Joseph D. Schmoker, MD

Education:

Training:

Residency

Fellowship

Specialty:

Certifications:

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Biography:

Dr. Schmoker serves as Associate Professor of Surgery and Medicine at the University of Vermont and is the Director of the Center for Thoracic Aortic Disease at Fletcher Allen Health Care. His clinical interests include repair of complex aortic defects, mitral valve repair, the use of arterial conduits in coronary artery revascularization, and surgery for heart failure.

Major Research Interests:

Dr. Schmoker's research interests include investigating the mechanisms of saphenous vein graft disease.  Specifically, the role of pressure on morphologic change within the saphenous vein, and comparison to arterial conduits, is studied.  Both organ culture and a novel pressure incubator are utilized.  The system will be validated with an in-line pressure/flow chamber that is currently under development.

A second major area of interest is investigation into the effect of pressure on the extracellular matrix of the aortic wall in relation to human thoracic aneurysm formation.  Special emphasis is placed on the study of the aortopathy associated with bicuspid aortic valve disease.  A pressure incubator is utilized to study the effect of pressure on the expression of matrix metalloproteinases and their inhibitors within the aortic wall.  Studies are now being directed towards elucidating the signaling pathways leading to pressure-associated matrix destruction, including reactive oxygen species generation and their induction of the mitogen-activated-protein-kinase signaling pathways.

A third area of investigation involves the study of the effects of cardiopulmonary bypass and profound hypothermic circulatory arrest on the cerebral resistance vessels and the cerebral microcirculation. A multi-factor approach utilizes an in vivo cranial window preparation, an ex vivo organ chamber, cell culture, and molecular biological methods to characterize phenotypic changes that occur within the pial arterioles and endothelial cells after exposure to the potentially injurious insults.

The final area of interest is the development of a reproducible animal model of graded thoracic aortic injury, used to investigate the mechanisms leading to either accident scene death or survival to surgery.

Recent Grant Support

Grant Title: The Effect of Cardiopulmonary Bypass Perfusate Temperature on Cerebral Resistance Vessels
Sponsor: The Totman Center for Cerebrovascular Research
Co-Investigator: George Wellman, Ph.D.

Grant Title:  Pressure-Induced REmodeling of the Human Thoracic Aortic Wall: Role of Reactive Oxygen Species and Induction of the MAP Kinase Pathway
Sponsor:  URECA! Undergraduate Research Endeavors and the Vermont Space Grant Consortium (2008)
Co-Investigator:  Maggie Saxe-Sager, Honor's College

Publications:

Representative Publications from a Total of 45

Faul JL, Hoang K, Schmoker JD, Vagelos R, Berry GJ: Constrictive pericarditis due to
coccidiomycosis. Annals of Thoracic Surgery 68:1407-1409, 1999.

Patel MA, Schmoker JD, Moses PL, Anees R, D'Agostino R: Mycotic arch aneurysm and aortoesophageal fistula in a patient with melioidosis. Annals of Thoracic Surgery 71:1363-1365, 2001.

Schmoker JD, Miller DC: A simple trick for repairing coronary pseudoaneurysm complicating a Bentall operation. Annals of Thoracic Surgery 74:268-270, 2002.

Fellinger E, Trombley L, Schmoker JD: Matrix metalloproteinase levels in thoracic aortic aneurysms. Journal of the American College of Surgeons 195(3S):S101, 2002.

Loubser PG, Stoltz SM, Schmoker JD, Bonifacio F, Battle RW, Marcus S, Krumholz CF, Moskowitz DM, Shander A, Lemmer JH Jr:  Blood conservation strategies in Jehovah's Witness patients undergoing complex aortic susrgery: A report of three cases.  Journal of Cardiothoracic and Vascular Anesthesia 17:528-535, 2003.

Boyum J, Fellinger EK, Schmoker JD, Trombley L, McPartland K, Ittleman FP, Howard AB.  Matrix metalloproteinase activity inthoracic aortic aneurysms associated with bicuspid and tricuspid aortic valves.  Journal of Cardiothoracic Surgery 127:686-691, 2004.

Schmoker JD, McPartland KJ, Fellinger EK, Boyum J, Brombley L, Ittleman FP, Terrien C 3rd, Stanley A, Howard A:  Matrix metalloproteinase and tissue inhibitor expression in atherosclerotic and nonatherosclerotic thoracic aortic aneurysms.  Journal of Thoracic Cardiovascular Surgery 133:155-161, 2007.

Bradley JT, Schmoker JD, Dauerman HL:  Complete cypher(r) stent fracture andmigration in the ostium of the right coronary artery.  Journal of Invasive Cardiology 19:E99-E101, 2007.

Schmoker JD, Lee CH, Taylor R, Chung A, Trombley L, Hardin N, Russell SR, Howard A: A novel model of blunt thoracic aortic injury: a mechanism confirmed?  Journal of Trauma 64:923-931, 2008.

Schmoker JD, Terrien III C, McPartland KJ, Boyum J, Wellman G, Trombley L, Kinne J: Cerebrovascular response to continuous cold cerebral perfusion and hypothermic circulatory arrest.  Journal of Thoracic Cardiovascular Surgery, in press.