Joseph G. Rogers, M.D. | The Texas Heart Institute at Baylor College of Medicine-Year in Review

Thank you very much, Andrew. I appreciate it. And thanks everybody for coming. Um it is really incredible honor to be able to stand up in front of this group and tell you all the great things that you did this year. >> [laughter] >> Um I would just I'd like to just start by suggesting that we have lived through um you know, a a very difficult couple of years. Um some of it applied on us externally, some of it internal. But think about the amazing change that we've seen over the last couple of years with changes in NIH funding, um with turnover of the leadership of the college, with the affiliation between Baylor and the Texas Heart Institute. I would argue that probably the biggest thing that we've had to focus on is change management and how we work through these things. And what I hope to do today is is just acknowledge the fact that we all there's there's pebbles in our shoes, you know, and it it's not the most easy place to work some days. There are a lot of sort of frustrations like there is everywhere in medicine and health care and science. But what I want us to do for the next hour is just pause and think about some of the amazing things that happen here. And I hope at the end of the hour we all leave with a deeper appreciation for the fact that despite all of those distractions that we have, we remain laser focused on our true north and that is improving the health of patients who come to see us, advancing science, and teaching the next generation of clinicians and scientists. So I have no financial disclosures related to this talk. Um but I do have a disclosure and that is there is simply no way to capture all of the amazing things that people do throughout a year. And so, while I have tried to include as many of you as I could in these comments, I just want to acknowledge I haven't captured everyone. So, but there's next year. And so, I will try to be distributive and make sure that we highlight the amazing work that everybody's doing. And I just want to start here with with what we called out when we decided that we were going to bring the Texas Heart Institute and Baylor College of Medicine together, we said this is going to be our vision. And our vision is going to restore the academic program in the hospital back into the top 10 nationally. And I'll show you through the next hour how I think we're making progress in that direction. And from my perspective, the way this all starts is with quality. And I just I want to acknowledge the work of Scott Lykken, who is the director of quality for the heart center of a cardiovascular center, who's done a remarkable job. And I just I I want to highlight to you the fact that our quality initiative in the center reports up to the quality committee of the board. So, this is not something that's being done even locally. The the the joint venture board between Baylor and Baylor St. Luke's is getting these reports. Scott has spent an enormous amount of time and and energy um organizing our quality initiative and and kind of redesigning it. We had one that was in the academic program, one that was in the hospital. We've combined those so that we're really working together now. And Scott's vision was to have a group that was working on things that are primarily surgical, and another group working on things that are primarily non-surgical. But the key themes that sort of overarch all of that are shown at the bottom of the slide, and that is we are trying mightily to to develop a best-in-class so that we can understand quality and act on quality in real time. Scott's perspective is to empower the teams with data so that they can make actionable changes. And perhaps most importantly and is to create a culture of continuous improvement. We're not always going to be perfect. But the question is what can we learn in an ongoing way so that we can continue to get better each and every day. So I'll start with maybe one of the most visible measures of quality and that is the US News and World Report rankings. And I'll just acknowledge at the beginning that we are a ranked program. We are in rare air, but we're not ranked as highly as we used to be. And so what I hope to convince you of is we're moving we will be moving back in the right direction based on the work we're doing. Here are some of the measures that US News and World Report aggregates to come up with your final score. And if you sort of walk through a lot of this on the left, you can see that we're actually doing quite well in cardiovascular. One space that will tie into a later comment is we really need to move more patients through the system. But I really want to train your eye over on the right side of the slide. And these are the things that are in the control of our medical teams. And I will just highlight for you that we are high performing in every one of these domains. We're not going to do any better than five out of five in these. So I think this acknowledges the fact that the work that we're doing in the hospital every day is a very high quality when we benchmark ourselves nationally. Our work is also recognized by our professional societies. These are the badges that we have from the American College of Cardiology that look at the different domains of Cardiology care, EP, chest pain, heart failure, TAVR, cath lab. And we actually once again have the national distinction of excellence for heart care centers. So again, while we do, you know, like there are pebbles in the shoes, we are we're doing a remarkably good job at at at the at the work that really matters to our patients. So to highlight now for you some of the work that's gone on in the last year in the quality domain, I asked Scott to put together what he thought some of the most important highlights were in some of our programs. And and under the leadership of Mark Moon and Scott and others in cardiac surgery, we've seen a remarkable reduction in isolated CABG mortality. And I'll show you a little bit more about this cuz there's a really amazing story that's going to emerge, I think, soon about isolated CABG. But a 35% reduction in in isolated CABG mortality. The TAVR program tends to be high volume, low morbidity, low mortality. Great work going on in there. I'll highlight [clears throat] some of the work that's happened in EP, but under the leadership of Abdi Rossic and our other electrophysiologists, very high compliance rates with the national guideline metrics and very low complication rates. And Enrique Garcia Sayon, who's here, has spent a lot of time working on the operational aspects of the echo lab. And I'll show you a little bit more granular data about that in a few slides. So here's some of the incredible work that's gone on in the cardiac surgery group pertaining to quality. And again, sort of very intentional work by all of the cardiac surgeons under Mark's leadership. But we are now approaching the point of becoming a three-star STS cardiac surgery program. And And I I don't know if this has changed since this we made this slide, but Scott and I had this conversation. Um the isolated CABG mortality right now is zero uh this year. So, I mean really incredible um performance not only by the surgeons but by our anesthesiology teams, the cardiac care teams. And I think the important way to frame this is to think about the patients that our surgeons are operating on. This is an incredibly sick group of patients to have this kind of outcome is really remarkable. And and to the credit of this group, all of these cases are being reviewed uh postoperatively to look for opportunities for improvement. Scott and his team are working mightily through the ICU to shorten lengths of stay, to decrease the amount of time our patients are mechanically ventilated. And And an important initiative has been to focus on optimizing these patients before they go into the operating room. And it's really this concept of having a shared uh vision and a shared leadership uh for this kind of initiative. So, it's really all of the providers uh who are working in this space. Here's the amazing part about this STS star ranking. And And just so you know if it's top right, a one-star program has as expected outcomes, a two-star program is better than that. A three-star program represents a top decile performer nationally. And we are 1.16 percentage points away from being a three-star program in isolated CABG. And And Scott is laser-focused on this issue of reducing morbidity, but we are so close. And And I think a few years ago, many of us were looking at this and wondering whether we could get to a two-star program. So, with a concerted effort and a focus on quality, I think this will be something that we all can be remarkably proud of. When you look at some of the other morbidities in cardiac surgery, we do very, very well with lower rates than national average in prolonged ventilation, the need to go back to the operating room, renal failure, and stroke. So, across the morbidity spectrum, we're also doing very well, but that's the space where we need to work. How about in cardiology? Here are some of the different uh registries that we submit our data to, and you can see that there are areas in which we do very, very well. And then there's some areas in which we have opportunities to improve. And I think this is one of the parts of this quality journey. I I I like this quote by Foster, who said that quality is not an accident. It's It's the result of high intention, sincere effort, intelligent direction, and skillful execution. And whenever we approach some benchmark for quality, the benchmark will move. People are getting better. This is one of the challenges with US News & World Report. We're continuing to get better, but there are other programs that are getting better even faster than we are. We need to catch up. And so, the these bell-shaped curves in the quality domain are becoming very, very narrow, and the difference between being a 50th percentile program and a 90th percentile program is oftentimes a few percentage points. I mentioned the work that our electrophysiologists have done. And this is just one example of some of the great work. This is looking at the proportion of patients who had an A-fib ablation who were treated with an anticoagulant, and you can see that we up, almost in every quarter, around 100%. And I mentioned to you that um Dr. Garcia-Sayan, when he took on this role, he took up Whoops-A-Daisy. He took on this role sort of over on the left side of this graph, but you can see the remarkable improvements in EchoLab performance um in just uh getting the times down from the time we put in an order until the time the patient gets scanned, till the time where the report comes out. Um very nice and important improvements, and this is a large patient cohort. This is 18,000 patients um in this uh on an annual basis that are going through our lab. I wanted to just highlight a couple of other things that are happening in the EchoLab which are exciting. So, in recognition of some of the work of Dr. Diaz and his colleagues for in cardio-oncology um in conjunction with the EchoLab, we're now being able to perform echoes at the Daniel L. Duncan Cancer Center. A a remarkable bit of work by some of our colleagues in echo is interventional echo, and Dr. Garcia-Sayan, and Dr. Coulter, and others are oftentimes called into the cath lab or into the operating room to provide high-level guidance to um our procedural colleagues about how they can um uh you know, sort of fix um a lesion in a more appropriate way, and they get outstanding expertise. That's now becoming a formalized service. Um the EchoLab has been uh acknowledged as one of three centers nationally as a hypertrophic cardiomyopathy center of excellence. And you also know that we've had some challenges with the new uh CV PACS system uh in the hospital, and we are decided that we are not going to sit by passively, that we are going to take a very active role in trying to make that better for the entire Common Spirit system. And then I'm hopeful that all of you who are clinical or getting the pushes from me on a weekly basis about length of stay, but this ties back into the US news story that I told you just a minute ago. The length of stay in this hospital generally is long and we all understand that there are a number of reasons for that. It's also incumbent upon us to shorten it. And I would say it's completely within our domain to shorten it. We have told Redondo that we plan to shorten our length of stay across the service line by one day. Uh which is not a trivial undertaking and we've started to make some pretty good progress, but I think the thing I want you to see is up on the top right side of the slide. And the number of if if we shorten the length of stay the number of days, extra days that we can have for cardiovascular patients is approaching 10,000. So in a system where we actually need to move more patients through, there's actually there's a demand for our services, for our expertise. And we're often times bed locked. If we can work on these processes together and shorten length of stay, we will increase our ability to care for more patients. That also then is reflected in the US news rankings. So I think there's some really interesting data in this slide and I wanted to highlight this for you because many of you may not know that this process has started. It's not been rolled out publicly yet, but this goes back to what's going on inside the hospital. What are their commitments back to us? So the hospital has started a strategic planning process for our key service lines and their expressed goal is a couple. They want to restore the cardiovascular program back to a top 10 program in US News and World Report. And they intend to have the dominant market share at the Texas Medical Center within the next 5 years. And starting with that premise, we've worked backwards to understand what are the investments the hospital's going to need to make to achieve those goals. One of them is to build out centers of excellence and I've shown you what the selected centers of excellence are are on the right side. If your center of excellence is not shown, come talk to me after after the conference and we can figure out how we slot you in. But these are the investments that the hospital believes is going to get us to this market share goal and back into the top 10. They also are very interested in expanding our footprint out beyond the Texas Medical Center in a much more aggressive way and to be the preferred industry partner for sponsored research and for innovation to bring into the market. The The current market shares are shown up on the right side of the slide. So, we've got some work to do to get this done. But the thing I wanted to show you is down at the bottom left side of the slide and I pulled this data at 10:52 this morning. These are the Google star ratings of Baylor St. Luke's Medical Center and Houston Methodist Hospital and we are significantly out in the lead and I think we should just pause, smile, and when we walk out of here, you know, sort of appreciate the fact that that we walk around and you know, it's certainly is not the prettiest hospital on the block, but I will argue that the care in this hospital is second to none on this block. So, what are we doing to help with the infrastructure? Um I went this week and stopped by Cath Lab 4. This will be Emerson Emerson Peron's great delight as the director of the Cath Lab. This is what the Cath Lab looks like this week. Um So, the renovation has started. The plan is to renovate five of the 11 labs uh over the next couple of years, and I'll show you that timeline in just a second. But, to highlight for you what this will ultimately end up looking like, I've shown you on the right side of the slide the build-out of the hybrid OR, which was renovated for some of the endovascular work that we'll talk about in a few minutes. And, the renovations are turning out remarkably well. So, uh very exciting. This is what the construction timeline looks for the like for the cath labs. We're working on rooms four and nine now. When that work is done, uh they'll start on room 11. And, when room 11 is done, then they will work on room 10. And, I can't remember if there's one other or not. But, each of those renovations takes about 3 and 1/2 months, and it's projected that we can get through that entire portfolio of construction work in just over 2 years. And, the hope is that by the end of this construction that we will have uh 11 functional cath labs. And, how long's it been, Emerson, since we've had that? A long time. And, um we just had a really wonderful meeting. We um have worked this year with the Rice MBA uh executive MBA students to help us think about new ways to improve efficiencies in the cath lab so that we can get more cases done. I also had the chance to get in front of the St. Luke's Foundation board, who asked me, "What are your fundraising priorities?" And, so I will show you the slides that I presented to the foundation board. And, they're very excited about supporting the cardiovascular program. I said, "We need to continue working on the cath lab. Not only on the renovations, but making sure that we have the most contemporary equipment so that we can maintain a technology gradient with our competitors and the programs out in the community. We have an opportunity to build out the next hybrid OR, which is not yet funded. We have needs to build out a more aggressive platform in the electrophysiology laboratories. We could use another robot. And I will talk about the cardiac robotic program in a little bit. We could use some TEE probes. We need new echo machines. There's some needs in cardiac advanced cardiac imaging. These kinds of proposals really resonated with the board, and I think they're excited about raising money for us. And then we talked about some of the people that they could support, including nurse navigators and some research coordinators. And we also talked about the fact that they could have the opportunity to endow grand rounds. So I think there's a lot of opportunity for us to go out and fundraise in conjunction with the hospital that will support the interests of all of us who practice inside the walls of Baylor St. Luke's Medical Center. So I wanted to turn now a little bit away from quality and fundraising and talk to you about what we've been doing clinically over the last year. The service line at Baylor St. Luke's is busy. We mean the the numbers here are impressive. 250 Tavers on an annual basis. The cath lab doing about 8600 cases. Enrique and his team in the non-invasive suite doing over 25,000 non-invasive studies. And the cardiac OR is really quite busy at 3300. So it's a it's a very busy place. There's a lot of churn, a lot of throughput through through the service line. There's some really great work that's going on, and I wanted to highlight a couple of these programs. And And I wanted to just make sure that we've that everybody here in the room and who's listening to this um appreciates the hard work of Juan Lopez and Enrique and Shree and Luba Frank. And I'll just show you that this kind of dip down here on the green these are the cardiac CTs CTAs that were performed. And you can see that we sort of hit a nadir last summer. And I like to call this the Lopez effect. So So when Juan came he said, "We're going to fix this and we are going to increase the throughput and we are going to be a high quality advanced imaging program." And you can see with some focused effort what's happened. The remarkable growth in coronary CTA CMR program similarly if you look from last summer till now the the volumes have gone up. Remember that that graph the bar on the right side of the slide is month-to-date so it wasn't a full month toward the data. And Dr. Lopez has a very important perspective for us and that is that this should be an entry point for patients into the system that can be accessed by anybody. So it's very important for us as cardiovascular professionals that we can get our patients through but what if you thought about this a little bit differently and democratize this so that primary care doctors could begin utilizing these kinds of services. And so Juan's perspective is why don't I get go out and start marketing these services to primary care docs. So if they if their patient gets imaged and they have sort of a low risk profile I can send back recommendations that are guideline based about how to manage them. And if they're if I find a high risk study we can immediately get them into a cardiologist for further evaluation care. It's a great entry point into the cardiovascular programs here. And here is an example that Juan shared with me. This this was a 55-year-old woman who had no chest pain but was getting breathless when she exercised. She was a tobacco user and had hypertension and diabetes. Somebody who you would think probably was at high risk for having uh atherosclerotic cardiovascular disease. Her lipid profile is shown there. Her hemoglobin A1C was high and she had a coronary calcium score zero. And so Dr. Lopez did a coronary CTA and you can see the images over on the right side of the slide and it seems like if I move the mouse um uh it advances the slides advance so I'm I'm not going to take my chances. But I think if you look in that middle slide at the top of the LED you can see that there is a there's a plaque there that he was able to identify. And so one of the really interesting innovations that Dr. Lopez is bringing to our center is the use of AI-enabled plaque analysis. Where we can begin to really take a look inside those vessels. And this [clears throat] was a woman again who had no calcium. Uh but there was a high level of suspicion. But with this sort of approach he's been being able to help us identify soft plaque. And this is actually what's the etiology likely of this woman's exertional breathlessness. So I think this kind of interplay now that we have Dr. Lopez and Dr. Garcia-Sayán and Dr. Tonaru and Dr. Frank working in this space in really a dedicated concerted effort. Let's start that conversation about how we can utilize those services better. The other thing that's amazing is I think many of you who ordered coronary CTs in the past um have found that it was cumbersome to slow the heart rates down and you'd have to use a beta blocker prep uh in order to get patients relatively bradycardic. But with the [clears throat] new scanning technology and with the new protocols that's actually no longer necessary. So I would [clears throat] highly recommend that we collaborate more with Dr. Lopez and the advanced imaging team. I probably don't need to remind this group of the incredible program that's been developed in cardiac surgery by Dr. Liao and supported by Dr. Moon and Dr. Rosen Garden but this was Dr. Liao's celebration of the 900th robotic cardiac surgery case and as far as I know we haven't hit 1,000 cuz I haven't been invited for more cake yet. But we're close and you know Ken is doing some really remarkable work. He's one of the highest volume robotic cardiac surgeons in the United States and I hope you had a chance to see Ken's grand rounds from a few months ago. If not, it's available on our website and you can go back and watch that but really remarkable work and a lot people are coming now from all over the country again to Baylor St. Luke's and the Baylor and to the Texas Heart Institute of Baylor College of Medicine to get this kind of very unique service that he offers. And then I wanted to tell you another story of one what I think is one of our signature programs and it's the aortic program and I was reflecting on this case and how this group of our colleagues makes the extraordinary look ordinary. This is the story of a 65-year-old man who came in with an aortic dissection and it was very clear in the emergency room that there was malperfusion from his from his head to his legs. And I I just copied Dr. Caselli's op note to show you what he found but there was there was a type one dissection that involved the the sinuses of Valsalva, his left common carotid had thrombosed. They dissected into the innominate up the left carotid into the left subclavian down the thoracoabdominal included the SMA occluded [clears throat] the left renal artery, and was compromising blood flow to the left lower extremity. And when the pericardium was open, this aorta had ruptured. So, the mortality rate, as you know, with aortic dissections is about 4% per hour. Uh this had to be substantially higher as the aorta had already ruptured. The procedure that was performed on this man is shown at the bottom. And I won't read through everything that happened, but basically this started with Dr. Caselli and his team in the cardiac OR operating all night long. And then extending into the next day, and I'll show you in just a second. What you see on the right side of the slide is a 3D reconstruction of the aorta, and you can see the dissection's lab that starts just above the valve and goes all the way down into the abdominal aorta. So, a- after the case was um taken from uh the cardiac OR, went to the the vascular suite. And at the end, this is what the aorta of this gentleman looked like. And you can begin to appreciate, if you can just sort of train your eye on the right side of that slide, you can see where the surgical repair ended and the endovascular repair started, but basically reconstructed the entirety of this aorta. Uh and this gentleman left the hospital about a month later and is fine. And so, really it's just incredible work uh that's being done by this team. I had a chance to talk to Gustavo and Steve Maximus about some of their endovascular aortic work. Gustavo was telling me that this was um probably the busiest year he's had in his entire career um in terms of the number of endovascular cases. And I think you can begin to appreciate uh they have um the uh in the let the CMD are basically custom-made devices that they're they're designing with one of the companies specifically fitted to the anatomy of the unique anatomy of a patient. Uh the PMEG are physician-modified endographs. So, so Dr. Maximus and Dr. Oderich are actually an hour before the operation with very thoughtful, careful 3D modeling um modifying and custom-making these devices so that they fit into the patients. Uh and I want to just highlight for you that they're doing this work under an IDE, but I wanted to highlight for you the remarkably low morbidity and mortality rate considering what they're actually doing in these with these graphs. So, I think this is amazing work and as you saw earlier, this is one of the uh centers of excellence that we'll be focusing on not just in the heart center academically, but also in the hospital. So, I wanted to turn for a few minutes away from the clinical part of what we do and think a bit more about what we do in the research domain. And I wanted to focus many of my comments this year on our on our translational research program. So, first I and just in case people haven't seen this, as we've begun to put the center together, uh we have a leadership structure for our research initiative. Uh the deputy director for translational and clinical sciences is Dr. Kay Lou. The deputy [clears throat] director for the CVRI is Dr. Werns, and Dr. Werns has run the CVRI admirably for years. Um Dr. Darren Woodside is going to focus us on translational science and commercialization, and we've not yet named the directors for clinical research and outcomes research, but those will be coming probably in the next couple of months. We put together a research advisory committee that's going to give us a different perspective. It's going to open the voice of the faculty to help guide our initiatives in research. And I just also wanted to highlight for you that we have a new director of the the Cullen Lab, which is the large animal lab down in B2, and it's Teimour Ardeshir Shavdi who's done a remarkable job um trans- transitioning all of our large animal protocols over into Baylor. So, how have we done in the last 12 months? And a year when there was a lot of uncertainty at NIH, where we were transitioning all kinds of administrative tasks. And I will just highlight for you that we submitted almost $160 million worth of grants. Uh we've received over $27 million of those. Our funding success at NIH is just shy of 25% and all of our funding success is just shy of 50. And you can kind of break that all out by the different categories of grants. It's a remarkable body of work that our scientists have done over the last year. I wanted to highlight a couple of these translational programs that we've been involved with, and Daniel Timms is here with us today, who's the inventor of the BiVACOR total artificial heart. As of today, and I think I've got this number right, Daniel. I think it's 14 have been implanted. And I'm happy to tell you that we have implanted more than anybody in the world. We've put in 36% of those pumps. Um in addition, our team travels with BiVACOR not only across the country, but around the world because of the expertise that we have here that started in the animal lab with the implants, and it carried over into our ORs and our intensive care units and our nursing teams and our perfusion teams. When we started this program, we had unprecedented expertise with this particular device. And I just wanted to highlight for you we just implanted another one this week and I grabbed a quick picture of Thomas in Orlando with Daniel Timms. But also Alexa Schappi who's been the primary surgeon here who recently flew to Taiwan and assisted with their first implant. Um and then Karthik Valery who also has done a remarkable job in the ICU supporting this program and helping us learn with every implant. Um this program is developing rapidly. Um the plan was to do uh 20 implants and then go back to FDA with us with a strategy to do um a pivotal trial as a bridge to transplant with this device. I also wanted to highlight the work that um the Jim Martin's lab has done and I think many of you have heard Jim talk about the work that he's doing in cardiac regeneration and modifying the Hippo pathway. And as a non-molecular biologist I can just like simply explain this is in a ways that I can understand it. But all of you recognize that when we're born essentially our cardiac heart cardiac muscle cells stop dividing. And as we get bigger as we grow those cells get larger but they don't continue to divide which is why myocardial infarctions are so devastating because you don't replace that injured heart muscle with new muscle cells. So Jim and his lab have defined a key pathway that tells the cells to stop dividing when they're born. And then has developed a gene therapy to turn off the stop signal and allow those cells to re-enter in the cell cycle begin to divide. And when you do when you cause a myocardial infarction in an animal and you give the gene therapy you can see what happens at the bottom right side of that slide where in in the slices of heart, you can see the scar down at the bottom. That white uh is just fibrous tissue. But, if you look at what happens if you administer Dr. Martin's gene therapy, you can see you can hardly tell that there's scar there. And so, in a translational research initiative, uh Jim spun off a company called Medley. Uh and we are doing first-in-human uh it work with this gene therapy. Uh and Emerson Perin is the primary operator. I I That's him actually with the cap and uh mask on, but I put his smiling mug up there too so that you would recognize who's behind there. And not only did we But, Emerson had had to invent the catheter to inject the gene therapy so that he can go and map very carefully inside the ventricle what heart muscle's alive, what heart muscle's not alive, and make the injections right along that border zone. And so, this is uh been approved by FDA. It's a nine-patient dose-escalating um safety study, and I'm happy to tell you that this week the eighth of those nine patients has been completed, and the anticipation is that as long as there's no adverse safety signal, uh this will probably move on then to a randomized controlled clinical trial. So, great work. And again, not this I think an example of the research portfolio that we have in the center. I wanted to highlight a couple of others. So, this is Mehdi Razavi and Alison Post have spun off a company called Rivio. And I I talked to you a couple years ago about their electroconductive hydrogels, two liquids that come together to form a semi-solid that conducts electricity. And Mehdi's perspective is that he can mitigate some of the abnormal electrical channels in a myocardial infarction by injecting this into the veins and sort of make the electrical pathway straight again so that we don't have re-entering cycles. And this is now spun off into a company and received from the FDA a breakthrough device designation. So, really an important and big therapeutic advance. And so, watch this cuz I mean this is going to be really exciting. And then some of our other colleagues, Shaheen Wang and Chris Chan and Gabe Lor are upstairs in the on the up in the Cooley building working on a strategy to prolong organ preservation. And they're starting with lung, but this also could be applied to heart and liver and kidney with the idea that we could extend the time that an organ is outside the body and and trying to get you know, either rein- reinvigorated or moved. They want to try to extend that from a few hours to 100 hours, which would completely democratize organ donation in the world. It also might buy you time to allow organs to recover from the, you know, injuries that often occur when patients go through brain death. Or it might allow us to genetically modify these grafts so that they work better, they're less immunogenic. So, again, they they spun off a company called Organ Veep and it'll be really interesting to see them uh go forward. And then I'm going to go through these quickly the next couple of slides, but these are some of our uh sponsored research trials just to show you the breadth of the work that we are doing. And and I think it's important for us as clinicians and clinician scientists um to understand that this is a real opportunity for our patients to have access to the latest, most cutting-edge therapies that are available in the United States. So, these are a list of the heart failure trials. This is the portfolio that sat inside the Texas Heart Institute with some really important trials. And finally, it's a lot of the work that you've seen recently that's come out of Christie Ballantyne's lab and his initiatives. Um focused on some of the new drugs to lower cholesterol and some really remarkable work that's being done by that group. So, I I've spent a bit of time talking about the aortic the endovascular service, but there's something else that happened this year that you might not know about yet. And that is we were asked, Dr. Odell and his colleagues were asked to submit a proposal to the Marcus Foundation for an aortic center of excellence. And I thought that that team, along with Nick Ryan and the development team at Baylor, put together a phenomenal proposal that builds out a clinical area that integrates imaging into an outpatient clinic that designs a um a data repository for vascular images that could be used by all vascular surgery trials in the world and sets up a new training center a new a new for using simulation to train our colleagues in how to do endovascular work. I'm happy to tell you that this was funded by the Marcus Foundation to the tune of about 17 million dollars and the work will start soon. This is what we're going to use we're going to repurpose the old THI library for the simulation center, a suite of offices, and this remarkable vision that Dr. Odell has to service a data repository. So, I wanted to, as we begin And close, talk a little bit about our impact. And I showed this slide um a couple of weeks ago just to highlight for you what I think are some of the really important publications just in the last month. These are just some of the papers that have been published recently by our faculty. But in an attempt to try to make this a little bit more a little broader over the last year. We put all of our faculty names into an AI generator and we said, "Tell us where we published. Show us the high impact journals that we've published in." And you can see uh in this pie chart the number of papers and this sort of the the um the journals that we've published in. And and what the analysis of our publication record in the last year was is we have remarkable strengths in publishing. And but I what I really wanted to highlight for you was what AI's interpretation of the portfolio was. And you can bu- I didn't The prompt wasn't tell us some really good stuff about our publication portfolio. This is what it said. The portfolio is consistent with a globally competitive cardiovascular research institution that demonstrates strengths in clinical trials, translational medicine, guideline leadership, AI-enabled medicine, and multidisciplinary cardiovascular science. The concentration of publications in elite journals reflects substantial national and international visibility and influence. If we are going to become a top 10 program, this is where This is how we do it, right? We need to have a national and then international visibility into the work that we do. We have two journals and many of you know this. We We might have more than this, but I These are the two that I know about. So, Becker is editing uh Jack Heart Failure. I'm editing the Journal of Heart and Lung Transplantation. I'll tell you that her impact factor is better than mine, but Beckham, if you're listening, I'm coming for you. And then, our faculty has been recognized both nationally and locally, and I wanted to just highlight this for people because this is really important. Uh and Christie Ballantyne received one of the highest honors that you can receive from the American Heart Association this year. He was named as a distinguished scientist for his lifetime's worth of work on understanding lipids and the role of inflammation in atherosclerotic vascular disease. He was also named the Virgil Brown Distinguished Achievement Award winner. Beckham won the Laura Lynch Executive Leadership Award. Misra, David, Natesh all received awards at the uh at the Cardiovascular Research Symposium earlier this month. And then, I also wanted to highlight for people that Baylor recognizes, once a year recognizes, our faculty for their contributions, and you can see these contributions here, and I'm not going to read all these. I would like to highlight one, and that's Dr. Sanusi's award. That was actually given It was voted on by the Medical Executive Committee of the hospital, and it was a hospital award based on the work that he's done uh to advance our efforts in cardiovascular critical care. And then, I wanted to just um again, as we close, I'm thinking a little bit about education. Thank Kerry Sprung, who um has transitioned over to the School of Health Professions at Baylor and was charged with figuring out how to move the School of Perfusion Technology into into Baylor, and has done a remarkable job. And many of you probably don't realize, but today that is a certificate program that lasts 18 months, and we have sort of an ongoing rotation of students through the through the Perfusion School. Kerry had a vision to create a master's program for this group and so that will be kicking off shortly and will be transitioning this to a master's degree program which is actually much more marketable and aligned with what people want in the space. And then and finally I just would say it is impossible to do the work that we just talked about without the work of our fellows and the people who come here to train. You know it this is the reason that you can't provide the kind of care that is provided in this hospital in community hospitals and it's not because the attending physicians are in the hospital day long is because this group of people has worked remarkably hard for years and has done an incredible job taking care of our patients and I just want to pause and have the faculty appreciate all of you. Congratulations on finishing your training. >> [applause] >> I'm also happy to say that I believe that every one of these people has a job. So also good work. And finally I'll I'll just close this way to say thank you. It it is it's not been the easiest year here there's been a lot of transition a lot of change. You are a resilient group of people and I'm we're all indebted to you for the work that you've done in in whatever domain that you work in when you walk in the front door with a commitment to excellence which would make Dr. Cooley and make Dr. DeBakey proud of this place. I want to acknowledge the incredible work of the administrative team. Especially we need to thank Megan who just forever keeps me out of trouble and keeps me pointed in the right direction. Brett Coffman has done a phenomenal job this year helping figure out how THI and Baylor come together into into a functional whole. And I don't mean to exclude anybody cuz I think the administrative team has done a phenomenal job as well. I just want to be sure that we acknowledge them. So, thank you very much. I hope that you walk out of here today and say, "Wasn't intensely boring, but we're really doing remarkable work. And walk out of here with your head held high. Enjoy your summer. Take a few days off and and relax and enjoy your families and let's keep advancing the science of cardiovascular medicine and improving the care of the patients who trust us every day to make their lives better. So, thank you very much." >> [applause]