Dr. Lattouf speaks about the case on Fox News.

Edita Tracey with her husband Ken and baby

Arabella.

CONTENTS
By saving one life, Dr. Lattouf
unites two
Emory CSAT liver app 1.0
available in iTunes, 2.0 in
development
Dr. Dodson receives the Emory
Williams Award for
Distinguished Teaching
Congratulations to our 2013-
2014 graduating chiefs!
Long-time CSAT editor Carol
Froman retires
Upcoming events









By saving one life, Dr. Lattouf unites two
In February 2012, Emory
cardiothoracic surgeon Dr. Omar
Lattouf experienced what he
came to refer to as the most
difficult case of his career: the
emergency removal of a large
blood clot in a young mother's
heart immediately after her twins
were delivered by c-section.
When Dr. Lattouf and his team
opened the patient's chest, they
found one end of the clot
dangling in her right atrium and
the other in the left. "It was like someone shoots a bullet and you have to go in
and grab that bullet before it hits the target," Dr. Lattouf said. The operation
was a success, and the twins were sent home after several months in Emory
University Hospital Midtown's (EUHM) special care neonatal and perinatal unit.
But for prominent surgeons like
Dr. Lattouf, pinnacle events can
become just one in a series of
unprecedented situations. One
afternoon in late April of this year,
Dr. Lattouf was introduced to his
next impossible, never-before-
encountered case via several CT
scans urgently sent to him over
his cell phone. Relayed by an
obstetrician from Northside
Hospital, the scans were of the
chest of eight-month pregnant
Edita Tracey of Roswell, GA,
who had presented at the ER with chest pains. The ER team was initially
concerned that something might be wrong with the baby. What the scans
revealed, however, was a huge aneurysm in the wall of her aorta that was not
only bulging, it was ripping apart. There was a foot-long tear in the inner wall of
Edita's aorta and blood was pooling around her heart.
"I have performed probably thousands of emergency heart operations and many
dozens of aortic dissections, and I had never been so scared," says Dr. Lattouf.
"That little soon to-be-born baby intimidated me like no one ever before. In her
weakness she was the most powerful person I have ever encountered."
With time at a premium, Edita was airlifted from Northside to EUHM, where two
surgical teams gathered: one led by Emory OB GYN Dr. John Horton to
deliver the baby, and the other to repair the aneurysm led by Dr. Lattouf. "We
had to do it right the first time," Dr. Lattouf says. "There was no room for error,
there could be absolutely no missteps."
Being very aware that the general anesthesia going to Edita was also going to
the baby, the c-section team performed their job very quickly. "As soon as
mom went to sleep, it literally took about 30 seconds and that baby was out
and screaming," says Dr. Lattouf. The child, named Arabella, was 6 pounds, 12
ounces, and perfectly healthy.
Dr. Lattouf's team immediately took over and began what would stretch into an
almost nine-hour surgery. After opening her chest, they drained the blood
pooling around Edita's heart and placed her on a heart-lung bypass machine.
Dr. Lattouf replaced her aortic arch, reimplanted the great arteries supplying the
arms and brain, replaced the ascending aorta and aortic valve, and re-
implanted the coronary arteries. Once the last stitch was placed, the clamps
removed, and the heart started beating on its own, Edita's various physiological
processes began returning to near normal. Dr. Lattouf allowed himself to "take
a deep breath."
"Those nine hours passed like nine minutes," he says. "There were no breaks,
no story telling, no music in the room. J ust full attention on one small area:
Edita's heart. That was my entire world for that time period."
Despite one precarious moment after another, the procedure had gone well,
and Edita awoke the next day in the ICU to her husband Ken and held Arabella
for the first time. "What a great feeling to save a mom's life and see her holding
her newborn child the next day," says Dr. Lattouf. "As I look back, I am so
thankful that things turned out so well. I don't know if I could have continued
my career if I had failed Arabella by not saving her mom."















Emory CSAT liver app 1.0 available in iTunes, 2.0
in development
Produced under the auspices of the Thalia and Michael Carlos and Alfred A.
Davis Center for Surgical Anatomy and Technique (CSAT), the first version of
the "Surgical Anatomy of the Liver" iPad app is now available to non-Emory
users in the Apple iTunes App Store, and for free to Emory users via the new
Emory Internal App Store (Apperian). The 2.0 version of the app has just
received funding for development.
CSAT has existed since 1984 with the mission of providing education in human
macro anatomy in order to create surgeons and surgeon scientists who
understand and respect the anatomic basis of modern surgical care. Building
upon a rich tradition of landmark publications in the field, CSAT is currently
harnessing the communications innovations of the 21st century to package and
transmit its educational resources, and the liver app has publicly initiated
CSAT's new focus on electronic education.













The liver app can be used in a variety of environments, including the OR.
Intended for trainees, medical students, instructors, and anyone that needs a
quick way to learn or teach liver anatomy, this interactive 3D app allows users
to mentally map the anatomy of the liver in ways that were never before
possible with print illustrations or imaging studies. The user can rotate the liver,
turn structures off and on to understand the relationships, and tap anatomy to
reveal a label.
With the support of Dr. Keith Delman, program director of the Emory general
surgery residency, Emory surgical oncologist Dr. Shishir Maithel guided Emory
School of Medicine medical illustrator Michael Konomos through the intensive
process of accurately sculpting the complex anatomy of the liver, with the end
product achieving a synthesis of radiographic, cadaveric, and surgical
references as well as the distillation of hundreds of hours of liver surgery. CSAT
medical illustrator Andy Matlock contributed 3D animations that display the
typical configuration of the liver as it pertains to surgical anatomy. The app also
includes over 12 minutes of liver videos narrated by Dr. Maithell.
Concept art for the 2.0 version of the liver app.
In May 2014, CSAT was approved to receive an Emory Fund for Innovative
Teaching Grant (FIT) to support the development of the 2.0 version of the liver
app, entitled "Surgical Anatomy of the Liver: 3D Model and CT Scan
Integration." FIT grants are awarded to projects that display progressive
research in education, creative interdisciplinary pedagogy, and integration of
teaching innovations into the future curriculum of Emory.
Building upon the first edition of the app, the team plans for 2.0 to include a CT
scan function that perfectly matches the liver and would allow the user to
understand the connection between 2D tomographic images and the 3D
anatomy encountered in the OR. Users would be able to turn vessels on and
off, rotate the liver and connected CT images up to 360, and draw
tomographic planes through the y and z planes of the liver that would create
horizontal and coronal views of CT images.
This 2.0 version of the liver app is expected to be available on iTunes and for
free to Emory users by February 2015.
Tom Dodson
Dr. Dodson receives the Emory Williams Award
for Distinguished Teaching
Established in 1972 by alumnus Emory Williams, the Emory Williams Award
for Distinguished Teaching is Emory Universitys most prestigious teaching
award. Mr. Williams was a1932 graduate of the Emory College of Arts and
Sciences. He began serving as a trustee in 1964 and was elected to emeritus
status in 1981. He died in February 2014 at the age of 102.
Dr. Thomas Dodson, chief of the Emory division of vascular surgery, was
chosen to receive the 2104 edition of the award for fostering participation,
inquiry, and creative expression in the academic environment; being an
outstanding role-model for teaching and scholarship; and serving as a gracious,
trustworthy, and admirable mentor to students.
Before enrolling in Emorys vascular surgery fellowship in 1987, Dr. Dodson
was an assistant professor of surgery and coordinator of the third-year surgical
clerkship at Harvard Medical School and associate director of the SICU at New
England Deaconess Hospital.
Upon completing his fellowship, Dr. Dodson joined the faculty of the
Department of Surgery. He was appointed associate program director of the
general surgery residency in 1991 and full director in 1997, a position he held
until J une 2011. He has received numerous teaching and best doctor awards,
served as president of the Georgia Surgical Society, and was a member of the
Education Task Force of the American College of Surgeons.

Congratulations to our 2013-2014 graduating
chiefs!
The photo belowsnapped by Stephen Konigsberg, PA-C, Emory Vascular
Surgeryfeatures Emory Surgery's 2013-2014 chief residents at the annual
chiefs banquet, held on Saturday, May 17, at the Woodruff Arts Center. The
photo includes Dr. Keith Delman (5th from left), program director of the
general surgery residency, and Dr. John Sweeney (7th from left), interim chair
Phyllis Bazinet, Dr. Skandalakis, Cynthia Painter,
and Carol Froman at the original CSAT offices,
1998.
of the Emory Department of Surgery. The residents are (left to right) Sameer
Patel , who will go on to a surgical oncology fellowship at M.D. Anderson
Cancer Center; Preeti Subhedar, breast fellowship, Memorial Sloan-Kettering
Cancer Center; Jamil Stetler, endosurgery fellowship, Emory; Melissa DeVito,
private practice; Jennifer Avise, vascular surgery fellowship, Wake Forest
University; Peter Thompson, plastic surgery fellowship; Michael Lowe,
surgical oncology fellowship, Memorial Sloan-Kettering Cancer Center; Sarah
Hill , pediatrics fellowship, Childrens Healthcare of Atlanta; Swetha
Ramakrishnan, colorectal surgery fellowship, Washington University in St.
Louis; and Lee Ocuin, surgical oncology fellowship, University of Pittsburgh
School of Medicine.
Long-time CSAT editor Carol Froman retires
In the early 1990s, the volume
of publications associated with
the Thalia and Michael Carlos
and Alfred Davis Center for
Surgical Anatomy and
Technique (CSAT) of Emory
University had grown to the
degree that Dr. John
SkandalakisCSAT's late
founding directorbegan
assembling an editorial staff.
Carol Froman was hired
shortly thereafter. Following two
decades of faithful and effective
service to the center's mission
of educating professional
physicians, medical students,
and residents about the anatomic basis of modern surgical care, Carol will
retire from Emory in late May.
"By happenstance, I was recommended to 'Dr. Skan' by a former neighbor who
worked at Emory and was familiar with some of my freelance writing and
editing," Carol says when reflecting on her first meeting with Dr. Skandalakis.
"When he discovered that we shared an obsession with history, he was
delighted."
Carol is a founding member and former president
of Toastmasters@Emory.
Carol's skillset was initially shaped by her study of linguistics, which earned her
a BA from Wellesley College. "Understanding how languages work and the
components of efficient versus ineffective communication can teach you what
works best when writing for different audiences," says Carol. "Even though the
audience for Dr. Skandalakis and his colleagues' work was familiar with the
jargon of the field, the text had to be as uncluttered and direct as possible since
it described complex and sometimes variable relationships between anatomic
structures and certain surgical procedures. It was imperative for the readers to
be able to take the concepts in the material and translate them to the OR with
minimal struggle. Like anything instructive, the more concise the teaching, the
better the recall."
However, editors are responsible for much more than polishing text, a fact that
comes into play most intensively with books. To meet the demands of this
extended format, editors must juggle multiple and overlapping tasks and
associated timelines/deadlines, including the chapter assignment phase,
numerous author and coauthor communications, manuscript reviews, requests
for revisions, acquiring permissions for copyrighted materials, submitting
material to the publisher, and other functions. Carol helmed this process for
several of CSAT's most well-known and respected books, including the 2nd
edition of Embryology for Surgeons and the 4th edition of Surgical Anatomy
and Technique: A Pocket Manual.
Carol also shared author credit with Dr. Skandalakis on "One Snake or Two:
The Symbols of Medicine," published in American Surgeon, 74(4):330-4, 2008.
The article analyzed the history of the erroneous interchange between the
caduceus (a staff entwined by two snakes topped with wings) and the asklepios
(one snake wrapped around a staff) as the symbol of medicine. Although the
asklepios is generally considered the correct symbol because of its association
with Asclepius, a deity that represented healing and medicine, the caduceus is
still used as the symbol for such organizations as the U.S. Army Medical
Corps. Carol and Dr. Skandalakis argued that this confusion did not arise from
ignorance, but from the loss of the deeper significance of the symbols and the
replacement of religious iconographic constraints by aesthetic and decorative
considerations.
In August 2009, the center suffered a tragic loss when Dr. Skandalakis died of
leukemia. "I truly admired Dr. Skan's curiosity and how much he loved what he
did, and I was very sad that I wouldn't be able to share that with him anymore,"
says Carol. "He never stopped being a student of surgery and anatomy, which
he called his mistress. He was also a faithful supporter of budding researchers
and wouldn't hesitate to assist them with their pursuits."
Various projects were in process
at the time, so Carol, CSAT
editor Phyllis Bazinet (hired in
1996), and administrative
manager Cynthia Painter (who
joined CSAT shortly after Carol)
focused on completing the
publications while running the
day-to-day activities of the
center. Dr. Keith Delman was
appointed director of CSAT in
2012, and began laying the
groundwork for adapting Dr.
Skandalakis' legacy to the
communications technology of the 21st century. In 2013, the center relocated
from its offices at 1462 Clifton Road, NE, to the Surgical Education Office in
Emory University Hospital.
During this period, Carol and Phylliswho retired in mid 2013assisted Emory
vascular surgery chief Dr. Thomas Dodson with the 5th edition of Medical
Management of the Surgical Patient, a book featuring Emory authors that
provides an evidence-based approach for perioperative care and surgical
management. "It was a wonderful experience to work with surgeons across the
entire breadth and depth of the Department of Surgery. There is such a passion
for delivering optimal patient care across clinical fields," says Carol.
Throughout her CSAT years, Carol has been an avid participant in several of
Emory's initiatives, including Mentor Emory, the Transforming Community
Project, the Center for Women, and the Office of Sustainability. "My husband
and I get particular pleasure from serving as a host family for international
participants in the Humphrey Fellows Program of the Rollins School of Public
Health," says Carol. She plans to continue such activities as a retiree, primarily
because, "Emory has given so much to me, and I just want to give back."
Upcoming events
EVENT DATE/TIME LOCATION
SURGICAL GRAND
ROUNDS
The Prospective
Surveillance Model at Grady
Hospital & Implementing a
Screening Tool for
Identifying Patients at Risk
for Hereditary Breast and
Ovarian Cancer: A
Statewide Initiative
Presented by Brannon
Traxler, MD, and Veronica
J ones, MD
Breast Surgical Oncology
Fellows, Department of
Surgery, Emory University
School of Medicine
7:00 a.m. 8:00 a.m.,
J une 5, 2014
EUH auditorium
SURGICAL GRAND
ROUNDS
Joseph M. Craver Visiting
Teacher Lectureship
Pulmonary Endarterectomy
(PTE)
Presented by Stuart W.
J amieson, MB
Distinguished Professor of
Surgery and Chief of
Cardiothoracic Surgery, UC
San Diego School of Medicine
Dean, Cardiovascular
Affairs, UC San Diego Health
7:00 a.m. 8:00 a.m.,
J une 12, 2014
EUH auditorium
System
Department of Surgery
Division Chiefs Meeting
5:30 p.m. 7:00 p.m.,
J une 17, 2014
Surgery Education
Office, EUH H108 &
110
SURGICAL GRAND
ROUNDS
Technical Aspects of
Pancreatic Surgery:
Evidence and Controversies
in Breaking the Third Rule
of Surgery
Presented by Lee Ocuin, MD
Chief Resident, Department
of Surgery, Emory University
School of Medicine
7:00 a.m. 8:00 a.m.,
J une 19, 2014
EUH auditorium
SURGICAL GRAND
ROUNDS
Using Guidelines to
Approach the Diabetic Foot
Ulcer Epidemic
Presented by Glenn M.
LaMuraglia, MD
Associate Professor of
Surgery, Division of Vascular
and Endovascular Surgery,
Department of Surgery,
Massachusetts General
Hospital
7:00 a.m. 8:00 a.m.,
J une 26, 2014
EUH auditorium