Bio

Bio


Dr. Garcia-Toca earned his medical degree at the Universidad Anahuac in Mexico. He received his general surgery training at the Massachusetts General Hospital and Brown University in 2008. He then completed a Vascular Surgery fellowship at Northwestern University in 2010.

Dr. Garcia-Toca joined Brown University as an Assistant Professor of Surgery and served as the Surgery Clerkship Director for the Medical School. Dr. Garcia-Toca is board certified in both vascular surgery and general surgery.

Dr. Garcia-Toca joined the Stanford University, Division of Vascular Surgery on March 1, 2015 as a Clinical Associate Professor of surgery. His research interests include new therapeutic strategies and outcomes for the management of vascular trauma, cerebrovascular diseases, aortic dissection and aneurysms.

Clinical Focus


  • Vascular Surgery

Academic Appointments


Professional Education


  • Board Certification: General Surgery, American Board of Surgery (2009)
  • Medical Education:Universidad Anahuac (2000) Mexico
  • Residency:Rhode Island Hospital/Brown UniversityRI
  • Fellowship:Northwestern Memorial HospitalIL
  • Residency:Massachusetts General HospitalMA
  • Internship:Cleveland Clinic FoundationOH
  • Board Certification: Vascular Surgery, American Board of Surgery (2011)
  • Board Certification, American Board of Surgery, Vascular Surgery (2011)
  • Fellowhip, Northwestern University, Feinberg School of Medicine (2010)
  • Board Certification, American Board of Surgery, General Surgery (2009)
  • Residency, Rhode Island Hospital, Brown University., General Surgery (2008)
  • Residency, Massachusetts General Hospital (2006)
  • Internship, Cleveland Clinic Foundation (2004)
  • Residency, Instituto Nacional de Ciencias Médicas Salvador Zubiran, Mexico (2003)
  • Medical Education, Universidad Anahuac, Mexico (1999)

Research & Scholarship

Current Research and Scholarly Interests


Open and endovascular management of vascular trauma, aortic dissection, complex thoracic and abdominal aortic aneurysm disease, critical limb ischemia, extracranial cerebrovascular disease and dialysis access.

Teaching

2017-18 Courses


Publications

All Publications


  • Post-operative infections are associated with increased risk of cardiac events in vascular patients. Annals of vascular surgery Chun, T. T., Garcia-Toca, M., Eng, J. F., Slaiby, J., Marcaccio, E. J., Cioffi, W. G., Heffernan, D. S. 2017

    Abstract

    Despite advances in perioperative care, the rate of cardiac events in vascular patients remains high. We have previously shown that infections in trauma patients are associated with higher rates of subsequent cardiac complications, likely due to the additive effect of a second hit of an infection following the trauma. The aim of this study was to investigate whether there is an association between postoperative infections and subsequent cardiac events in vascular patients.A 5-year retrospective review of demographics, comorbidities, operative interventions, infectious, and cardiac events in all vascular patients who underwent an operative intervention at a single tertiary referral center was performed. In patients with clinical suspicion of myocardial injury, myocardial damage was defined as troponin >0.15 ng/mL and myocardial infarction (MI) as troponin >1 ng/mL. Pneumonia was diagnosed using bronchoalveolar lavage (BAL) and considered positive if BAL fluid culture contained >10,000 colony-forming units (cfu). Urinary tract infection (UTI) was diagnosed if the urine culture contained >100,000 cfu. All other infections were diagnosed by culture data. Regression analysis was performed to assess risk of cardiac events as a function of infections adjusting for age, gender, and comorbidities.We analyzed 1,835 vascular operative interventions with the mean age of the cohort 65.5 years (65.9% male). The overall infection rate was 13.2%, with UTI being the most common (60.3%). The overall rate of myocardial damage was 8.1% and the rate of MI 3.8%. Rates of both myocardial damage (15.5 vs. 7.7%; P = 0.0015) and MI (7.1 vs. 3.4%; P = 0.018) were significantly higher in patients with infections, compared to those without infections. Adjusting for age, gender, medical comorbidities, open versus endovascular cases as well as statin and steroid use, patients with UTI were more likely to subsequently develop either myocardial damage (odds ratio [OR] = 3.57 [95% confidence interval = 1.51-8.45]) or MI (OR = 4.20 [1.23-14.3]). A similar association was noted between any infections and either myocardial damage (OR = 2.97 [1.32-6.65]) or MI (OR = 4.31 [1.44-12.94]).We herein describe an association between postoperative infections, most commonly UTI, and subsequent cardiac events. Efforts should be made to minimize the risk of developing infections to ensure cardioprotection in vascular patients during perioperative period.

    View details for DOI 10.1016/j.avsg.2016.09.026

    View details for PubMedID 28238924