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NCIRE-The Veterans Health Research Institute is the leading private nonprofit institute devoted to Veterans health research in the United States. Our mission is to advance Veterans health through research.

We support the work of some of the nation's foremost physicians and scientists at the San Francisco Veterans Affairs Medical Center, the premier biomedical research facility in the VA system. All have faculty appointments at the University of California, San Francisco, which has its own proud traditions of research and patient care. We also partner with the U.S. Department of Defense to support health research on behalf of our men and women in the Armed Forces.

Those who have served in uniform have given their best for their country. In return, we believe that they deserve nothing less than the best health care research we can provide.

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Arthur Wallace, MD, PhD

Chief, Anesthesiology Service, SFVAMC

Professor of Anesthesia and Perioperative Medicine, UCSF
Email: Art.Wallace@va.gov

Reducing Risks of Surgery

Patients with a history of coronary artery disease, peripheral vascular disease, or risk factors including hypertension, smoking, diabetes, elevated cholesterol, or age greater than 65 have a substantially increased risk of heart attack and death when they have major surgery. Dr. Wallace demonstrated that the use of a beta blocker reduces the risk of death around the time of an operation by 50 to 90 percent, at a cost of less than $1 per patient and less than $33 per life saved. Dr. Wallace then demonstrated that clonidine, a generic drug used to treat hypertension, also reduced the risk of death associated with surgery, potentially helping patients with risk factors associated with use of beta blockers. The use of beta blockade around the time of surgery has not only reduced operative risk, but has changed the approach of cardiology to the surgical patient and dramatically reduced operative costs. Perioperative beta blockade protocol has been adopted by the American Heart Association and American College of Cardiology for patients with coronary artery disease or peripheral vascular disease. Dr. Wallace created a two-hour online course for medical practitioners entitled "Beta Blocker and Clonidine Protocol," available at http://www.betablockerprotocol.com/. The course is free and can be taken for continuing medical education credit.

 Dr Wallace has also worked extensively on medical device and software design. He designed and developed the ECOM  (Endotracheal Cardiac Output Monitor), the AVD (Electronic Sedation System), and Pre-Procedural Checklist Tool. Each of these projects is designed to reduce perioperative risk, morbidity, and mortality.

To see Dr. Wallace on Pub Med, click here.