Dr. Orazio Amabile, a native Arizona resident and cardiothoracic surgeon is a youthful appearing 41-year-old with a ready smile and an engaging manner. I am rounding with him today in Flagstaff, as he fills in for the local surgeon* who is on a much deserved vacation.
Dr. Amabile is one of several cardiothoracic surgeons at Phoenix Cardiac Surgery in Phoenix, Arizona, a metropolitan city of around 6 million residents. He has been a board certified CT surgeon since 2008. It’s our second meeting, and I am impressed by his relaxed yet focused approach. We start the interview when I ask him to recount the 2007 episode in Tucson that led to his police citation for bravery. He, and his colleague, cardiothoracic surgeon, Dr. M. Christina Smith were out to satisfy a late pregnancy ‘tater tot’ craving after a long day in surgery, when they witnessed a drive by shooting. After several shots were fired into a nearby car after being side-swiped by a larger vehicle, the two surgeons (Amabile & Smith) followed the injured man’s car – and finding the man gravely, and severely injured with a bullet wound to the chest, immediately arranged for transport and emergency surgery. Dr. Amabile had already alerted the operating room, and was carrying the actively dying young man to a nearby squad car when an ambulance diverted to the scene. He climbed into the ambulance and administered emergency aid during transport including CPR as the patient arrested at the entry to hospital. He and Dr. Smith then performed the emergency surgery that saved the young man’s life. (Dr. Amabile was a fellow in cardiothoracic surgery at the University of Arizona at the time.)
Since then, Dr. Amabile has worked in Phoenix, seeing patients at several institutions (St. Joseph’s, St. Luke’s and several other smaller facilities), though Banner’s Good Samaritan Hospital is his primary center of operations. As a cardiothoracic surgeon, he operates on the whole spectrum of cardiovascular and thoracic conditions, specializing in LVADs, Aortic Surgery (aortic arch/ thoracic aortic surgery) and minimally invasive thoracic surgery including single port lobectomies, wedge resections and other lung surgeries. He estimates that he does roughly 100 – 150 lung surgeries a year as part of his practice. He states that 90% of these procedures are done via minimally invasive techniques but that he doesn’t hesitate to use open techniques if that’s what is required to get the best surgical results for his patients.
Dr. Amabile also feels that large, centralized surgery programs are essential for optimal patient outcomes. For example, he states, “Arizona has 25 cardiac surgery programs which means that each surgeon, and each surgery program has much less volume [and thus experience] than if Arizona had just a few programs.” This also has an impact on the allocation of resources – which are now shunted into twenty-five directions instead of three or four major facilities.
I ask his opinion of the future of thoracic surgery and robotics – of which he is not a fan. Like many surgeons I’ve spoken to, Dr. Amabile does not feel that the use of robotics is always justified by the increased risks to the patients. “It can make a dangerous operation more dangerous.” We discuss the lack of technical advantages and the increased case durations with robotic approaches for a few minutes before the conversation turns.
Dr. Amabile sees LVADs and device therapies as the future of thoracic surgery – particularly the use of ECMO and ambulatory ECMO devices for end stage lung disease. He became more interested in the new applications of ECMO after he attended the ELSO conference in Scottsdale last year. He envisions this treatment, device therapy as a destination rather than a bridge to transplantation. To this end – he recently started a LVAD program at Good Samaritan hospital and has recently implanted his 6th device this year. He hopes to implant ten devices in the program’s first year. As part of this, he is participating in the Intermacs database to continue research into circulatory devices. (It’s his interest in this area, and the pathophysiology involved in circulatory arrest that fuels his interest and enjoyment of aortic surgery.)
At 41, Dr. Amabile is just at the beginning of a long career in cardiothoracic surgery. After attending medical school at Universidad Autonoma De Guadalajara in Guadalajara, Mexico, D. Amabile returned to the United States to do an additional year at New York Medical College. He then completed two years of his general surgery residency at Creighton University in Omaha, Nebraska before returning to his home state of Arizona for the remainder of his general surgery training and his cardiothoracic surgery fellowship (at the University of Arizona in Tucson.) Along the way, he gathered several awards in addition to his police citation mentioned above, including awards as best intern teacher, a Golden Apple award nominee (2002) and an award for excellence in customer service (the ‘Target 100’).
Dr. Orazio Amabile, MD
Phoenix Cardiac Surgery
3131 East Clarendon Ave.
Phoenix, AZ 85016
* Disclosure: I previously worked for the Flagstaff based surgeon, Dr. Steven Peterson at the Heart & Vascular Center of Northern Arizona.