In Remembrance of Dr. William Maixner

William Maixner, DDS, PhDIt is with profound sadness that we inform you about the passing of a beloved member of our Duke Anesthesiology family, William “Bill” Maixner, DDS, PhD. He passed away on November 2 at the age of 68 after battling an illness. Duke flags were lowered on November 4 in honor of his life and legacy.

Dr. Maixner, the Joannes H. Karis, MD, Professor of Anesthesiology, was a world-renowned pioneer in pain research and one of our department’s most distinguished faculty. He will be remembered as an extraordinary leader, innovator, scientist and mentor who dedicated his life-long career to unraveling the mysteries of chronic pain and was committed to translating basic discoveries into novel diagnostics and treatments to positively impact research, education and patient care.

On January 1, 2016, Dr. Maixner joined our department from the School of Dentistry at the University of North Carolina at Chapel Hill (UNC-CH), where he was the Mary Lily Kenan Flagler Bingham Distinguished University Professor, to further expand our clinical and research program in pain medicine. During his short time with us here at Duke, he achieved incredible milestones. Dr. Maixner developed and led the Center for Translational Pain Medicine, which recently received the rare and prestigious designation as a National Center of Excellence through an $8.5 million National Institutes of Health (NIH) program project grant (PPG), the first PPG in 40 years awarded to our department. He was a visionary who brought to fruition a center that united leading basic scientists, clinicians and clinical researchers under one umbrella, with the core mission of developing novel pain therapies to improve patient care. Through his leadership, this center has rapidly become internationally-recognized as a best-in-class translational pain medicine program, ultimately transforming the way we diagnose and treat painful conditions. He was also instrumental in developing Duke Innovative Pain Therapies, a first-of-its-kind multispecialty pain practice focused on non-opioid therapies, which opened its doors to patients in September 2016. In 2017, Dr. Maixner received one of the highest honors in academia with his appointment as the Joannes H. Karis, MD, Professor of Anesthesiology, designated by the Duke University School of Medicine, becoming only the fifth faculty member in our department to be named a distinguished professor. This endowed professorship recognized his remarkable achievements in advancing medical science, significantly shaping the field of pain research and education, profoundly impacting patient care and exemplifying superior mentorship. That same year, he was named our department’s vice chair for research.

Dr. Maixner was originally from Ottumwa, Iowa. After completing his BA, PhD, and DDS at the University of Iowa, he became a research fellow at the National Institute of Dental Research. He went on to become faculty at UNC-CH, where over the span of 30 years, he served as a professor in the Departments of Endodontics and Pharmacology, co-director of the Oral and Maxillofacial Pain Program, associate dean for academic affairs in the School of Dentistry, and director of the Center for Pain Research and Innovation.

Dr. Maixner played a key role as a knowledge leader in the field of pain; he served as president of the American Pain Society and on our nation’s Health and Human Services Interagency Pain Research Coordinating Committee and the NIH’s Pain Consortium, in which he helped shape the direction of our nation’s national strategies in pain research, education and patient care. He considered chronic pain to be a “hidden epidemic” and proudly campaigned for more research support amongst colleagues, sponsors, health organizations, and congressional committees.

Dr. Maixner earned several accolades throughout his career, including the New York College of Dentistry Distinguished Scientist Award and the Wilbert E. Fordyce Clinical Investigator Award from the American Pain Society. His primary research focus was on biological, environmental and genetic factors involved in pain transmission and modulation. Notably, Dr. Maixner was the principal investigator on the National Institute of Dental and Craniofacial Research’s (NIDCR) $19 million, seven-year OPPERA study to examine pain produced by temporomandibular joint and muscle disorders. In 2012, the NIDCR awarded him and his team an additional $16 million in funding to support the study (called OPPERA II) for an additional five-year period. He published more than 200 manuscripts and book chapters and was continuously funded by the NIH since 1986.

Additionally, Dr. Maixner was appointed as a member of the Foundation for Anesthesia Education and Research Academy of Research Mentors in Anesthesiology. His mentorship skills were evidenced by the success of the numerous students, trainees and mid-career scientists whom he mentored throughout his career.

Dr. Maixner’s legacy of innovation within all three pillars of research, education and patient care will forever be remembered here at Duke as we continue to honor his accomplishments and grow his goals. Most importantly, his legacy will live through his family. He was a dedicated and loving husband to his wife, Viravan, father to his two children, William and Dylan, and grandfather to two granddaughters born earlier this year.

Please join us in extending our sincerest condolences to Dr. Maixner’s family, friends and colleagues. At the request of the family, in lieu of flowers, memorial gifts may be made to our DREAM Campaign in support of research through the DREAM Innovation Grants.

Stacey HiltonIn Remembrance of Dr. William Maixner
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Duke University Hospital Program Earns Distinguished Three-Star Ratings

By Tracey Koepke, Duke Heart Center

We are pleased to share with you that our Adult Cardiac Surgery program at Duke University Hospital has, for the first time, earned three simultaneous distinguished three-star ratings from The Society of Thoracic Surgeons (STS) for its patient care and outcomes in the following areas: isolated coronary artery bypass grafting (CABG) procedures; isolated aortic valve replacement (AVR) surgery, and isolated mitral valve replacement and repair (MVRR) surgery. The three-star rating, which denotes the highest category of quality, places our program among the elite for CABG, AVR and MVRR in the U.S.

“This is a significant validation of the quality and performance that we are able to deliver in cardiac surgery — the three-star rating means that our outcomes are in the top 10 percent of all centers in the United States,” said Peter K. Smith, MD, chief of the division of Cardiovascular and Thoracic Surgery and co-director of Duke Heart Center. “That we have achieved this within each of the three most important domains of cardiac surgery — bypass surgery, aortic valve replacement, and mitral valve repair or replacement – is a tribute not just to the surgeons but our entire team of dedicated health care professionals in our Operating Room, Intensive Care Unit, and Step-down Units.”

The STS star rating system is one of the most sophisticated and highly regarded overall measures of quality in health care, rating the benchmarked outcomes of cardiothoracic surgery programs in the U.S. The star rating is calculated using a combination of quality measures for specific procedures performed by an STS Adult Cardiac Surgery Database (ACSD) participant. We achieved a two-star rating in each of the remaining two areas of reporting: AVR+CABG and MVRR+CABG.

“Any scoring system has its limitations, but this is one of the most scientifically validated systems for heart surgery. It involves a huge amount of data from almost all centers in the U.S. and a very complicated and well thought out risk-adjustment model,” according to Carmelo Milano, MD, Chief of the Section of Adult Cardiac Surgery in the division of Cardiovascular and Thoracic Surgery. “Not only are they looking at raw outcomes like survival, but they take into consideration the pre-operative conditions that may make certain cases much higher risk. This is a very well respected grading system for heart surgery.”

The latest analysis of data for CABG covers a 1-year period, from January 2019 to December 2019; the analysis of data for isolated AVR, isolated MVRR, AVR+CABG and MVRR+CABG surgeries covers a 3-year period, from January 2017 to December 2019.

Mihai V. Podgoreanu, MD

Mihai V. Podgoreanu, MD

“Achieving the elite STS three-star rating, one of the most sophisticated and highly regarded overall measures of quality in health care, is a testament to our program’s commitment to quality improvement and safety across the cardiac surgical patient journey – from careful preoperative planning and optimization, to relentless attention to detail and coordination of intraoperative and postoperative decision making among multi-disciplinary heart team members,” added Mihai Podgoreanu, MD, chief of Cardiothoracic Anesthesiology and Critical Care. “In these unprecedented times, we are united in our dedication, resilience, compassion, and innovative spirit to continue pursuing our highest purpose – excellence and quality care for patients in need of cardiac surgery and their families.”

“As an organization and a group – the STS three star rating is evidence of the dedication of our entire Heart Center around how we care for our patients with multi-disciplinary teams that start with the evaluation and identification of patients needing coronary revascularization or valve surgery all the way through recovery, rehab, and return to life,” said Manesh Patel, MD, chief of the division of Cardiology and co-director of Duke Heart Center. “I am excited that during these challenging times our teams have continued the dedication and work to stay focused on patient outcomes.”

The STS National Database was established in 1989 as an initiative for quality improvement and patient safety among cardiothoracic surgeons. The STS ACSD houses approximately 6.9 million surgical records and gathers information from more than 3,800 participating physicians, including surgeons and anesthesiologists from more than 90 percent of groups that perform heart surgery in the US. The Database includes three other components: the Congenital Heart Surgery Database (CHSD), the General Thoracic Surgery Database (GTSD), and the mechanical circulatory support database (Intermacs). Duke has participated in the STS National Database since its inception.

Stacey HiltonDuke University Hospital Program Earns Distinguished Three-Star Ratings
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Friendships Keep Anesthesia Technician at Duke for 40 Years

By Morag Maclachlan, Duke Health

Jessie Swain, CRNAWhen Senior Anesthesia Technician Jessie Swain started at Duke in 1978 he never thought he would stay until retirement.

“You never go anywhere thinking you’ll be there for 40 years,” Swain said. “But when you like what you do, why change?”

Swain retired on July 31 after 42 years at Duke. He spent the majority of those four decades with Duke Anesthesiology. He began his career as a medical supply assembler, turning over rooms after cases and stocking carts. He then became an anesthesia technician, assisting the anesthesiologists with administering medication to patients and troubleshooting equipment. Not only did he enjoy the work, he enjoyed the people.

“The most important part of the job was the friendships I made with the residents, anesthesiologists and surgeons,” Swain said. “We have a responsibility to help patients in their time of need. And we worked together as a family.”

Anesthesiologist Madhav Swaminathan, MD, said Swain always referred to him as “professor,” even early on in Swaminathan’s career. He also always asked how Swaminathan’s family was doing.

“Jessie is the consummate professional and one of the kindest human beings I know. Always working with a smile and a laugh. Eager to help anyone at any time, he simply was the role model and set the bar for professionalism in the OR,” said Swaminathan. “He makes everyone around him feel valued and important. He has probably positively shaped more lives in his 42 years at Duke than he will ever know.”

Swain is hoping to return to his Duke family in a part-time capacity beginning this fall.

“I don’t want to quit anything cold turkey,” he said. “I will come back a couple days a week to keep the camaraderie.”

Stacey HiltonFriendships Keep Anesthesia Technician at Duke for 40 Years
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