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Preventing an Electrical Storm FACULT Y SPOTLIGHT

Dr. Arturo Suarez

Just days after the new year, Dr. Arturo Suarez and Jennifer Reilly gave each other a fist bump and headed into the operating room for a surgery that has never before been documented. This 28-year-old patient was like none other Dr. Suarez had treated before – she has Brugada syndrome, a potentially life-threatening heart rhythm disorder, and was diagnosed with end-stage liver disease, desperately in need of a liver transplant. She also has an implantable cardioverterdefibrillator, a device that can shock her to return her heart to normal rhythm should it go into lethal arrhythmia, making her transplant exceptionally challenging. Looking back, Reilly describes Dr. Suarez, chosen for this year’s “Faculty Spotlight,” as “a little piece of a miracle.” Reilly’s journey to the OR began in August of 2015 when she noticed her eyes were jaundice and she was diagnosed with mononucleosis. Three months later when her skin also turned jaundice, she went straight to the ER for another round of steroids and additional testing. On December 21, Reilly was diagnosed with end-stage liver 22

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DUKE ANESTHESIOLOGY

disease. After spending the holiday with her family in Pennsylvania, she was admitted to Duke University Hospital with spontaneous bacterial peritonitis (SBP), an infection of the ascitic fluid accumulated in the abdomen. On January 2, her name was placed at the top of the liver transplant list. Just three days later, she was matched with

a liver and introduced to Dr. Suarez. “He sat down on my bed with me and explained that he spent many nights at home researching my case to make sure that I was going to be safe during anesthesia. That brought me to tears,” remembers Reilly, who had never before been anesthetized. “I was so appreciative of that because you rarely find that personal touch in a doctor.” “The prevalence of Brugada syndrome is very low,” says Dr. Suarez. “To couple that with a liver transplant is remarkably rare.” Brugada syndrome is a genetic disease that is characterized by abnormal electrocardiogram findings and an increased risk of sudden cardiac arrest, most frequently diagnosed in adult men. Knowing this risk, Dr. Suarez spent weeks developing a detailed plan, outlining every step of the anesthesia protocol and researching drugs that he could use to not only put Reilly to sleep, but that could support her during the most stressful stages of surgery. “We could not afford for Reilly to become hemodynamically unstable, or have her

Photos Courtesy of Dr. Arturo Suarez

By Stacey Hilton

2016 BluePrint  
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