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Matters of the Heart

By CARRIE ST. MICHEL

The heart busily beats about 115,000 times per day, while shuttling the 2,000 gallons or so of oxygenated blood that keeps the body’s other vital organs in business.

Plenty can go wrong with this four-chambered pump, as evidenced by the fact that heart disease is the leading cause of death worldwide. Fortunately, physicians like the 100-plus cardiovascular specialists at the Smidt Heart Institute have dedicated their careers to revolutionizing cardiovascular care.

Here, five Smidt Heart Institute experts weigh in on cardiology game-changers and— because nonexperts tend to associate the heart with this anatomically inaccurate emoji and all things pitter-patter—their favorite love stories as well.

ALFREDO TRENTO, MD

Senior Heart Surgeon Estelle, Abe and Marjorie Sanders Chair in Cardiac Surgery

EXPERTISE: Alfredo Trento, MD, performed the first heart transplant at Cedars-Sinai in 1988. Since then, he’s performed more than 10,000 cardiac surgeries—including heart transplants, coronary artery bypass grafts, valve repairs and complex multivalve surgeries. GAME-CHANGER: Robotic-assisted surgery. Since 2005, Trento has used a robotic-surgical system that’s improved patient outcomes for a host of procedures, from coronary artery bypass to mitral valve repair and replacement.

NEXT BREAKTHROUGH: Aortic heart-valve replacements made of polymers. Defective valves currently are replaced with mechanical or animaltissue-based valves that either wear out or require a lifetime of taking blood thinners. Polymer valves being tested for safety are free of these downsides and the surgery is minimally invasive.

FAVORITE LOVE STORY: Nine years ago, a 35-year-old married father of twin 3-year-old boys suddenly developed heart failure. Nine months later, Trento performed a successful transplant. “Seeing the couple in the ICU simultaneously sobbing and hugging, you could feel the love,” Trento recalls.

ALI AZIZZADEH, MD

Director of Vascular Surgery

EXPERTISE: While Ali Azizzadeh, MD, humbly describes himself as “a plumber for the body,” he’s widely recognized for his expertise in repairing trauma to the aorta and for pioneering minimally invasive techniques to treat vascular disease. GAME-CHANGER: In 2018, Azizzadeh became the first vascular surgeon to use a minimally invasive device to repair potentially life-threatening aortic aneurysms.

NEXT BREAKTHROUGH: Azizzadeh’s sights are set on the aortic arch, which transports blood to the head, neck and arms. He’s testing a device to treat aneurysms and tears without making chest incisions.

FAVORITE LOVE STORY: At the tender age of 10, Azizzadeh saw Love Story, starring Ali MacGraw and Ryan O’Neal. “That was my first introduction to an adult romantic relationship,” Azizzadeh says. He felt “profoundly sad” when MacGraw’s character dies of cancer. “I became a doctor because I love science and people, but maybe this movie influenced me on a subconscious level.”

JIGNESH PATEL, MD, PHD

Medical Director, Heart Transplant Program Director, Cardiac Amyloidosis Program

EXPERTISE: Jignesh Patel, MD, PhD, specializes in advanced heart failure. “Being able to take care of very sick patients and get them better and back to their families is extremely fulfilling,” he says. GAME-CHANGER: Demand for heart transplants consistently outpaces supply. “What’s helping fill this void are ventricular assist devices,” Patel explains. These implanted devices buy time for those awaiting transplants and, in some instances, can restore heart function.

NEXT BREAKTHROUGH: Patel just completed a pilot study testing the investigational use of a drug to treat certain blood disorders. “We’re the first medical center worldwide to use this medication to prevent organ rejection, and we’re very pleased with the results.”

FAVORITE LOVE STORY: Patel managed the care of a woman who had a heart transplant. Soon after the operation, her boyfriend proposed to her, fully aware she would face lifelong medical challenges. He became a professional athlete, and later an actor, but always made taking care of her his top priority. In the end, cancer took her life. “He was a man of his word and always by her side. Seeing that was very touching,” Patel says.

JANET WEI, MD

Cardiologist, Barbra Streisand Women’s Heart Center, Smidt Heart Institute Associate Program Director, Cedars-Sinai Cardiology Fellowship Training Program Assistant Medical Director, Biomedical Imaging Research Institute

EXPERTISE: When Janet Wei, MD, was a resident, she diagnosed coronary microvascular dysfunction—a condition more common in women than men—in a woman with chronic angina that other doctors concluded was in the patient’s imagination. “She was so relieved her pain was caused by a real disease,” Wei recalls. GAME-CHANGER: Wei says studies demonstrate that men are often brought to the cath lab for emergency treatment of acute heart attacks more quickly than women, and that women have higher heart attack morality rates. “We’ve conducted research showing that if the same protocol is followed for men and women, these gender differences disappear,” she says.

NEXT BREAKTHROUGH: “Cardiovascular disease is the leading cause of death among pregnant women and those post-pregnancy. We’ve recognized that pregnancy is really a woman’s first official stress test in life,” Wei says.

FAVORITE LOVE STORY: Jane Austen’s novel Pride and Prejudice warms Wei’s heart “because it’s not a traditional love story. Mr. Darcy and Elizabeth Bennet’s journey to build a relationship results in each becoming a better person.”

EVAN ZAHN, MD

Director, Guerin Family Congenital Heart Program, Smidt Heart Institute Director, Division of Pediatric Cardiology

EXPERTISE: Evan Zahn, MD, is among the world’s preeminent interventional cardiologists. His revolutionary, lifesaving methods treat congenital heart defects and structural problems with minimally invasive procedures. He heads a nationwide clinical trial testing a procedure he’s pioneered to noninvasively mend holes in the hearts of premature infants. GAME-CHANGER: “One very meaningful advance is the dramatically increased survival rates for infant heart surgeries. Another is our ability to treat all four valves of the heart without requiring open-heart surgery,” Zahn says.

NEXT BREAKTHROUGH: Zahn calls a stent he’s developing with biomedical engineers “the Holy Grail.” “The goal is to create a stent that could be inserted into a tiny baby’s narrowed pulmonary artery; it would then remain there throughout adulthood,” he explains.

FAVORITE LOVE STORY: Zahn’s parents. After returning from World War II to his Brooklyn home, his father spotted a young woman sitting on a stoop. It was mutual love at first sight. “My dad died many years ago, and Mom consistently says, ‘I married the man of my dreams; there will never be anyone else.’”

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For more stories from our heart experts, visit cedars-sinai.org/discoveries