that attempts to shock the heart into a normal rhythm) weren’t working. Her cardiac index — a measure of how much blood her heart was pumping — was low. Rogers wouldn’t survive long without a heart transplant.

Leventhal made a call to Dr. Maya Guglin of UK HealthCare’s Heart Transplant Program, who immediately began the process to put Rogers on the priority wait list. She received her new heart about a month later, and on Dec. 28, 2016, she left the hospital with a new lease on life.

Rogers describes waking up after surgery to a strange feeling.

“I was laying there and felt something weird and a little uncomfortable on my back,” she says. She then realized that the sensation she was feeling was that of a healthy, beating heart.

“It had been so long since I’d felt a real heartbeat that I didn’t even recognize it at first.”

Grateful for a second chance

Rogers follows up regularly at the Gill under the care of Dr. Navin Rajagopalan, medical director of heart transplantation.

“Adrianne is taking great care of the gift she has been given,” Rajagopalan said. “I always have a moment of gratification when the surgery is completed and the patient is doing well, but it’s especially rewarding when we can help a younger person recover and live a normal, healthy life.”

She now visits the gym regularly for strength training and has used her recovery time to take up skateboarding, painting and guitar. She returns to UK in the fall and will graduate in December.

“It’s crazy how good I feel,” Rogers said. “I really haven’t felt well since I was 11 or 12, so this all feels amazing.”

At each follow-up appointment she makes a point to see every member of her care team, all of whom made her feel like she was their only patient, she says.

“They were so accessible and helpful; I felt super-comfortable during my time in the hospital waiting for a new heart,” she says. She even painted gifts for Donna Dennis and Heather Ross, who were responsible for coordinating her care pre- and post-transplant.

Paying it forward

While Rogers was hospitalized and waiting for her new heart, she was visited by a young man who’d recently had a heart transplant of his own.

“He really calmed my nerves and made me realize this was doable,” she says.

So, when Dennis asked Rogers if she would talk to another transplant candidate, she was more than willing to pay it forward.

“I can give them an experience to relate to, and they see that a transplant isn’t so scary,” she said.

Leventhal wants young people diagnosed with heart defects to understand the importance of regular follow-up care with a cardiologist trained to work with these unique conditions.

“Even if you’ve been told you’re cured, even if you’re feeling good, you need to have a relationship with a cardiologist who specializes in treating adult patients with congenital heart defects,” he said. “Adrianne’s story is the perfect example of someone who was careful about managing her defect but still became critically ill. Thankfully, she was wise to keep up with her care and seek help when she didn’t feel well. That was a huge factor in this success story.”

Check out the video below to see Adrianne talk about life after her heart transplant.

Next steps:

DASH diet

The DASH diet is easy to follow and good for your health

Do you want to eat better, but don’t know where to start? Consider the Dietary Approaches to Stop Hypertension, or DASH diet.

The DASH diet was initially created to help lower blood pressure. But studies have also found the DASH diet to be one of the best options to prevent heart disease, stroke, diabetes and even some forms of cancer. Research also shows the DASH plan is safe and effective for short-term and permanent weight loss.

The best news is the DASH diet is easy to follow because it does not restrict entire food groups. Because the plan focuses on fresh fruits and veggies, controlling your calories is easier, too. Learn more about the DASH diet below.

What is the DASH diet?

The DASH plan is promoted by the National Heart, Lung and Blood Institute, part of the National Institutes of Health. The plan helps reduce the risk for serious health problems because it is low in:

  • Saturated fat
  • Cholesterol
  • Total fat
  • Red meat
  • Sweets
  • Sugary beverages

The DASH diet encourages:

  • Fruits
  • Vegetables
  • Fat-free or low-fat milk and dairy products
  • Whole-grain foods
  • Fish
  • Poultry
  • Nuts

The DASH diet is also rich in important nutrients such as:

  • Potassium
  • Magnesium
  • Calcium
  • Protein
  • Fiber

Tips for following the DASH diet

To reduce the amount of sodium in your diet, try these steps:

  • Choose fresh, frozen or canned vegetables that have low sodium or no added salt.
  • Use fresh poultry, fish or meat instead of canned, smoked or processed options.
  • Limit cured foods such as bacon and ham, foods packed in brine, and condiments.
  • Cook rice or pasta without salt.
  • Cut back on frozen dinners, packaged mixes, and canned soups or broths.
  • Rinse canned foods such as tuna and canned beans to remove some of the salt.
  • Use spices instead of salt to flavor foods.
  • Add fruit to breakfast or have it as a snack.
  • Treat meat as one part of the whole meal, instead of the main focus.

Some days you might eat more sodium or fewer foods from one group than the plan suggests. But don’t worry. Try your best to keep the average on most days close to the DASH plan levels.

Following the DASH diet

Here’s how much of each food group you should eat every day, based on eating 2,000 calories per day.

6-8 servings of whole grains. A serving size is about one slice of bread, 1 ounce of dry cereal or 1/2 cup of cooked rice or pasta.

4-5 servings of vegetables. A serving size is about 1 cup of raw, leafy vegetable or a 1/2 cup of cut-up raw or cooked vegetables.

4-5 servings of fruits. A serving size is about one medium fruit; 1/4 cup of dried fruit; 1/2 cup of fresh, frozen or canned fruit; or 1/2 cup of real fruit juice.

2-3 servings of fat-free or low-fat dairy. A serving size is about 1 cup of milk or yogurt or 1 1/2 ounces of cheese.

Up to 6 servings of lean meat, poultry, fish. A serving size is about 1 ounce of cooked meat, poultry, or fish, or one egg.

4-5 servings per week of nuts, seeds, legumes: A serving size is about 1/3 cup or 1 1/2 ounces of nuts, 2 tablespoons of peanut butter, 2 tablespoons or 1/2 ounce of seeds, 1/2 cup of cooked, dry beans or peas.

2-3 servings of fats and oils: A serving size is about 1 teaspoon of soft margarine, 1 teaspoon of vegetable oil, 1 tablespoon of  mayonnaise or 2 tablespoons of salad dressing.

Up to 5 servings per week of sweets: A serving size is about 1 tablespoon of sugar, 1 tablespoon of jelly or jam, 1/2 cup of sorbet or gelatin or 1 cup of lemonade.

Next steps:

men's health month

Men, now’s the time to fine-tune your health

June is Men’s Health Month, which means it’s the perfect time to take a look at what men of all ages can do to live a heathier lifestyle.

From keeping your heart healthy to being proactive about cancer screenings, here’s what you can do to be the healthiest version of yourself:

  • Know your family’s medical history. Knowing your family’s health story can give you insight into what preventive actions you can take in order to stay healthy. Genetics can play a role in your risk for heart disease, Alzheimer’s, some cancers and osteoporosis. Check out a blog by UK Gill Heart & Vascular Institute’s Dr. Gretchen Wells for more about the benefits of knowing your family’s health history.
  • Be proactive about cancer screening. Regular cancer screenings can help catch early signs of the disease and find treatment options. The American Cancer Society recommends most men get regular screenings for prostate, lung and colon cancers at age 50. If you have a family history of cancer, talk with your healthcare provider about when you should start regular screenings.
  • Exercise regularly. Staying active will help to maintain a healthy weight, and it can also help reduce high blood pressure, high blood sugar and cholesterol. Aim for 30 minutes of moderate activity five times a week. Something as simple as a brisk walk or bike ride with a friend will work wonders for your overall health. Don’t know where to start? Check out our five-step guide to beginning a new exercise routine.
  • Stop smoking. Toxins in cigarettes can damage your lungs and can lead to lung cancer. Your heart takes a beating, too. If you do smoke, now’s the time to quit. Check out our guide for finally kicking your smoking addiction.
  • Talk to someone. Depression affects more than 6 million men in the U.S. Men are less likely to talk about how they are feeling, but it is important to know warning signs of depression and ways to find help and treatment. Learn more about the symptoms of depression and what you can do if you or a loved one needs help.
  • Don’t put off regular healthcare visits. You may feel perfectly healthy and not see the need to go to the doctor, but it is important to make sure you see a healthcare provider regularly. Some medical issues, like high blood sugar and high cholesterol, may not have any early symptoms, but a physician can provide diagnosis and treatment.
  • Stay social. If you’re having trouble sticking to a health regimen or just want some help in staying healthy, ask your friends and family join in on your new journey to a healthier life. You’re more likely to stick to your healthy lifestyle if you have support and others that can hold you accountable for your actions.

Although June is Men’s Health Month, it is important to remember that your health matters all year long. By making these simple lifestyle changes, you can have a lasting, positive impact on your health.

Next steps:

smoking heart

When you use tobacco, your heart takes a beating

We’ve all heard the statistics – smoking and tobacco use greatly increase your risk of heart disease. But what, exactly, does tobacco do to your heart?

How tobacco hurts your heart

  • Nicotine, the addictive component in tobacco, speeds up the pulse rate and raises blood pressure making the heart work harder.
  • Smoking decreases HDL (good) cholesterol, increases triglyceride levels and damages the lining in blood vessels.
  • Tobacco smoke contains high levels of carbon monoxide, depriving the heart and other vital organs of the oxygen it needs.
  • Smokeless tobacco is not a safe alternative to cigarettes because it increases the risk of high blood pressure leading to heart disease and stroke.
  • Exposure to secondhand smoke also has a negative effect on cardiovascular health. Nonsmokers’ bodies tend to react more dramatically to tobacco exposure than do smokers’ bodies.

Why quitting is worth it

Quitting has benefits you’ll start to notice right away. For example:

  • Within 24 hours after your last cigarette or tobacco use, blood pressure and pulse rate drop to normal and heart attack risk starts to drop.
  • Within a few days or weeks, exercise endurance and heart functioning improve, and HDL (good) cholesterol increases.
  • Within a year, the risk for most cardiovascular diseases will be cut in half.

Quitting is tough

We know that quitting is easier said than done, and many ex-smokers try three or more times to quit before they succeed. The good news is there are plenty of resources out there to help you quit. Ask your doctor to suggest the best quitting aid for you and check out our tips for finally conquering your smoking addiction.

Next steps:

UK's collaborative nature has allowed the ECMO (Extracorporeal Membrane Oxygenation) program, which provides emergency support to patients, to thrive.

UK leads the way in life-saving ECMO transport

Technology plays an enormous role in advancing the quality and effectiveness of medical treatment. New technology tends to arrive first in larger, academic medical centers and subsequently spreads into the smaller city and community hospitals. As the technology continues its march to the far corners of the world, many academic hospitals consider it a moral responsibility to support the smaller hospitals, much like a big sister teaches her little sister how to ride a bike.

ECMO is a fitting example of this process. Extracorporeal membrane oxygenation (ECMO) technology provides emergency mechanical support for desperately ill patients by mimicking the natural function of the heart and lungs. This allows the patient to rest and heal from a variety of severe cardiac and respiratory illnesses, such as flu, pneumonia, cardiomyopathy or heart attack. External pumps and oxygenators remove carbon dioxide from the blood, replace it with life-saving oxygen and then return it to the patient’s circulatory system. The patient’s heart continues to beat, but stress on the heart and lungs is diminished because the ECMO machine does much of the pumping. While ECMO doesn’t fix the underlying problem, it supports the patient hemodynamically until they can get treatment or heal on their own.

A patient on ECMO is supported around the clock by a large, highly coordinated team, including specialized nursing care, nurse practitioners, physicians and perfusionists, as well as respiratory, physical and occupational therapists. It’s an expensive process, and hospitals with smaller patient volumes often cannot support its cost.

As the technology has been adopted by more hospitals around Kentucky, they have turned to UK HealthCare for support. UK HealthCare has been using ECMO to treat its patients since 1993, and today it offers an innovative, coordinated program to assist surrounding hospitals.

Getting the program off the ground

In some cases, a hospital already has ECMO technology but doesn’t have the infrastructure to support patients long-term. In other cases, a patient needs ECMO, but the hospital doesn’t have the technology. In both cases, a place like UK is well-suited to assist.

Michael Sekela, MD, now surgical director of the UK Gill Heart & Vascular Institute, first conceived the idea of ECMO transport in the early 1990s. But at that time, ECMO technology had not yet matured. “It took a long time to get the ECMO technology reliably to that level,” he said, “and it is best undertaken by a hospital with high treatment volumes and a relatively large catchment area.”

2016 data from Vizient (a think tank of hospitals around the country that embrace information sharing for performance improvement) ranks UK HealthCare No. 10 in adult ECMO patient volume, treating more patients than centers with loftier reputations, such as Cleveland Clinic, Mayo Clinic and Johns Hopkins.

As Sekela’s email inbox filled with requests for help, he recognized the need for a more formal model to support smaller hospitals and the patients they serve. “There is a large unserved need, as many institutions do not have the infrastructure in place to embrace this service,” he said. “We have the skills and the resources, and we already serve large swaths of regional and rural hospitals in and adjacent to Kentucky.”

But building such a program from the ground up would be no easy feat.

Positive reactions

For more than a year, a team at UK HealthCare worked on a blueprint for transferring ECMO patients safely to UK. The team included Sekela, Dr. Jay Zwischenberger (chairman of the Department of Surgery), Dr. Paul Tessmann, Dr. Anil Gopinath, Dr. Walt Lubbers and Patti Howard from Emergency Medicine, as well as EMS Manager Matt Ward, Mechanical Circulatory Support (MCS) Manager Julia Akhtarekhavari, MCS Coordinator Thomas Tribble and Chief Perfusionist Chuck McClendon. The plan had to support multiple scenarios (hospitals that offered ECMO but could not support a patient long-term, and hospitals that did not offer ECMO but had a patient who needed it). Any patient transport needed the space and equipment to accommodate a highly skilled team of EMTs, paramedics, critical care nurses trained in ECMO, and perfusionists. If the patient was at a hospital without an ECMO service, a surgeon was added to the transport to connect the patient to the ECMO equipment before they were transported to UK.

UK is the only center in Kentucky offering adult ECMO transport – in fact, you’d have to travel more than three hours in any direction – as far east as Charlottesville, as far north as Indianapolis, as far west as Nashville – to find another center with the same service.

Initial response to the fledgling program has been extremely positive. Wayne Lipson, MD, a cardiothoracic surgeon at Baptist Health in Madisonville, Ky., says the service helped save one of his desperately ill patients earlier this year. He describes the transfer process – from the phone call to patient transport – as seamless. “Mike [Sekela] showed up with his team at 2 a.m., less than five hours after we made the call,” he said. “Transporting a patient like this is a very difficult process, and it’s a testament to UK HealthCare that their system is so responsive.”

“Having this service available enables our team to treat more complex patients closer to home. We are armed with the knowledge that the UK HealthCare team will support us when we need it,” Lipson said

Sekela credits the team’s methodical approach to transport issues and meticulous planning and training for the service’s fantastic early success.

“This program exemplifies the collaborative culture at UK,” Sekela said. “Many months of planning and training with Emergency Medicine, Cardiovascular Surgery, Nursing and Perfusion were significant factors in the program’s success.”

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Next steps:


6 ways to prevent a stroke

When it comes to preventing a stroke, simple lifestyle changes can make all the difference.

Strokes occur when blood vessels that carry oxygen and nutrients to the brain burst or are blocked by a clot. When that happens, brain cells begin to die, affecting a person’s memory and ability to control muscles.

Stroke is the fifth-leading cause of death in the U.S. and in Kentucky, but there’s good news: Nearly 80 percent of all strokes are preventable.

In celebration of American Stroke Month, we’ve put together a list of things you can do to live a healthier lifestyle and better your chances of avoiding a stroke.

1. Get moving.

Regular physical activity will help lower your cholesterol and blood pressure, two of the biggest risk factors for stroke. Aim for 30 minutes of moderate activity five times a week. Something as simple as a brisk walk or bike ride with a friend will work wonders for your overall health.

2. Stop smoking.

Smokers are twice as likely to experience a stroke as nonsmokers. That’s because smoking thickens blood and increases the likelihood of clots. If you’re struggling to quit smoking, ask your doctor for help. And check out our blog with tips and resources that can help you or someone you know start on the path toward success.

3. Eat your vegetables.

And beans, whole grains and nuts, too – all of which are staples of a healthy diet. Improving your diet will help lower your cholesterol and blood pressure and help you maintain a healthy weight. Check out our guide for kick-starting a healthy diet.

4. Drink less.

Alcohol can increase blood pressure and the risk of stroke. Moderation is the key: For men, no more than two drinks a day, and for women, no more than one.

5. Learn about Afib.

Atrial fibrillation, also known as Afib, is a type of irregular heartbeat. If left untreated, Afib can cause blood clots in the heart that can move to the brain and cause a stroke. Talk to your doctor about Afib if you experience symptoms such as heart palpitations or shortness of breath. Learn more about the UK Gill Heart & Vascular Institute’s Heart Rhythm Program and listen to a podcast with our Afib specialist, Dr. Ted Wright.

6. Understand the things you can’t control.

Although improving your diet, ramping up your activity and living a healthy lifestyle can all decrease your risk for stroke, there are some risk factors you cannot control. Things like age, gender and race all play a role in stroke risk, and even though you can’t change those factors, it’s important to understand if you’re more susceptible.

Click the icon below to see our Stroke Quick Facts inforgraphic.

Stroke quick facts infographic from UK HealthCare

Next steps:

  • At the UK Comprehensive Stroke Center, we offer treatment, prevention and rehabilitation services for stroke patients. Learn more about our program.
  • Dr. Gretchen Wells, director of UK’s Women’s Heart Health Program, writes about why knowing your family health history can help you understand your own risk of disease. Read her blog.


Congenital heart defects

48 years later, UK heart patient continues to thrive

Sonja Embry

Childhood photo of Sonja Embry

Sonja Embry was born with a congenital heart defect called tetralogy of Fallot. It’s a condition known as “Blue Baby Syndrome,” because valve defects and holes in the heart cause oxygen-poor blood to pump into the body, giving kids and infants with the condition blue-tinged skin.

Embry’s condition prevented her from having a normal childhood. She was often so tired that neighbors carried her to her one-room school every day.

At the time of Embry’s birth, most children with the condition did not survive to adulthood because no surgical procedure existed to repair the defects.

But Sonja did survive, and in 1969 at the age of 24, she underwent a new surgical procedure at the University of Kentucky to repair her heart defects. She went on to secretarial school and enjoyed a long career with the Department of the Navy in Washington D.C. and Memphis. At 71, she leads an active life and still drives to and from her home in Memphis to Western Kentucky to visit family and friends.

She is believed to be one of the oldest living patients with this defect.

Four decades of comprehensive treatment for heart defects

Now, nearly 50 years after Embry’s surgery, the UK Gill Heart & Vascular Institute is a leader in providing comprehensive, personalized care for adults born with congenital heart defects.

Adults born with heart defects face unique challenges. They outgrow their pediatric cardiologists, but their heart problems can be very different from cardiac conditions that begin during adulthood.

The Kentucky Adult Congenital Heart Program (KACH) at Gill is led by Dr. Andrew Leventhal and is the only such program in Central and Eastern Kentucky.

Unlike when Sonja needed treatment and follow-up care, adult patients with congenital heart defects can now turn to the KACH Program for lifelong care of their conditions.

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