Dr. Thomas L. Spray is chief of the Division of Cardiothoracic Surgery at The Children's Hospital of Philadelphia, director of the Hospital's Thoracic Organ Transplantation Program and Alice Langdon Warner Professor of Surgery at the University of Pennsylvania School of Medicine. Dr. Spray received his medical degree and training in general and cardiothoracic surgery at the Duke University School of Medicine and specialty training at the National Institutes of Health before joining the staff at Washington University, St. Louis, going on to become chief of cardiothoracic surgery there. He joined the staff at The Children's Hospital of Philadelphia in 1994.
Dr. Spray takes a creative, individualized approach to reconstructive operations in neonates and infants and is a proponent of early corrective repair when possible. Dr. Spray has also maintained the Hospital's preeminence in the management of infants and children with complex "single ventricle" physiology. He is an internationally recognized leader in the application of the pulmonary autograft as a replacement for the aortic valve ("Ross procedure") in the pediatric population. He has contributed widely to the literature in congenital cardiothoracic surgery and holds numerous leadership positions in national and international professional associations.
Dr. Spray also brought to the institution unique capabilities in pediatric heart and lung transplantation. In just a few years, the program has become the most comprehensive service of its kind on the eastern seaboard. Infants and children with a wide variety of complex cardiac and pulmonary disorders, for whom transplantation is the optimal treatment, can be fully evaluated and treated by a specialized multidisciplinary team at Children's Hospital under Dr. Spray's direction. He has successfully transplanted a series of children following a period on extracorporeal membrane oxygenation (ECMO) as a "bridge" to transplant and added living-donor lobar lung transplantation to the program.
Under Dr. Spray's leadership, a multidisciplinary approach to the care of pediatric cardiothoracic patients was put in place. Cardiac services at Children's Hospital have now expanded to provide total care for the full range of infants and children with congenital cardiothoracic disorders.
- Education and Training
MD - Duke University School of Medicine, Durham, NC
General and Thoracic Surgery - Duke University School of Medicine, Durham, NC
Research Fellow in Surgery - Duke University School of Medicine, Durham, NC
Staff Associate, Pathology Branch - National Institutes of Health, Rockville, MD
- Titles and Academic Titles
Chief, Division of Cardiothoracic Surgery
Alice Langdon Warner Endowed Chair in Pediatric Cardiothoracic Surgery
Professor of Surgery, Perelman School of Medicine at the University of Pennsylvania
- Centers and Programs
Kirshbom PM, Gaynor JW, Spray TL. Heart and lung transplantation. In: Nelson, Greeley et al (Eds.) Critical Heart Disease in Infants and Children, Harcourt Health Sciences. In press
Rychik J, Spray TL. Strategies to treat protein-losing enteropathy. In: Pediatric Cardiac Surgery Annual of the Seminars in Thoracic and Cardiovascular Surgery, Vol 5, 2002.
Spray TL, Bridges ND: Lung transplantation for pulmonary hypertension. In: Braunwald E (Ed.) Advances in Cardiology, McGraw-Hill Professional, New York, NY 2002.
Gardner TJ, Spray TL (Eds.) Rob & Smith's Operative Surgery. London: Arnold Publishers, 2002.
Hoffman TM, Spray TL. Foreword. In: Rychik J, and Wernovsky G (Eds.). The Hypoplastic Left Heart Syndrome, 2001.
Hoffman TM, Spray TL. Infant heart transplantation for HLHS. In: Rychik J, and Wernovsky G (Eds.). The Hypoplastic Left Heart Syndrome, 2001.
Spray TL. Reconstructive surgery: First stage. In: Rychik J, and Wernovsky G (Eds.). The Hypoplastic Left Heart Syndrome, 2001.
Spray TL. Invited Commentary on: Kumar RNS, Dharmapuram AK, Rao IM, Gopalakrishnan VC, Pillai VR, Nazer YA, Cartmill T. The fate of the unligated vertical vein after surgical correction of total anomalous pulmonary venous connection in early infancy. J Thorac Cardiovasc Surg 2001;122:615-17
Wernovsky G, Marino BS, Spray TL. Immediate results after the Ross operation. In: Miller WJ (Ed.) Progress in Pediatric Cardiology 2001.
Spray TL. Use of pulmonary autograft for aortic valve replacement. In: Gardner TJ and Spray TL (Eds.). Rob & Smith Operative Cardiac Surgery. 5th Edition. London: Arnold Publishers, 2001.
Spray TL. Hypoplastic left heart syndrome. In: Gardner TJ and Spray TL (Eds.). Rob & Smith Operative Cardiac Surgery. 5th Edition, London: Arnold Publishers, 2001.
Spray TL. Atrioventricular septal defects. In: Gardner TJ and Spray TL (Eds.). Rob & Smith Operative Cardiac Surgery. 5th ed. London: Arnold Publishers, 2001.
Gold JP, DeCamp MM Jr., DiSesa VJ, Grossi EA, Spray TL, Whyte RI, Wood D, Zwischenberger JB (Eds.). Prerequisite thoracic surgery curriculum. A multimedia textbook of introductory topics in cardiothoracic surgery. 2001 Thoracic Surgery Directors Association: 2001 Thoracic Surgery Directors Association: Irvington (New York): Amadeus Multimedia Technologies; 2001.
Spray TL (Ed.). Seminars in thoracic and cardiovascular surgery. Pediatric Annual 1999. Philadelphia (PA): WB Saunders Co., 1999.
Kaiser LR, Kron L, Spray TL (Eds.) Mastery of Cardiothoracic Surgery. Lippincott-Raven Publishers, Philadelphia, 1997.
Spray TL. Transposition of the great arteries. In: Kaiser LR, Kron L, Spray TL (Eds.). Mastery of Cardiothoracic Surgery. Lippincott-Raven Publishers, Philadelphia, 1997, 785-800.
Spray TL. Truncus Arteriosus. In: Kaiser LR, Kron L, Spray TL (Eds.). Mastery of Cardiothoracic Surgery. Lippincott-Raven Publishers, Philadelphia, 1997, 759-770.
Spray TL. Lung and Heart-Lung Transplantation in Children. In: Kaiser LR, Kron L, Spray TL (Eds.). Mastery of Cardiothoracic Surgery. Lippincott-Raven Publishers, Philadelphia, 1997, 916-929.
Ballweg JA, Dominguez TE, Tabbutt S, Rome JJ, Gaynor JW, Nicolson SC, Spray TL, Ravishankar C. Reintervention for arch obstruction after stage 1 reconstruction does not adversely affect survival or outcome at Fontan completion. J Thorac Cardiovasc Surg. 2010 Sep;140(3):545-9. Read abstract.
Nathan AT, Marino BS, Dominguez T, Tabbutt S, Nicolson S, Donaghue DD, Spray TL, Rychik J.Tricuspid valve dysplasia with severe tricuspid regurgitation: fetal pulmonary artery size predicts lung viability in the presence of small lung volumes. Fetal Diagn Ther. 2010;27(2):101-5. Epub 2010 Jan 12.
Fuller S, Spray TL. How I manage mitral stenosis in the neonate and infant. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2009:87-93.
Licht DJ, Shera DM, Clancy RR, Wernovsky G, Montenegro LM, Nicolson SC, Zimmerman RA, Spray TL, Gaynor JW, Vossough A. Brain maturation is delayed in infants with complex congenital heart defects. J Thorac Cardiovasc Surg. 2009 Mar;137(3):529-36; discussion 536-7.
Jacobs JP, Jacobs ML, Lacour-Gayet FG, Jenkins KJ, Gauvreau K, Bacha E, Maruszewski B, Clarke DR, Tchervenkov CI, Gaynor JW, Spray TL, Stellin G, O'Bien SM, Elliott MJ, Mavroudis C.
Pediatr Cardiol. 2009 Nov;30(8):1117-30.
Hehir DA, Dominguez TE, Ballweg JA, Ravishankar C, Marino BS, Bird GL, Nicolson SC, Spray TL, Gaynor JW, Tabbutt S. Risk factors for interstage death after stage 1 reconstruction of hypoplastic left heart syndrome and variants. J Thorac Cardiovasc Surg. 2008 Jul;136(1):94-9, 99.e1-3. Epub 2008 May 22.
Ballweg JA, Dominguez TE, Ravishankar C, Gaynor JW, Nicolson SC, Spray TL, Tabbutt S. A contemporary comparison of the effect of shunt type in hypoplastic left heart syndrome on the hemodynamics and outcome at Fontan completion. J Thorac Cardiovasc Surg. 2010 Sep;140(3):537-44. Read abstract.
Durduran T, Zhou C, Buckley EM, Kim MN, Yu G, Choe R, Gaynor JW, Spray TL, Durning SM, Mason SE, Montenegro LM, Nicolson SC, Zimmerman RA, Putt ME, Wang J, Greenberg JH, Detre JA, Yodh AG, Licht DJ. Optical measurement of cerebral hemodynamics and oxygen metabolism in neonates with congenital heart defects. J Biomed Opt. 2010 May-Jun;15(3):037004. Read abstract.
Hanna BM, El-Hewala AA, Gruber PJ, Gaynor JW, Spray TL, Seliem MA. Predictive value of intraoperative diagnosis of residual ventricular septal defects by transesophageal echocardiography. Ann Thorac Surg. 2010 Apr;89(4):1233-7. Read abstract.
Ades AM, Dominguez TE, Nicolson SC, Gaynor JW, Spray TL, Wernovsky G, Tabbutt S. Morbidity and mortality after surgery for congenital cardiac disease in the infant born with low weight. Cardiol Young.2010 Feb;20(1):8-17. Epub 2009 Dec 18.
Spray TL. The quality conundrum. J Thorac Cardiovasc Surg. 2009 Nov;138(5):1053-9. No abstract available.