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Saving the heart that is saving the world

Published: July 31, 2018
John Lukas has dedicated the last 30 years to saving the okapi from extinction. View Larger Image
Dr. Soffer standing next to John Lukas the morning after his procedure. View Larger Image

Wildlife biologist can continue to protect endangered animals thanks to UF Health cardiologists.

They were once considered the mythical unicorns of the forest, with many people unsure they even existed.  The large mammal looks like a mix of deer, giraffe and zebra, and can only be found deep inside the African jungles of the Democratic Republic of Congo.

“The okapi is entirely dependent on the forest sanctuary for its survival, and deforestation, along with poaching and mining, have led to its decline,” said John Lukas, conservation manager at the Jacksonville Zoo and Gardens.

Lukas, 69, is the president of the Okapi Conservation Project and is a founding member and vice president of the Wildlife Conservation Network. He has dedicated the last 30 years to trying to save this elusive animal from extinction.

“The okapi is extremely rare and was only discovered in 1901, even though they have been living in the forests of the Congo for 6 million years,” Lukas said. “We estimate that there might only be around 25,000 left in the wild.”

It’s just one of many endangered animals the conservation biologist works to keep alive, including the five remaining species of rhino. He travels all over the United States and Africa to address congressional committees, attend fundraisers, conduct research, speak at conferences and manage the okapi sanctuary.

“When I took this project on in 1987, there was no protected area for this animal in all of Africa,” Lukas said. “The Okapi Wildlife Reserve is now almost 14,000 square kilometers, or about one-and-a-half times the size of Yellowstone National Park.”

Last year, Lukas’ active lifestyle significantly slowed down. He became too weak to travel or speak at conferences, so he made an appointment at UF Health Cardiovascular Center – Jacksonville.

“He noticed significant deterioration in his exercise capacity and experienced shortness of breath and fatigue that was unusual for him,” said Daniel Soffer, MD, medical director of endovascular cardiology. “It worsened within a few months to a year, so it was a relatively rapid deterioration.”

Lukas has degenerative aortic valve disease, which causes his heart valves to harden over time. Ten years ago, Lukas underwent open-heart surgery in New York to have a tissue valve replacement. Tests showed the valve had weakened since his surgery, severely limiting the amount of blood going through his heart.

“His echocardiogram showed there was severe narrowing of the valve, which required a transcatheter aortic valve replacement, also known as a TAVR,” Soffer said.

“Open-heart surgery carries significant risks the first time you do it, but open-heart surgery a second time carries a much higher risk,” said John Pirris, MD, a cardiothoracic surgeon at UF Health Jacksonville and chief of cardiothoracic surgery at the University of Florida College of Medicine – Jacksonville. “Based on the fact that he had prior open-heart surgery and a few other medical problems, we felt it best that he have a TAVR.”

Similar to a stent placed in an artery, the TAVR approach delivers a fully collapsible replacement valve through a catheter. Once the new valve is expanded, it pushes the old valve out of the way and the tissue in the replacement valve takes over the job of regulating blood flow. Soffer was able to perform the procedure through a small incision in the groin.

“We are able to perform it with just a poke in the groin in more than 95 percent of our patients, which is far greater than any other program,” Soffer said. “Most of our patients are awake with minimal sedation, and we are able to keep them comfortable throughout the procedure. It provides a quicker recovery and allows us to take care of higher-risk patients.”

Immediately after the TAVR, Lukas had a pacemaker implanted to further improve blood flow to his heart. Despite having two procedures, he was able to walk out of the hospital the next day.

“My recovery this time around was nothing like when I had open-heart surgery,” Lukas said. “Ten years ago, I was down for more than a month, but with this procedure, I was back on my feet after two nights.”

Lukas was even able to speak at the 2017 Fall Wildlife Conservation Expo in San Francisco, which serves as a major fundraiser for the Okapi Conservation Project.

“It is through education that we are able to save endangered wildlife in important places around the world,” Lukas said. “It is how we fight the exploitation mentality and help people on the ground level understand.”

Pirris refers to Lukas as an example of how minimally invasive techniques can be used to achieve excellent outcomes.

“We applaud him for his effort and ability to be able to recover as quickly as he did and go on to live a very fruitful life,” Pirris said.

Pirris and Soffer are two members of the structural heart team at UF Health Jacksonville. The group meets every Monday to discuss the procedures scheduled to take place that week.

“A patient may only be in direct contact with one or two cardiologists, but the entire team plays a role in their care,” said Andres Pineda Maldonado, MD. “We analyze every patient’s case together and discuss the treatment plan that will provide the best possible results.”

Since his procedure, Lukas has returned to Africa three times and has continued flying around the country, advocating for the protection of endangered species. Thanks to his UF Health providers, Lukas can continue fighting to ensure okapis can live peacefully in the Congo for many more years to come.

John Lukas has dedicated the last 30 years to saving the okapi from extinction.
Dr. Soffer standing next to John Lukas the morning after his procedure.

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