February is American Heart Month, an opportunity to raise awareness about the health impacts of heart disease and to spotlight the innovative ways that Mass General researchers are working to tackle these challenges.
Cardiac surgery has helped many patients nationwide to help prevent or treat heart malfunction or other issues. Over 900,000 cardiac surgery procedures are performed each year in the United States.
Asishana Osho, MD, MPH, and the team at the Mass General Heart Center work year-round to treat cardiac patients in all sorts of conditions with their needs, adding to the high number of annual cardiac procedures performed in the United States.
See his answers below when we asked him about his excitement and passion for cardiac surgery.
What Interests You About the Heart?
I think that the heart is a very complex organ. For physicians, the opportunity to understand the heart and how it interacts with the various drugs, and the complexities of the anatomy and rhythm makes it a fascinating space to be involved in.
In cardiac surgery, I get the opportunity to really help people when they are in extremis, or near the point of death, and that is a privilege that I truly enjoy. Between the organ itself and the people I work with, I could not think of doing anything else.
Is the Area of Heart Transplantation at MGH Innovating? What Does MGH Excel In?
It is 100% innovative. We are leading the way in a few areas, and one is the ex vivo perfusion of hearts. Clinically, we have led a national trial that essentially used this method to bring previously inaccessible types of heart transplantation to the mainstream.
What Does Ex Vivo Mean?
Traditionally, you have to take a heart out and put it on ice, and then you have about four hours to put it into the transplant patient. After that, we innovated by using a device called the SherpaPak, which controls the temperature within four to eight degrees, which is better than ice, and extended the time frame for transplantation.
We have since taken that further to ex vivo perfusion, which does not just store the organ but perfuses it with the donor’s blood. From there, you can assess the heart, optimize it, and make critical decisions about using it. You can also travel further and use hearts that were not previously usable. So, the spectrum of possibilities is incredibly wide now.
The one other place that we’re also leaders is in xenotransplantation or the transplantation of organs and tissues between species. A lot of the work that Joren Madsen, MD, DPhil, and Robin Pierson, MD, have pioneered will also, I am sure, move xenotransplantation to the forefront of modern medicine very quickly. We are really poised to push the field forward as well.
What Are Your Current Major Projects?
We have been actively involved in outcomes around new policy changes in heart and lung transplantation and expect to remain in that space. Outside of transplants, some of my interests are in clinical trials, and we currently have two running in the atrial fibrillation space that are MGH-based.
We are also part of the Cardiothoracic Trials network and doing a few other clinical trials with collaborators throughout the country. Atrial fibrillation, or irregular heartbeats, is an interesting topic right now, so several of our trials are related to that, and we are building a research program around atrial fibrillation at this time.
How Would You Describe the Team at the Heart Center?
I think, right now, excited is probably the best word for it. People recognize that we are doing groundbreaking work; we are on the cusp of moving the field forward in many different directions. I think our trainees, our research residents, our clinical research coordinators, all the surgeons I work with, and the cardiologists in the heart center, everyone is truly excited to keep moving the field forward.
Our team is very collaborative. Whenever I have needed help, whether it is with statistics or understanding a part of the project that isn’t my specialty, I have always been able to get assistance from a coworker. So, I would say excitement and collaboration are the two words I would use in describing our research program right now.
What Are the Next Steps in Your Work?
We have got several trials going that I am hoping we’ll be able to complete in the next few years. One of our goals is to be a leader in designing some multi-center randomized controlled trials, and we are in the process of finding the funding and getting support for things like that, so that’s going to be a big priority.
Our ex vivo program is relatively nascent, and we are hoping to build our capacity to expand. Right now, it is a lot of assessment, things like protection and prolonging the duration of how long you can perfuse a heart outside the body. But, we hope to expand this to do therapies on the ex vivo platform, which I think is truly exciting stuff.
I am also interested in taking further steps in global surgery to increase access and resources in countries that have been affected predominantly by infectious diseases, as chronic heart conditions become an emerging public health priority. I grew up and lived in Nigeria until I came to college. I am passionate about doing some work there, so I have started going back on trips and focusing on education and research in that setting. I ultimately hope to improve the care in that part of the world in addition to the United States.
What Do You Do in Your Free Time Outside of Work/Research?
I grew up playing and watching soccer; it is one of my best or most fun pastimes. I recently ruptured my Achilles tendon while playing soccer, so I was out for a while, but I am going to get back into it soon.
I also enjoy reading. Fiction and autobiographies are two of my favorite areas. I recently read a biography of Winston Churchill, which is very interesting. He’s a very complex character, but I do say it provides a lot of interesting anecdotes about why the world is the way it is right now and how the thoughts and convictions of a single man had such important effects on many things that we do.
About the Mass General Research Institute
Massachusetts General Hospital is home to the largest hospital-based research program in the United States. Our researchers work side-by-side with physicians to develop innovative new ways to diagnose, treat and prevent disease.
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