Thoracic Surgery Residency Program
George J. Magovern Jr., M.D., Program Director
Robert J. Keenan, M.D., Program Co-Director
Stephen Bailey, M.D., Program Co Director
Under the direction of George J. Magovern, Jr., MD, the Allegheny thoracic surgery residency program comprises 2 years of clinical training. Pediatric cardiac surgery training is provided by the Children's Hospital of Pittsburgh under the direction of Dr. Victor Morell.
The Allegheny thoracic surgery residency program is noted for the collegial teaching environment engendered by the faculty. The program is coordinated by George Magovern, Jr. MD with the assistance of Robert Keenan, MD and Stephen Bailey, MD. The faculty currently includes 8 board-certified cardiothoracic surgeons;residents are rotated among all of the cardiothoracic faculty to provide a broad range of experience and teaching styles. The faculty and staff of the program are committed to offering a high quality educational environment and receive strong support in this effort from the Allegheny General leadership. Amenities for the residents include a shared office for the two junior residents and a private office for each senior resident. Each resident is provided with a computer and standard office software. Two weeks of vacation and attendance at one national conference are provided annually, with an additional week off during the December holidays. Clinical services are supported by a staff of physician assistants and nurse practitioners.
Senior residents serve as the first line of supervision for the cardiothoracic services, functioning as "junior attending surgeons" under the guidance of the faculty. Senior residents take no in-house call. In-house call is provided by the junior cardiothoracic residents and by general surgery residents rotating on the cardiothoracic services. In addition, Allegheny cardiology residents with credentials in ICU care cover in-house call for two nights each week.
Since the early 1950's Allegheny General has sponsored highly regarded ACGME accredited training opportunities in cardiothoracic surgery. The program offers a rich case mix of adult cardiac and general thoracic patients drawn from a network of affiliated clinical sites serving Pennsylvania, Ohio and West Virginia. Residents may elect to concentrate in either cardiac surgery or general thoracic surgery but must meet all requirements for ABTS certification in cardiothoracic surgery.
Academic achievement is fostered by an active clinical and laboratory research program. Supported by fully equipped and staffed research laboratories and ORs, studies are completed under the supervision of Cardiothoracic Surgery Research Director David A. Dean, MD and/or Dr. Keenan. The Allegheny thoracic surgery residency program is well known for the collegial and supportive teaching environment engendered by the faculty. Amenities for residents include computer equipped offices. Academic support is provided by department personnel skilled in data management, statistical analysis and technical writing. The department maintains comprehensive databases focused on in-patient quality assurance/outcomes analysis, including risk stratification modeling. Residents can access this data for patient review and research; the data is also used to support completion of resident operative experience logs for preparation of ABTS certification applications. Clinical services are supported by physician assistants, nurse practitioners and dedicated clinical trial managers.
The Department of Thoracic and Cardiovascular Surgery comprises Divisions dedicated to Cardiac Surgery, General Thoracic Surgery and Vascular Surgery.
Allegheny General Hospital
Allegheny General Hospital, part of the West Penn Allegheny Health System was founded in 1885 on Pittsburgh's historic North Side. Allegheny General Hospital has earned an international reputation for excellence and innovation in the care of patients, medical education and research. Serving Pittsburgh and the surrounding five-state area, the 829-bed academic health center offers a wide array of medical and surgical services.
Over the past eight years, Allegheny General has been recognized by U.S. News & World Report magazine as one of "America's Best Hospitals" for a number of clinical specialties, including cancer treatment, orthopaedic surgery, digestive diseases, neurology, neurosurgery, hormonal disorders, urology, rheumatology and geriatric medicine. The hospital has also been lauded as one of America's top 25 medical centers by the AARP's Modern Maturity magazine, which also identified Allegheny General as the nation's top hospital for the treatment of renal diseases and the second-leading center for the treatment of heart disease.
Division of Cardiac Surgery
Stephen Bailey, M.D., Director
The Division has expertise in all types of adult cardiac surgery, including coronary artery bypass and cardiac valve repair and replacement, performing between 500 – 600 cases per year. The Division is the region's most experienced center for surgical treatment of acute and chronic thoracic aortic disease and thoracic aortic trauma. Minimally invasive endovascular aortic repair is offered by a unique multidisciplinary team comprising cardiac surgeons, vascular surgeons and interventional radiologists. The cardiac arrhythmia service provides standard and minimally invasive approaches to the treatment of atrial fibrillation, including the state-of-the-art “mini-maze” procedure. As leading partners in the Allegheny General Heart Failure Service, Division surgeons perform heart transplantation and direct the mechanical heart assist program. Innovative surgical therapies for heart failure, including left ventricular reduction surgery are also offered.
Division of General Thoracic Surgery
Robert J. Keenan, M.D., Director
In western Pennsylvania, non-cardiac thoracic disease is a particularly prominent health-care problem. The Division of General Thoracic Surgery, through the Allegheny Center for Lung and Thoracic Disease, provides comprehensive and innovative diagnosis, treatment and surgery specifically directed to benign and malignant diseases of the lungs, esophagus and mediastinum. Seasoned clinicians using the latest techniques and technologies offer the best possible care and convenience for patients and families confronting cancer. Access to a full range of ACOSOG protocols and other innovative clinical trials is provided in collaboration with the Allegheny Cancer Center. General thoracic surgery specialists now perform over 800 major procedures each year, more than half employing minimally invasive techniques. In addition to curative and palliative procedures for thoracic malignancies, the Division has long-term expertise in thoracic surgery for benign conditions including gastroesophageal reflux, hyperhidrosis and thymectomy for myasthenia gravis. Lung transplantation and lung volume reduction services will be formally initiated in the summer of 2008.
Division of Vascular Surgery
Satish C. Muluk, M.D., Director
The Division of Vascular Surgery at Allegheny General performs more than 1200 major surgical procedures each year for all types of peripheral vascular diseases including abdominal aortic aneurysm, carotid stenosis, peripheral arterial disease and venous disorders. The Division is a regional leader in the use of endovascular techniques for aortic aneurysm, carotid stenosis and lower extremity arterial disease. The Division also specializes in the treatment of venous disorders and has expertise in radiofrequency ablation for varicose veins. An ACGME accredited vascular surgery fellowship for graduates of general surgery programs is offered. Staffed by four board certified vascular surgeons, the Division is an invaluable resource for thoracic surgery residents. The Division is not a formal participant in thoracic surgery training, however, residents are encouraged to use the service to gain exposure to this important allied field.
Children’s Hospital
Children’s Hospital of Pittsburgh is renowned for cardiology, cardiothoracic surgery, critical care medicine, diabetes, hematology/oncology, neurosurgery, organ and tissue transplantation, orthopaedics, otolaryngology (ENT) and pediatric surgery. Children’s Hospital is also the only accredited Level 1 Regional Resource Pediatric Trauma Center in western Pennsylvania and one of only three in the state.
The McGinnis Cardiovascular Institute at Allegheny General Hospital
The market for cardiovascular services is changing and Allegheny General is responding.
In September 2006 Allegheny General Hospital and the Department of Thoracic and Cardiovascular Surgery officially dedicated the The Gerald R. Mcginnis Cardiovascular Institute at Allegheny General Hospital. Located on the grounds of the hospital, the "CVI" comprises 15,000 square feet of space dedicated to outpatient consultation and diagnostic services in a multi-disciplinary clinic dedicated to research, diagnosis and treatment for cardiovascular disease. This critically important initiative was been endowed by a federal seed grant and the generosity of regional business leaders. The CVI is designed to operate as a unifying structure for delivery of exceptional patient-centered care and state-of-the-art clinical research. Initial CVI centers focus on:
• Valvular heart disease
• Heart failure
• Pulmonary Hypertension
• Management of atrial fibrillation
• Vascular disease
• Chronic Wound Management
• Thoracic disease
The CVI is currently serving as an outstanding venue for recruiting some of the nation's finest physicians and researchers to join the legacy of the highly regarded and experienced Allegheny team. The Institute is headed by surgical director George Magovern, Jr., MD and medical director Srinavas Murali, MD. An annual CVI symposium features nationally recognized clinicians and researchers presenting topics related to medical and surgical approaches to cardiothoracic disease. The CVI also sponsors lectures featuring prominent speakers from outside the medical community, including author David McCullough, journalist Tim Russert and former governor Tom Vilsack.
Cardiothoracic Surgery Information Systems
The residency program is complemented by coordinated cardiothoracic surgery and general thoracic surgery databases. These databases provide the information and analyses necessary to support the clinical research and administrative functions of the Department of Cardiothoracic Surgery.
Central to these services are comprehensive, clinical databases. The databases detail surgical procedures, pre- and post-operative morbidity, and outcome data for patients undergoing cardiovascular and thoracic surgery at Allegheny General Hospital. The databases also provide a record of staff and resident activities in the operating room and, more important, are the primary source for the timely review of morbidity and mortality. These reports are prepared by the designated residents, working in concert with the cardiothoracic surgery registry staff.
Residents are encouraged to use these databases for clinical reviews and investigations. David Dean, M.D., Director of Cardiac Surgery Research advises residents on all aspects ofproject development, analysis and manuscript preparation.
Research
Cardiothoracic
David A. Dean, M.D., Director
Allegheny General gained national recognition for innovation in cardiac care during the 1960's - the era in which the basic techniques for diagnosis and surgical treatment for cardiac disease were invented and refined. Today, the Division of Cardiac Surgery continues to aggressively address today’s unique patient care and practice management challenges. Working with the Cardiovascular Institute at Allegheny General Hospital, emphasis is placed on applied research with potential for rapid implementation.
Heart Failure is the focus for most of the research efforts. Supported by fully equipped and staffed research laboratories and operating suites, studies are completed under the supervision of Research Director James Magovern, MD. The technology for the TandemHeartâ PTVA System (Cardiac Assist, Pittsburgh, PA) was developed in the Allegheny Cardiac Surgery Bioengineering Laboratory. The Laboratory is now completing tests on a groundbreaking NIH-RO1 sponsored device that transforms skeletal muscle energy into power sufficient to drive a standard ventricular assist device. Allegheny researchers have collaborated with venture businesses in the design and testing of a novel method for left ventricular restraint, coronary anastomotic devices and an artificial tendon. The Division of Cardiac Surgery participates in carefully chosen clinical trials and was a site for the recent REMATCH trial which established the efficacy of long-term ventricular assist. Allegheny cardiac surgeons are currently participating in the STICH trial which will compare medical versus surgical therapy for ischemic heart failure.
Specific clinical research projects developed within the department are also undertaken regularly. Internal funds are readily available to support resident projects on clinical or experimental surgery topics.
Dr. David Dean works with each thoracic surgery resident to provide research experiences tailored to the resident’s background and interests. The goal is to allow each resident to produce at least one publication and presentation during their tenure at Allegheny General.
Thoracic
Robert J Keenan, M.D., Director
ACOSOG
The American College of Surgeons Oncology Group (ACOSOG) was established primarily to evaluate the surgical management of patients with malignant solid tumors. The ACOSOG includes general and specialty surgeons, representatives of related oncologic disciplines and allied health professionals in academic medical centers and community practices throughout the United States of America and foreign counties. The ACOSOG is one of ten cooperative groups funded by the National Cancer Institute (NCI) to develop and coordinate multi-institutional clinical trials and is the only cooperative group whose primary focus is the surgical management of patients with malignant solid tumors. The Cooperative Group Program was established in 1955 with an initial Congressional appropriation of $5 million. Continued growth has led to a progressive increase in funding, with an NCI appropriation of $154 million for the Cooperative Group Program in 2001.
NCCTG
The North Central Cancer Treatment Group (NCCTG) was founded in 1977 by pioneering physicians from the north central region of the United States and the Mayo Clinic in Rochester, Minn. These physicians saw a need to bring high-quality cancer care and research to the communities where patients live and receive most of their medical care. To achieve this goal, they formed a cancer clinical trials cooperative group. This cooperative group allows promising scientific ideas developed at Mayo Clinic to be tested in many communities throughout the NCCTG network, allowing broad access to the latest therapies. Today, NCCTG has grown to include more than 1,000 cancer specialists at community clinics and medical centers in 25 states, two Canadian provinces and Mexico, with a research base at Mayo Clinic in Rochester, Minn. In its first 25 years (1977 - 2002) NCCTG enrolled 57,750 patients in 430 trials. NCCTG receives much of its scientific and financial support through the National Cancer Institute.
RTOG
The Radiation Therapy Oncology Group (RTOG) is a multi-institutional cooperative organization, of which the principal objectives include: A national cancer study research group funded by NCI headquartered in Philadelphia with almost 30 years of experience in running clinical trials; Comprised of 250 of the major research institutions nationally and in Canada; Currently have 40+ active studies that involve radiation therapy either alone or in conjunction with surgery and/or chemotherapeutic drugs; Interested in quality of life issues and their effects on the cancer patient.
