Jefferson Heart Instituteand Cardiovascular Program

Thomas Jefferson University Hospital

Jefferson Medical College of Thomas Jefferson University

DIECUT CIRCLE

The Je f ferson H eart Inst i tu te and C ard iovascu lar

Program prov ide the h ighest qua l i ty comprehens i ve

med ica l and surgica l card iovascu lar care c l in ica l

serv ices . O ur a w ard-w inn ing card io logists and hear t

surgeons o f fer ta i lored therapy and mul t i d isc ip l inary

exper t ise . S ta te-o f- the-ar t c l in i ca l and bas i c

research seeks to transform the d iagnos is

and trea tmen t o f card iovascular d isease .

The Jefferson program offers a comprehensive range of treatment options

that are unequalled in the Delaware Valley. In addition to aggressive heart

failure therapy, the Advanced Heart Failure and Cardiac Transplant Center

provides access to the full spectrum of life-saving heart care, from the least

invasive to state-of-the-art transplants.

O ur physicians delivered comprehensive medical and surgical care to more than 50,000

patients with heart disease in 2004. This overview of the Jefferson cardiology program

highlights our research and clinical offerings; we are proud to work together as we

continue to diversify and strengthen our team.

Howard H . Weitz , M D

Associate Director, Division of Cardiology

Co-Director, Jefferson Heart Institute

James T. D iehl, M D

Director of Cardiothoracic Surgery, Thomas Jefferson University Hospital

Clinical Professor, Jefferson Medical College

Bernard L. Segal, M D

Director, Division of Cardiology, Jefferson Medical College

Director, Jefferson Heart Institute

DIECUT CIRCLE

Clinical Cardiology ........................................2

Advanced Heart Failure and Cardiac Transplant Center ............................6

Clinical Electrophysiology ..............................8

Non-Invasive Cardiology ............................10

Invasive (diagnostic and interventional) Cardiology ............................12

Center for Translational Medicine ................14

Multidisciplinary Programs ..........................16

Cardiac Surgery ..........................................18

Cardiac Care Close to Home ......................20

Cardiovascular Training Program ................22

Educating the Next Generation ....................24

Contacting Jefferson Cardiologists ................25

Contents

J e f fe r s o n H e a r t I n s t i t u t e O n e

Tw o J e f fe r s o n H e a r t I n s t i t u t e

C a r d i o v a s c u l a r P r o g ra m T h r e e

Jefferson’s D ivision of Cardiologyfaculty and research staff conductsmore than 50 clinical research projects annually. The programallows investigators to conductleading-edge research, and providesan educational program for new investigators, fellows, residents, and medical students.

D ef ining Cardiac Risk

The Sidney Kimmel CardiovascularDisease Prevention Center is committed to patient education andcare, research in the area of cardio-vascular disease and diabetes, andeducational programs for residents,fellows, and practicing physicians.The Center’s mission is to prevent the occurrence and progression ofatherosclerotic disease and therebyprevent heart attacks, strokes, andadvanced peripheral vascular disease.An extensive clinical research pro-gram has been instrumental in thedevelopment of the major therapiesfor dyslipidemia, as well as noveltreatments that are currently underdevelopment. In addition, the Center’sresearch includes nutritional elementsthat can supplement the effects oflow-fat diets and drug therapy.

Cardiovascular Disease Prevention Center215-955-5050www.JeffersonHospital.org/heart

Emergency and IntensiveCardiac Care

Coronary Care Unit

The leadership of Jefferson’sCoronary Care Units (CC U) overseespatient care, research, and educationon a daily basis and triages patientsto the CCU and other units, includingtelemetry. The Program D irector may be called upon to evaluatepatients in the telemetry unit whoare considered clinically stable, tobe either discharged from the hospital or transferred off service,allowing greater bed capacity forpatients with serious or critical cardiovascular problems.

Working with the EmergencyDepartment, patients with chestpain and significant EC G changescan be offered angiography and percutaneous interventions to establish reperfusion in less than 90 minutes, and thrombolytic treatment in less than 30 minutes.

Communication with patients, familymembers, and other caregivers, aswell as the triage of seriously illpatients are considered an integralpart of the provision of high-qualitymedical care. The ongoing trainingand assessment of physical diagnosisskills among the students and housestaff, as well as mentoring in thedevelopment of effective communi-cation in the Cardiology criticalcare setting, are top priorities.

Coronary Care Unit215-955-9465 or 215-955-3323www.JeffersonHospital.org/heart

Clinical Cardiology

• The Kimmel Cardiovascular Disease

Prevention Center seeks to identify and

prevent progression of disease through

better understanding of Lipoprotein(a),

C-reactive protein, homocysteine levels,

lipoprotein subfractions, and small

dense LDL cholesterol.

• Studies have been approved to test the

potential for statin drugs to slow or

reverse atherosclerosis and for testing

the effects of LDL-apheresis (removal of

LDL particles from the bloodstream).

This outpatient technique utilizes a new

and safe extracorporeal filtration of blood

plasma to reduce plaque formation in

patients in whom drug therapy cannot

accomplish this objective.

• New technology is being developed to

help detect early atherosclerosis through

ultrasound and ultra-fast CT scanners,

which help to link basic research and

clinical practice by looking at early effects

of lipoproteins on the myocardium and

vascular system.

Depiction of a postmortem, stained, cross-section specimen of a fissured atherosclerotic plaque of a diseasedhuman coronary artery. The blood clot occurs after edge breakage of the blue-stained rooflike cap of a vulnerableplaque, as its liquefied lipid pool of cholesterol esters seeps out to meet the arterial blood, thereby forming a blood flow barrier.

Fo u r J e f fe r s o n H e a r t I n s t i t u t e

Endocrinology and CardiologyRisk Factors

Research has shown that theAmerican epidemic of obesity leads to the “metabolic syndrome,”which heightens cardiovascular risk. Current research studies inJefferson’s Endocrinology D ivisionhave identified potential linksbetween a protein secreted by fat tissue called adiponectin andabnormalities in blood vessels that contribute to the developmentof atherosclerosis.

In NIH-funded laboratory studies,Jefferson physicians are exploringthe cellular mechanisms triggeredby adiponectin in blood vessels in order to determine therapeutic targets that reduce the risk of cardio-vascular disease. The D ivision ofEndocrinology, D iabetes, andMetabolic D iseases offers a numberof patient-centered programs forcardiovascular disease prevention,including nutritional counseling foroverweight patients and educationfor patients with diabetes.

Division of Endocrinology Outpatient Education Programs 215-955-1925www.JeffersonHospital.org/endocrinology

Preventive Health Care Program

For 20 years, the Preventive HealthCare Program of Thomas JeffersonUniversity’s D ivision of InternalMedicine has helped the businesscommunity in the Delaware Valleyprotect employees’ health by stressingthe preventive aspects of medicalcare. The program uses thorough,periodic physical examinations toidentify risks for disease before illnessoccurs, as well as a range of otherservices tailored to the needs ofeach participant. This approachhelps maintain a healthy and productive workforce while alsocontrolling healthcare costs.

Cardiovascular health is at the fore-front of Jefferson’s preventive careconcerns. Examinations include areview of personal and family history,nutrition review and education, aswell as a detailed risk analysis forcardiovascular disease, cancer, andosteoporosis. Also available are personalized nutrition consultations,analysis of medical history and labresults, treadmill electrocardiograms,and more.

Preventive Health Care Program215-955-0726www.JeffersonHospital.org/bhs

Clinical Cardiology continued

Researchers in the Division of Nephrologyare working in collaboration with theGenomics Laboratory in the Center forTranslational Medicine (see page 14) toinvestigate possible genotypes linked with phenotypic types of hypertensionsuch as salt-sensitive hypertension, obesity hypertension, and hypertensionamong diabetics.

Ongoing clinical trials at Jefferson test newmedications for the treatment of diabetesand related complications. Comprehensiveclinical programs support management ofweight loss as well as all forms of diabetesand related complications.

• Recent research at Jefferson in endo-

crinology sheds light on the mechanisms

leading to increased risk of macrovascular

disease in obesity and diabetes.

C a r d i o v a s c u l a r P r o g ra m F i v e

S i x J e f fe r s o n H e a r t I n s t i t u t e

Advanced H eart Failure andCardiac Transplant C enter

The Advanced Heart Failure andCardiac Transplant Center, estab-lished in 2004, offers the latest incardiovascular medicine, includinga multidisciplinary approach to care and improvements to the efficiency of cardiac function withleft-ventricular assist devices, pace-makers, and heart transplantation.

The program offers sophisticated support systems for patients with end-stage heart failure (Class III and IV) in preparation for device assistanceand other bridging techniques leading to cardiac transplantation.The Cardiac Transplant Program,which began in 2004, performedseven heart transplants in 2005.More than 1,900 new patients visited the Advanced Heart Failureand Cardiac Transplant Center in its first two years.

A unique approach , a crit ical need

The Jefferson program makes it possible to respond to the rapidlygrowing number of patients withheart failure with a comprehensiveapproach to the disease process.Jefferson’s aggressive program stresses interpersonal patient careand a multidisciplinary approachthat integrates science, health, psychosocial and social work tocreate an optimum environment for each patient’s return to health.Jefferson’s Heart Institute is based at a 19,000-square-foot space at 925 Chestnut Street in Philadelphia,offering state-of-the-art facilities.

Advanced Heart Failure Center215-955-2050www.JeffersonHospital.org/heart

D iverse and extensive experience

The Advanced Heart Failure and Cardiac Transplant Center’s cardiologists and surgeons havecombined experience of more than 1,100 heart transplants and 35 years in end-stage heart failureand cardiac transplantation. Heartfailure cardiologists work alongside transplant nurses and heart failure coordinators, who assist withdietary issues, social work needs,and any related kidney and liverproblems. For heart transplants, the Heart Failure Center teams withthe surgical transplant team in theDivision of Cardiothoracic Surgery(see page 18).

Inspiring and using the latest research

In addition to conducting heart failure outcomes analyses, theAdvanced Heart Failure andCardiac Transplant Center hasembarked on a multidisciplinaryresearch initiative and works closely with Jefferson’s Center forTranslational Medicine to bringstate-of-the-art research “from thebench to the bedside” (see page 14).

• The Advanced Heart Failure and Cardiac

Transplant Center has linked with the

Center for Translational Medicine to

participate in an NIH-funded study of

findings indicating that normalization

and enhancement of dysfunctional bAR

signaling can hasten reverse remodeling

after unloading, and that the bAR kinase

(bARK1) can play a critical role in the

pathogenesis of heart failure.

• Members of Jefferson’s Heart Failure

program lead the research to develop

efficacy of biventricular pacing in patients

with heart failure.

• The Center participates in a wide variety

of multi-center heart failure trials,

including MOMENTUM on the efficacy

of the Orqis™ Medical Cancion™ Cardiac

Recovery System (CRS), designed to

unload and rest the heart while

temporarily assisting in the perfusion

of the organs and tissues of the body.

• The Center carries out multiple studies

with the Division of Electrophysiology,

including the CareLink® Internet-based

remote monitoring service for patients

with implanted cardiac devices as well

as studies designed to enable physicians

to identify those patients most likely to

benefit from resynchronization therapy.

Novacor® LVAD is the first mechanical circulatory device to support a single patient for more than six years.

C a r d i o v a s c u l a r P r o g ra m S e v e n

E i g h t J e f fe r s o n H e a r t I n s t i t u t e

Clinical Electrophysiology

Jefferson is a regional leader in thediagnosis and treatment of cardiacarrhythmias. Patients with a varietyof heart rhythm disorders are referredto the medical staff of the Electrophys-iology Laboratory for evaluation andmanagement. The physicians evaluatepatients with a number of noninvasivetests, such as continuous ambulatoryECG monitoring, and prescribe appropriate therapy.

In some cases, physicians may refer patients to the Cardiac Electro-physiology Laboratory, where theyperform invasive procedures, utilizingcomputer-aided diagnostic and evaluation techniques – includingcomputerized mapping systems – toprecisely characterize and locatearrhythmias. As appropriate, the EPphysicians perform radiofrequency(RF) catheter ablation, a nonsurgicalalternative to treat arrhythmias suchas supraventricular tachycardia, atrial flutter, and atrial fibrillation.Following RF ablation most patientsare free of symptoms without theneed for drug therapy.

Jefferson is also a regional leader in implanting devices to treat

cardiac arrhythmias. These includepermanent pacemakers to treatbradyarrhythmias and implantablecardioverter-defibrillators (IC Ds) to treat life-threatening ventriculararrhythmias. EP physicians implantboth pacemakers and IC Ds inJefferson’s state-of-the-art CardiacElectrophysiology suite.

Select patients with congestive heartfailure may be candidates for cardiacresynchronization therapy (CRT), anew procedure that involves implan-tation of pacing leads in both theright and left ventricle to coordinatecardiac contraction. In cases whereintracardiac leads must be removeddue to infection or malfunction, the EP physicians perform leadextraction procedures using a lasersheath, to prevent the need forremoval by open-heart surgery.

The EP program is also involved in a number of clinical research studies,in which the staff investigates newdrugs and devices to treat a variety ofcardiac arrhythmias. This work dove-tails with Jefferson’s Clinical ResearchProgram (see page 16).

Jefferson has three full-time physicians,who are board-certified in ClinicalCardiac Electrophysiology (CCEP).They also supervise the FellowshipProgram in CCEP, which trains newphysicians each year and is certifiedby the American Council for GraduateMedical Education (ACGME).

Electrophysiology Laboratory215-955-7305www.JeffersonHospital.org/heart

The Cardiac Electrophysiology Laboratorysuite, opened in August 2005, is equippedwith two large laboratories for invasive cardiac electrophysiology procedures, aroom for more limited procedures, and an area for patients and families.

Electroanatomic map of a right atrial tachycardiaalong with the sites where radiofrequency catheterablation was delivered and successfully terminatedthe tachycardia (red dots).

C a r d i o v a s c u l a r P r o g ra m N i n e

Left: Recordings from a patient with symptomatic Wolff-Parkinson-White Syndrome (pre-excitation)demonstrate surface ECG as well as intracardiac electrograms. This shows a recording from a probe at the successful target site for radiofrequency ablation.

Right: Intracardiac recordings in the same patient during supraventricular tachycardia, which wasinduced by programmed electrical stimulation.

Te n J e f fe r s o n H e a r t I n s t i t u t e

C a r d i o v a s c u l a r P r o g ra m E l e v e n

N on-Invasive Cardiology

Since non-invasive methods are critical to the accurate diagnosis ofheart disease, Jefferson physiciansutilize them to focus on early diagnosis and expert treatment.Jefferson’s non-invasive cardiovas-cular diagnostic testing laboratoriesutilize a wide array of tests to help detect heart disease withoutcausing patients discomfort. These include transthoracicechocardiography (ultrasound);stress tests; stress echocardiographytesting; electrocardiography; dobutamine, dipyridamole, andadenosine pharmacologic stressstudies; and nuclear stress testsemploying dual isotope (thalliumand technetium) techniques (donein conjunction with the division of nuclear radiology).

Echocardiography employs the latestechocontrast and tissue doppleradvances to enhance the imagingquality and hence provide morereliable diagnostic information tothe referring physician. Jeffersonperforms thousands of these studies each year on inpatients and outpatients, utiliz ing the latesttechnological advances available.

Non-Invasive Cardiology215-955-5050www.JeffersonHospital.org/heart

Echocardiography Laboratory

The Echocardiography Laboratory at Jefferson is actively involved inthe investigation of new real time3D echocardiographic technology,and is engaged in a feasibility study of exercise stress echo and a 3D

assessment of different forms ofvalvular disease. Jefferson participatesin several multi-center trials of echocontrast in the evaluation of cardiacperfusion compared to nuclearimaging and angiographic findings.The laboratory also collaborateswith the Radiology Department inthe development of CT perfusionimaging and a potentially excitingnew technology for non-invasivelyimaging the coronary arteries.

Echocardiography Laboratory215-955-7100www.JeffersonHospital.org/news/2002/article7939.html

Images A and B show short axis of left ventricle and right ventricle outflow in normal, cardiac-gated, during suspended respiration (at 1.5T): blood-suppressedfast-spin echocardiogram (with and without fat suppression).

Abnormal views show transverse (C) and sagital (D) blood-suppressed, fat-suppressed images.

A B

C D

A 3-D volume rendering of a coronary CTangiogram showing normal left main, left anterior descending, and left circumflex arteries.Courtesy of the Department of Radiology,Thomas Jefferson University Hospital

Tw e l v e J e f fe r s o n H e a r t I n s t i t u t e

Invasive (diagnostic and interventional) Cardiology

Cardiac Catheterizat ionLaboratory

Thomas Jefferson UniversityHospital’s Cardiac CatheterizationLaboratory offers the region’s widestvariety of alternatives to surgery foropening blocked coronary arteries.These techniques and technologiesinclude balloon angioplasty; coronaryartery stenting; excimer laser angio-plasty; intracoronary ultrasound;and rotational, directional, andtransluminal extraction arthrectomy.

Jefferson Hospital cardiologists havealso pioneered some of the newestinterventional procedures, including:

• Drug-coated stents. In 2003,Jefferson became one of thenation’s first hospitals to use coatedstents to treat coronary blockage.

• Angioject thrombectomy, whichutilizes a catheter to clear clottedbypass grafts of patients who haveundergone bypass surgery.

• Small-vessel intracoronarystents. Jefferson doctors wereamong the first to use stents insmall coronary arteries.

• Brachytherapy. Jefferson was oneof the first in the world to offerthis low-dose radiation therapy, incollaboration with the Departmentof Radiation Oncology.

• New at Jefferson Heart Institute:Peripheral vascular angioplastyand stents, used to open occludedblood vessels outside of the heart.

• Sealing of the Patent ForamenOvale (PF O) in patients with cryptogenic stroke

Cardiac Catheterization Laboratory215-955-7109www.JeffersonHospital.org/heart

This series of images shows the sequence of a complex angioplasty in a 53-year-old man with a totally occluded artery. Image A demonstrates the right coronary artery with the point of total occlusion (see arrow). Image B shows a SafeCross infrared guidewire (see arrow) successfully traversing the obstruction, which previously was impenetrable by conventional guidewires. The tip of the wire isequipped with an infrared light that reflects off the plaque and has the capacity for radiofrequency ablation, which facilitates successful passage through the occlusion. Image C reveals the widely patent artery restored after placement of drug-eluting stents.

The Cardiac Catheterization Laboratory is

conducting a clinical trial of a minimally

invasive procedure in which an interven-

tional cardiologist threads, through an

incision in the patient’s right or left

femoral vein and continuing to the PFO

flap, a sheath that houses a small device

that looks like a two-sided umbrella. Once

the device is in position, the cardiologist

opens it up on each side of the PFO and

applies to seal the flap.

A B C

C a r d i o v a s c u l a r P r o g ra m T h i r t e e n

Fo u r t e e n J e f fe r s o n H e a r t I n s t i t u t e

Studies are in progress at the Center’s Clinical Genomics Core to identify the disease-causing mutation in an extended pedigree with a dominant inherited form of heart disease.

C a r d i o v a s c u l a r P r o g ra m F i f t e e n

C enter for Translational M edicine

Bringing discoveries from the laboratory bench to the pat ient ’s bedside

The Center for TranslationalMedicine is the focal point forresearch in the Department ofMedicine at Jefferson. The Centeraims to bridge basic scientific discoveries with physicians’ needsfor their patients. A t the forefront of academic health care, the Centerfocuses on leading-edge basicmolecular biomedical research andits translation into the most efficientand tailored forms of diagnosis and treatment as well as modes of prevention.

The Center relies on Jefferson clinicians as a source of patientsand information. Sharing novelaspects of research it undertakeswith the entire Department ofMedicine, the Center helps divisionsto work together to initiate newclinical trials. The Center also workswith the O ffice of TechnologyTransfer to develop new intellectualproperty born from this research.

Center for Translational Medicine215-955-9982www.Jefferson.edu/translational

Cardiovascular Research at the Center

A core devoted to Animal Models of D isease and Cardiac Physiologywas established in 2003 to providesupport for animal studies involvingcardiac diseases and measuring invivo physiology. In addition, theCenter has established active corefacilities in Clinical Genomics andGene Therapy.

The Center also organizes all cardiology research at ThomasJefferson University Hospital andJefferson Medical College, campus-wide. A virtual cardiology researchinstitute is in progress.

The Eugene Feiner Laboratory forVascular Biology and Thrombosis

Much of the research in the Feiner Laboratory is in the area ofhypertension: understanding howreceptors—the proteins that help toestablish blood pressure by bindinghormones including epinephrine—change their signaling in vascularsmooth muscle under disease conditions. As antihypertensivetherapeutic strategies are currentlyinadequate to decrease high bloodpressure in a significant proportionof patients with this disease,researchers at the Feiner Lab havealready developed a method todecrease blood pressure using anovel inhibitor of certain receptorpathways important in causingvasoconstriction. This is currentlybeing studied in animal models ofthe disease, but researchers intend

that strategies such as this may beadvanced to clinical trials, thusmaking it possible to develop newantihypertensive drugs and methodsof treatment for the disease.

Researchers in the Feiner Lab consult regularly with InternalMedicine and Cardiology to explorepossibilities to directly incorporateclinical observations into novel uses of research.

The George Zallie and FamilyLaboratory for Cardiovascular Gene Therapy

The multidisciplinary work of theGene Therapy Core introduceshuman genes into any organ in thebody—heart, lung, kidney, muscle—in order to change the function oftargeted organs or cells. The genesturn on (or off) certain mechanisms,such as the production of certainproteins. Gene therapy includesputting genes into cells to:

• replace defective genes (as in cystic fibrosis, metabolic diseases)

• change the function of normalgenes (heart failure, angiogenesis)

The research includes mouse modelsas well as larger animal models, inorder to validate before testing inhumans. Genes are introduced into the system via a virus and aredelivered either through cardiopul-monary bypass, or by subselectivecatheterization (similar to the use ofangioplasty/stent). All research isdisease-based.

S i x t e e n J e f fe r s o n H e a r t I n s t i t u t e

M ultidisciplinary Programs

Jefferson offers resources for patientswith heart failure, arrhythmias andconduction problems, device prob-lems, and mixed hyperlipidemia.Cardiology has developed closeworking relationships with theDivisions of Pulmonary Medicineand Endocrinology, in particular for patients with diabetes mellitusand metabolic syndrome.

Vascular D isease C enter

The Vascular D isease Center atJefferson incorporates Neurosurgery,Neurology, Radiology, Cardiology,and Vascular Surgery, as well as clinical and interventional services,research, and education. Venous disease, arterial disease, research,and educational programs distinguishthe Vascular Diseases Center fromother programs in the area. Jefferson’soutpatient anticoagulation program(JATS) has treated more than 500patients through the Division ofCardiology.

The Jefferson arterial disease programoffers Inpatient and O utpatient Peripheral Arterial D isease Consul-tation Services, including preoperativeevaluation as well as peripheral arterial disease management.

Jefferson provides an EndovascularPeripheral Arterial D isease Programthat combines the expertise ofCardiology, Cardiovascular Inter-ventional Radiology, Neurosurgery,and Vascular Surgery. Non-invasive(ultrasound) and invasive (arteriogra-phy) testing is also available.

Vascular disease research incorpo-rates the efforts of the Eugene FeinerLaboratory for Vascular Biology and Thrombosis in the Center forTranslational Medicine (see page14), the D ivision of Endocrinology,the Department of Physiology, the Department of ClinicalPharmacology, and the CardezaBlood Foundation.

Vascular Disease Center: 215-955-6540 For referrals: 215-873-6075

C linical Research ProgramClinical research plays an importantpart of Jefferson’s role as a leader in fighting cardiovascular disease.Faculty at the Jefferson HeartInstitute participate in a number of clinical trials, as an enrollingcenter. There are also a number ofJefferson-centric protocols beingdeveloped by faculty members inthe area of cardiovascular disease.

In the area of heart failure, Jeffersonfaculty have developed a number of related activities:

• multicenter clinical protocolsincluding examinations of sleepapnea in heart failure patientswith biventricular pacemakers,the use diagnostic data fromimplanted heart devices duringhospitalizations, and the evalua-tion of heart failure disease management strategies. Thesestudies seek to assess the efficiencyof clinical treatments for patientswith heart failure.

• trials to examine disparities andaccess to care in underservedpopulations with heart failure inPhiladelphia.

• in collaboration with the Centerfor Research in Medical Educationand Health Care, an outcomesdatabase for all Jeffersonresearchers to make all internalclinical resources available forfuture studies.

• an ongoing, NIH-funded studycalled HF-ACTIO N , a multicenterprogram examining exercise and its benefits for patients whohave heart failure.

HF-ACTION Program215-955-2007www.hfaction.org

Jefferson ’s C linical Research Net workDemonstrating its region-wide leadership, Jefferson has recentlycreated the Mid-A tlantic ResearchConsortium (MARC), a clinicalresearch network that offers a substantive infrastructure to supportthe complex needs of patient-oriented research.

This community of clinicians, coordinators, and researchprofessionals from academic medical centers, suburban hospitals,and large practices collaborates in performing leading-edge clinicalresearch and fosters bringing thoseadvances to care for patients in the most efficient way possible.

The consortium engages in all levels of clinical research activity,including translational research—especially in the area of heart failure—the use of novel therapeutics,safety surveillance of approveddrugs and devices, and research to foster a better understanding ofquality-of-care outcomes.

C a r d i o v a s c u l a r P r o g ra m S e v e n t e e n

Pennsylvania

New York

New Jersey

DelawareMaryland

Collaborating Centers for the Mid-Atlantic Research Consortium (MARC)

Albert Einstein Healthcare Network

Cardiology Associates of West Reading, Ltd.

Christiana Care Health System

Cooper University Hospital

Drexel University, Hahnemann University Hospital

Lehigh Valley Hospital and Health Network

Main Line Health System, Lankenau Hospital

Moffit Heart and Vascular Group, Pinnacle Health System

New York Medical College—Westchester Medical Center

New York University Medical Center, Bellevue Hospital

Pennsylvania Heart and Vascular Group

Penn State College of Medicine

St. Luke’s-Roosevelt Hospital

Thomas Jefferson University

University of Medicine and Dentistry of New Jersey—Robert Wood Johnson Medical School

University of Maryland Medical Center

Jefferson’s Clinical Research Network bringstogether 18 other centers in 5 states and offersaccess to a network of 25,000 patients.

E i g h t e e n J e f fe r s o n H e a r t I n s t i t u t e

CABG Coronary Artery Bypass Grafting

AVR Aortic Valve Repair or Replacement with or without other procedure

MVR Mitral Valve Repair or Replacement with or without other procedure

Other Open or closed case including cardiac tumor and post-MI VSD

Thoracic Aortic Aneurysm, Dissection, or Transection from root to diaphragm

GUCHD Grown-Up with Congenital Heart Disease

VAD/OHT Ventricular Assist Device including ECMO or Orthotopic Heart Transplant

/Cardiac Surgery Case Prof ile 2004

C a r d i o v a s c u l a r P r o g ra m N i n e t e e n

Cardiac Surgery

Cardiothoracic Surgery

Collaborating with cardiologists,surgeons in Jefferson’s D ivision ofCardiothoracic Surgery conduct anarray of complex cardiac procedures.The D ivision has also distinguisheditself in the areas of scientificresearch and as a training programfor cardiothoracic surgery.

The Division’s full-time staff of cardiothoracic surgeons performedmore than 600 major cardiothoracic operations in 2005. State-of-the-artprocedures included:

• Arterial revascularization

• Aortic valve replacements, mitral valve reconstructions

• Transmyocardial revascularizations (TMR)

• Coronary artery bypass graft surgery and valvular repair and replacement

• Implanted mechanical heartpump, or, as part of a researchprotocol, ventricular remodelingsurgery, along with valvular repair

• Heart transplantation

• O ff-pump coronary artery bypass

Jefferson Cardiac Surgery also offersa range of less invasive approachesto cardiac disease.

Jefferson clinicians work closelywith Cardiothoracic Surgery and the Transplant services and seek todevelop an oncologic cardiologyservice. The D ivision of ThoracicSurgery has expanded its patientpractice at the Jefferson HeartInstitute, allowing Medicine andSurgery to work side by side. Anoutpatient center for adult congenitalheart disease supports the compre-hensive care of patients with all cardiovascular problems. In addition,Jefferson conducts clinical activityat Albert Einstein Hospital’s Heartand Vascular Institute in the area of adult cardiac services.

Division of Cardiothoracic Surgery215-955-6996www.JeffersonHospital.org/cardiothoracic

Neurosurgery

The Division of CerebrovascularSurgery and Interventional Neuro-radiology within the Department ofNeurosurgery has been very active in carotid angioplasty and stenting for over a decade.

Jefferson physicians have beeninvolved in numerous trials involvingcarotid angioplasty and stenting.Most recently they are involved inthe CREST trial, a randomized trialcomparing carotid endarterectomyto carotid angioplasty and stenting.

Thomas Jefferson UniversityHospital is accredited as a primary stroke center by the JointCommission on Accreditation ofHealthcare Organizations (JCA H O)and has offered carotid angioplastyand stenting as well as intracranialangioplasty and stenting for over 10 years.

The faculty within the division hasbeen involved in the development ofnew devices and techniques utilizedfor cerebral revascularization forpatients suffering from occlusivedisease of the intracerebral vessels.

Department of Neurosurgery215-955-7000www.JeffersonHospital.org/neurosurgery

Jefferson’s cardiothoracic surgical team

Tw e n t y J e f fe r s o n H e a r t I n s t i t u t e

Cardiac Care Close to H ome

The current full-time cardiology faculty practices at the JeffersonHeart Institute at 925 Chestnut Street,with recently expanded facilities.The satellite cardiology offices arecurrently operational on the MainLine in Bala Cynwyd, NortheastPhiladelphia, and Voorhees, NewJersey (see left). Jefferson HeartInstitute cardiologists also work collaboratively with physicians ofH G N C Cardiology Associates atMethodist Hospital to provide carefor patients in South Philadelphia.Patients admitted to MethodistHospital and St. Agnes ContinuingCare Center can transfer to ThomasJefferson University Hospital for tertiary and quarternary care.

Jefferson continues to expand itsoutpatient practice by streamlining services and utiliz ing the “one stop

shopping” approach to patients who enter our outpatient offices.Each of these facilities provide acadre of clinical cardiologists on a daily basis, starting at 7:30 a.m.and ending at 5 p.m. Responding to increased demand for inpatientcare at Thomas Jefferson UniversityHospital in Center City, FrankfordHospital has provided Jefferson faculty with an additional tertiarycare facility at Frankford – TorresdaleHospital, now home for 30 to 40patients of the Jefferson HeartInstitute at any one time. Thesepatients are admitted either throughthe emergency department ordirectly to the coronary care unit for the diagnosis and managementof their cardiac problems. TheCardiac Catheterization Laboratoryis also available.

New JerseyPennsylvania

Voorhees

Bala Cynwyd

Frankford

Northeast Philadelphia

Center City Philadelphia

South Philadelphia

Jefferson Heart Institute Locations

Center City Philadelphia925 Chestnut Street, Mezzanine Philadelphia, PA 19107 215-955-5050www.JeffersonHospital.org/heart

Main Line 401 City Avenue, Suite 525Bala Cynwyd, PA 19004610-667-5555

Northeast Philadelphia9501 Roosevelt BoulevardNortheast Philadelphia, PA 19114215-676-8300

Jefferson HealthCARE — Voorhees443 Laurel Oak RoadVoorhees, NJ 08043215-955-5050www.JeffersonHospital.org/patient/article4085.html

For a complete list of Jefferson cardiologyoffices, see the inside back cover.

Jefferson Affiliations

Frankford – Torresdale HospitalDivision of Cardiovascular

Disease/CardiologyRed Lion and Knights RoadsPhiladelphia, PA 19114215-612-4110 or 1-800-JEFF-NOWwww.FrankfordHospitals.org/heart

South PhiladelphiaHGNC Cardiology Associates1339 Porter StreetPhiladelphia, PA 19148215-289-0607

Cardiologists at the main Jefferson campus support inpatient care at Thomas Jefferson University Hospital.

C a r d i o v a s c u l a r P r o g ra m Tw e n t y - o n e

The latest technology at Jefferson’s Frankford – Torresdalecampus brings together the best of cardiology andnuclear medicine.

HGNC Cardiology Associates provide care for patients atJefferson’s Methodist Hospital in South Philadelphia.

Tw e n t y - t w o J e f fe r s o n H e a r t I n s t i t u t e

Cardiovascular Training Program

The D ivision of Cardiology providesformal education for nurses, students,residents, fellows, and practicingcardiologists. The FellowshipProgram in Cardiology is the largestsubspecialty fellowship program inthe Department of Medicine andcontinues to be extremely popularand highly selective.

The cardiovascular training programincludes 36 months of training: 24months of core clinical cardiovasculartraining and an additional 12 monthsin a selected area of interest, suchas interventional cardiology, clinicalcardiac eletrophysiology, noninvasivecardiac imaging, or advanced heartfailure. Jefferson also trains a groupof fourth-year fellows in clinicalcardiac electrophysiology, interven-tional cardiology, and advancedheart failure/cardiac transplantation.

Fellows are an integral part ofJefferson’s clinical and basic science research programs. Theirefforts result in publications in peerreview journals and presentations atnational meetings.

Fellows gain experience in the evalua-tion and management of patients withboth acute and chronic cardiac disease.As part of the training program, fellowsdevelop technical expertise in the diagnostic evaluation of patients inareas such as cardiac catheterizationand cardiac angiography, invasiveelectrophysiologic studies, and non-invasive cardiac studies includingechocardiography, stress testing, andnuclear imaging.

Clinical care is an important elementof cardiology training. Through bed-side teaching, physicians-in-trainingdevelop a patient-oriented approachto the evaluation and management ofcomplex cardiac disease that leads tothe appropriate selection of drugs orother treatment modalities.

Weekly conferences are an importantpart of the training and include topicsin clinical cardiology, interventionalcardiology, cardiac electrophysiology,echocardiography, nuclear cardiology,and heart failure. Visiting professorsspeak on new advances in variousfields of cardiology.

C a r d i o v a s c u l a r P r o g ra m Tw e n t y - t h r e e

Jefferson cardiology fellows benefit froma wide range of hands-on training underthe leadership of renowned faculty members as well as the latest educationaltechnologies. Here fellows practice lifesaving procedures on SimulationManin consultation with Emergency Medicine.

Fellows come to the Jefferson cardio-vascular training program from a numberof prestigious medical schools:

Columbia University

Cook County Hospital, Chicago

Georgetown University

L.A. County & University of Southern California Medical Center

National Naval Medical Center

NYU/Bellevue Hospital Center

SUNY Downstate Medical Center, Brooklyn

SUNY Health Sciences Center, Syracuse

University of Arizona

University of Maryland

University of Medicine and Dentistry of New Jersey

University of Pittsburgh

University of Southern California

University of South Florida

University of Virginia

Cardiology Fellowship Program215-955-1976www.Jefferson.edu/cardiology/residency

Educating the N ext G eneration of Cardiologists

Tw e n t y - fo u r J e f fe r s o n H e a r t I n s t i t u t e

Jefferson University faculty includescardiologists and other clinicianswho are committed to advancingthe field through education as wellas publication. Faculty supplementstheir participation in internationalconferences and sponsoring ofContinuing Medical Education(CME) programs with an impressiverecord of publications in a widerange of journals. Jefferson is proudto carry its commitment to cardiologyfrom the medical students of todayinto the future through the power ofthe written word.

Among the prestigious journals inwhich Jefferson faculty membershave published recent articles are:

Circulation: Journal of the American Heart Association

Journal of the American College of Cardiology

The Journal of Biochemistry

The Journal of Clinical Investigation

Nature

New England Journal of Medicine

The mission of the Jefferson

Heart Institute (JHI) is to provide

exemplary comprehensive medical

and surgical care to the patient

needing cardiovascular care.

Through the combined impact of

the high-quality clinical services,

educational and research programs

it sponsors, JHI seeks to contribute

significantly to the diagnosis,

treatment, and prevention of heart

disease while training new physicians

and other healthcare professionals

to provide the highest quality

clinical care.

Jefferson Heart Institute Locations

Center City Philadelphia925 Chestnut Street Mezzanine Philadelphia, PA 19107 215-955-5050www.JeffersonHospital.org/heart

Main Line401 City Avenue, Suite 525Bala Cynwyd, PA 19004610-667-5555

Northeast Philadelphia9501 Roosevelt BoulevardNortheast Philadelphia, PA 19114215-676-8300

Jefferson HealthCARE — Voorhees443 Laurel Oak RoadVoorhees, NJ 08043 215-955-5050www.JeffersonHospital.org/patient/article4085.html

Jefferson Affiliations

Frankford – Torresdale HospitalDivision of Cardiovascular Disease/CardiologyRed Lion and Knights RoadsPhiladelphia, PA 19114215-612-4110 or 1-800-JEFF-NOWwww.FrankfordHospitals.org/heart

Methodist HospitalDivision of Cardiology2301 South Broad StreetPhiladelphia, PA 19148215-952-9000www.JeffersonHospital.org/methodist/healthcare/medicine/cardiology.html

South PhiladelphiaHGNC Cardiology Associates1339 Porter StreetPhiladelphia, PA 19148215-289-0607

Cardiothoracic Surgery Centers

Thomas Jefferson University HospitalDepartment of Surgery620 Curtis Building1015 Walnut StreetPhiladelphia, PA 19107215-955-5654www.JeffersonHospital.org/cardiothoracic

Albert Einstein Medical CenterEinstein Institute for Heart and Vascular Health5501 Old York RoadPhiladelphia, PA 19141 215-955-5654 www.einstein.edu/yourhealth/heart

Jefferson HealthCARE — Voorhees443 Laurel Oak RoadVoorhees, NJ 08043 856-741-1000www.JeffersonHospital.org/patient/article4085.html

C a r d i o v a s c u l a r P r o g ra m Tw e n t y - f i v e

C ontacting Jefferson Cardiologists

925 Chestnut Street

Mezzanine

Philadelphia, PA 19107

JG 05-0391

A d v a n c e d M e d i c i n e . S u p e r i o r C a r e . ™

For information on cardiovascular care

at Jefferson, please call

215-955-5050 or visit

www.JeffersonHospital.org/heart or

www.Jefferson.edu/cardiology

For an appointment with

a Jefferson physician,

please call 1-800-JEFF-N O W.