News from UCLA Health UCLA Clinical Updates Learn about the Latest Advances from UCLA UCLA thoracic transplant programs Limb-sparing surgery for rare bone cancers The UCLA thoracic transplant programs are among the largest and busiest in the nation, having performed more than 2,000 heart transplants and 1,000 lung transplants. UCLA’s programs have the resources to care for the most complex cases. Limb-sparing surgery avoids amputation by removing only the tumor and a small portion of the surrounding soft tissue. Over 90 percent of bone sarcoma cases can be surgically managed by limb-sparing surgery. Cardiac revascularization program Study analyzes radiotherapy, surgery for very aggressive prostate cancer The UCLA CHIP program focuses on treating patients with complex coronary artery disease and heart failure who are considered high risk for surgical revascularization procedures, such as vascular bypass. Radiofrequency ablation for spinal metastases Radiofrequency ablation (RFA) has emerged as a highly successful approach to alleviating the intense pain experienced by cancer patients with bone metastases. UCLA is one of only a few centers in the country with experts trained to offer RFA for this type of palliative care. First dissolvable cardiovascular stent available at UCLA UCLA is now offering the first bioabsorbable stent approved by the U.S. Food and Drug Administration to patients with coronary artery disease requiring coronary stenting. After the stent resorbs, the vessel regains normal vasomotor function, while late complications that can occur with metallic stents are eliminated. A retrospective analysis by researchers at UCLA’s Jonsson Comprehensive Cancer Center has concluded that high-dose radiation therapies may be as effective as radical prostatectomy for treating very aggressive prostate cancer. Discovery Could Lead to New Insomnia Treatments UCLA scientists have found evidence that a gene outside the brain controls the ability to rebound from sleep deprivation. The discovery could lead to greatly improved treatments for insomnia and other sleep disorders that do not involve getting a drug into the brain. uclahealth.org/sleepbiology Placement and removal of inferior vena cava filters Combination Therapy Could Provide New Treatment for Ovarian Cancer While inferior vena cava filters can effectively prevent blood clots from traveling to the heart and lungs, the FDA recommends their removal as soon as protection from blood clots is no longer needed. UCLA researchers have pinpointed a combination therapy that may be effective for up to 50 percent of women with ovarian cancer. Clinic treats male-factor fertility issues uclahealth.org/combinationtherapy Male-factor fertility problems play a role for about half of all couples having difficulty getting pregnant. When properly identified, most male-factor fertility problems can be overcome, and couples can often succeed in initiating a pregnancy. To download these and other clinical advances at UCLA Health, go to: uclahealth.org/clinicalupdates Virtual Reality Unlocks Mysteries of Memory A study by UCLA researchers is the first to blend virtual reality with a surgically implanted prosthesis to reveal what happens in the brain when people create memories. uclahealth.org/mysteriesofmemory New cardiac revascularization program aimed at high-risk patients Clinic treats male-factor fertility issues Managing symptoms and improving quality of life In-house, same-day semen analysis Since 2015, UCLA has been performing in-house, same-day semen analysis at The Men’s Clinic andrology lab in Santa Monica. In the past, patients with complex cardiovascular disease or heart failure may have been denied treatment due to the risks of intervention. In the UCLA CHIP program, these patients are evaluated and offered treatments that may dramatically impact longevity and quality of life, says Ali Nsair, MD, assistant professor in residence at UCLA. The UCLA CHIP program, (Complete Revascularization in High-risk Indicated Patients) focuses on treating patients with complex coronary artery disease (CAD) and heart failure who are considered high risk for surgical revascularization procedures, such as vascular bypass. The UCLA CHIP team — which includes experts in cardiothoracic surgery, interventional cardiology, electrophysiology, heart failure and mechanical circulatory support — specializes in caring for high-risk patients, offering multi- disciplinary patient evaluations aimed at determining the most appropriate and safest interventions and therapies. The program uses advanced technologies, such as percutaneous hemodynamic support devices during revascularization procedures, to support high-risk patients during these procedures. The program was developed to serve the growing number of patients with high-risk CAD who require interventions that can best be provided at a tertiary center with the appropriate expertise. CAD is the most common type of heart disease, resulting in more than 370,000 deaths in the United States annually. The disease is characterized by plaque buildup that constricts the arteries supplying blood to the heart. Today, CAD patients are typically living longer despite risk factors that include advanced age, diabetes, previous cardiac surgeries and peripheral vascular disease. These patients typically experience poor quality of life due to angina, shortness of breath and restricted activity and are at increased risk of heart attack. UCLAHEALTH.ORG 1-800-UCLA-MD1 “This is a one-stop shop where these complex patients get assessed by the team,” he says. “Then, working with the patient, their family and the team, we ask, ‘What is the best option for this patient?’” Recent advances, such as a percutaneous ventricular assist device, provide high-risk patients with treatment options that can significantly improve their lives. “These patients often experience intractable chest pain and are incapacitated by their symptoms,” Dr. Nsair says. “Our objective is to offer the best treatment to improve the quality of life of these patients so they can live longer and healthier lives.” (1-800-825-2631) UCLAHEALTH.ORG “When couples come in for a fertility evaluation, the man’s semen can be analyzed and we can review the results as part of the initial consultation and begin planning treatment with the couple on the day of their initial visit,” says Jesse N. Mills, MD, associate professor of urology and director of The Men’s Clinic at UCLA. While fertility treatments have typically focused on the female partner, male-factor fertility problems play a role for about half of all couples having difficulty getting pregnant. When properly identified, most male-factor fertility problems can be overcome and couples can often succeed in initiating a pregnancy. Lifestyle options for improving male fertility Nutrition, exercise and sleep are three lifestyle factors that can play large roles in improving male fertility. Good nutrition habits to improve fertility include eating dark-fleshed fruits and vegetables, which are good sources of antioxidants and can improve sperm function. Physical activity also increases antioxidant levels and helps produce healthy sperm. Poor sleep is associated with hormonal problems in men, including altered testosterone levels. Insufficient sleep and disturbed sleep due to work shifts outside of customary daylight hours can affect men’s ability to produce sufficient healthy sperm. The Men’s Clinic at UCLA, which takes a novel approach to men’s health by encouraging men to take ownership of their own healthcare, can help direct men to lifestyle habits that are consistent with good reproductive health. UCLAHEALTH.ORG 1-844-4UCLADR (1-844-482-5237) 1-800-UCLA-MD1 (1-800-825-2631) “Instead of having to go to an outside laboratory and waiting for days for the results,” explains Dr. Mills, “couples and their physicians are able to get the information they need and we can begin treatment expeditiously.” Conscious Sedation a Safe Alternative for Heart-valve Procedure UCLA scientists have found that conscious sedation is a safe and viable option to general anesthesia for people who are undergoing transcatheter aortic-valve replacement. uclahealth.org/conscioussedation