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The A-Teams for Advanced Heart Failure

Two RWJBarnabas Health Heart Transplant Programs Collaborate to Offer World-Class Care, Close to Home for New Jersey Residents.

In 1989, cardiologist Mark Jay Zucker, MD, relocated from Chicago to join nationally renowned cardiovascular surgeon Victor Parsonnet, MD, at Newark Beth Israel Medical Center (NBI). Both physicians saw an opportunity to build a world-class heart failure treatment and transplant program at NBI.

Toward that end, Dr. Zucker and other members of the NBI team met with cardiologists around the state, gave talks and lectures, and sent out educational mailings to introduce the medical community to the new program.

Over the course of 30 years, the goal of creating a nationally renowned heart failure and transplant center has been met, perhaps beyond the team’s wildest dreams—and certainly beyond those of many patients. By 2017, the Advanced Heart Failure Treatment and Transplant Program at NBI had performed more than 1,000 transplants, one of only a dozen programs in the U.S. to reach that milestone. Today the program performs about 50 to 55 transplants each year; has roughly 70 staff members, seven physicians, three surgeons and a full complement of nurses and nurse practitioners; and follows more than 4,000 patients at five different offices.

Covering the State

The NBI program and the Advanced Heart Failure and Heart Transplant Program at Robert Wood Johnson University Hospital in New Brunswick (RWJUH) are the only two heart transplant programs in New Jersey.

“We are one of the major referral centers for heart conditions in the state, particularly in central New Jersey,” says Aziz Ghaly, MD, Surgical Director, Advanced Heart Failure and Heart Transplant Program at RWJBH. “We offer the most advanced options for treatment of heart failure available. That means we can do complete workups for patients under one roof.”

As collegial members of the same health system, the two programs provide seamless treatment to any patient in need of complex cardiac care, not only from the hospitals of the RWJBarnabas Health system but from any hospital inside New Jersey or beyond. For New Jersey residents, that means advanced cardiac care is always available close to home.

The connection between the two teams further enhances patient care. “Leadership of both programs meet regularly to discuss how to coordinate care, improve safety, streamline services and sometimes just to learn from one another as well,” says Dr. Ghaly.

Multidisciplinary Approach

At NBI, Dr. Zucker, Director of the Cardiothoracic Transplantation Program, and Margarita Camacho, MD, Surgical Director of Heart Transplantation, are two of the most senior physicians in the field, with a combined experience of caring for more than 1,500 transplant patients. Both physicians are at the forefront of advanced heart failure treatments, and both have been at NBI for the majority of their careers. “That translates to consistency,” says Dr. Zucker. “We have danced together for a long time.” The RWJUH transplant program has been in place for more than 20 years, with year after year of excellent outcomes, says Dr. Ghaly.

Both programs rely on multidisciplinary teams to provide the highest quality of care. “Advanced cardiac care requires a tightly integrated, well-functioning team of talented and knowledgeable clinicians, paramedical professionals, social workers, pharmacists and dietitians,” says Dr. Zucker.

“Heart transplantation is not maintenance-free after surgery,” explains Dr. Ghaly. “Our heart failure cardiologists and nurse coordinators monitor patients very closely afterward, becoming like part of the patient’s family. The role is crucial to the patient’s survival post-transplant, and they are the heart and soul of our program.”

Future-facing

Both programs are national leaders in treatment for advanced heart failure, including the use of ventricular assist devices (VADs). These surgically implanted mechanical pumps can keep patients alive as they wait for a heart transplant or when other medical conditions have rendered them ineligible for transplantation.

The NBI and RWJUH programs also participate in multiple research trials that offer patients access to new investigational medications and devices prior to commercial availability. Most recently, the teams have been studying medications to treat advanced congestive heart failure, amyloid and lamin A/C cardiomyopathy.

The transplant center at NBI is currently undergoing a $4.3 million renovation. “The transplant suite will soon integrate the mechanical support, heart and lung transplant programs all under one roof,” says Dr. Zucker. “The ability to interact on a moment-to-moment basis provides an ability to exchange ideas and ensure that all team members are up to date with new and emerging technologies.”

This type of interaction is crucial when it comes to caring for such critically ill patients, says Dr. Zucker. “After all, the management of heart failure is a 24/7 operation that only works when you have a team of truly committed individuals.”

Back in the Game

Former football player and current football commentator Matt MillenDuring Matt Millen’s storied career as a football player, observers often said he showed “a lot of heart.” That description resonated with many when they learned he was waiting for a life-saving heart transplant at Newark Beth Israel Medical Center (NBI).

An All-American linebacker at Penn State, Millen had a 12-year NFL career, including four Super Bowl wins. He served as president and CEO of the Detroit Lions, followed by a successful career as a football commentator.

As the years went on, he began to feel weaker and increasingly short of breath. It became hard to navigate the few stairs to his basement wood shop.

Ultimately, Millen was diagnosed with the rare disease amyloidosis. Abnormal proteins called amyloids had been deposited in his heart muscle, rendering it stiff and unable to function properly. In the fall of 2018, Millen spent three months at NBI, under the care of Mark Jay Zucker, MD, Director of the Cardiothoracic Transplantation Program, and his team. On December 24, 2018, Millen underwent heart transplant surgery performed by Margarita Camacho, MD, Surgical Director of Heart Transplantation, and Mark Russo, MD.

The surgery was a success. With a new heart and a new lease on life, Millen is back in the broadcasting booth for the 2019 football season.

Your heart doesn’t beat just for you. Get it checked. To reach an RWJBarnabas Health cardiac specialist near you, call 888.724.7123 or visit www.rwjbh.org/heart.