in a heartbeat - medstar health · 2017-07-07 · cardiac surgery 2 structural heart disease 4...
TRANSCRIPT
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2016
in a heartbeat
MEDSTAR HEART & VASCULAR INSTITUTE IS THE LEADING
CARDIOVASCULAR PROGRAM IN THE MID-ATLANTIC REGION,
AND PROVIDES COMPREHENSIVE CARE AND TREATMENT
FOR COMPLEX CARDIOVASCULAR DISORDERS.
stats at a glanceMedStar Heart & Vascular Institute Statistics
CONTENTSCardiac Surgery 2
Structural Heart Disease 4
Interventional Cardiology 6
Electrophysiology 8
Advanced Heart Failure 10
VAD/Transplant 12
Vascular Surgery 14
Cardiology 16
Cardiac Imaging 17
Cardiogenetics 18
Cardio-oncology 18
Pulmonary Hypertension Clinic 19
Anesthesiology, APCs, Nursing 20
Weekly Team Meetings 21
Cardiovascular Research 22
Zirkin Heart & Vascular Hospital 24
Cleveland Clinic Alliance 25
GME and CME 26
MedSTAR Transport 27
Physician Listing 28
Contact Information 29
1-5051-100101-50005001-60006001-8000
2300CARDIAC
SURGERIES ANNUALLY
5000+EP PROCEDURES
ANNUALLY
500+VADSTO DATE
TAVR PROCEDURES
TO DATE
1500+
Geographic Distribution of MedStar Washington Hospital Center Admissions in FY15 & FY16
D.C.
Stuart F. Seides, MD Physician Executive Director,
MedStar Heart & Vascular Institute
From the vantage point of the ages, 60 years is simply a single heartbeat. Yet in that heartbeat—the time since we opened our doors at MedStar Washington Hospital Center—the medical community has been rapidly uncovering the mysteries of our body’s most amazing organ: the heart.
It was only in the late 1950s that we discovered the power of an external defibrillator to return a quivering heart back to normal rhythm. That’s how basic our knowledge was at the beginning of this “heartbeat.” At the Hospital Center, birthplace of MedStar Heart & Vascular Institute (MHVI), we have long been at the forefront of this journey of discovery. In the early 1960s, we opened the first Coronary Care Unit and launched the first Code Blue system in the nation’s capital; in 1988, we were one of the first four hospitals in the world to implant a VAD; and since 2007, we have been involved in every major clinical trial of TAVR devices, the future for the treatment of structural heart disease. We are joined by MedStar Union Memorial Hospital, our cardiovascular hub in the Baltimore region, as well as the hospitals and providers who care for heart and vascular patients across our entire geographic footprint.
Together, we are still discovering, still trying to fully understand this complex electrically powered pump that keeps us alive. As we gather more and more data, we are doing a better job of quantifying the results of our work—not from the perspective of just one patient or one device, but from a greater vantage point. Where are we going overall? With all that we have learned in the past 60 years, how do we map the future direction of cardiovascular care for all patients and for our communities? Through continued research, leadership and collaboration, we will find answers to these questions in the next 10, 20, 60 years— in our next heartbeat.
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Stuart F. Seides, MD Physician Executive Director
MedStar Heart & Vascular Institute
in a heartbeat...
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C A R D I A C S U R G E R Y
MedStar Heart & Vascular Institute's (MHVI) cardiac surgery program offers some of the nation’s best outcomes and has one of the highest volume centers in the area, earning the highest rating from the Society of Thoracic Surgeons for 10 straight years.
With a focus on innovation, MHVI has a long history of creating and testing new technologies, techniques and approaches, placing it at the leading edge of the most advanced, effective and efficient care. As one of the first five clinical trial sites in the nation to evaluate transcatheter aortic valve replacement (TAVR), it is an international leader in the continuing development of catheter-based strategies for valvular disease. Beating-heart surgery, developed and perfected here 20 years ago, is now used in nearly half of all coronary artery bypass graft and other cardiothoracic procedures at MedStar Washington Hospital Center and MedStar Union Memorial Hospital, resulting in fewer complications and faster recovery.
■ 2,300 cardiac surgeries each year, from open procedures to grafts to combination therapies
■ Nearly 50 percent of CABGs performed off-pump systemwide
■ 100+ complex mitral valve surgical repairs annually
■ Dedicated, multidisciplinary ECMO team
■ 3-star recognition from Society of Thoracic Surgeons for CABG
restoringTHE COMPROMISED HEART
COMPLEXMITRAL VALVE
SURGICAL REPAIRS ANNUALLY
100+COMPLEX
MITRAL VALVE
2300CARDIAC
SURGERIES
Michael Fiocco, MD Chief, Cardiac Surgery
MedStar Union Memorial Hospital
Source: Combined MedStar Washington Hopsital Center and MedStar Union Memorial Hopsital 30 Day mortality rate CY 2014-2016
Actual
Predicted Mortality
CABG MORTALITY
0% 2% 4% 6%
Actual
Predicted Mortality
AVR MORTALITY
0% 2% 4% 6%
Actual
Predicted Mortality
AVR + CABG MORTALITY
0% 2% 4% 6%
C A R D I A C S U R G E R Y
AVRCardiac Surgery
AORTIC VALVE REPLACEMENT
THE SOCIETY OF THORACIC SURGEONS
AVRCardiac Surgery
AORTIC VALVE REPLACEMENT
THE SOCIETY OF THORACIC SURGEONS
CABGCardiac Surgery
CORONARY ARTERY BYPASS GRAFTING
THE SOCIETY OF THORACIC SURGEONS
CABGCORONARY ARTERY BYPASS GRAFTING
3-Star Infographics 3-ways.qxp_Layout 1 1/31/17 11:44 AM Page 1
Paul Corso, MD Chairman, Cardiac Surgery
MedStar Heart & Vascular Institute
“ As patients get sicker and need more advanced care, MHVI is their best chance to survive and thrive. No other cardiovascular program
in the region comes close to offering what we do.”
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TAVR FOR LOW-RISK PATIENTS In 2016, MHVI launched the first multi-institutional, clinical trial in the nation to evaluate the benefits of using TAVR in low-risk patients. The study, based at MedStar Washington Hospital Center, will enroll up to 200 patients in several centers across the United States. A separate, international study of low-risk patients is underway at MedStar Union Memorial Hospital. MedStar Washington Hospital Center’s
TAVR Team (L to R) Paul Corso, MD, Ron Waksman, MD, Lowell Satler, MD, and Itsik Ben-Dor, MD
MedStar Union Memorial Hospital’s TAVR Team (L to R) Michael Fiocco, MD, and John Wang, MD (not pictured: Nauman Siddiqi, MD, and Dipin Gupta, MD)
“ We can often use a catheter-based strategy to treat structural disease and get the same result as a standard open-chest operation, thanks to our experience combining interventional, surgical and imaging techniques.”
Lowell Satler, MD Medical Director
Cardiac Catheterization Lab MedStar Washington Hospital Center
TRANSCATHETER AORTIC VALVE REPLACEMENTSince participating in the initial 2007 study of transcatheter aortic valve replacement
(TAVR), MHVI has been a site for every major clinical trial. After testing TAVR’s efficacy for patients at intermediate risk, MedStar
Washington Hospital Center designed and launched the nation’s first multi-institutional, FDA-approved clinical
trial in 2016 to evaluate the device’s benefits among low-risk patients. A separate, international study of low-risk patients is also underway at MedStar Union Memorial Hospital.
Some highlights of the structural heart program include: ■ A combined average of 340 TAVR procedures annually at MHVI’s
two anchor hospitals
■ A multidisciplinary, structural heart team comprising cardiovascular surgeons, interventional cardiologists and cardiovascular imaging specialists. The Structural Heart Team convenes daily to discuss and analyze all patients that are screened for any structural heart procedure at MedStar Washington Hospital Center.
■ A Structural Heart Clinic for comprehensive patient evaluation and management
■ Access to innovative therapies through the MedStar Cardiovascular Research Network
S T R U C T U R A L H E A R T
LESS INVASIVE OPTIONS FOR MORE PATIENTS
1500TAVR
PROCEDURES TO DATE
5CATHETER-BASED
AORTIC VALVE REPLACEMENT
PLATFORMS
rebuilding structural integrity
Comprehensive Structural Heart Options
TAVR Mortality
<5%
TOTAL TAVR MORTALITYIncluding previously non-operative patients
AORTIC VALVE • SAPIEN S3, XT• CoreValve® Evolut™ R • Portico™ (trial)• Lotus™ (trial)• JenaValve for stenosis
and regurgitation
PARA-VALVULAR LEAK*• Amplatzer Vascular Plug *Can be placed in multiple locations
MITRAL VALVE REGURGITATION• MitraClip™• Tendyne valve (trial) • SAPIEN S3 and XT
for mitral annular calcification, valve-in-valve and valve-in-ring (MITRAL trial)
CONGENITAL HEART DEFECTS• ASD occluder• VSD occluder • PFO occluder for
cryptogenic stroke
LEFT ATRIAL OCCLUDER FOR STROKE PREVENTION AND A-FIB• WATCHMAN™ Device• AMPLATZER™ Amulet
device (trial)
DYSFUNCTIONAL RVOT CONDUIT• SAPIENT XT• Melody® Transcatheter
Pulmonary Valve
TRICUSPID VALVE REGURGITATION• Trialign™ (trial)
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I N T E R V E N T I O N A L C A R D I O L O G Y
John Wang, MD Medical Director
Cardiac Catheterization Lab MedStar Union Memorial Hospital
TRANSRADIAL CATHETERIZATION
MHVI cardiac interventionalists are national leaders in adopting transradial catheterization, with specialists at MedStar Union Memorial Hospital using the newer approach in 80 percent or more of their cases. Based on the demand for the procedure at MedStar Union Memorial, they are constructing a dedicated Transradial Lounge.
MedStar Heart & Vascular Institute is always among the first sites in the nation to evaluate new technology and procedures in interventional cardiology. MHVI is home to world-renowned authorities in the field who offer state-of-the-art and evolving interventional approaches including:
■ Advanced therapies for treating chronic total occlusion (CTO)
■ New stent platforms. MHVI was the first in the region to offer Absorb™—the first FDA-approved, fully dissolving, bioresorbable stent
Providing extensive experience, MHVI has one of the highest volume catheterization programs, averaging nearly 12,000 procedures annually at MedStar Washington Hospital Center and MedStar Union Memorial Hospital
TOMORROW’S TECHNOLOGY TODAY
perfecting
PCI PROCEDURE IN-HOSPITAL MORTALITY
Risk-Adjusted Mortality
2
1
0
1.5
0.5
MUMH
*
MWHC
*
Perc
ent
MWHC= MedStar Washington Hospital Center MUMH = MedStar Union Memorial Hospital* Better than expected compared to ACC-NCDR peer group
2.5
3
Source: ACC-NCDR Database; Second Quarter 2016
Lowell Satler, MD Medical Director, Cardiac Catheterization Lab
MedStar Washington Hospital Center
INTERVENTIONAL CARDIOLOGY: A HOSPITAL WITHOUT WALLS❶ Committed to promoting knowledge and awareness of the most up-to-date practices and thinking, MHVI’s weekly cath lab conferences often feature lectures and case studies by national and international experts as well as presentations of specific MHVI cases. ❷ MHVI’s specialists also serve as consultants for cardiologists across the region, reviewing and analyzing between 300 and 600 complex cases monthly. ❸ Revascularization of complex chronic coronary total occlusion (CTO) ❹ Procedure depicting TAVR evaluation. ❺ Cath Lab staff are on site to receive Code Heart patients via MedSTAR air or ground transport.
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❶ ❷ ❸ ❹ ❺
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Zayd Eldadah, MD, PhD Medical Director, Electrophysiology Lab
MedStar Washington Hospital CenterMedStar Georgetown University Hospital
E L E C T R O P H Y S I O L O G Y
The Cardiac Electrophysiology (EP) program at MedStar Heart & Vascular Institute (MHVI) is the region’s leading referral program and an internationally recognized contributor to advances in the field. It features one of the largest, best equipped, and most sophisticated cardiac EP laboratories in North America today, enabling comprehensive management of even the most complex cardiac arrhythmias. The program is a national leader in performing cryoablation procedures for atrial fibrillation and is also the mid-Atlantic’s most experienced facility with the WATCHMAN™ Device, the first FDA-approved left atrial appendage occlusion device for patients with atrial fibrillation. MHVI's EP program spans the spectrum of arrhythmia management in disease states, complexity and even geography. Its team of fellowship-trained, board-certified cardiac electrophysiologists manages patients at multiple sites in Virginia, Maryland and the District of Columbia. Among the capabilities offered are advanced epicardial therapies for ventricular arrhythmias, specialized techniques for cardiac resynchronization therapy and—together with cardiac surgeons— combined endocardial and epicardial ablation for refractory atrial fibrillation, extraction of cardiac rhythm management device leads, and other complex procedures.
■ 5,000+ EP procedures each year
■ 15 board-certified specialists
■ 100+ WATCHMAN procedures to date
■ 13 regional outpatient clinic sites
■ 2 concurrent clinical trials—ASAP-TOO, Amulet™—to test the next generation of left atrial appendage occlusion devices
fascinating rhythmsRESTORING HARMONY IN THE HEART
E L E C T R O P H Y S I O L O G Y
WATCHMAN™ DEVICE: BREAKTHROUGH THERAPY Designed to prevent blood clots from exiting the left atrial appendage in patients with non-valvular atrial fibrillation, WATCHMAN debuted in the spring of 2015. Before WATCHMAN ever reached the market, MHVI’s EP specialists and interventional cardiologists spent eight years testing the device under multiple clinical trials.
100+WATCHMAN
PROCEDURES TO DATE
Glenn Meininger, MD Medical Director, Baltimore RegionElectrophysiology Programs
(L to R) Sarfraz Durrani, MD, and Manish Shah, MD, perform a
WATCHMAN procedure.
5000+EP PROCEDURES
EACH YEAR
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A D V A N C E D H E A R T F A I L U R E
Samer Najjar, MD Medical Director Advanced Heart Failure Program MedStar Washington Hospital Center
“ We have broken down the silos of cardiology and cardiothoracic surgery and come together as one integrated team, united by our passion for patient care.”
TRANSITIONS CLINICThe Transitions Clinic, created through a generous gift from a grateful patient, provides patient care for complex cardiovascular patients in the first 30 days after hospital discharge. The clinic’s mission includes ensuring the successful and smooth transition from hospital to home, providing continuity of care and avoiding readmission to the hospital.
HEARTTRANSPLANT
LVAD
INOTROPICAGENTS
PALLIATIVECARE
END OF LIFE
A D V A N C E D H E A R T F A I L U R E
MHVI’s Advanced Heart Failure program provides the full range of medical management, mechanical circulatory support and heart transplantation to alleviate symptoms and lengthen lives for patients all across the continuum. An international pioneer in left ventricular assist devices, it is renowned for its innovations and aggressive pursuit of more effective therapies for the sickest of the sick, especially the subset of heart failure patients who have progressed to ACC/AHA (Stage D), the end stage of this disease.
At its core is a large, multidisciplinary team of more than 40 professionals, unrivaled within the mid-Atlantic for its scope of services, quality of care and outcomes. Beyond cardiologists and cardiothoracic surgeons, the group includes intensivists and other advanced practice clinicians, clinic and home health nurses, nutritionists, medical ethicists, VAD and transplant coordinators, physical and occupational therapists, pharmacists, nurse navigators and more. Most recently, the program became one of the first to fully integrate palliative care every step along the way, for the most personalized and holistic team approach possible.
The program’s range of diagnostic techniques, therapies and services includes:
■ Specialized cardiopulmonary stress studies for the early identification of heart failure patients who have transitioned to a more advanced state
■ A comprehensive pulmonary hypertension program offering inpatient and outpatient care, including advanced intravenous and vasodilator treatments and dedicated expertise
■ Inotropic medication for the in-home management of patients
with end-stage disease
FOR THE SICKEST OF THE SICK
When heart failure progresses to the advanced stage, a spectrum of therapies is available.
comprehensive care
Spectrum of Care
ADVANCED HEART FAILURE
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This year, the Transplant program at MHVI celebrates 30 years. The program currently includes two experienced cardiothoracic surgeons with special expertise in LVAD and transplant, along with advanced heart failure cardiologists with subspecialty board certification in transplant cardiology. They are joined by a multidisciplinary team of cardiac intensivists, transplant coordinators, nurses, social workers, pharmacists, physical therapists, nutritionists and other dedicated staff with transplant expertise, who collaborate to provide a comprehensive experience to patients, their families and their caregivers.
Highlights of the program include:
■ 250+ heart transplants since first introducing the procedure to the region in 1987
■ 1 of 5 regional heart transplant programs nationwide participating in an NIH research project to evaluate novel methods to non-invasively assess rejection
TRANSPLANTING HEARTS & HOPE
A D V A N C E D H E A R T F A I L U R E
Ezequiel Molina, MD Cardiovascular and Transplant Surgeon MedStar Washington Hospital Center
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Hea
rt T
rans
pla
nt V
olu
me
20
15
10
5
0
12
16
91.6% 87.5% 100%
18
2014 2015 2016
*CY 2016 based on six month patient follow-upHEART TRANSPLANT 1-YR SURVIVAL
A D V A N C E D H E A R T F A I L U R E
MHVI is an international leader in developing, applying and perfecting mechanical assist devices. In 1988, MedStar Washington Hospital Center became one of the first four hospitals in the world to implant a ventricular assist device (VAD). It has remained in the forefront of the field, based on expertise, infrastructure, innovation and achievements.
Internationally renowned leaders Steven Boyce, MD, and Samer Najjar, MD, lead a team of more than 40 outstanding healthcare providers managing one of the busiest VAD implanting sites in the United States. Committed to reducing mortality and improving quality of life for patients suffering from end-stage heart failure, MHVI has been involved in virtually every important new VAD development since its inception. In addition, the team has been on the forefront in all the major clinical trials testing new devices and has pioneered surgical techniques and medical management strategies of third generation continuous flow LVADs.
■ One of the top 10 surgical innovators in mechanical circulatory assist devices
■ Implanted 500+ ventricular assist devices to date
■ Currently manages 150+ VAD patients, many of whom have been living successfully with the devices for years
SMALLER DEVICES, BIGGER RESULTS
Steven Boyce, MD Surgical Director
LVAD/TransplantationMedStar Washington Hospital Center
“ End-stage CHF kills more people in the U.S. each year than most cancers, but the supply of transplantable hearts has remained steadily stagnant at around 2,000. By continuing to improve VADs, we can help revolutionize the global treatment of heart failure and extend quality of life for millions.”
IMPLANTS BY DEVICE PER YEAR
Num
ber
of I
mp
lant
s
80
60
40
20
02014 2015 2016
HMIIHM3 HVAD
70
50
30
10
Implants per year
Pro
po
rtio
n Su
rviv
ing
Years
1.00
0.75
0.50
0.25
0.000 .5 1 1.5 2
DTBTT
NUMBER AT RISK
127175
56112
2972
BTT (Bridge to Transplant) DT (Destination Therapy)
LVAD 2-YR SURVIVAL RATES
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Edward Woo, MD Director, MedStar Vascular Program
Chairman, Department of Vascular SurgeryProfessor of Surgery, Georgetown University
V A S C U L A R S U R G E R Y
The MedStar Vascular Program is the largest and most experienced program for the management of aortic disease in the mid-Atlantic and a recognized leader in the treatment of peripheral vascular disease.
These physicians are known for their expertise and quality in all aspects of vascular services. They provide care ranging from straightforward vascular disease to the most complex vascular disorders such as thoracoabdominal aortic aneurysms and aortic dissections.
A leader in minimally invasive endovascular techniques, the program is at the forefront of advancing techniques and technologies, collaborating on numerous clinical trials. It is one of only 40 sites nationwide testing the GORE® TAG® Thoracic Branch Endoprosthesis—a new investigational stent-graft that could change aortic arch to a minimally invasive procedure.
■ Performing over 270 aortic procedures in 2016, more than any other health system in the mid-Atlantic
■ Leading expertise in treating carotid disease—including endarterectomy, stenting and resection of carotid body tumors
■ Offering the most current minimally invasive approaches to limb salvage
■ Treating deep venous issues and performing radiofrequency ablation and sclerotherapy for varicose veins
■ Shaping the future of vascular surgery in clinical research and scientific advancement
■ Training the newest generation of vascular surgeons through dedicated fellowship and integrated residency programs
■ 24 vascular surgeons in a network of 9 acute care hospitals and 15 outpatient clinics
■ Noninvasive vascular laboratories performing 20,000+ studies per year
pioneeringADVANCED VASCULAR TECHNIQUES
<1% STROKE
CAROTID REVASCULARIZATIONABDOMINAL AORTIC ANEURYSM
(AAA) REPAIR*
Mortality Rate
*MedStar Washington Hospital Center Data
V A S C U L A R S U R G E R Y
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INTERDISCIPLINARY APPROACH TO COMPLEX AORTIC PATHOLOGY The Aortic program at MHVI combines the expertise of a vascular surgeon and a cardiac surgeon to thoroughly evaluate patients with complex aortic disease. During one visit, both specialists evaluate patients together to determine the least invasive, most effective surgical solution. The surgeons review images and use three-dimensional reconstruction to obtain the high level of detail needed for precise evaluation. Patients with aortic pathology—dissections, thoracic aneurysms, penetrating ulcers and connective tissue disorders, among other conditions—benefit from this interdisciplinary approach. Surgery is performed in a hybrid operating room, with sophisticated imaging and perfusionists as needed, so surgeons can perform both open and endovascular procedures.
At left, surgeons perform a complex endovascular repair of a thoracoabdominal aortic aneurysm using parallel grafting technique.
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C A R D I O L O G Y
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CARDIAC IMAGING: ILLUMINATING INFORMATION FOR CARDIOLOGISTS EVERYWHERE A trailblazer in using echocardiography and CT to diagnose and assess cardiovascular disease and guide treatment planning, MHVI has one of the most advanced cardiac imaging programs in the region. Its state-of-the-art capabilities include such advanced technologies as 3D interventional echocardiography, optical coherence tomography, fractional flow reserve studies, intravascular ultrasound, nuclear imaging, and more. A high-volume program, the team routinely reviews and interprets between 300 and 600 images each month from MedStar Health physicians and other cardiologists and subspecialists throughout the region. As a result, MHVI’s experts can quickly recognize rarely seen anomalies for the most accurate diagnosis and treatment.
If you have an image you’d like to discuss, call Lowell Satler, MD, Medical Director, Cardiac Catheterization Lab, MedStar Washington Hospital Center at 202-877-5975. Your images can be uploaded to MedStarImageShare.com
(L to R) Zuyue Wang, MD, Steven Goldstein, MD, and Gaby Weissman, MD, review a 3D transesophageal
echo (TEE) of prosthetic mitral valve.
C A R D I O L O G Y
From a straightforward diagnosis to the rarest of cases, heart patients from throughout the area are routinely referred to MHVI by other physicians in the area, a pattern that extends back nearly 60 years. With access to the most sophisticated diagnostic tools, advanced therapies and a reservoir of collective experience and knowledge, MHVI’s cardiac specialists create personalized treatment plans for patients with even the most challenging conditions. Through participation in research and contributions to emerging subspecialties, they are also helping to shape the future of care.
■ Cardiac-focused hospitalists, intensivists and specialists for consistent, responsive care, 24/7
■ Comprehensive care across an academic cardiovascular health system of 9 acute care hospitals and numerous ambulatory clinics
■ Inpatient and outpatient cardiac rehabilitation at multiple sites
■ 35,000 ambulatory visits per year
■ Top ratings from the National Cardiovascular Data Registry
KNOWLEDGE & EXPERIENCE WITHIN CARDIAC CARE
integrating
Allen J. Taylor, MD Chief, CardiologyMedStar Washington Hospital CenterMedStar Georgetown University Hospital
Mun K. Hong, MD Chief, CardiologyMedStar Southern Maryland Hospital Center
George Ruiz, MD Chief, CardiologyMedStar Union Memorial HospitalMedStar Good Samaritan Hospital
Sriram Padmanabhan, MD Chief, CardiologyMedStar Franklin Square Medical Center
35,000AMBULATORY
VISITS PER YEAR
1 OF NATION’S BUSIEST
CORONARY &CARDIAC IMAGING
PROGRAMS
C A R D I O L O G Y
Pulmonary Hypertension Clinic A large population of patients—many who go undiagnosed—suffer from pulmonary hypertension (PH). Despite the complexities of this disease, effective therapies are available in MHVI’s pulmonary hypertension clinic, under the direction of Christopher Barnett, MD, MPH. Because PH is a complex, multifactorial disease, patients undergo comprehensive evaluations to first determine the cause of PH and the best treatment for each particular case. One condition treated in the clinic—pulmonary arterial hypertension (PAH), a rare disease—is rapidly fatal if not diagnosed and treated with special medications that are complex, difficult to manage, and require close monitoring and follow up. MHVI also provides patients opportunities to participate in clinical trials and potentially gain access to new and innovative therapies to treat this disease.
MHVI partners with the National Institutes of Health to provide access to cutting edge diagnostic testing and clinical trials not available anywhere else as well as with the Pulmonary Hypertension Association to provide support for patients and caretakers.
Referrals can be made by calling the clinic at 202-877-4698 or 202-877-2339.
BREATHING LESSONS
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WASHINGTON ADULT CONGENITAL HEART CENTER The Washington Adult Congenital Heart Center (WACH) combines the forces of MHVI and Children's National Health System to treat patients with adult congenital heart disease (ACHD). The partnership is one of the few programs in the nation that caters to the complex needs of adult congenital heart patients. WACH merges the expertise of specialists at both hospitals, building on the collective experience and innovations of adult and pediatric cardiology including a team of ACHD trained specialists in electrophysiology, structural intervention, pulmonary hypertension, mechanical cardiac support, cardiovascular imaging and cardiogenetics. Call 202-877-7777.
Unraveling the Code to Heart Disease
An early adopter of the still-evolving practice, MHVI’s cardiovascular genetics services program is staffed by electrophysiologist Susan O'Donoghue, MD, and genetics counselor Aime Agather. Together, they work to improve screening, early detection and treatment of patients at risk for certain cardiac conditions with a known genetic cause. On a more basic level, MHVI is investigating the genetic basis of coronary artery disease with one current study examining the genomic compounds of atherosclerosis and others devoted to better understanding disease manifestations among diverse populations. Jose Vargas, MD, PhD, a cardiologist and researcher with MHVI, based at MedStar Georgetown University Hospital, says, “The human genome project has opened up opportunities not available before. We are poised to really understand the difference in genetic codes of individuals and how it relates to disease status.”
To reach Dr. O'Donoghue, call 202-877-7685.
CARDIOGENETICS
Leading the Way in Cross-Specialty Collaboration MHVI is among the nation’s leaders in the newly recognized field of cardio-oncology. In 2015, the American College of Cardiology (ACC) appointed the program’s founder, Ana Barac, MD, as first chair of a new section devoted to the subspecialty. This year, ACC will offer its inaugural cardio-oncology course, co-directed by Dr. Barac.
For more information, call MedStar Washington Hospital Center at 202-877-7925 or MedStar Georgetown University Hospital at 202-444-7296 or email [email protected].
CARDIO-ONCOLOGY
C A R D I O L O G Y C A R D I O L O G YC
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A weekly Catheterization Conference, led by Cath Lab Director Lowell Satler, MD, extends beyond MHVI, to physicians and researchers from all over the world who discuss recently published papers and presentations with the MHVI team. The conference engages the MHVI team with other key opinion leaders to remain up to date on important global advances in the field of interventional cardiology.
WEEKLY CARDIAC CATHETERIZATION CONFERENCE
Sharing Insight Among SubspecialistsThe Structural Heart team convenes to discuss and analyze all patients that are screened for any structural heart procedure at MedStar Washington Hospital Center. The multidisciplinary discussion focuses on the patient’s eligibility for— as well as the potential benefits of—the procedure. In addition, the team covers details of post-procedure care and discharge planning to ensure a successful and satisfying experience for the patient and patient’s family.
In addition to the Structural Heart team meeting, MHVI holds weekly Cardiology Grand Rounds, Cardiac Surgery Grand Rounds, Electrophysiology Core Curriculum Conference and Echocardiography team meetings where the specialists provide insights for improving clinical care.
COLLECTIVE WISDOM
Working alongside the surgeons, cardiologists and other specialized heart and vascular physicians are highly trained staff who help make the continuum of care seamless from entry into MHVI to long after discharge.
Cardiac AnesthesiologistsMore than a dozen cardiac anesthesiologists work at MedStar Washington Hospital Center and MedStar Union Memorial Hospital, handling the unique challenges of cardiac patients. Many of these patients have co-morbidities, may be critically ill at baseline, and often undergo major surgery with significant blood loss. The fellowship-trained cardiac anesthesiologists’ skills include placing invasive hemodynamic monitoring lines and using transesophageal echocardiography (TEE). In the electrophysiology lab, they are involved in hybrid convergent atrial fibrillation (A-fib) ablation procedures, and in the cardiac catheterization lab, in providing care during TAVR, mitral clipping and WATCHMAN™ Device procedures.
Advanced Practice CliniciansMore than three decades ago, cardiac surgeons Paul Corso, MD, and Jorge Garcia, MD, brought a team of Advanced Practice Clinicians (APC) into their practice, the first service to introduce the use of nurse practitioners and physician assistants. A novel idea at the time, it has since helped transform care delivery throughout MHVI. Now dozens of APCs, in collaboration with their attending physicians, are responsible for evaluating and treating medical problems, coordinating care with consulting services, communicating with families and the other members of the healthcare team, and discharge planning.
NursesNearly 450 nurses complete in-house training to work with patients in MHVI. They work with inpatients in critical care and ambulatory areas as well as with advanced heart failure patients. Others specialize in the procedural areas in the cardiac catheterization lab and electrophysiology lab. These nurses have chosen to specialize in heart and vascular care because of their commitment to these patients, and the opportunity to be a part of the MHVI team.
WITH HIGHLY SPECIALIZED SKILLS
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R E S E A R C H
From bench to bedside, the MedStar Cardiovascular Research Network is responsible for all heart-related basic, translational and clinical research across the MedStar Health system. The network is part of MedStar Health Research Institute, which provides needed infrastructure, including clinical research organization and IRB capabilities, research nurses, technicians and support services and staff. Led by basic scientists, senior cardiovascular investigators and cardiovascular physicians, MCRN is a comprehensive and successful research and education program designed to improve survival and quality of life for people with cardiovascular disease.
■ 12 physician scientific leads, with protected research time of 50 to 75 percent and a support team of 100
■ An internationally recognized Cardiovascular Core Laboratory with dedicated facilities and experts in angiography, echocardiography, intravascular ultrasound, cardiac MRI, cardiac CT and carotid intima-media thickness
■ Among the top cardiovascular research institutions nationwide in terms of publication, with 95 manuscripts in print for FY16 alone
■ 120 active studies on such topics as acute coronary syndrome/MI interventions, cardiac imaging, congestive heart failure, gene discovery, angiogenesis/myogenesis, investigational device studies and more
■ Founder and convener of the annual Cardiovascular Research Technologies (CRT) international conference, now in its 20th year
definingTHE FUTURE OF CARDIOVASCULAR RESEARCH
120ACTIVE STUDIES
CV RESEARCHMANUSCRIPTS IN PRINT FY16
95
CRT Group Foundation is a not-for-profit corporation dedicated to providing educational services in the field of cardiology through the website, CRTonline.org and the Cardiovascular Research Technologies (CRT) annual symposium. CRT focuses on the advances and changes in the field of cardiovascular medicine, and is designed to provide access to the world’s leading clinicians and the latest research to improve practice and treatment outcomes for a variety of healthcare professionals.
The CRT Group Foundation is located on the campus of MedStar Washington Hospital Center, the founding hospital of MedStar Heart & Vascular Institute.
This year, the annual symposium celebrates its 20th anniversary at CRT 2017, with more than 2,200 attendees. MedStar Heart & Vascular Institute supports CRT as a forum for physician and healthcare professional education about new cardiovascular technology and interventional procedures in the field.
CRT Group Foundation
NEW HYBRID THERAPIES FOR VALVULAR ABNORMALITIES MHVI is one of six centers evaluating Tendyne, a new transcatheter-based mitral valve repair system that approaches its target through a small opening in the bottom of the heart, avoiding both a sternectomy and cardiopulmonary bypass. The study is restricted to a total of 50 patients nationwide.
“ Through our robust research program, MHVI is experienced with every new device before it even gets to market.”
Ron Waksman, MD Director, MedStar Cardiovascular
Research Network and Advanced Education
Associate Director, CardiologyMedStar Washington Hospital Center
LIPID-RICH PLAQUE MHVI Leads International, Multicenter Study Using angiograms and an imaging technology that combines IVUS with near-infrared spectroscopy, MHVI is evaluating whether the presence of lipid-rich plaques can predict a future coronary event in heart patients traditionally considered at low or moderate risk. To date, more than 1,500 patients have enrolled in the MHVI-designed and led project, in 16 centers throughout the United States, Europe and Japan.
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MHVI has a dedicated quality improvement function staffed with physicians, nurses and support personnel who monitor 150 process and outcomes metrics. Each month the team meets for an in-depth review of performance against internal improvement goals and benchmarking against national registries and databases. A “deep dive” into each of the cardiac sub-specialties and the vascular program occurs on a rotating basis.
MHVI and Cleveland Clinic clinicians and staff have developed a collegial and transparent relationship that facilitates rapid cycle quality improvements. The ability to learn from each other benefits the patients and elevates the career satisfaction of all participants.
A clinical and research alliance between MHVI and the Cleveland Clinic Sydell and Arnold Miller Family Heart & Vascular Institute, now in the fifth year, has proven to be an excellent vehicle to build on the expertise of both institutions.
At the operational level, quality and safety clinicians are charged with implementing quality improvement initiatives including evaluating treatment protocols, validating and reporting outcomes, and comparing performance to national benchmarks.
The alliance also promotes communication between basic scientists and clinicians for a blended approach to research. Together, MHVI and Cleveland Clinic share a large and diverse pool of potential participants for comprehensive clinical investigations.
MHVI Quality and Safety
Cleveland Clinic Alliance
Jonathan Patrick, MD MHVI Quality and Safety Officer
Director, Cardiology Ward Service
A new era of coordinated, centralized specialty care for the most complex cardiovascular cases
In June 2016, MedStar Heart & Vascular Institute dedicated Washington, D.C.'s first cardiovascular hospital. Located within MedStar Washington Hospital Center, the opening of The Nancy and Harold Zirkin Heart & Vascular Hospital ushered in a new era of coordinated, centralized specialty care for the most complex heart and vascular cases. Every aspect of the new hospital was designed for patients’ comfort, convenience and safety, and to create an environment conducive to healing.
The $60 million, four-story, 160,000- square-foot facility was made possible, in part, through the generosity of Nancy and Harold Zirkin, who contributed $10 million to the effort.
The physical improvements position MHVI, already one of the busiest cardiac surgical centers in the United States, for continued accomplishments in the years ahead.
THE NANCY AND HAROLD ZIRKIN HEART & VASCULAR HOSPITAL
WHAT'S INSIDE
■ Outpatient clinic area including offices for cardiologists and surgeons, an enlarged Echocardiology Lab
■ An expanded 44-bed cardiovascular intensive care unit, combining cardio recovery, coronary critical care and surgical intensive care into one
■ Central booms suspended from the ceilings in ICU rooms for medical gases, electrical and data outlets, giving staff 360-degree patient access
■ 164 mostly private rooms, furnished with couches and other amenities to increase the comfort and satisfaction of patients and their families
■ Patient floors featuring their own echocardiography, X-ray, stress tests and other non-invasive services for faster, more convenient examinations and evaluations
HOSPITALS AND AMBULATORY SITESAberdeen
Bel Air
Joppatowne
White Marsh
Nottingham
Rossville
Towson
Cockeysville
Hampstead
Westminster
Reisterstown
EldersburgOwings Mills
Randallstown
Ellicott City
BALTIMORE
Arbutus
ColumbiaElkridge
Brooklyn Park
Edgemere
Glen Burnie
Severna Park
Arnold
Mt. Airy
Union Bridge
Damascus
Clarksburg
Germantown
Gaithersburg
Rockville
Potomac
White Oak
Bowie
CroftonGreenbelt
Laurel Fort Meade
Odenton
Shady SIde
Annapolis
Deale
Chesapeake Beach
Huntington
Prince Frederick
Lusby
California
La Plata
St. Charles
Clinton
Brandywine
Palmer Park
Hyattsville
Lexington Park
Hughesville
Cloverly
Colesville
Silver Spring
Suitland
Kettering
Mt. Vernon
Groveton
Alexandria
Annandale
McLean
Mitchellville
Jarrettsville
WASHINGTON, D.C.
UpperMarlboro
FortWashington
Waldorf
White Plains
Bethesda
Perry Hall
Essex
Dundalk
Overlea
Olney
Leonardtown
Charlotte Hall
Aberdeen
Bel Air
Joppatowne
White Marsh
Nottingham
Rossville
Towson
Cockeysville
Hampstead
Westminster
Reisterstown
EldersburgOwings Mills
Randallstown
Ellicott City
BALTIMORE
Arbutus
ColumbiaElkridge
Brooklyn Park
Edgemere
Glen Burnie
Severna Park
Arnold
Mt. Airy
Union Bridge
Damascus
Clarksburg
Germantown
Gaithersburg
Rockville
Potomac
White Oak
Bowie
CroftonGreenbelt
Laurel Fort Meade
Odenton
Shady SIde
Annapolis
Deale
Chesapeake Beach
Huntington
Prince Frederick
Lusby
California
La Plata
St. Charles
Clinton
Brandywine
Palmer Park
Hyattsville
Lexington Park
Hughesville
Cloverly
Colesville
Silver Spring
Suitland
Kettering
Mt. Vernon
Groveton
Alexandria
Annandale
McLean
Mitchellville
Jarrettsville
WASHINGTON, D.C.
UpperMarlboro
FortWashington
Waldorf
White Plains
Bethesda
Perry Hall
Essex
Dundalk
Overlea
Olney
Leonardtown
Charlotte Hall
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MedStar Georgetown UniversityHospital
MedStar WashingtonHospital Center
MedStar National RehabilitationHospital
MedStar Southern MarylandHospital Center
MedStar MontgomeryMedical Center
MedStar Franklin Square Medical Center
MedStar Harbor Hospital
MedStar Union MemorialHospital
MedStar Good SamaritanHospital
MedStar St. Mary’sHospital
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MEDSTAR HEART & VASCULAR INSTITUTE PHYSICIAN DIRECTORY
Stuart F. Seides, MD Physician Executive Director
CARDIOLOGYAllen J. Taylor, MD Chief of Cardiology
MedStar Washington Hospital Center MedStar Georgetown University Hospital
George Ruiz, MD Chief of Cardiology MedStar Union Memorial Hospital
MedStar Good Samaritan Hospital
Mun K. Hong, MD Chief of Cardiology MedStar Southern Maryland Hospital Center
Sriram Padmanabhan, MD Chief of Cardiology MedStar Franklin Square Medical Center
For a complete listing of cardiologists, go to MedStarHeartInstitute.org
ADVANCED HEART FAILURESamer S. Najjar, MD Medical Director
Advanced Heart Failure Program MedStar Washington Hospital Center
George Ruiz, MD Chief of Cardiology MedStar Union Memorial Hospital
MedStar Good Samaritan Hospital
ELECTROPHYSIOLOGYZayd A. Eldadah, MD Medical Director, Electrophysiology
MedStar Washington Hospital Center MedStar Georgetown University Hospital
Glenn R. Meininger, MD Medical Director, Electrophysiology Programs Baltimore region
CARDIAC SURGERY Paul J. Corso, Jr., MD Chairman, Cardiac Surgery
MedStar Heart & Vascular Institute
Michael Fiocco, MD Chief, Cardiac Surgery MedStar Union Memorial Hospital
HEART TRANSPLANT AND VENTRICULAR ASSIST DEVICES Steven W. Boyce, MD Surgical Director, VAD/Transplantation
Ezequiel J. Molina, MD
INTERVENTIONAL CARDIOLOGYMun K. Hong, MD Chief, Department of Cardiology
MedStar Southern Maryland Hospital CenterLowell F. Satler, MD Medical Director, Cardiac Catheterization Lab
MedStar Washington Hospital Center
Ron Waksman, MD Director, Cardiovascular Research and Advanced Education MedStar Cardiovascular Research Network Associate Director of Cardiology MedStar Washington Hospital Center
John C. Wang, MD Medical Director, Cardiac Catheterization Lab MedStar Union Memorial Hospital
VASCULAR SURGERY Edward Y. Woo, MD Director, MedStar Vascular Program Chairman, Department of Vascular Surgery
Raghuveer Vallabhaneni, MD Director, Vascular Surgery, Baltimore Region
Reza Abrishamchian, MDAmmar S. Bafi, MDSteven W. Boyce, MD Jennifer L. Ellis, MD
Dipin Gupta, MDEzequiel J. Molina, MDChristian C. Shults, MD
Jennifer A. Brown, MDChristopher F. Barnett, MDMark R. Hofmeyer, MDSandeep M. Jani, MD
Selma Mohammed, MD, PhD Maria E. Rodrigo, MDFarooq H. Sheikh, MD
Jonathan A. Altschuler, MDNelson L. Bernardo, MDItsik I. Ben-Dor, MDRobert A. Gallino, MDAntony G. Kaliyadan, MDScott M. Katzen, MDJohn J. Kennedy, MDRobert A. Lager, MDBenjamin I. Lee, MDKenneth M. Lee, MD
Michael B. Lee, MDMichael J. Lipinski, MDConor F. Lundergan, MDDavid L. Pearle, MDAugusto D. Pichard, MDDavid Peichert, MDVenkatesh K. Raman, MDNauman Siddiqi, MDWilliam O. Suddath, MDJeffrey B. Trabb, MD
Steven D. Abramowitz, MDCameron M. Akbari, MDFrederick P. Beavers, MDRobert J. Breslin, MDDale Buchbinder, MDDavid Coll, MD
Arthur Flatau III, MDMisaki M. Kiguchi, MDRajesh K. Malik, MDTareq M. Massimi, MDKapil Simlote, MD
Rafique Ahmed, MDSarfraz A. Durrani, MDMargaret B. Fischer, MDMichael Goldstein, MDSung W. Lee, MDJay Mazel, MDSusan O’Donoghue, MD
Edward V. Platia, MDDavid J. Schamp, MDManish H. Shah, MDDavid A. Strouse, MDAthanasios Thomaides, MDAllison Warren, MD
110 Irving Street, NWWashington, DC 20010
MedStarHeartInstitute.org
M E D S T A R T R A N S P O R T
when minutes matter
Soon to celebrate its 35th anniversary, the MedSTAR Transport helicopter/ambulance service continues to set national standards for the transport of critically ill or injured patients. Flights are staffed with a critical care nurse and critical care paramedic, providing tertiary-level care in the air for both adult and pediatric patients. Since its inaugural flight in 1983, MedSTAR (Medical Shock Trauma Acute Resuscitation) has been on the scene for the most dramatic and traumatic events to affect the National Capital area, both natural and man-made.
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■ More than 64,000 missions to date ■ Nearly 50 percent of transports for
cardiovascular patients ■ Regularly covers a 150-mile radius from
Washington, D.C., throughout Maryland, Virginia, Pennsylvania and Delaware, with some flights as far away as Ohio, New York City and North Carolina
■ 95 percent of transports are from other area hospitals to MedStar Health
■ Airborne within 10 minutes of notice■ A fleet of four helicopters and one
ground critical care ambulance stationed throughout the region
■ 24/7 MedSTAR Communications Center
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Graduate Medical EducationMedStar Health is one of the largest providers of graduate medical education in the United States today, training an average of 1,100 students and residents annually in more than 100 specialty and sub-specialty programs.
This year, MedStar Washington Hospital Center has 27 fellows who have come to this high-volume, high-diversity hospital to develop and acquire knowledge and skills in a variety of cardiovascular-related programs. Because the Hospital Center is an independent academic medical center, affiliated with the Georgetown University School of Medicine, residents and fellows enjoy extensive collaboration with community-based medical staff in a rigorous academic environment.
In addition, 10 residents rotate through the Cardiovascular ICU each month, and four through the cardiology units.
Continuing Medical EducationThrough its Department of Continuing Professional Education, MedStar Health is committed to providing the highest-quality learning opportunities for physicians and healthcare professionals throughout the mid-Atlantic region and beyond. Each year, approximately 20 percent of its programs focus on cardiovascular-related issues and topics.
The department currently operates under MedStar Georgetown University Hospital’s Level 3 accreditation with commendation from the Accreditation Council for Continuing Medical Education (ACCME). This distinction places MedStar Health among the top 20 percent of all continuing medical education providers in the United States.
medical education
18 Cardiovascular Disease Fellows
4 Interventional Cardiology Fellows
2 Clinical Cardiac Electrophysiology Fellows
1 Advanced Heart Failure Fellow
1 Advanced Echocardiography
1 CT/MRI Fellow
(not general)
(Others don’t need Advanced)
18 Cardiovascular Disease Fellows
4 Interventional Cardiology Fellows
2 Clinical Cardiac Electrophysiology Fellows
1 Advanced Heart Failure Fellow
1 Advanced Echocardiography
1 CT/MRI Fellow
(not general)
(Others don’t need Advanced)