Cardiothoracic surgeon Ahmet Kilic is sharply aware that he stands at the midpoint of a see-saw, one tilting downward.

Kilic was hired in 2017 as the Director of Johns Hopkins’ Heart Transplantation and Mechanical Circulatory Support Program for his art and skill in transplanting hearts and expertise in matching recipients with donors. If an organ is unavailable in a timely manner, the decision can be made to pursue surgical therapy through a ventricular assist device (VAD) or other mechanical circulatory support system.

Kilic is confident that soon, surgical therapy will level the see-saw of outcomes for sicker patients and  start its tilt in the other direction. LVAD design is steadily improving, for example. Also, Kilic says, there’s research on new materials.

He ticks off other changes: “We now see our advanced patients earlier as a team,” Kilic explains, “and we’re more often introducing the pumps earlier, when people are less sick.”

“As we solve the shortcomings of device therapy, guided by our outcomes research, we can expect procedures to become more routine,” he adds. “So far, I like best care as opposed to most care, and that is absolutely what we strive for at Hopkins—it’s our bottom line.”

Read the full story in Cardiovascular Report.