Leaders atHeart - Inova Heart and Vascular Institute

Transcription

Leaders atHeart - Inova Heart and Vascular Institute
Leaders at
Heart
Inova Heart and Vascular Institute
2015
Cardiac
Outcomes
“
We may never know the true impact that
Inova Heart and Vascular Institute has had on
the lives of the people who have entered our
doors, but this much we know: that over the
past 11 years, 184 of our neighbors and friends
received new hearts, 227 lung transplants,
181 TAVRs, and we performed 2,855 Afib
ablations, 5,674 CABG and 4,703 heart valve
procedures, while caring for more than 17,205
PCI patients with 4,163 presenting as STEMI.
We are grateful to have been a part of their
lives, and to the dedicated physicians, nurses
and staff who have made Inova Heart and
Vascular Institute a leader in cardiovascular
medicine across the region, the nation and
”
beyond.
Patrick Christiansen, PhD
Chief Executive Officer
Inova Fairfax Medical Campus
2 | Inova Heart and Vascular Institute
inovaheart.org |
3
Table of Contents
5
Welcome
6
National Resource
7
Award-Winning Care
8
Our Team
10Innovation
13
Cardiac Diagnostics
14
Cardiac Catheterization
15 Acute Myocardial Infarction
16 Door-to-Balloon Time
17 Percutaneous Coronary Intervention
18 Patient Story | A Fighting Chance
19 Women and Heart
19Pharmacogenomics
20 Cardiac Rhythm Disorders
21 Atrial Fibrillation
22 Patient Story | Live to See the Day
23 Chronic Total Occlusion
24 Cardiac Surgery
25 Coronary Artery Bypass Grafting
26 Valve Disease/Surgery
27 Patient Story | Miracle Girl
28 Aneurysm of Great Vessels
29 Vascular Disease
30 Thoracic Surgery
32 Thoracic Surgery and Interventional Pulmonology
33 Lung Transplantation
34 Advanced Heart Failure
35 Patient Story | For My Girls
36 Heart Transplantation
37 Pediatric Congenital Heart Program
38 Patient Story | The Gift of a Lifetime
39 Pediatric Interventional Catheterization
40 Adult Congenital Heart Program
41
Cardiac Rehabilitation
42 Research/Publications
49 Our Physicians
51Locations
4 | Inova Heart and Vascular Institute
Welcome
Welcome to the Inova Heart and Vascular Institute (IHVI). It is my privilege, along with Patrick Christiansen,
PhD, CEO of Inova Fairfax Medical Campus and EVP of Inova Health System, to share with you the exciting
new developments and opportunities at the Inova Heart and Vascular Institute. Beginning over 40 years
ago, our program was one of the first in the country to develop a broad cardiovascular surgical program.
IHVI faculty participated in the first randomized trial of left ventricular assist device (LVAD) research
and is one of the few programs in the world tracking the outcomes of patients undergoing the surgical
atrial fibrillation surgery (Maze) procedure. Patients throughout the DC-Metro area, across the country
and around the world benefit from outstanding quality care, research, education and training through
the practice of our highly skilled physicians and healthcare providers who deliver the most innovative
therapies.
This year we are excited to be selected by Healthgrades and Premier as one of the most outstanding
hospitals and heart and vascular institutes in the country for the quality of care provided to our patients.
We have initiated the Inova Center for Thrombosis Research and the Program for Cardiovascular
Personalized Medicine. We are leading the efforts to develop new ways to understand the risk of bleeding
and clotting in patients with cardiovascular disease and the development of new blood thinners to reduce
the risk of stroke, myocardial infarction and cardiovascular death. In February, we opened our new 24-bed,
state-of-the-art, Phase I cardiovascular testing unit. In this unit, we investigate novel therapies to improve
the health of our patients. We have embarked on value-based care as the recipient of the CMS innovative
bundle payment programs for heart failure and PCI patients, with the intent of improving outcomes,
reducing costs, and improving value over 90-days after hospitalization. In this report, you will learn more
about our new, innovative programs in Women’s Cardiovascular Health, Advanced Structural Heart
Disease, ablation therapy for cardiac arrhythmias and Advanced Cardiopulmonary Heart Disease.
“
Our unique blend of expertise, technology,
convenience and accessibility means your patients
will be cared for in a nationally-recognized
It is a great honor and privilege to serve in a leadership capacity at the Inova Heart and Vascular Institute
in our journey to become a Top 10 Cardiovascular and Lung Center. We are excited about the future
and I hope you enjoy this report on our programs, initiatives, academic contributions, outcomes, and
commitment to lifelong learning.
Sincerely,
”
comprehensive center.
Christopher O’Connor, MD
Chief Executive Officer
Inova Heart and Vascular Institute
Christopher O’Connor, MD, CEO
Inova Heart and Vascular Institute
inovaheart.org |
5
A Renowned
National Resource
Inova Heart and Vascular Institute is the largest cardiac
program in the Northern Virginia region, and has grown
from a network of hospitals across Virginia to a regional and
national destination for complex cardiovascular care.
For more than 40 years, even prior to the establishment of
IHVI as an Institute, our team of world-renowned surgeons,
cardiologists, highly skilled nurses, and support staff has
worked together to deliver comprehensive cardiac care. Our
patient-centered focus emphasizes the importance of state of
the art technology in a caring and beautiful environment that
supports all aspects of healing.
Our convenient network of hospitals across Northern Virginia
makes it easy for patients and families to seek the care they
need. See the inside back cover for a listing of facilities.
Award-Winning Care
Inova Heart and Vascular Institute is consistently
recognized as one of the top cardiovascular
programs in the country. Our awards for services,
treatment and results include:
• Inova Heart and Vascular Institute received
the Cardiac Surgery Excellence Award and
a 5-star rating for 30-day mortality for heart
failure patients from HealthGrades, the
leading online resource that helps consumers
search, evaluate and compare physicians and
hospitals. We are among only 5% of hospitals
in the nation to be so designated.
• The Joint Commission awarded
its Gold Seal of Approval® to
Inova Heart and Vascular Institute
for treatment of acute myocardial
infarction (heart attack) and left
ventricular assist device (LVAD) patients.
• U.S. News and World Report
ranked Inova Children’s Hospital
a top performing regional
hospital in pediatric cardiology
and heart surgery in 2015.
• Inova Fairfax Medical Center
received the Women’s Choice
Award as one of America’s
Best Hospitals for Heart Care
in 2015. The award recognizes
hospitals that perform well on heart care
measures and have a high recommendation
rate among women. Only 290 hospitals out of
4,500 facilities nationwide made the list.
• We received the Platinum Performance
Achievement Award for 2014 /2015 from
the National Cardiovascular Data Registry
(part of the American College of Cardiology
Foundation) Registry-Get with the Guidelines
Program for demonstrating sustained
achievement of performance measures in
the treatment of acute myocardial infarction
patients.
• The Society of Thoracic Surgeons awarded
Inova Heart and Vascular Institute a three-star
designation – the highest category of quality
for coronary arterial bypass grafts.
• Inova Fairfax Hospital earned the Mission:
Lifeline® Silver Plus Award from the American
Heart Association for its efforts to improve the
quality of care for heart attack patients.
• Inova Fairfax Medical Campus received
the 2015 #1 Consumer Choice ranking as
“Washington DC’s Most Preferred Hospital for
Overall Quality and Image.”
• The American Association of
Critical Care Nurses presented
Inova Heart and Vascular
Institute’s Cardiac Intensive
Care Unit its Beacon Award for
excellence.
• All five Inova Hospitals
received an “A” rating
for safety in 2015 from
The Leapfrog Group which evaluates and
reports on the safety and quality performance
of U.S. hospitals for the benefit of consumers,
employers and other health care purchasers.
IHVI is consistently recognized
as one of the top cardiovascular
programs in the country.
6 | Inova Heart and Vascular Institute
inovaheart.org |
7
Our Team
The award-winning team of heart and vascular specialists at Inova Heart and
Patient Safety:
The Overarching Priority
Vascular Institute is among the nation’s leaders in innovative heart research, clinical
excellence and the achievement of superior patient outcomes. Our experienced
specialists, sub-specialists and highly skilled nursing and support staff offer the full
range of advanced treatments at many locations, with five state-of-the-art hospitals
consistently ranked among the top programs both regionally and nationally for
cardiovascular research and clinical care.
Among our highly-skilled experts is a network of four cardiac hospitalist teams
– two teaching and two non-teaching – which recently added two physician
extenders. This dedicated group rotates through IHVI and includes a nurse
practitioner who helps with facilitating early discharges and throughput for patients
in Interventional Cardiovascular Admission and Recovery and the Progressive
Coronary Care Unit (PCCU). IHVI’s cardiac hospitalists work collaboratively with
cardiologists, pulmonologists, intensivists, electrophysiologists, vascular and
cardiac surgeons to provide safe, high quality care for heart patients with complex
conditions.
By leveraging a truly multidisciplinary approach to treatment, Inova Heart and
Vascular Institute has been able to improve important clinical parameters and
outcomes including throughput, length of stay, readmission rates and patient
satisfaction. As a result, HCAHPS scores are consistently up, and we continue to
strive to reach ever higher rates of success.
“
Dr. Charles Murphy
Patient safety is the overarching priority at IHVI.
As one important element of this commitment,
IHVI has selected a Chief Patient Safety Officer,
Dr. Charles Murphy, who reports directly to the
CEO. Dr. Murphy was a 2015 American Hospital
Association-National Patient Safety Foundation
Patient Safety Leadership Fellow.
This structure reflects the priority given to patient
safety within the organization. The foundation
of the safety culture at IHVI is a robust reporting
system, just culture, and an environment of
psychological safety. Leader rounds and safety
huddles are key elements. All five hospitals in the
Inova Health System attained an “A” grade for
A heart institute is more than a building – it’s the passion and
patient safety in the 2015 Leapfrog rankings.
expertise of the people inside. From our phenomenal nurses,
anesthesiologists, physician assistants and cath lab technicians, to
our surgeons, pulmonologists, and cardiologists, to our dedicated
researchers, everyone is focused on just one thing: excellent
”
outcomes for our patients.
Alan Speir, MD
Medical Director, Cardiac Surgical Services
8 | Inova Heart and Vascular Institute
inovaheart.org |
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Innovation
The IHVI Patient Experience Team, from left:
Rebecca Hanson, Alissa Nobblitt, Merdod
Ghafouri, MD, Heather Hunn, Beth Belluzzo
INNOVATION IN RESEARCH - INOVA CLINICAL TRIALS INSTITUTE
unit based teams, and with input
In 2015, IHVI took a dramatic new step with the announcement of the new Inova Clinical Trials Institute (ICTI), led by
from Patient and Family advisory
world-renowned cardiovascular researcher, Paul A. Gurbel, MD. Formerly of Mt. Sinai Medical Center in Baltimore,
groups, standardized processes
MD, Dr. Gurbel brings with him a highly experienced clinical research team that is actively engaged in building the
and appropriate metrics will be
new center at Inova, which will allow for Phase 1 through Phase IV Clinical Trials onsite.
developed and implemented.
Patient safety continues to be a
INOVA THROMBOSIS RESEARCH AND DRUG DEVELOPMENT CENTER
major priority as well, and 2015
The Center for Thrombosis Research is engaged in studies to explore novel anti-thrombin agents and new treatment
saw a 22% reduction in total
options for patients with acute coronary syndromes, stroke, atrial fibrillation, heart failure requiring LVAD mechanical
harm events.
support, and other cardiovascular conditions. Christopher deFilippi, MD, an internationally renowned expert in
the utilization of biomarkers to assess cardiovascular risk, was recently added to the staff, and is currently leading
important NIH-funded research in that area. The goal of IHVI is to be recognized as a top-tier site for multi-center
pharmaceutical and device trials.
THE INOVA CARDIOVASCULAR CENTER FOR PERSONALIZED MEDICINE
DNA and other critical information will be collected on all patients coming into IHVI to help in predicting risk,
outcomes, and side effects. As we move into 2016, the Inova Center for Personalized Health will be expanded to
include a state-of-the-art signature Ambulatory Cardiovascular Center, a Center for Destination Cardiovascular Care,
and a Genomics clinic. Integrating clinical and translational research will be facilitated through strategic partnerships
with local healthcare systems, universities, professional societies, research institutes and key government agencies.
INNOVATION IN THE DELIVERY
OF PATIENT CARE
Under the leadership of Merdod Ghafouri, DO,
Chief Patient Experience Officer and Director of
Cardiovascular CME, IHVI has launched a major
effort to transform the patient experience, and
enhance the patient-centric culture. Working through
Inova Thrombosis Research and Drug Development
Center Team, from left to right: Wendy Crego, Dr. Rahul
Chaudhary, Dr. Paul Gurbel, Kevin Bliden, Udaya Tantry,
Andrea Fitzgerald, Christopher McLeod 10 | Inova Heart and Vascular Institute
New, less invasive, safer and less costly cardiovascular interventional procedures are the
treatments of choice when possible. IHVI was the first in the metropolitan area to use a new
stent with a bioabsorbable polymer to promote rapid healing and additional safety. The
Watchman Left Atrial Appendage (LAA) closure program for patients with AFib at high risk for
stroke will be launched in 2016, as will the MitraClip procedure for patients with severe mitral
regurgitation and CHF with high or prohibitive risk for surgical valve repair/replacement.
INNOVATION IN EDUCATION
Through the Center for Educational Excellence and Innovation, IHVI uses new methods to
transmit knowledge, educate healthcare providers, and disseminate information across the
broad spectrum of practitioners in the region, and on a national and international level.
• Through state-of-the-art programs, world renowned faculty present clinically relevant
updates on the latest findings and best practices in all aspects of the diagnosis,
treatment and management of cardiovascular disease, with a focus on the patient
experience, patient safety and the delivery of high value health care.
• New models, protocols and metrics are being developed to standardize the delivery
of care across the health system, reduce costs and measurably improve patient
care. In addition, International Observerships are being offered whereby physicians
and healthcare providers from developing countries spend terms ranging from
one week to a full year working closely with physicians, nurses, pharmacists and
other healthcare providers at IHVI to exchange ideas on best practices. These
programs provide excellent training opportunities, promote Inova, and
are an important step in the development and enhancement of strategic
partnerships with countries across the globe.
• The robust Visiting Professorship program is further evidence of IHVI’s
commitment to provide high quality education and promote the exchange
of information on the latest research results. Each month a world renowned
expert in a specific field spends a full day at the Inova campus, participates
in a Medical Grand Rounds, a Cardiology Grand Rounds and informal
discussions with members of the IHVI cardiac care team.
• CME Symposia Series: Launched in early 2015, the Inova Continuing
Medical Education Symposia Series has grown to a yearlong schedule of
highly valuable symposia that draws experts in cardiovascular medicine
from around the nation as speakers as well as attendees.
The remaining schedule for 2016 is as follows:
Cardiovascular
Symposium
April 15-16, 2016
Ritz Carlton, Tysons
Corner
Mid Year Patient
Safety Meeting
June 10, 2016
Inova Fairfax Medical
Campus
Patient Experience
Nursing Symposium
May 13, 2016
Inova Fairfax Medical
Campus
Advanced Heart
Failure Symposium
October 14-15, 2016
Washington DC (venue
TBC)
The October 2015 IHVI Symposium featured Eugene
Braunwald, MD, considered the leading international
cardiologist in the areas of congestive heart failure,
coronary artery disease, and valvular heart disease.
inovaheart.org |
11
Cardiac Diagnostics
EDUCATING THE COMMUNITY – THE VIEW FROM
THE DOME
CARDIAC DIAGNOSTICS: BUILDING A WORLD-CLASS RESOURCE
When Trish Seifert, RN, began her nursing career at Inova in 1975,
she had no idea she would spend her entire career with us – and
Fast, accurate diagnosis is the first step in successful treatment of heart disease. Today’s advanced
“
techniques allow cardiologists to visualize and assess a wide range of conditions that once required
head nurse in the cardiac OR, Trish had a desire to get more involved
The Dome Observation Program is such a
great way to show people firsthand how important
with Inova’s pioneering research and teaching work. So in 2001,
IHVI is to the local community and to the world.
IHVI is building a state-of-the-art clinical diagnostics program with the goal of serving as a regional
Trish Seifert, RN
years of experience in cardiac diagnostics, including expertise in cardiovascular patient care and
come to be absolutely irreplaceable as the “Master of the Dome.” As
she teamed up with cardiothoracic surgeon Edward Lefrak, MD, to
create one of the most unique and successful educational outreach
programs in the region – an observational dome that allowed
”
more invasive diagnostic procedures to be fully understood.
and national resource for physicians and health care organizations, staffed by skilled clinicians with
in-depth knowledge of imaging techniques.
people a “birds-eye view” of actual cardiac surgery from a glassed in
The IHVI Cardiac Diagnostics Unit is led by hands-on experts in transesophageal echocardiography
viewpoint high above the OR.
(TEE), to effectively diagnose conditions such as valve disease, adult congenital heart disease,
The Cardiac Surgical Observation Dome Program began as a
endocarditis, blood clots, aortic tears and aortic aneurysm than traditional echocardiography.
vehicle for high school students to learn about heart health, explore
With capabilities in transthoracic, transesophageal and 3D echos as well as cardiac CT and MRI,
professional opportunities and watch surgical teamwork in the Dome.
IHVI is building a clinical diagnostics program of distinction in the area with the most sophisticated
But word of the popular program spread and soon Trish launched a
imaging equipment available, a wide variety of services (especially for uncommon conditions) and
second program for adult groups, including community and political
unparalleled expertise to perform procedures and interpret results.
“
leaders, cardiologists and surgeons, who came in droves over the
years from around the world.
Non-Invasive Cardiology: 2014 Data
As the program’s docent, Trish loved showcasing the latest
IFH
technology and care delivery innovations at Inova. “If I heard it once,
I heard it one thousand times, ‘Wow, we had no idea you were
doing this!’” says Trish, who retired in December 2015. “The Dome
Observation program is such a great way to show people firsthand
how important IHVI is to the local community and to the world.”
Transesophageal
Echocardiogram (TEE)
We pride ourselves on a collaborative approach with
referring physicians, radiologists, surgeons and cardiologists
IAH
ILH
IMVH
IFOH
IHVI
Combined
843
227
137
115
145
1,467
Echo
10,767
4,308
2,105
723
2,458
20,361
Transthoracic Echo and
Nuclear Studies
2,661
1,195
1,327
1,727
266
7,176
Graded Exercise Test (GXT)
1,320
1,250
148
1,015
N/A
3,733
Cardiac MRI
1
18
N/A
N/A
N/A
19
Cardiac CT
179
25
20
10
N/A
234
to assess each patient’s situation and develop the best
”
course of treatment.
Pamela Sears-Rogan, MD
Medical Director, Cardiac Diagnostics
IFH - Inova Fairfax Hospital
IAH - Inova Alexandria Hospital
ILH - Inova Loudoun Hospital
IHVI - Inova Heart and Vascular Institute
12 | Inova Heart and Vascular Institute
inovaheart.org |
13
Cardiac Catheterization
The innovative outpatient cardiac catheterization
Acute Myocardial Infarction
Diagnostic Cardiac Catheterizations
STEMI Volume Combined
As the largest acute cardiovascular care provider in Northern Virginia, Inova Heart
and Vascular Institute is uniquely skilled in managing complex cardiac incidents. Our
program at Inova Heart and Vascular Institute blends
Facility
2013
2014
multidisciplinary expertise with convenient patient
IFH
3,487
3,284
ST-elevation myocardial infarction teams are experts in handling the most critical
access. A coordinated approach using state-of-the-art
IAH
690
680
cases from across the region, including transfers from other hospital emergency
catheterization labs and a dedicated interventional
ILH
307
589
departments. Our mortality rates for acute myocardial infarction patients are among
cardiology admission and recovery suite staff all
IHVI Combined
4,484
4,553
contribute to complication rates comparable to the
national average.
264 Non-Transfer Patients
the country’s lowest, with 30-day mortality rates below the national benchmark.
patients and staff by 75 percent during complex cardiovascular procedures without
IHVI Composite
NCDR
Like Hospitals
2.0%
1.7%
1.6%
0.0
0.5
1.0
PCI Performed within 90 Minutes
1.5
IHVI Composite
NCDR
Like Hospitals
Medicare.gov/hospitalcompare
NCDR
93.3% Like Hospitals
30-Day Readmission
Q2, 2012 - Q3, 2014
National
20
Inova
2.0
14.9% 2013
14.2% 2014
13.8%
586 12.2%
258
15.1%
176
20
17.8% 2013
10
5
5
0
0
17.0%
182
20
40
60
80
100
17.0% 2014
15
17.2%
819 17.7%
268
IHVI Combined
NCDR
Like Hospitals
93.5%
0
Q2, 2012 - Q3, 2014
14.6%
14.3%
678 13.5% 176
252
97.1%
2014
30-Day Mortality
10
16.3%
723 17.1%
281
16.8%
179
Process of Care Indicators
Overall AMI Performance Composite Score
2014
2013
100
95.6 92.5 94.6 94.5
93.6
97.8 97.2 98.7 97.9
95.1
80
60
Daily multidisciplinary rounds with nursing and case management in the PCCU and
cardiac telemetry units promote communication and teamwork and help improve important
clinical parameters including throughput, length of stay and readmission rates.
Anne Summers, MD
Hospitalist, IHVI
14 | Inova Heart and Vascular Institute
94.8% IHVI Combined
Acute Myocardial Infarction (AMI)
15
“
100 150 200 250 300
2013
1.8%
2014
50
cardiac catheterization labs. This advanced technology reduces radiation exposure to
Any Adverse Event
2013
99 Transfer Patients
0
sacrificing image quality.
IHVI is one of the few centers in
the nation to use optimized X-ray
equipment in the cardiac cath labs.
Non-Transfer Patients
91 Transfer Patients
2014
We are one of the few centers in the country to use optimized X-ray equipment in our
IFH - Inova Fairfax Hospital
IAH - Inova Alexandria Hospital
ILH - Inova Loudoun Hospital
IHVI - Inova Heart and Vascular Institute
284
2013
”
IFH IAH ILH
Q2 2012 - Q3 2013
IFH IAH ILH
Q2 2013 - Q3 2014
IFH IAH ILH
Q2 2012 - Q3 2013
IFH IAH ILH
Q2 2013 - Q3 2014
40
20
0
IFH - Inova Fairfax Hospital
IAH - Inova Alexandria Hospital
ILH - Inova Loudoun Hospital
IHVI - Inova Heart and Vascular Institute
IFH IAH ILH IHVI
Comb.
Combined
Like
Hospitals
IFH IAH ILH IHVI
Comb.
Combined
Like
Hospitals
inovaheart.org |
15
Percutaneous Coronary Intervention
PCI Risk Adjusted Mortality for All Patients
2.5
PCI Volume - IHVI Combined
2013
1,867
Any Adverse Events (PCI With STEMI)
2.0
14.8% IHVI Combined
1.5
NCDR
Like Hospitals
1.0
2013
2.0%
2014
15.5%
1,577
0
500
1000
IFH Distribution of Performance
10th
Percentile
1.07 1.08
12.1% IHVI Combined
2014
1500
NCDR
Like Hospitals
14.7%
2000
0
PCI Success
5
10
15
20
Any Adverse Events (PCI Without STEMI)
99.1%
IHVI Combined
99.0%
NCDR
Like Hospitals
99.1%
2014
IHVI Combined
98.9%
99.0%
0
20
40
60
80
NCDR
Like Hospitals
100
4.9%
2013
IHVI Combined
NCDR
Like Hospitals
5.8%
IHVI Combined
5.0%
2014
5.2%
0
1
2
3
4
5
NCDR
Like Hospitals
0.0
IAH IFH
ILH IHVI
(Weighted)
PCI Risk Adjusted Mortality (STEMI)
3
IFH Distribution of Performance
4.34
4
3.23 3.11
3.40
10th
Percentile
11.86
50th
Percentile
6.50
90th
Percentile
3.19
2
3.11
IFH
1
0
IAH IFH
ILH IHVI
(Weighted)
6
PCI Risk Adjusted Mortality (STEMI Excluded)
Door-To-Balloon Median Time (minutes)
Non-Transfer Patients: 2008-2014
16 | Inova Heart and Vascular Institute
3.19
1.29
90th
Percentile
1.01
1.07
IFH
5
2013
50th
Percentile
1.84
0.5
1,705
2015
2.41
2.0
“
Inova Heart and
Vascular Institute
NCDR Like Vol.
Hospitals
2008
69
69
2009
61
62
Inova has embraced the aggressive goal of 60 minutes for Door to Balloon time for STEMI patients
2010
65
66
that present at our ED. Our in-hospital and 30 day mortality for the acute MI patients is significantly
2011
60
61
better than the national benchmarks.
2012
56
60
2013
60
59
2014
60
59
The experienced STEMI team for Inova delivers rapid evidence-based care of acute myocardial
infarction patients with best in class outcomes. As the largest heart attack center in Northern Virginia,
Harvey Sherber, MD
Medical Director, IHVI
”
1.89
IFH Distribution of Performance
10th
Percentile
1.5
2.02
1.0
90th
Percentile
0.42
0.87
0.66
0.66
IFH
0.5
0.0
50th
Percentile
1.84
IAH IFH
ILH IHVI
(Weighted)
IFH - Inova Fairfax Hospital
IAH - Inova Alexandria Hospital
ILH - Inova Loudoun Hospital
IHVI - Inova Heart and Vascular Institute
inovaheart.org |
17
Patient Story | Jennifer Grillo
A Fighting Chance
Jennifer Grillo is a survivor: not once, but twice by the age of 40.
Chemotherapy for breast cancer when she was only 38 was so
aggressive, it knocked the cancer back but took a terrible toll on her
heart. As her condition deteriorated, the salon owner from Clinton,
Maryland tried various therapies, including medication and a LifeVest™
“
By establishing the Center for Women’s
Cardiovascular Health, Inova has an opportunity
to improve cardiovascular outcomes in women
and make a substantial impact on population
health throughout the region.
”
Kelly Epps, MD
Medical Director, Women’s Cardiovascular Program
personal defibrillator, to optimize her heart function. Nothing worked.
With less than 10% heart function, she had few options other than
LVAD to help her survive.
Women and Heart
Her next most significant choice was to come to Inova Heart and
A DEDICATED WOMEN’S HEART RESOURCE
Vascular Institute. “Immediately, my confidence lifted,” she says.
Studies show that women with cardiovascular disease are under-
“Everything was better. The atmosphere was peaceful, the nursing
care was amazing, and there was constant communication from my
medical team.” When she woke up from her LVAD surgery, not only
could she breathe more easily, but for the first time in months she had
an appetite.
Jennifer spent the next few weeks in physical therapy to build her
strength and endurance. She is now back at work part-time at her
business, J.Bené Salon and Spa in Upper Marlboro. With the help of
medication, she hopes she’ll improve to the point where she can one
day have the LVAD removed. With a personal motto of “Style for Life,”
which she adoped during her cancer bout, Jennifer says, “Living with
“
Thanks to the support of my family and the support of Inova,
I’m getting stronger and feeling better every day.
Jennifer Grillo
18 | Inova Heart and Vascular Institute
”
diagnosed, under-treated and under-studied. They tend to have
poorer outcomes than men. And they comprise only 30% of
participants in cardiovascular clinical trials.
IHVI’s Center for Women’s Cardiovascular Health will change this.
Currently in the planning stages, the center will focus on assessing
and managing a woman’s unique cardiovascular risk, providing
coordinated, multi-disciplinary care for a wide range of conditions,
including pregnancy and heart disease; ischemic heart disease;
cardio-oncology; and peri-partum cardiomyopathy. The center will
also recruit women into clinical trials.
Pharmacogenomics: The Here and Now
As healthcare shifts from a one-size-fits-all approach to a more personalized dynamic, clinicians focus on
individual genomic variability – how it dictates disease progression, responds to therapies and predicts
future health events. “Pharmacogenomics,” the combination of Pharmacology and Genomics, is the
essence of personalized medicine – and Inova stands at the forefront.
Inova was already well ahead of the curve when President Obama announced a national Precision
Medicine Initiative to individualize disease prevention and treatment based on differences in people’s
genes, environment and lifestyle. Researchers at Inova Translational Medicine Institute (ITMI) conduct
groundbreaking studies to identify biomarkers that predict and prevent disease. Inova Center for
Personalized Health, slated to open in the near future, extends this commitment as it connects ITMI
researchers, physicians, patients and commercial partners to perform even more advanced integrative
genomics research.
Inova was first in the Washington metropolitan area to introduce pharmacogenomic testing. Pharmacogenomics investigates genetic variations in enzymes and transporters that alter the metabolism of drugs,
changing their pharmacokinetic and pharmacodynamic properties. This knowledge helps physicians
make safer choices for their patients when choosing a new therapeutic agent or adjusting a dose to
ensure an appropriate therapeutic effect.
Within cardiology, there are currently three commonly prescribed medications – clopidogrel, warfarin and
simvastatin – with common pharmacogenomic variations that can affect metabolism and alter efficacy and
potential toxicity. Inova Heart and Vascular Institute, in conjunction with the CLIA-certified Inova Genomics
Laboratory, conducts physician-ordered testing for many key pharmacogenomics variants. Testing is
easy, inexpensive and fast. The lab reports include clinical guidance to help physicians make medication
decisions based on detected genetic variants.
Our clinical genomics division is available to help any physician make the right therapeutic decision for
patients. To learn more about patient testing, contact us at 1.844.GENEHELP or GENEHELP@inova.org.
cancer and heart failure is a huge challenge and recovery is a slow
Comprehensive screening, prevention and research will advance
process, but thanks to the support of my family and the support of
women’s heart care, says Kelly Epps, MD, who will lead the center.
Inova, I’m getting stronger and feeling better every day.” I just want a
“By establishing the Center for Women’s Cardiovascular Health,
normal life, and now I have hope that I can.”
Inova has an opportunity to improve cardiovascular outcomes in
therapeutics will improve the safety profile of some of the most commonly
women across their lifespan and make a substantial impact on
prescribed medications and improve outcomes for our patients.
population health throughout the region.”
“
At Inova we believe a personalized approach to cardiovascular
”
Palak Shah, MD
Director of Heart Failure Research
inovaheart.org |
19
Cardiac Rhythm Disorders
Atrial Fibrillation
Inova Heart and Vascular Institute is a national leader in electrophysiology, offering a variety of novel
FDA test site for the world’s first leadless pacemaker, which requires no surgical pocket.
Our surgical program for atrial fibrillation (Afib) remains one of the
largest and most effective in the country. We offer patients both
traditional open surgery, which is frequently performed with other
cardiac procedures, and a more advanced minimally invasive
version, which allows a much faster recovery.
Device Implants Volume: 2013 and 2014
We were first in the Washington, DC, metropolitan area to use the Arctic Front®
cryoballoon ablation system, and we remain among the top one percent of heart
centers in the country to offer this technology. Cryoablation uses cold energy,
rather than heat, to isolate lesions that cause arrhythmias.
imaging modalities, ablation strategies and devices to manage simple and complex heart rhythm
disorders. We perform the most ventricular ablation procedures in the region, including the innovative
epicardial ablation technique to eliminate arrhythmias on the outside of the heart. In addition, we are an
IFH
IAH
ILH
IHVI
Combined
IFH
IAH
ILH
IHVI
Combined
Pacemaker
662
104
129
855
736
106
127
969
ICD’s
487
58
63
608
495
45
63
603
Biventricular
204
12
35
251
206
16
43
265
Dual Chamber
285
37
28
350
289
30
20
339
41
3
6
50
124
14
5
143
IFH
IAH
ILH
IHVI
Combined
Loop Recorder
Surgery for Atrial Fibrillation
IHVI surgical program
for Afib remains one
of the largest and most
effective in the country.
71
11
10
2012
62
16
2013
9
76
7
2014
0
10
33
20
30
40
50
60
70
80
Concomitant Cox Maze Procedures
Stand-Alone Cox Maze
Concomitant Left Atrial Ablation
Electrophysiology Lab Volume: 2013 and 2014
IFH
IAH
ILH
IHVI
Combined
Electrophysiology Studies
771
27
53
851
709
19
120
848
Ablation Procedures (Total)
791
22
56
869
860
15
80
955
243
3
0
246
206
3
0
209
AVN
61
8
37
106
97
2
56
155
VT
61
0
0
61
93
1
2
96
SVT
368
11
15
394
471
1
24
496
34
0
0
34
23
0
0
23
Afib (including
Radiofrequency and Cryo)
Laser Device Lead
Extraction Procedures
IFH - Inova Fairfax Hospital
IAH - Inova Alexandria Hospital
20 | Inova Heart and Vascular Institute
“
The Inova Atrial Fibrillation program features
unique, long-term follow-up that meticulously monitors
each patient’s medical progress and quality of life
in the months and years after treatment.
Marc Wish, MD
”
Cardiac Electrophysiologist
ILH - Inova Loudoun Hospital
IHVI - Inova Heart and Vascular Institute
inovaheart.org |
21
Patient Story | Edward MacMahon, MD
Live to See the Day
Chronic Total Occlusion
Inova Heart and Vascular Institute’s advanced
Long-time orthopedic surgeon Edward MacMahon, MD, may be retired from medical
treatment for chronic total occlusion (CTO) is the
practice, but he hasn’t slowed down one bit. The 89-year-old resident of Middleburg, VA,
final frontier in interventional cardiology. CTO refers
pursues his passion for medical research and keeps up with his large family of six children
to arteries completely blocked for more than 30
and 11 grandchildren. After emigrating from his native Australia in the 1950s, Dr. MacMahon
days, and is one of the most common cardiovascular
opened an orthopedic practice in Annandale. He spent many years performing surgery
conditions, but historically difficult to treat with
at Inova Fairfax Hospital, where he witnessed the small community hospital grow into the
interventional techniques. In the past, patients faced
nationally recognized medical campus of today.
open heart surgery or a lifetime of medications and
So the day Dr. MacMahon received a surprise diagnosis of severe aortic stenosis, he knew
where to turn for the best cardiac care. “Inova’s standard is on par with any great heart
center in the country, and it’s right in my backyard, so why go anywhere else? It was the
obvious choice,” he says.
debilitating symptoms. Now, minimally invasive
methods offer new hope. IHVI is at the forefront of
this innovative technology and features one of the
largest CTO programs in the Mid-Atlantic region.
Advanced stenosis made Dr. MacMahon a good candidate for transcatheter aortic valve
replacement (TAVR), a minimally invasive procedure in which the surgeon delivers the
replacement valve via catheter instead of opening up the chest. IHVI is the first and only
heart center in Northern Virginia to offer this lifesaving solution for patients too sick for
traditional valve replacement.
“Our program uses both commercially available valves and investigational valves, which
means we can customize the best available implant for each patient based on size and
clinical factors,” says Bryan Raybuck, MD, Director of the IHVI Valve Clinic, and part of of a
multidisciplinary team that includes interventional cardiologists, cardiac surgeons, cardiac
anesthesiologists and echocardiographers, hybrid OR nurses and a cardiac radiologist.
Following successful surgery, Dr. MacMahon returned home to Middleburg where he’s
“
actively involved in research to develop a non-surgical treatment for thoracic scoliosis
Inova’s standard is on par with any great heart center
in the country, and it’s right in my backyard, so why go
anywhere else? It was the obvious choice.
Edward MacMahon, MD
Retired Inova Orthopedic Surgeon
22 | Inova Heart and Vascular Institute
in teenagers. “It’s possible this technique could become commonplace within just a few
years,” he says. “Thanks to the care I received at Inova, I’ll be around to see it through.”
”
inovaheart.org |
23
Cardiac Surgery
Coronary Artery Bypass Grafting
Inova Heart and Vascular Institute is home to one of the most
Inova Heart and Vascular Institute’s team of highly skilled cardiac surgeons performs state-of-the-
experienced, collaborative cardiovascular surgery programs in
CABG Post-Operative Length of Stay
Year
IHVI
STS Benchmark*
art coronary artery bypass (CABG) surgical procedures. CABG is an integral component of our
2011
5 days
6 days
the nation. We offer tertiary level care in all aspects of cardiac
armamentarium patient treatment modalities, along with valve repair and replacement, ventricular
2012
4 days
6 days
surgery – from myocardial revascularization, percutaneous valvular
assist devices, heart and lung transplant, and catheter-based interventions.
2013
4 days
6 days
2014
4 days
6 days
intervention and large vessel surgery to heart and lung transplant
and pediatric cardiac surgery. We are one of the few programs in
the country to administer adult, pediatric, thoracic and vascular
surgery from within the same group. A robust cardiac surgical
Mortality and 30-day readmission rates for bypass patients remain well below the national average.
Major complications from isolated CABG are half the national benchmark set by the Society of
Thoracic Surgeons (STS).
Pure CABG Readmission Within 30 Days
research agenda differentiates our program and defines us as
an institute.
Our patient-centered care delivery model focuses on the patient
and family from the moment they enter our hospital to discharge
and beyond. HCAHPS scores for our cardiac and thoracic surgery
437
2
2013
23
10
unit continue to be excellent, placing us in the 85th percentile for
patients likely to recommend the hospital. In addition, patients give
our clinicians – both physicians and nurses, high marks for skill.
5
2014
24
13
6
2015
5
0
18
50
412
59
IHVI
STS Benchmark*
2011
10.4%
10.10%
2012
7.55%
10.00%
IHVI
STS Benchmark*
2011
11.65%
34.8%
2013
7.77%
9.50%
2014
9.91%
9.70%
2012
10.76%
32.8%
2013
6.07%
30.9%
2014
8.40%
28.4%
Pure CABG Mortality
52
2.0
100
CABG+Mitral
Valve Repair
200
300
CABG+Mitral
Valve Replacement
400
CABG+Aortic
Valve Replacement
CABG+Carotid
500
1.5
Post-Op Blood Products Used
Year
IHVI
STS Benchmark*
2011
13.86%
40.30%
2012
12.59%
37.8%
2013
12.62%
34.4%
2014
7.10%
31.0%
* All sources are National Adult Cardiac Surgery Database.
24 | Inova Heart and Vascular Institute
Year
Year
393
Pure CABG
IHVI is one of the few programs in the
country to perform adult, pediatric,
thoracic and vascular surgery from
within the same group.
Intra-Op Blood Products Used
CABG and CABG Combined Volume
1.0
0.5
0.0
2009
2010
Inova Mortality
2011
2012
2013
2014
STS Benchmark
inovaheart.org |
25
Patient Story | Stacy Bowling
“
Inova’s comprehensive destination valve center performs the most valve repairs and
Miracle Girl
Stacy Bowling (pictured with mother, Marie)
replacements in Virginia. Recent innovations include the minimally invasive transcatheter aortic
One minute, Stacy Bowling was on her way to a doctor’s appointment. The next, she
valve replacement (TAVR) procedure – a promising option for high-risk patients with aortic
was waking up from a 17-day coma in the Inova Fairfax Medical Center ICU. But Stacy,
stenosis. The surgeon uses a catheter to implant a bioprosthetic valve within the original aortic
43, has no memory of the truck that slammed into her while crossing busy Sudley Road
valve. The new valve is then expanded, pushing the old valve leaflets out of the way. Because
in Manassas, VA, or the helicopter that flew her to Inova Trauma Center with multiple
the chest is not cut open, patients experience less pain and a faster recovery. Inova Heart and
life-threatening injuries, including a broken pelvis, two broken hips, a broken spine
Vascular Institute was the first heart center in Northern Virginia to offer TAVR.
and head injuries. Upon arrival, Inova trauma surgeons, orthopedic surgeons and
Valve Disease/Surgery
Catheter-Based Aortic Valve Treatments
2012
2013
2014
TAVR
12
22
63
Balloon Aortic
Valvuloplasty
20
24
40
It’s beyond my imagination that this type of care
”
is so close to home. Inova saved my life.
neurosurgeons worked together to treat her critical injuries. Despite this lifesaving care,
Isolated Valve Surgery Mortality
she remained in a coma for more than two weeks and doctors told her parents she
2012
2013
2014
Valve Surgeries
203
189
167
Mortalities
5
3
1
might never regain consciousness. Then, on day 17, she opened her eyes. “Can you
wake me up now?” she asked.
Stacy was awake, but her medical condition remained unstable. Doctors quickly
discovered a life-threatening tear on the inner wall of her aorta, the major artery that
carries blood from the heart, likely caused by the horrific impact of the crash. Left
untreated, the aorta could rupture, causing death. Cardiac surgeon Liam Ryan, MD,
Valve Volume
2012
25
2013
14
2014
20
0
and vascular surgeon John Edwards, MD, teamed up to perform an emergency repair
procedure. They removed as much of the dissected aorta as possible, blocked the entry
475
109
of blood into the aortic wall, and reconstructed the artery with a graft.
69
Following her successful surgery, Stacy spent another month and a half in the hospital,
505
101
but she had a long recovery ahead of her to re-learn how to walk and perform other
skills including many of the basic functions she performs as a cosmetic specialist who
74
58
100
teaches and travels around the world.
503
89
Soon, she hopes to return to work at Harmony Salon and Spa in Manassas, the business
200
300
400
500
600
she’s owned for 23 years – and she knows she’s one of the lucky ones. Eventually she
Total
will ski and ride a motorcycle again. “When they brought me into the emergency room,
Isolated Aortic Valve Replacement
I had only a 3 percent chance of survival, but now my doctors say there’s no reason I
Isolated Mitral Valve Replacement
can’t recover 100 percent,” she says. “It’s beyond my imagination that this type of care is
Isolated Mitral Repair
so close to home. I know that Inova saved my life. And now,” Stacy says, “they’re calling
me the ‘Miracle Girl’.”
26 | Inova Heart and Vascular Institute
inovaheart.org |
27
Aneurysm of Great Vessels
As a tertiary and quaternary care referral center, Inova
Heart and Vascular Institute specializes in complex
surgery for conditions involving the aorta, the main artery
that feeds blood to the body. We routinely handle high
numbers of patients with thoracic aortic aneurysms and
aortic dissections – two life-threatening conditions that
often require emergency surgical intervention. Our highly
skilled team, which includes a dedicated thoracic aortic
aneurysm surgeon, performs open chest repair as well as
endovascular stent graft procedures.
IHVI’s outcomes for complex
aortic surgery matches
those of the nation’s leading
vascular centers.
Vascular Disease
Inova Heart and Vascular Institute takes a pioneering approach to
the treatment of peripheral arterial disease uniting vascular surgeons,
interventional radiologists, and interventional cardiologists in one comprehensive program. At every Inova hospital, patients have access to the full
range of experts without the added stress of having to coordinate multiple
specialist referrals and appointments. Our vascular team collaboratively
evaluates emerging technologies, medications and procedures to create the
most effective treatment plan for each patient.
• Traditional endograft repair, which places a stent graft into the aorta
to repair the aneurysm via small incisions in the groin
• Open surgical aneurysm repair
• Entirely percutaneous endograft repair
• Ruptured abdominal aortic aneurysm repair
• Fenestrated stent graft repair
• Dissecting thoracic aneurysm repair: Type A and Type B
Inova Heart and Vascular Institute is a tertiary and quaternary care center for
complex aortic surgery with outcomes that match those of the nation’s leading
vascular centers. Our highly specialized team treated more than 110 patients
requiring abdominal aneurysm repair at Inova hospitals in 2014 with an
average length of stay just under two days; one of the shortest in the region.
Our team treats all types of aortic aneurysm disease utilizing techniques from
endovascular repair to open surgical repair.
Vascular: 2014 Data
Carotid Artery Stent
Carotid Endarterectomy
• Penetrating aortic ulcer repair
• Repair of intramural hematomas of the aorta
• Complex adjunct aneurysm repair procedures such as “snorkels,”
“periscopes” and “sandwiches”
IFH IFOH IAHIMVH ILH TOTAL
Proc
Death
22
0
Proc
59
Death
Proc
Death
0
9
0
Proc
Death
Proc
Death
Proc
Death
1
0
0
0
91
0
%
0
160
0
0
0
2
0
1
0
6
0
169
0
0
Endovascular AAA Repair
61
1
19
0
5
0
7
0
1
0
93
1
1.08
Hemodialysis Access
46
0
151
0
60
1
0
0
0
0
257
1
0.39
IVC Filter
74
2
21
0
10
0
0
0
1
0
106
2
1.89
Lower Extremity Amputation
25
1
10
0
4
0
1
0
1
0
41
1
2.44
Open AAA Repair
9
1
1
1
0
0
0
0
0
0
10
2
20
Peripheral Vascular Intervention
313
1
16
0
72
1
28
0
79
0
508
2
0.39
Lower Extremity Bypass - Supra
Inguinal
21
0
5
0
1
0
0
0
0
0
27
0
0
Thoracic Endovascular
Aneurysm Repair
15
0
0
0
0
0
0
0
0
0
15
0
0
746
6
282
1
163
2
38
0
88
0
1317
9
0.68
TOTAL
28 | Inova Heart and Vascular Institute
We specialize in the following treatments and procedures:
inovaheart.org |
29
Thoracic Surgery
Inova Heart and Vascular Institute’s thoracic surgery program provides
care to the largest number of patients with lung and esophageal disease
in the region.
A multidisciplinary treatment team performs lung resections, esophageal
resections, diaphragmatic hernia repairs, biopsies, surgery for reflux
disease and more. Minimally invasive techniques, including robotics, are
used whenever possible.
Thoracic Surgery Volumes
380
2013
53
185
310
2014
49
Lung
Esophagus
Other
177
0
50
100 150 200 250 300 350 400
Thoracic Surgery Volumes
800
700
600
“
694
675
500
We believe optimal patient outcomes and a phenomenal patient experience are only possible through the close collaboration of super
sub-specialists, experienced and highly educated healthcare practitioners and a committed adminstration. Inova’s thoracic program has
made this a reality and is pushing beyond boundaries technologically and with systems of care. Our commitment to aggressive
peri-operative ambulation is a fine demonstration of the success of this collaboration.
Sandeep Khandhar, MD
”
721
618
600
536
400
The program was one of the first in the
country to develop a pathway to have
patients up and walking within an hour
of complex thoracic surgery.
300
200
100
0
2009
2010
2011
2012
2013
2014
Medical Director, Thoracic Surgery
30 | Inova Heart and Vascular Institute
inovaheart.org |
31
Thoracic Surgery and Interventional Pulmonology
Lung Transplantation
2014
Inova Heart and Vascular Institute’s thoracic surgery team is one of the few nationwide to
Inova is home to the Washington, DC, region’s first and only lung and heart-lung transplant program.
Lung Transplant Volume
provide advanced diagnostic and therapeutic techniques that offer patients less invasive
Since we pioneered the area’s first lung transplant more than 20 years ago, our team of highly experienced
options than traditional surgical approaches. Because of our synergistic approach, this unique
surgeons has performed more than 325 such procedures. Our survival statistics continue to match or
program provides expedited, comprehensive assessment and state-of-the-art treatment within
exceed the national average, with a one-year lung transplant survival rate of 93 percent compared to the
25
days rather than months.
national average of 88 percent as reported by the Scientific Registry for Transplant Recipients.
20
30
A NATIONAL LEADER IN LUNG DISEASE AND TRANSPLANTATION
Inova Heart and Vascular Institute brings highly trained specialists together to offer treatment
first lung transplant more than 20 years ago and continues to set the bar for treatment and transplant
5
tailored to each patient’s specific need. Our multidisciplinary thoracic surgery team includes
options. The Inova Advanced Lung Disease program offers the only accredited Pulmonary Hypertension
one member not found in most heart centers: a dedicated interventional pulmonologist. Amit
0
Comprehensive Care Center and Pulmonary Fibrosis Foundation Care Center in the DC Metropolitan area.
Mahajan, MD, specializes in minimally invasive approaches to diagnose and treat complex
The program is also a designated Alpha-one Antitrypsin Center of Excellence.
airway and pleural disease. He is one of just a handful of fellowship-trained, board-certified
interventional pulmonologists in the country.
Led by Medical Director Steven Nathan, MD, the Advanced Lung Disease and Transplant Program is the
Dr. Mahajan develops and implements new technology – including rigid bronchoscopy
patients the latest treatment techniques and lung transplant technology. These advancements may delay
and airway stenting – to treat malignant airway disease. He performs both diagnostic and
or forestall the need for a lung transplant and offer options to patients not eligible for transplantation. “We
therapeutic procedures. These include endobronchial ultrasound bronchoscopy for mediastinal
constantly seek out new treatment choices to help people live as full a life as possible, both in terms of
lymph node staging, navigation bronchoscopy for diagnosis of peripheral lung nodules, rigid
quality and quantity,” Dr. Nathan says.
bronchoscopy with laser ablation, electrocautery, cryotherapy and stent placement. Pleural
procedures include indwelling pleural catheters, thoracentesis, and chest tube placement.
Additionally, the thoracic surgery team performs bedside percutaneous tracheostomies.
21
28
27
24
24
20
15
DEDICATED INTERVENTIONAL PULMONOLOGIST PROVIDES
TAILORED TREATMENT
Inova is both pioneer and leader in lung and heart-lung transplant. Our team performed the region’s
26
10
2008 2009 2010 2011
2012
2013
2014
Observed Survival
only one of its kind in the Washington, DC, metropolitan area. An integrated team of lung specialists offers
92.95%
In 2015, survival statistics continued to exceed the national average, with a one-year lung transplant survival
rate of 92 percent compared to the national average of 87 percent, as reported by the Scientific Registry
Expected Survival
for Transplant Recipients. The median wait time for a lung transplant at Inova remains very short at 45 days.
With proven outcomes, we attract patients from both near and far, reflecting our status as a regional and
national referral center.
“
Our patients place a lot of faith and confidence in us and we constantly work to
improve everything we do, including diagnostic and treatment options, support groups,
clinic flow and communication.
Steven Nathan, MD
”
Medical Director, Advanced Lung Disease and Transplant Program
32 | Inova Heart and Vascular Institute
87.58%
Lung transplantation survival
statistics continue to exceed
the national average.
Based on 63 transplants between 7/1/2012 – 12/31/2014.
One year patient survival for patients transplanted
from 7/1/2012 through 12/31/2014.
inovaheart.org |
33
Patient Story | Terry Thompson
Advanced Heart Failure
For My Girls
Our flagship program offers consummate care for patients with every stage of heart
failure, including those with advanced disease. We are a leader in the development
Seal of Approval® for quality care and service.
After 40 years with the Secret Service, Terry Thompson was hoping for a little less
excitement. But worsening heart failure threatened his dream of a healthy and
active retirement.
VAD
Instead of hunting, playing chess, or enjoying his five beautiful granddaughters,
he spent days in and out of the hospital, lost more than 65 pounds and suffered
severe muscle wasting.
and use of ventricular assist devices (VADs), earning The Joint Commission’s Gold
Terry’s cardiologist urged him to join a clinical trial of the HeartMate 3 – the latest
generation of left ventricular assist devices (LVADs) – at Inova Heart and Vascular
Institute. Terry did not hesitate. “Many of my friends had been to Inova and (former)
Vice President Cheney had his heart transplant there,” he says. “If it was good
enough for him, it must be the best.”
80
70
60
63
50
40
50
41
30
61
53
38
The HeartMate 3 offers long-term support for patients with end-stage heart failure
who are not candidates for a heart transplant. IHVI is one of just 48 hospitals
nationwide to test the new device, says Shashank Desai, MD, Medical Director,
Heart Failure/Transplant at IHVI. “Trial centers go to the biggest programs with
the best outcomes to evaluate new technology. IHVI is well known for the high
quality, high quantity VAD work we’ve done over the last 10 years. We regularly
participate in research to develop improved devices for both bridge-to-transplant
and destination therapy.”
38
20
10
0
“
2008 2009 2010 2011
2012
2013
2014
IHVI cardiac surgeons performed Terry’s procedure in September, 2015. “When I
woke up and saw the tangle of tubes sticking out of me, I thought ‘Hey, what have
I got myself into?’” he recalls. “But the folks at IHVI took such good care of me and
had such confidence, I knew everything would be fine.”
The Inova Advanced Heart Failure Program is a national leader in developing
a network that supports patients with severe heart failure. By providing a huband-spoke model of care with physicians and hospitals throughout the region, we
provide the full spectrum of heart failure care to patients – no matter where they
live. With this approach we see patients earlier and provide a superior quality of
care to the community.
Shashank Desai, MD
”
Medical Director, Heart Failure/Transplant
34 | Inova Heart and Vascular Institute
“
I was in good hands at Inova and I’m grateful for the excellent care
I received. I wouldn’t have survived without it – and my granddaughters
”
would have lost their favorite guy.
Terry Thompson
United States Secret Service, retired
Terry’s strength slowly returned and he now relishes the simple things he couldn’t
do before his LVAD procedure, such as tying his shoes, tinkering with his truck or
taking his wife shopping. His mental acuity rebounded as well and he plays four
games of chess every day – and spends as much time as he can with his “girls.”
“I was in good hands at Inova and I’m grateful for the excellent care I received,” he
says. “The HeartMate 3 restored my quality of life and made me less dependent
on other people. I wouldn’t have survived without it – and my granddaughters
would have lost their favorite guy.”
inovaheart.org |
35
Heart Transplantation
In the past 11 years, Inova’s Heart Transplant Program
has grown to one of the largest and most highly
respected in the Mid-Atlantic. The number of patients
IHVI Heart Transplant Volume
Pediatric Congenital Heart Program
The Congenital Heart Program at Inova Children’s Hospital has been
30
27
25
caring for the hearts of our region’s children for more than 25 years. Our
pediatric cardiologists, electrophysiologists, anesthesiologists, radiologists,
receiving ventricular assist devices and heart transplants
20
at Inova Fairfax Hospital is at an all-time high and
15
helping children overcome complex congenital heart abnormalities. Our
continues to grow rapidly. Growth is due to the success
10
specialized programs include the Inova Fetal Care Center, focused on the
of these treatments for heart failure and Inova’s
5
commitment to programs that provide this advanced
0
level of care.
Inova’s Heart Transplant Program is one of the few CMS-
20
21
perinatologists and cardiac surgeons have dedicated their practice to
20
prenatal diagnoses and management of congenital heart disorders; the
2011
2012
2013
2014
Single Ventricle Clinic, providing multi-disciplinary care for Hypoplastic
Left Heart Syndrome and other single ventricle anomalies; and a
Neurodevelopmental Followup Clinic; among others. Part of Inova Heart
Observed
and Vascular Institute, the Congenital Heart Program is able to provide a
certified programs in the Washington, DC, region.
lifetime of care, starting before birth through childhood and throughout
90.74%
adult life in the Adult Congenital Program.
Expected
90.28%
“
in patients who do not respond to conventional therapy
and are not good candidates for heart transplantation.
The device can support a patient’s heart function and
improve quality of life.
”
Anthony Rongione, MD
Medical Director, Heart and Lung Transplantation
36 | Inova Heart and Vascular Institute
What makes our program unique is a complete scope of services
that spans a lifetime. We specialize in the diagnosis and management
LVADs represent a promising option as a
destination therapy for advanced-stage heart failure
“
Based on 69 transplants
between 7/1/2012 – 12/31/2014.
One year patient survival for patients
transplanted from 7/1/2012 through 12/31/2014.
of all forms of congenital heart disease in people of all ages – from the
tiniest patients in utero to adults requiring ongoing care. Our patients
have the advantage of seamless access to the collective expertise of
our highly skilled pediatric and adult specialists in a single location,
which improves outcomes and enhances quality of life.
Lucas Collazo, MD
”
Medical Director, Pediatric and Congenital Cardiac Surgery
inovaheart.org |
37
Pediatric Interventional Catheterizations by Type: 2010-2014
Patient Story | Adele Spitz
PDA
The Gift of a Lifetime
Coil
ASD
Septostomy
From the moment her daughter Adele was born, Kim Spitz knew something was wrong. The baby was
sluggish. She struggled to eat. She rarely cried. Doctors reassured Kim and her husband Doug that
everything was fine. “Nobody seemed to take our concerns seriously,” Kim says.
Finally, a pediatrician detected a heart murmur. Kim and Doug rushed Adele to Inova Children’s Hospital,
where an echocardiogram revealed a devastating diagnosis: total anomalous pulmonary venous return
(TAPVR), a rare congenital malformation in which the heart’s four pulmonary veins do not connect
normally to the left atrium. Adele’s heart was dangerously enlarged. She would need surgery urgently to
repair the defect.
Hybrid
48
2010
7
20
A few weeks later, Kim and Doug took their daughter home to Aldie, VA. She continued to astound her
family with rapid progress and today, she is a healthy, thriving 3-year-old. The family is eternally grateful
to Dr. Collazo and the entire Inova Children’s Hospital team for saving Adele’s life. “They gave us our
daughter back,” Kim says. “It’s amazing to think that if this had happened just a few years ago, our child
would have died. But today she can be treated and go on to live a very fulfilled life.”
Inova’s Pediatric Cardiology Program is uniquely positioned to handle cases such as Adele’s. “Our
comprehensive campus allows us to provide cardiac care from prenatal through adult life,” Dr. Collazo
says. “Expanded services in our new Inova Children’s Hospital include a dedicated cardiac ICU and a
strong genomics program to better predict, treat and prevent heart defects in children.”
“
It’s amazing to think that if this had happened just a few years ago, our child would
have died. But today she can be treated and go on to live a very fulfilled life.
Kim Spitz
38 | Inova Heart and Vascular Institute
”
Balloon Dilation
Melody
0
13
ICD
7 5
2010
1
2011
39
2
34
38
2012
28
8
28
53
15
44
2011
18
2012
17
01
2013
7
36
23
Pacers
Ablation
EP
56
13
5
11 5
0
3
59
2013
11
10
49
7
7
5
52
5
58
1
11
Kim and Doug struggled to digest the news. The hospital’s pediatric heart surgery team, led by cardiac
surgeon Lucas Collazo, MD, offered reassurance and support. They had performed this type of complex
procedure many times before – on babies just as small – with excellent results. Dr. Collazo reconnected
Adele’s pulmonary veins in the proper position, closed off the abnormal connections between the blood
vessels and closed the atrial septal defect. The surgery was a complete success. When Kim saw her
daughter in the recovery room, she was moving like a normal baby for the first time in her life.
Pediatric Electrophysiology Procedures by Type: 2010-2014
2014
33
0
3 10
30
41
60
43
90
16
2014
120
6
0
150
20
49
1
40
60
2
80
100
2013
2013
Volume Survival
2014
Volume
2014
Survival
15
100%
Volume and Survival by Surgical Procedure: 2010-2014
Surgical Procedure
2010
Volume
2010
2011
2011
Survival Volume Survival
2012
Survival
19
100%
20
Ventricular Septal Defect (VSD)
27
100%
14
Tetralogy of Fallot (TOF)
10
100%
11
91%
6
100%
5
100%
7
100%
Atrial Septal Defect (ASD)
4
100%
6
100%
13
100%
8
100%
3
100%
Arterial Switch for TGA
9
78%
6
100%
5
100%
7
100%
8
88%
20
100%
13
100%
27
96%
26
100%
17
100%
6
100%
7
100%
7
86%
3
100%
9
100%
Total Anomalous Pulmonary Venous Return (TAPVR)
2
100%
3
100%
4
100%
3
100%
3
66%
Partial Anomalous Pulmonary Venous Return (PAPVR)
5
100%
2
100%
3
100%
4
100%
2
100%
Caval Pulmonary Connections (Glenns and Fontans)
7
100%
17
100%
12
100%
16
100%
11
73%
Coarctation of the Aorta
9
100%
10
100%
14
100%
10
100%
8
100%
Systemic-Pulmonary Shunt
10
80%
9
100%
3
66%
4
100%
3
100%
Pacemakers and ICDs (primary and replacements)
20
100%
13
100%
8
100%
9
100%
11
100%
Norwood/ Damus-Kaye-Stansel/Hybrids
10
80%
15
93%
2
50%
8
100%
5
80%
ECMO Support
12
58%
12
58%
4
50%
5
80%
6
33%
Valves/Conduits
Atrioventricular Canal Repair (AVC)
100%
2012
Volume
100%
inovaheart.org |
39
Adult Congenital Heart Program
Cardiac Rehabilitation
As techniques in the treatment of pediatric congenital heart disease continue to advance, the need for adult congenital heart care becomes
Inova Heart and Vascular Institute’s comprehensive cardiac rehabilitation program begins in the hospital and
increasingly apparent. A 20-year member of the Adult Congenital Heart Association, the Inova Adult Congenital Heart Program has been a trailblazer
continues on an outpatient basis. Patients recovering from any heart condition or procedure – including heart
in meeting the unique healthcare needs of this patient population. The clinic includes pediatric and adult specialists, as well as double boarded
attack, valve surgery, transplant or angioplasty – may participate. New congestive heart failure guidelines
physicians. As an integral part of Inova Heart and Vascular Institute, the program is able to offer patients all non-surgical and surgical care options,
from CMS open the benefits of cardiac rehab to a broader array of patients.
including mechanical circulatory support and transplant, when needed.
We are the only program in the area certified for more than 16 years by the American Association of
Cardiovascular and Pulmonary Rehabilitation for adherence to rigorous national standards and guidelines.
With locations across Northern Virginia, patients have access to a complete, personalized heart-disease
management program close to home and work. Inpatient and outpatient cardiac rehabilitation services are
Inova Children’s Hospital Congenital Heart Surgery Volume: 2010-2014
Congenital Cardiac Catheterizations Volume: 2010-2014
120
88
2010
2011
110
2014
70
0
30
60
43
2012
94
118
38
132
82
2013
2011
2013
103
90
120
150
■ Pediatric Interventional ■ Pediatric Diagnostic ■ Adult Interventional and Diagostic
34
0
130
Inova Fairfax Medical Campus
3300 Gallows Road
Falls Church, VA 22042
703.776.3635
128
100
108
95
89
116
51
2014
Inova Alexandria Hospital
4320 Seminary Road
Alexandria, VA 22304
703.504.3398
141
135
122
77
2012
186
26
130
104
88
117
2010
available at the following Inova hospitals:
50
100
150
Inova Loudoun Hospital
44035 Riverside Parkway
Suite 500B
Leesburg, VA 20176
703.858.6674
Patient
Visits
Phase II
2012
10,318
2013
11,396
2014
11,137
Inova Mount Vernon Hospital
2501 Parkers Lane
Alexandria, VA 22306
703.664.8034
200
■ Pediatric Open ■ Pediatric Closed ■ Adult Congenital
“
We have an amazing staff, wonderful facilities and we meet strict accreditation
criteria. Above all, our program helps patients improve their quality of life and
reintegrate back to daily activities following a cardiac event.
Robert Shor, MD
Medical Director, Cardiac Rehabilitation
40 | Inova Heart and Vascular Institute
”
To learn more about cardiac rehabilitation
from the patient’s perspective, visit
inova.org/video/patricia
inovaheart.org |
41
Research/Publications
JOURNAL PUBLICATIONS 2015
Cotter G, Davison BA, Milo O, Bourge RC, Cleland JG, Jondeau
G, Krum H, O’Connor CM, Metra M, Parker JD, Torre-Amione
G, van Veldhuisen DJ, Kobrin I, Rainisio M, Senger S, Edwards
C, McMurray JJ, Teerlink JR; VERITAS Investigators. Predictors
and Associations with Outcomes of Length of Hospital Stay
in Patients with Acute Heart Failure: Results From VERITAS.
J Card Fail. 2015 Dec 22. pii: S1071-9164(15)01248-8. doi:
10.1016/j.cardfail.2015.12.017. PMID: 26721775
Samsky MD, Dunning A, DeVore AD, Schulte PJ, Starling
RC, Wilson Tang WH, Armstrong PW, Ezekowitz JA, Butler
J, McMurray JJ, Teerlink JR, Voors AA, Metra M, Mentz RJ,
O’Connor CM, Patel CB, Hernandez AF. Liver function tests
in patients with acute heart failure and associated outcomes:
insights from ASCEND-HF. Eur J Heart Fail. 2015 Dec 28. doi:
10.1002/ejhf.440. PMID: 26707029
Cooper LB, Mentz RJ, Stevens SR, Felker GM, Lombardi C,
Metra M, Stevenson LW, O’Connor CM, Milano CA, Patel
CB, Rogers JG. Hemodynamic Predictors of Heart Failure
Morbidity and Mortality: Fluid or Flow? J Card Fail. 2015 Dec
15. pii: S1071-9164(15)01221-X. doi: 10.1016/j.cardfail.2015.11.012.
PMID: 26703245
Banks AZ, Mentz RJ, Stebbins A, Mikus CR, Schulte PJ, Fleg
JL, Cooper LS, Leifer ES, Badenhop DT, Keteyian SJ, Piña IL,
Kitzman DW, Fiuzat M, Whellan DJ, Kraus WE, O’Connor CM.
Response to Exercise Training and Outcomes in Patients With
Heart Failure and Diabetes Mellitus: Insights From the HFACTION Trial. J Card Fail. 2015 Dec 11. pii: S1071-9164(15)012166. doi: 10.1016/j.cardfail.2015.12.007. PMID: 26687984
O’Connor CM. Bundle Up for Value-Based Heart Failure
Care. JACC Heart Fail. 2015 Nov;3(11):931-2. doi: 10.1016/j.
jchf.2015.09.003. No abstract available. PMID: 26541789
Emmens JE, Ter Maaten JM, Matsue Y, Metra M, O’Connor
CM, Ponikowski P, Teerlink JR, Cotter G, Davison B, Cleland
JG, Givertz MM, Bloomfield DM, Dittrich HC, Todd J, van
Veldhuisen DJ, Hillege HL, Damman K, van der Meer P, Voors
AA. Plasma kidney injury molecule-1 in heart failure: renal
42 | Inova Heart and Vascular Institute
mechanisms and clinical outcome. Eur J Heart Fail. 2015 Oct
28. doi: 10.1002/ejhf.426. PMID: 26511274
O’Connor CM. Heart Failure “End Result Cards”: Solid B. JACC
Heart Fail. 2015 Dec;3(12):1001-2. doi: 10.1016/j.jchf.2015.10.004.
No abstract available. PMID: 26671677
Perez AL, Grodin JL, Wu Y, Hernandez AF, Butler J, Metra M,
Felker GM, Voors AA, McMurray JJ, Armstrong PW, Starling RC,
O’Connor CM, Tang WH. Increased mortality with elevated
plasma endothelin-1 in acute heart failure: an ASCEND-HF
biomarker substudy. Eur J Heart Fail. 2015 Dec 14. doi:
10.1002/ejhf.456. PMID: 26663359
Demissei BG, Valente MA, Cleland JG, O’Connor CM, Metra
M, Ponikowski P, Teerlink JR, Cotter G, Davison B, Givertz MM,
Bloomfield DM, Dittrich H, van der Meer P, van Veldhuisen DJ,
Hillege HL, Voors AA. Optimizing clinical use of biomarkers in
high-risk acute heart failure patients. Eur J Heart Fail. 2015 Dec
3. doi: 10.1002/ejhf.443. PMID: 26634889
Cooper LB, Mentz RJ, Sun JL, Schulte PJ, Fleg JL, Cooper
LS, Piña IL, Leifer ES, Kraus WE, Whellan DJ, Keteyian SJ,
O’Connor CM. Psychosocial Factors, Exercise Adherence,
and Outcomes in Heart Failure Patients: Insights From Heart
Failure: A Controlled Trial Investigating Outcomes of Exercise
Training (HF-ACTION). Circ Heart Fail. 2015 Nov;8(6):1044-51.
doi: 10.1161/CIRCHEARTFAILURE.115.002327. PMID: 26578668
Ambrosy AP, Hernandez AF, Armstrong PW, Butler J, Dunning
A, Ezekowitz JA, Felker GM, Greene SJ, Kaul P, McMurray
JJ, Metra M, O’Connor CM, Reed SD, Schulte PJ, Starling RC,
Wilson Tang WH, Voors AA, Mentz RJ. The clinical course
of health status and association with outcomes in patients
hospitalized for heart failure: insights from ASCEND-HF. Eur J
Heart Fail. 2015 Oct 14. doi: 10.1002/ejhf.420. PMID: 26467269
O’Connor CM. Physician-Leaders: A Call for Cardiovascular
Specialists to Step Up.JACC Heart Fail. 2015 Oct;3(10):843-4.
doi: 10.1016/j.jchf.2015.08.004. No abstract available.
PMID: 26450003
Grodin JL, Perez AL, Wu Y, Hernandez AF, Butler J, Metra
M, Felker GM, Voors AA, McMurray JJ, Armstrong PW, Califf
RM, Starling RC, O’Connor CM, Tang WH. Circulating Kidney
Injury Molecule-1 Levels in Acute Heart Failure: Insights From
the ASCEND-HF Trial (Acute Study of Clinical Effectiveness of
Nesiritide in Decompensated Heart Failure). JACC Heart Fail.
2015 Oct;3(10):777-85. doi: 10.1016/j.jchf.2015.06.006.
PMID: 26449997
Brunner-La Rocca HP, Eurlings L, Richards AM, Januzzi JL,
Pfisterer ME, Dahlström U, Pinto YM, Karlström P, Erntell H,
Berger R, Persson H, O’Connor CM, Moertl D, Gaggin HK,
Frampton CM, Nicholls MG, Troughton RW. Which heart failure
patients profit from natriuretic peptide guided therapy? A
meta-analysis from individual patient data of randomized trials.
Eur J Heart Fail. 2015 Dec;17(12):1252-61. doi: 10.1002/ejhf.401.
Epub 2015 Sep 30. PMID: 26419999
Mentz RJ, Velazquez EJ, Metra M, McKendry C, Chiswell K,
Fiuzat M, Givertz MM, Voors AA, Teerlink JR, O’Connor CM.
Comparative effectiveness of torsemide versus furosemide in
heart failure patients: insights from the PROTECT trial. Future
Cardiol. 2015 Sep;11(5):585-95. doi: 10.2217/fca.15.56. Epub
2015 Sep 25. PMID: 26403536
Felker GM, Mentz RJ, Adams KF, Cole RT, Egnaczyk GF, Patel
CB, Fiuzat M, Gregory D, Wedge P, O’Connor CM, Udelson JE,
Konstam MA. Tolvaptan in Patients Hospitalized With Acute
Heart Failure: Rationale and Design of the TACTICS and the
SECRET of CHF Trials. Circ Heart Fail. 2015 Sep;8(5):997-1005.
10.1161/CIRCHEARTFAILURE.115.002259. Review.
PMID: 26374918
O’Connor CM. What Is a Life Worth?: A Tribute to Dr. William
Little, a Pioneer in the Understanding of Heart Failure
With Preserved Ejection Fraction. JACC Heart Fail. 2015
Sep;3(9):734-5. doi: 10.1016/j.jchf.2015.07.002. No abstract
available. PMID: 26362451
Ovchinnikova ES, Schmitter D, Vegter EL, Ter Maaten JM,
Valente MA, Liu LC, van der Harst P, Pinto YM, de Boer RA,
Meyer S, Teerlink JR, O’Connor CM, Metra M, Davison BA,
Bloomfield DM, Cotter G, Cleland JG, Mebazaa A, Laribi S,
Givertz MM, Ponikowski P, van der Meer P, van Veldhuisen DJ,
Voors AA, Berezikov E. Signature of circulating microRNAs in
patients with acute heart failure. Eur J Heart Fail. 2015 Sep 8.
doi: 10.1002/ejhf.332. PMID: 26345695
Zeitler EP, Piccini JP, Hellkamp AS, Whellan DJ, Jackson KP,
Ellis SJ, Kraus WE, Keteyian SJ, Kitzman DW, Ewald GA, Fleg
JL, Piña IL, O’Connor CM; HF-ACTION Investigators. Exercise
training and pacing status in patients with heart failure:
results from HF-ACTION. J Card Fail. 2015 Jan;21(1):60-7. doi.
10.1016.j.cardfail.2014.10.004. Epub Oct 15.
DeVore AD, Hasselblad V, Mentz RJ, O’Connor CM, Armstrong
PW, McMurray JJ, Ezekowitz JA, Tang WH, Starling RC, Voors
AA, Califf RM, Hernandez AF. Loop diuretic adjustments after a
hospitalization for heart failure: insights from ASCEND-HF. Eur
J Heart Fail. 2015 Mar;17(3):340-6. doi. 10.1002/ejhf.235. Epub
2015 Jan 23.
O’Connor CM. War and peace: the role of medical journals in the
discussion of conflict. JACC Heart Fail. 2015 Feb;3(2):192. doi.
10.1016/j.jchf.2014.11.002.
Dardas T, Li Y, Reed SD, O’Connor CM, Whellan DJ, Ellis SJ,
Schulman KA, Kraus WE, Forman DE, Levy WC. Incremental and
independent value of cardiopulmonary exercise test measures
and the Seattle Heart Failure Model for prediction of risk in
patients with heart failure. J Heart Lung Transplant. 2015 Mar 26.
pii: S1053-2498(15)01113-4. [Epub ahead of print]
Buggey J, Mentz RJ, Pitt B, Eisenstein EL, Anstrom KJ, Velazquez
EJ, O’Connor CM. A reappraisal of loop diuretic choice in heart
failure patients. Am Heart J. 2015 Mar;169(3):323-333. doi.
10.1015/j.ahj.2014.12.009. Epub 2015 Jan 6. Review.
O’Connor CM. Hop, Skip, and Jump: Do We Need Phase
II Cardiovascular Clinical Trials? JACC Heart Fail. 2015
Mar;3(3):273-4. doi. 10.1016/j.jchf2014.12.003. No abstract
available.
Yun H, Delzell E, Saag KG, Kilgore ML, Morrisey MA, Muntner
P, Matthews R, Guo L, Wright N, Smith W, Colón-Emeric C,
O’Connor CM, Lyles KW, Curtis JR. Fractures and mortality
in relation to different osteoporosis treatments. Clin Exp
Rheumatol. 2015 May-Jun;33(3):302-9. Epub 2014 Jul 28.
Butler J, Fonarow GC, O’Connor C, Adams K, Bonow RO, Cody
RJ, Collins SP, Dunnmon P, Dinh W, Fiuzat M, Georgiopoulou VV,
Grant S, Kim SY, Kupfer S, Lefkowitz M, Mentz RJ, Misselwitz F,
Pitt B, Roessig L, Schelbert E, Shah M, Solomon S, Stockbridge
N, Yancy C, Gheorghiade M. Improving cardiovascular clinical
trials conduct in the United States: recommendation from
clinicians, researchers, sponsors, and regulators. Am Heart J.
2015 Mar;169(3):305-14. doi: 10.1016/j.ahj.2014.12.001. Epub 2014
Dec 17.
Whellan DJ, Kraus WE, Kitzman DW, Rooney B, Keteyian SJ,
Piña IL, Ellis SJ, Ghali JK, Lee KL, Cooper LS, O’Connor CM.
Authorship in a multicenter clinical trial: The Heart Failure-A
Controlled Trial Investigating Outcomes of Exercise Training
(HF-ACTION) Authorship and Publication (HAP) scoring system
results. Am Heart J. 2015 Apr;169(4):457-63.e6. doi: 10.1016/j.
ahj.2014.11.022. Epub 2015 Jan 10. Review.
Jiang W, Boyle SH, Ortel TL, Samad Z, Velazquez EJ, Harrison
RW, Wilson J, Kuhn C, Williams RB, O’Connor CM, Becker RC.
Platelet aggregation and mental stress induced myocardial
ischemia: Results from the Responses of Myocardial Ischemia
to Escitalopram Treatment (REMIT) study. Am Heart J. 2015
Apr;169(4):496-507.e1. Epub 2014 Dec 17.
O’Connor CM. Reading RVUs: How can we meet the
informational needs of cardiologists? JACC Heart Fail. 2015
Apr;3(4):340-1.
Kelly JP, Mentz RJ, Mebazaa A, Voors AA, Butler J, Roessig
L, Fiuzat M, Zannad F, Pitt B, O’Connor CM, Lam CS. Patient
selection in heart failure with preserved ejection fraction clinical
trials. J Am Coll Cardiol. 2015 Apr 28;65(16):1668-82. Review.
Rosendorff C, Lackland DT, Allison M, Aronow WS, Black HR,
Blumenthal RS, Cannon CP, de Lemos JA, Elliott WJ, Findeiss L,
Gersh BJ, Gore JM, Levy D, Long JB, O’Connor CM, O’Gara PT,
Ogedegbe O, Oparil S, White WB; American Heart Association,
American College of Cardiology, and American Society of
Hypertension.Treatment of hypertension in patients
with coronary artery disease: a scientific statement from the
american heart association, american college of cardiology, and
american society of hypertension. J Am Coll Cardiol. 2015 May
12;65(18):1998-2038. Epub 2015 Mar 31.
Davison BA, Metra M, Cotter G, Massie BM, Cleland JG, Dittrich
HC, Edwards C, Filippatos G, Givertz MM, Greenberg B,
Ponikowski P, Voors AA, O’Connor CM, Teerlink JR; PROTECT
and RELAX-AHF Executive Committees. Worsening Heart Failure
Following Admission for Acute Heart Failure: A Pooled Analysis
of the PROTECT and RELAX-AHF Studies. JACC Heart Fail. 2015
May;3(5):395-403.
Mentz RJ, Buggey J, Fiuzat M, Ersbøll MK, Schulte PJ, DeVore
AD, Eisenstein EL, Anstrom KJ, OʼConnor CM, Velazquez EJ.
Torsemide versus furosemide in heart failure patients: insights
from duke university hospital. J Cardiovasc Pharmacol. 2015
May;65(5):438-43.
Mentz RJ, Babyak MA, Bittner V, Fleg JL, Keteyian SJ, Swank AM,
Piña IL, Kraus WE, Whellan DJ, O’Connor CM, Blumenthal JA; HFACTION Investigators. Prognostic significance of depression in
blacks with heart failure: insights from heart failure: a controlled
trial investigating outcomes of exercise training. Circ Heart Fail.
2015 May;8(3):497-503. Epub 2015 Apr 21.
Farzaneh-Far A, Shaw LK, Dunning A, Oldan JD, O’Connor
CM, Borges-Neto S. Comparison of the prognostic value of
regadenoson and adenosine myocardial perfusion imaging. J
Nucl Cardiol. 2015 May 19. [Epub ahead of print]
Hess PL, Shaw LK, Vemulapalli S, Pagnanelli R, O’Connor CM,
Borges-Neto S. An alternative method to examine the predictive
value of mechanical dyssynchrony. J Nucl Cardiol. 2015 May 21.
[Epub ahead of print]
O’Connor CM. Medical editors’ grand rounds: a discussion of
timely topics and editorial emergencies. JACC Heart Fail. 2015
May;3(5):422-3.
Givertz MM, Anstrom KJ, Redfield MM, Deswal A, Haddad H,
Butler J, Tang WH, Dunlap ME, LeWinter MM, Mann DL, Felker
GM, O’Connor CM, Goldsmith SR, Ofili EO, Saltzberg
inovaheart.org |
43
MT, Margulies KB, Cappola TP, Konstam MA, Semigran MJ,
McNulty SE, Lee KL, Shah MR, Hernandez AF; NHLBI Heart
Failure Clinical Research Network*. Effects of Xanthine Oxidase
Inhibition in Hyperuricemic Heart Failure Patients: The Xanthine
Oxidase Inhibition for Hyperuricemic Heart Failure Patients
(EXACT-HF) Study. Circulation. 2015 May 19;131(20):1763-71. Epub
2015 Apr 14.
Ahmad T, O’Brien EC, Schulte PJ, Stevens SR, Fiuzat M, Kitzman
DW, Adams KF, Kraus WE, Piña IL, Donahue MP, Zannad F,
Whellan DJ, O’Connor CM, Felker GM.. Evaluation of the
Incremental Prognostic Utility of Increasingly Complex Testing
in Chronic Heart Failure. Circ Heart Fail. 2015 Jul;8(4):709-16.
Boyle SH, Matson WR, Velazquez EJ, Samad Z, Williams
RB Jr, Sharma S, Thomas B, Wilson JL, O’Connor C, Jiang
W. Metabolomics analysis reveals insights into biochemical
mechanisms of mental stress-induced left ventricular
dysfunction. Metabolomics. 2015 Jun 1;11(3):571-582.
O’Connor CM. Time for Recognition. JACC Heart Fail. 2015
Jun;3(6):508-9.
Mentz RJ, Metra M, Cotter G, Milo O, McKendry C, Chiswell K,
Davison BA, Cleland JG, Bloomfield DM, Dittrich HC, Fiuzat M,
Ponikowski P, Givertz MM, Voors AA, Teerlink JR, O’Connor CM.
Early vs. late worsening heart failure during acute heart failure
hospitalization: insights from the PROTECT trial. Eur J Heart Fail.
2015 Jul;17(7):697-706.
Harinstein ME, Butler J, Greene SJ, Fonarow GC, Stockbridge
NL, O’Connor CM, Pfeffer MA, Mehra MR, Solomon SD, Yancy
CW, Fiuzat M, Mentz RJ, Collins SP, McMurray JJ, Vaduganathan
M, Dunnmon PM, Rosano GM, Dinh W, Misselwitz F, Bonow RO,
Gheorghiade M. Site selection for heart failure clinical trials in
the USA. Heart Fail Rev. 2015 Jul;20(4):375-83. doi: 10.1007/
s10741-015-9473-z.
Xiong GL, Prybol K, Boyle SH, Hall R, Streilein RD, Steffens DC,
Krishnan R, Rogers JG, O’Connor CM, Jiang W; SADHART-CHF
Investigators Inflammation Markers and Major Depressive
Disorder in Patients With Chronic Heart Failure: Results From
the Sertraline Against Depression and Heart Disease in Chronic
44 | Inova Heart and Vascular Institute
Heart Failure Study. Psychosom Med. 2015 Jul 16. [Epub
ahead of print]
Garber AM, Mentz RJ, Al-Khalidi HR, Shaw LK, Fiuzat M,
O’Connor CM, Velazquez EJ. Clinical predictors and outcomes
of patients with left ventricular thrombus following ST-segment
elevation myocardial infarction. J Thromb Thrombolysis. 2015
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O’Connor CM, Ahmad T. The Role of Sodium and Chloride in
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HR, Glower DD, Milano CA, Alexander JH, O’Connor CM, Wang
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O’Connor CM, et al. Heart Rate or Beta-blocker Dose?
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Chaudhary R, Bliden KP, Tantry US, Mohammed N, Mathew
D, Gesheff MG, Franzese CJ, Gurbel PA. Association of
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Tantry US, Gurbel PA. A Bigger Look Into the “Therapeutic
Window” of Platelet Reactivity to Adenosine Diphosphate. JACC
Cardiovasc Interv. 2015 Dec 28;8(15):1988-9.
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prevention of atherothrombosis. Expert Rev Cardiovasc Ther.
2015 Dec;13(12):1293-305.
Reny JL, Fontana P, Hochholzer W, Neumann FJ, Ten Berg J,
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T, Alessi MC, Berdagué P, Gurbel PA, Yong G, Angiolillo DJ, Aradi
D, Beigel R, Campo G, Combescure C. Vascular risk levels affect
predictive value of platelet reactivity for the occurrence of MACE
in clopidogrel treatment. Systematic review and collaborative
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Gurbel PA, Tantry US. Deciding about prolonged ticagrelor
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Sr, Kubica J, Volpe M, Agewall S, Kereiakes DJ, Kelm M. Effects
of Proprotein Convertase Subtilisin/Kexin Type 9 Antibodies in
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Oct;35(10):2081-2.
Baber U, Mehran R, Kirtane AJ, Gurbel PA, Christodoulidis G,
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Henry TD, Cox DA, Duffy PL, Mazzaferri EL Jr, Xu K, Parise H,
Brodie BR, Stuckey TD, Stone GW. Prevalence and impact of
high platelet reactivity in chronic kidney disease: results from
the Assessment of Dual Antiplatelet Therapy with Drug-Eluting
Stents registry. Circ Cardiovasc Interv. 2015 Jun;8(6):e001683.
Jeong YH, Smith SC Jr, Gurbel PA. Long-Term Use of Ticagrelor
in Patients with Prior Myocardial Infarction. N Engl J Med. 2015
Sep 24;373(13):1273-4.
Rafeedheen R, Bliden KP, Liu F, Tantry US, Gurbel PA. Novel
antiplatelet agents in cardiovascular medicine. Curr Treat
Options Cardiovasc Med. 2015 Jun;17(6):383.
Tricoci P, D’Andrea DM, Gurbel PA, Yao Z, Cuchel M, Winston
B, Schott R, Weiss R, Blazing MA, Cannon L, Bailey A, Angiolillo
DJ, Gille A, Shear CL, Wright SD, Alexander JH. Infusion of
Reconstituted High-Density Lipoprotein, CSL112, in Patients With
Atherosclerosis: Safety and Pharmacokinetic Results From a
Phase 2a Randomized Clinical Trial. J Am Heart Assoc. 2015 Aug
25;4(8):e002171.
Liu F, Tantry US, Gurbel PA. P2Y12 receptor inhibitors for
secondary prevention of ischemic stroke. Expert Opin
Pharmacother. 2015 Jun;16(8):1149-65.
Kowalewski M, Schulze V, Berti S, Waksman R, Kubica J,
Kołodziejczak M, Buffon A, Suryapranata H, Gurbel PA, Kelm
M, Pawliszak W, Anisimowicz L, Navarese EP. Complete
revascularisation in ST-elevation myocardial infarction and
multivessel disease: meta-analysis of randomised controlled
trials. Heart. 2015 Aug;101(16):1309-17.
Franzese CJ, Bliden KP, Gesheff MG, Pandya S, Guyer KE,
Singla A, Tantry US, Toth PP, Gurbel PA. Relation of fish oil
supplementation to markers of atherothrombotic risk in patients
with cardiovascular disease not receiving lipid-lowering therapy.
Am J Cardiol. 2015 May 1;115(9):1204-11.
Aradi D, Kirtane A, Bonello L, Gurbel PA, Tantry US, Huber K,
Freynhofer MK, ten Berg J, Janssen P, Angiolillo DJ, Siller-Matula
JM, Marcucci R, Patti G, Mangiacapra F, Valgimigli M, Morel O,
Palmerini T, Price MJ, Cuisset T, Kastrati A, Stone GW, Sibbing D.
Bleeding and stent thrombosis on P2Y12-inhibitors: collaborative
analysis on the role of platelet reactivity for risk stratification
after percutaneous coronary intervention. Eur Heart J. 2015 Jul
14;36(27):1762-71.
Mahla E, Tantry US, Gurbel PA. Platelet Function Testing Before
CABG is Recommended in the Guidelines: But Do We Have
Enough Evidence? J Interv Cardiol. 2015 Jun;28(3):233-5.
Gurbel PA, Kreutz RP, Bliden KP, Tantry US. Platelet activation
and pneumonia: is soluble p-selectin the right marker? J Am Coll
Cardiol. 2015 Apr 14;65(14):1492-3.
Jung JH, Tantry US, Gurbel PA, Jeong YH. Current antiplatelet
treatment strategy in patients with diabetes mellitus. Diabetes
Metab J. 2015 Apr;39(2):95-113.
Lhermusier T, Lipinski MJ, Tantry US, Escarcega RO, Baker N,
Bliden KP, Magalhaes MA, Ota H, Tian W, Pendyala L, Minha S,
Chen F, Torguson R, Gurbel PA, Waksman R. Meta-analysis of
direct and indirect comparison of ticagrelor and prasugrel effects
on platelet reactivity. Am J Cardiol. 2015 Mar 15;115(6):716-23.
Gurbel PA, Kuliopulos A, Tantry US. G-protein-coupled receptors
signaling pathways in new antiplatelet drug development.
Arterioscler Thromb Vasc Biol. 2015 Mar;35(3):500-12.
Lee K, Yoo SY, Suh J, Park KH, Park Y, Tantry US, Park KS, Han
SH, Kang WC, Shin DH, Lee C, Choi SW, Lee JH, Cho YH, Lee
NH, Jeong MH, Ahn Y, Kubica J, Gurbel PA, Park JH, Jeong
YH. Efficacy of cilostazol on inhibition of platelet aggregation,
inflammation and myonecrosis in acute coronary syndrome
patients undergoing percutaneous coronary intervention: The
ACCEL-LOADING-ACS (ACCELerated Inhibition of Platelet
Aggregation, Inflammation and Myonecrosis by Adjunctive
Cilostazol Loading in Patients With Acute Coronary Syndrome)
study. Int J Cardiol. 2015;190:370-5.
Gurbel PA, Gesheff MG, Franzese CJ, Bliden KP, Tantry US. Is
light transmittance aggregometry still a useful tool to assess
pharmacodynamic effects of antiplatelet therapy? Platelets.
2015;26(6):608-9.
Gurbel PA, Navarese EP, Tantry US. What is the best
anticoagulant therapy during primary percutaneous coronary
intervention for acute myocardial infarction? Pol Arch Med
Wewn. 2015;125(6):461-70.
Ad N. The importance of standardization in the surgical ablation
of atrial fibrillation. Invited commentary on: Shah et al., Gender
difference in outcomes following surgical ablation of atrial
fibrillation, J Thorac Cardiovasc Surg 2015, in press. [Editorial.]
Ad N, Holmes SD, Shuman DJ, Pritchard G, Massimiano PS.
Minimally invasive mitral valve surgery without aortic crossclamping and with femoral cannulation is not associated
with increased risk of stroke compared with traditional mitral
valve surgery: a propensity score-matched analysis. Eur J
Cardiothorac Surg. 2015 Dec;48(6):868-72.
inovaheart.org |
45
Ad N, Holmes SD, Shuman DJ, Pritchard G. Impact of atrial
fibrillation duration on the success of first-time concomitant Cox
maze procedures. Ann Thorac Surg. 2015 Nov;100(5):1613-9.
Ad N, Holmes SD, Shuman DJ, Speir AM, Pritchard G, Halpin
L. Should asymptomatic patients discharged with lower
hemoglobin expect worse outcomes after valve surgery? J
Thorac Cardiovasc Surg. 2015 Nov;150(5):1322-9.
Je HG, Shuman DJ, Ad N. A systematic review of minimally
invasive surgical treatment for atrial fibrillation: a comparison of
the Cox-Maze procedure, beating-heart epicardial ablation, and
the hybrid procedure on safety and efficacy. Eur J Cardiothorac
Surg. 2015 Oct;48(4):531-41.
Ad N. Reply to: Karabacak K, et al., Perioperative strict or flexible
glycemic control strategy may not have a predictive value on
patient survival after coronary bypass grafting, Ann Thorac
Surg 2015;99:1866–1867 [comment on: Ad N et al., Impact of
perioperative glycemic control strategy on patient survival after
coronary bypass surgery, Ann Thorac Surg 2014 Oct;98(4):1281–
1285]. Ann Thorac Surg 2015 May;99(5):1867.
Ad N, Massimiano PS, Shuman DJ, Pritchard G, Holmes SD.
New Approach to Exclude the Left Atrial Appendage During
Minimally Invasive Cryothermic Surgical Ablation. Innovations
(Phila). 2015 Sep-Oct;10(5):323-7.
Ad N. Reply to: Phan K, Yan TD, Minimally invasive Cox maze
procedure, beating-heart epicardial ablation, hybrid procedure
and catheter ablation: a call for comparative evidence, Eur J
Cardiothorac Surg 2015;48(3):515 [comment on: Je H, et al.,
A systematic review of minimally invasive surgical treatment
for atrial fibrillation: a comparison of the Cox maze procedure,
beating-heart epicardial ablation, and the hybrid procedure on
safety and efficacy, Eur J Cardiothorac Surg 2015;48(4):531–
541]. Eur J Cardiothorac Surg 2015 Sep;48(3):515–516.
Ad N, Holmes SD, Shuman DJ, Pritchard G, Massimiano PS,
Rongione AJ, Speir AM, Halpin L. Potential impact of modifiable
clinical variables on length of stay after first-time cardiac
surgery. Ann Thorac Surg 2015 Aug 11. [Epub ahead of print]
46 | Inova Heart and Vascular Institute
Ad N, Holmes SD, Massimiano PS, Spiegelstein D, Shuman
DJ, Pritchard G, Halpin L. Operative risk and preoperative
hematocrit in bypass graft surgery: Role of gender and blood
transfusion. Cardiovasc Revasc Med 2015 Aug 8. [Epub ahead
of print]
Ad N, Holmes SD, Shuman DJ, Pritchard G, Miller CE.
Amiodarone after surgical ablation for atrial fibrillation: Is it really
necessary? A prospective randomized controlled trial. J Thorac
Cardiovasc Surg. 2015 Jul 17. [Epub ahead of print]
Ad N, Massimiano PS, Burton NA, Halpin L, Pritchard G,
Shuman DJ, Holmes SD. Effect of patient age on blood product
transfusion after cardiac surgery. J Thorac Cardiovasc Surg
2015 Jul;150(1):209–214.
Gillinov M, McCarthy PM, Benussi S, Damiano RJ Jr, Ad N.
Surgical ablation for atrial fibrillation. Semin Thorac Cardiovasc
Surg 2015 Spring;27(1):65-79.
Ad N, Tran HA, Halpin L, Speir AM, Rongione AJ, Pritchard G,
Holmes SD. Practice changes in blood glucose management
following open heart surgery: from a prospective randomized
study to everyday practice. Eur J Cardiothorac Surg 2015
Apr;47(4):733–739.
Fitzgerald DC, Holmes SD, St. Onge JR, Ioanou C, Martin LM, Ad
N. Systemic inflammatory response during cardiac surgery: a
pilot study. Innovations (Phila) 2015 Mar-Apr;10(2):125–132.
Ad N. del Nido cardioplegia: ready for prime time in
adult cardiac surgery? J Thorac Cardiovasc Surg 2015
Feb;149(2):637–638.
Ad N. Transient systolic anterior motion after mitral valve repair:
does it affect long-term outcomes? J Thorac Cardiovasc Surg
2015 Feb;149(2):447.
Mavroudis C, Stulak JM, Ad N, Siegel A, Giamberti A, Harris
L, Backer CL, Tsao S, Dearani JA, Weerasena N, Deal BJ.
Prophylactic atrial arrhythmia surgical procedures with
congenital heart operations: review and recommendations.
Ann Thorac Surg 2015 Jan;99(1):352–359.
Ad N, Holmes SD, Stone LE, Pritchard G, Henry L. Rhythm
course over 5 years following surgical ablation for atrial
fibrillation. Eur J Cardiothorac Surg 2015 Jan;47(1):52–58.
Spiegelstein D, Holmes SD, Pritchard G, Halpin L, Ad N.
Preoperative hematocrit as a predictor of perioperative
morbidities following nonemergent coronary artery bypass
surgery. J Card Surg 2015 Jan;30(1):20–26.
PUBLISHED ABSTRACTS 2015
Fornaresio, L.M., Holmes, S.D., Ad, N. (2015). What impacts
recovery after cardiac surgery? A mixed method approach.
Quality of Life Research, 24(Suppl 1), 47.
Holmes SD, Martin LM, Miller CE, Shuman DJ, Ad N. How
do minimally invasive cardiac surgery patients compare to
median sternotomy patients on expectations and psychosocial
outcomes? Innovations 2015;10(suppl 2):S47.
An N, Holmes SD, Shuman DJ, Pritchard G, Martin LM. Healthrelated quality of life after minimally invasive cardiac surgery.
Innovations 2015;10(suppl 2):S56.
Fornaresio LM, Holmes SD, Shuman DJ, Pritchard G, Ali R,
Armstrong K, Ad N. Predictors of Health-related Quality of
Life After Isolated CABG Surgery. Circulation 2015;132(suppl
3):A18727.
An N, Holmes SD, Shuman DJ, Pritchard G, Martin LM. Healthrelated quality of life after minimally invasive cardiac surgery.
Innovations 2015;10(suppl 2):S56.
BOOK CHAPTERS 2015
Mukherjee D, Kfoury E. Carotid Endarterectomy - Vascular
Surgical Perspective. In: Laligam N. Sekhar, ed. Textbook of
Neurosurgery. Place of publication: Thieme Publishers; in press.
PAPERS PRESENTED AT SCIENTIFIC
MEETINGS 2015
Fornaresio LM, Holmes SD, Shuman DJ, Pritchard G, Ali R,
Armstrong K, Ad N. Predictors of Health-Related Quality of Life
After Isolated CABG Surgery. Annual Scientific Sessions of the
American Heart Association, Orlando, FL, November 2015.
Ad N, Holmes SD, Lamont D, Massimiano P. Five-year success
of the minimally invasive stand-alone Cox maze procedure for
nonparoxysmal atrial fibrillatin. Annual Meeting of the European
Association for Cardio-Thoracic Surgery, The Netherlands,
October 2015.
Martin LM, Holmes SD, Ad N. What Impacts Recovery
After Cardiac Surgery? A Mixed Method Approach. Annual
Conference for the International Society for Quality of Life
Research, Vancouver, British Columbia, October 2015.
Ad N, Holmes SD, Speir AM, Rongione AJ, Massimiano PS,
Pritchard G. Impact of a TAVR program initiation on a standard
aortic valve replacement surgery program. 41st Annual Meeting
of the Western Thoracic Surgical Association, Whistler, British
Columbia, Canada, June 2015.
Holmes SD, Martin LM, Miller CE, Shuman DJ, Ad N. How
do minimally invasive cardiac surgery patients compare to
median sternotomy patients on expectations and psychosocial
outcomes? Annual Meeting of the International Society for
Minimally Invasive Cardiothoracic Surgery (ISMICS), Berlin,
Germany, June 2015.
Ad N, Holmes SD, Shuman DJ, Pritchard G, Martin LM. Healthrelated quality of life after minimally invasive cardiac surgery.
Annual Scientific Meeting of the International Society for
Minimally Invasive Cardiothoracic Surgery (ISMICS), Berlin,
Germany, June 2015.
Ad N, Holmes SD, Shuman DJ, Speir AM, Pritchard G, Halpin
L. Should asymptomatic patients discharged with lower
hemoglobin expect worse outcomes after valve surgery? 95th
Annual Meeting of the American Association for Thoracic
Surgery, Seattle, WA, April 2015.
Ad N, Holmes SD, Pritchard G, Shuman DJ, Miller CE.
Amiodarone after surgical ablation for atrial fibrillation―is it
really necessary? A prospective randomized controlled trial.
95th Annual Meeting of the American Association for Thoracic
Surgery, Seattle, WA, April 2015.
Ad N, Holmes SD, Shuman DJ, Pritchard G. Impact of atrial
fibrillation duration on the success of first-time concomitant Cox
maze procedure. 51st Annual Meeting of the Society of Thoracic
Surgeons, San Diego, CA, January 2015.
Ad N, Holmes SD, Shuman DJ, Pritchard G, Massimiano PS,
Rongione AJ, Speir AM, Halpin L. The potential impact of
modifiable clinical variables on length of stay after first-time
cardiac surgery. 51st Annual Meeting of the Society of Thoracic
Surgeons, San Diego, CA, January 2015.
Ad N, Holmes DJ, Halpin L, Shuman DJ, Miller CE, Lamont D. Is
frailty in the cardiac surgery patient associated with outcomes?
51st Annual Meeting of the Society of Thoracic Surgeons, San
Diego, CA, January 2015.
Ad N, Holmes SD, Massimiano PM, Spiegelstein D, Shuman DJ,
Pritchard G, Halpin L. Operative risk and preoperative hematocrit
in bypass graft surgery: role of gender and blood transfusion.
51st Meeting of the Society of Thoracic Surgeons, San Diego,
CA, January 2015.
Ad N, Holmes SD, Pritchard G, Shuman DJ. Impact of energy
source on rhythm restoration by left atrium size and duration
of atrial fibrillation after the Cox maze procedure: a propensity
score–matched analysis. 51st Meeting of the Society of Thoracic
Surgeons, San Diego, CA, January 2015.
Fornaresio LM, Holmes SD, Shuman DJ, Pritchard G, Ali R,
Armstrong K, Ad N. Predictors of Health-Related Quality of Life
After Isolated CABG Surgery. Annual Scientific Sessions of the
American Heart Association, Orlando, FL, November 2015.
Ad N, Holmes SD, Lamont D, Massimiano P. Five-year success
of the minimally invasive stand-alone Cox maze procedure for
nonparoxysmal atrial fibrillatin. Annual Meeting of the European
Association for Cardio-Thoracic Surgery, The Netherlands,
October 2015.
Martin LM, Holmes SD, Ad N. What Impacts Recovery
After Cardiac Surgery? A Mixed Method Approach. Annual
Conference for the International Society for Quality of Life
Research, Vancouver, British Columbia, October 2015.
Ad N, Holmes SD, Speir AM, Rongione AJ, Massimiano PS,
Pritchard G. Impact of a TAVR program initiation on a standard
aortic valve replacement surgery program. 41st Annual Meeting
of the Western Thoracic Surgical Association, Whistler, British
Columbia, Canada, June 2015.
Holmes SD, Martin LM, Miller CE, Shuman DJ, Ad N. How
do minimally invasive cardiac surgery patients compare to
median sternotomy patients on expectations and psychosocial
outcomes? Annual Meeting of the International Society for
Minimally Invasive Cardiothoracic Surgery (ISMICS), Berlin,
Germany, June 2015.
Ad N, Holmes SD, Shuman DJ, Pritchard G, Martin LM. Healthrelated quality of life after minimally invasive cardiac surgery.
Annual Scientific Meeting of the International Society for
Minimally Invasive Cardiothoracic Surgery (ISMICS), Berlin,
Germany, June 2015.
Ad N, Holmes SD, Shuman DJ, Speir AM, Pritchard G, Halpin
L. Should asymptomatic patients discharged with lower
hemoglobin expect worse outcomes after valve surgery? 95th
Annual Meeting of the American Association for Thoracic
Surgery, Seattle, WA, April 2015.
Ad N, Holmes SD, Pritchard G, Shuman DJ, Miller CE.
Amiodarone after surgical ablation for atrial fibrillation―is it
really necessary? A prospective randomized controlled trial.
95th Annual Meeting of the American Association for Thoracic
Surgery, Seattle, WA, April 2015.
Ad N, Holmes SD, Shuman DJ, Pritchard G. Impact of atrial
fibrillation duration on the success of first-time concomitant Cox
maze procedure. 51st Annual Meeting of the Society of Thoracic
Surgeons, San Diego, CA, January 2015.
inovaheart.org |
47
Our Physicians
Ad N, Holmes SD, Shuman DJ, Pritchard G, Massimiano PS,
Rongione AJ, Speir AM, Halpin L. The potential impact of
modifiable clinical variables on length of stay after first-time
cardiac surgery. 51st Annual Meeting of the Society of Thoracic
Surgeons, San Diego, CA, January 2015.
Ad N, Holmes DJ, Halpin L, Shuman DJ, Miller CE, Lamont D. Is
frailty in the cardiac surgery patient associated with outcomes?
51st Annual Meeting of the Society of Thoracic Surgeons, San
Diego, CA, January 2015.
Ad N, Holmes SD, Massimiano PM, Spiegelstein D, Shuman DJ,
Pritchard G, Halpin L. Operative risk and preoperative hematocrit
in bypass graft surgery: role of gender and blood transfusion.
51st Meeting of the Society of Thoracic Surgeons, San Diego,
CA, January 2015.
Ad N, Holmes SD, Pritchard G, Shuman DJ. Impact of energy
source on rhythm restoration by left atrium size and duration
of atrial fibrillation after the Cox maze procedure: a propensity
score–matched analysis. 51st Meeting of the Society of Thoracic
Surgeons, San Diego, CA, January 2015.
48 | Inova Heart and Vascular Institute
CHIEF SAFETY OFFICER
Mukherjee D. A Cost-Effective Comparison of CEA under Local
vs General Anesthesia. General Surgery Grand Rounds, Inova
Fairfax Medical Campus. June 2015; Falls Church, VA.
Mukherjee D. Management of complications of carotid
endarterectomy. Annual Meeting of the Vascular Society of India.
October 2015; Pune, India.
Mukherjee D. A Cost-Effective Comparison of CEA under Local
vs General Anesthesia. Neurological Society of the Virginias.
January 2015; Greenbriar, WV.
Mukherjee D. Percutaneous EVAR vs Surgical EVAR - Real World
Results. VEITH Symposium. November 2015; New York City, NY.
ADVANCED HEART
FAILURE
Mukherjee D. Role of lower extremity bypass in the management
of CLI - is it headed for extinction? Annual Meeting of the
Vascular Society of India. October 2015; Pune, India.
Shashank Desai, MD
Palak Shah, MD
Christopher May, MD
Gurusher Panjrath, MD
Mukherjee D. A Cost-Effective Comparison of CEA under Local
vs General Anesthesia. Society of Vascular Surgeons Annual
Meeting. June 2015; Chicago, IL.
Mukherjee D. Carotid endarterectomy under local anesthesia.
Annual Meeting of the Vascular Society of India. October 2015;
Pune, India.
Mukherjee D. Contribution of surgeons of South East Asian
origin and the world of vascular surgery. Annual Meeting of the
Vascular Society of India. October 2015; Pune, India.
Mukherjee D. Lessons learned from 30 years of trying to perfect
Carotid Endarterectomy. General Surgery Grand Rounds, Inova
Fairfax Medical Campus. January 2015; Falls Church, VA.
Mukherjee D. Role of lower extremity bypass in the management
of Critical Limb Ischemia. American College of Surgeons Annual
Meeting. October 2015; Chicago, IL
Charles Murphy, MD
CARDIOLOGY/
CARDIOVASCULAR
DISEASE
Raushan K. Abdula, MD
Tarel Abou-Ghazala, MD
Khalid A. Abousy, MD
Marjaneh Akbari, MD
Muhammad Ali, MD
Aysha Arshad, MD
Walter L. Atiga, MD
Tariq A. Aziz, MD
Nicholas R. Balaji, MD
Michael R. Banihashemi, MD
Subash B. Bazaz, MD
George W. Bell, MD
Kambeez Berenji, MD
Rachel L. Berger, MD
Steven F. Berman, MD
George A. Besch, MD
Elizabeth S. Biegelsen, MD
Carl P. BonTempo, MD
Kenneth M. Brooks, MD
Christine D. Bussey, MD
Dean Carpousis, MD
Felix D. Castro, MD
Anthony C. Chang, MD
Tania Chao, MD
Asad E. Chaudhry, MD
Keith H. Chu, MD
Mariano D. Chutuape, MD
Nicholas A. Cossa, MD
Robert E. Cunnion, MD
Anna T. Czajka, MD
Stephen M. Day, MD
Christopher R. deFilippi, MD
Shashank S. Desai, MD
Paul E. DiLorenzo, MD
Thien M. Do, MD
James Duc, MD
Sarfraz A.K. Durrani, MD
Zayd A. Eldadah, MD
Kelly C. Epps, MD
Michael G. Escano, MD
Aldo R. Esposito, MD
Timothy P. Farrell, MD
Adam S. Fein, MD
Cleveland Francis, MD
Ted D. Friehling, MD
Rajat Garg, MD
Nadim Geloo, MD
Merdod Ghafouri, DO
Mohammad M. Ghazvini, MD
John S. Golden, MD
Michael H. Goldman, MD
Tariq M. Haddad, MD
Afsane Haddad-Mashad, MD
Seyed M Hashemi, MD
Edward W. Howard, MD
Edwin K. Huang, MD
Denise L. Hurst, MD
Leonard IIkhanoff, MD
Jeffrey A. Jackman, MD
Ahsan Q. Jafir, DO
Laurance W. Kam, MD
Ejaz M. Khan, MD
Charanjit S. Khurana, MD
Joseph M. Kiernan, MD
Albert H. Kim, MD
Bhanumathi Krishnan, MD
Sara Kulangara, MD
Amey R. Kulkarni, MD
Sung W. Lee, MD
Warren S. Levy, MD
Yaning Liu, MD
Jeffrey S. Luy, MD
Shahryar Mafi, MD
Alireza Maghsoudi, MD
Carey M. Marder, MD
Christopher W. May, MD
Alexander Mayer, DO
Robert L. McSwain, MD
Stuart A. Meyers, MD
Lawrence A. Miller, MD
Azita Moalemi, MD
Jason M. Morda, MD
Mehrdad Mostaan, MD
Alfred C. Myaing, MD
Pradeep Nayak, MD
Minh V. Ngo, MD
Michael P. Notarianni, MD
John T. O’Brien, MD
Paul J. O’Brien, MD
Christopher M. O’Connor, MD
Susan O’Donoghue, MD
Gurusher S. Panjrath, MD
Antonio R. Parente, MD
David J. Park, MD
Young D. Park, MD
Dhaval R. Patel, MD
Richard P. Perrin, MD
Paula E. Pinell-Salles, MD
Edward V. Platia, MD
Pio F. Poblete, MD
Dean M. Pollock, MD
Ashok J. Prasad, MD
Jun Anthony V. Quion, MD
Narian P. Rajan, MD
Gautam Ramakrishna, MD
Devanhalli Ramaswamy, MD
Haroon Rashid, MD
Jason M. Rashkin, MD
Bryan D. Raybuck, MD
Archana Reddy, MD
Kevin M. Rogan, MD
Arnold J. Rosenblatt, MD
Stephen P. Rosenfeld, MD
Lawrence R. Rubin, MD
Anne M. Safko, MD
Chirag M. Sandesara, MD
Pamela Sears-Rogan, MD
Palak Shaa, MD
Neel K. Shah, MD
Syed T. Shahab, MD
Robert E Shapiro, MD
Rishabh Sharma, MD
Jennifer A. Shea, MD
Stuart E. Sheifer, MD
Mazhar Sheikh, MD
Harvey S. Sherber, MD
Robert A. Shor, MD
Padma Shukla, MD
Balbir S. Sidhu, MD
Tseday E. Sirak, MD
Prachak Tom Siriprakorn, MD
Tina L. Slottow, MD
Rahsaan Cain Smith, MD
Michael A. Solomon, MD
Adam S. Strickberger, MD
David A. Strouse, MD
Anne E. Summers, MD
Hassan Tabandeh, MD
Hamid Taheri, MD
Mark P. Tanenbaum, MD
Naghmeh Tebyanian, MD
Behnam N. Tehrani, MD
Eric M. Thorn, MD
Henry A. Tran, MD
Ketan K. Trivedi, MD
Constantine J. Tziros, MD
Ganesh S. Venkataraman, MD
Kinda N. Venner-Jones, MD
Ajay Virmani, MD
Mark C. Vives, MD
Timothy S. Welch, MD
Jonathan E. Yager, MD
Ogei Yar, MD
Shahram Yazdani, MD
Kambiz Yazdani-Najafabadi, MD
Rafiq M. Zaheer, MD
Qiong Zhao, MD
CLINICAL CARDIAC
ELECTROPHYSIOLOGY
Aysha Arshad, MD
Walter L. Atiga, MD
Anthony C. Chang, MD
James Duc, MD
Sarfraz A.K. Durrani, MD
Zayd Adnan Eldadah, MD, PhD
Adam S. Fein, MD
Ted D. Friehling, MD
Mohammad Monireddin
Ghazvini, MD
Denise L. Hurst, MD
Leonard Ilkhanoff, MD
Sung W. Lee, MD
Robert L. McSwain, MD
Susan O’Donoghue, MD
Edward V. Platia, MD
Haroon Rashid, MD
Jason Mark Rashkin, MD
Chirag M. Sandesara, MD
Manish H Shah, MD
Adam S. Strickberger, MD
David A. Strouse, MD
Athanasios Thomaides, MD
Ganesh S. Venkataraman, MD
Marc H. Wish, MD
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INTERVENTIONAL
CARDIOLOGY
Tarek Abou-Ghazala, MD
Khalid A. Abousy, MD
Marjaneh Akbari, MD
Ather Anis, MD
Nicholas Raman Balaji, MD
Kambeez Berenji, MD
Rachel L. Berger, MD
Steven F. Berman, MD
George A. Besch, MD
Elizabeth S. Biegelsen, MD
Kenneth M. Brooks, MD
Felix D. Castro, MD
Nicholas A. Cossa, MD
Stephen M. Day, MD
Paul E. DiLorenzo, MD
Kelly C. Epps, MD
Aldo R. Esposito, MD
Rajat Garg, MD
Nadim A. Geloo, MD
John S. Golden, MD
Michael H. Goldman, MD
Paul A. Gurbel, MD
Seyed M. Hashemi, MD
Edward Howard, MD
Ahsan Qayyum Jafir, DO
Andrew J. Keller, MD
Charanjit S. Khurapa, MD
Charanjit S. Khurana, MD
Joseph M. Kiernan, MD
Albert H. Kim, MD
Warren S. Levy, MD
Alexander Mayer, DO
Stuart A. Meyers, MD
Lawrence A. Miller, MD
John T. O’Brien, MD
Antonio R. Parente, MD
Richard P. Perrin, MD
Dean M. Pollock, MD
Ashok J. Prasad, MD
Vikram Prasanna, MD
Jun Anthony V. Ouion, MD
Narian P. Rajan, MD
Devanhalli Ramaswamy, MD
Bryan D. Raybuck, MD
Kevin M. Rogan, MD
Stephen P. Rosenfeld, MD
S.T. Shahab, MD
Rishabh Sharma, MD
Balbir S. Sidhu, MD
Prachak T. Siriprakorn, MD
Tina L. Slottow, MD
Rahsaan C. Smith, MD
Hamid Taheri, MD
Behnam N. Tehrani, MD
Alexander G. Truesdell, MD
Ajay Virmani, MD
Shahram Yazdani, MD
M Rafiq Zaheer, MD
PEDIATRIC CARDIOLOGY
Hasan I. Abdallah, MD
Annette K. Ansong, MD
Robert Barlow, MD
Alan E. Benheim, MD
Patrick F. Callahan, MD
Amir Dangol, MD
Robert B. Escalera, MD
Frank Galioto, MD
Wali Gauvin, MD
Georgios A Hartas, MD
Steven Herold, MD
Jared A Hershenson, MD
Thomas J. Hougen, MD
Bahram Kakavand, MD
Sharon S. Karr, MD
William C. Kirby, MD
Jennifer H Lindsey, MD
Mohamed Mardini, MD
50 | Inova Heart and Vascular Institute
Jeffrey Paul Moak, MD
Jennifer Brown O’Neil, MD
Jin Hyuk Park, MD
Harish S. Rudra, DO
Iran M. Sadr, MD
Stephen R. Shapiro, MD
Michael Charles Slack, MD
Christopher Jon Talluto, MD
Sherif S. Tawfik, MD
Kalpana Thammineni, MD
James A. Thompson, MD
Rahel Zubairi, MD
PEDIATRIC CARDIAC
SURGERY
Lucas Collazo, MD
CARDIAC SURGERY
Niv Ad, MD
Linda J. Bogar, MD
Marcelo Cardarelli
Lucas R. Collazo, MD
Paul S. Massimiano, MD
Kathleen R. Petro, MD
Anthony J. Rongione, MD
Liam P. Ryan, MD
Ramesh Singh, MD
THORACIC SURGERY
VASCULAR AND
INTERVENTIONAL
RADIOLOGY
ADVANCED LUNG DISEASE
AND TRANSPLANT
PROGRAM
Sandeep Bagla, MD
James M. Cooper, MD
Alain T. Drooz, MD
Allen E. Joseph, MD
Michael G. Karnaze, MD
Hong T Lim, MD
Salman S. Mufti, MD
Calvin D. Neithamer, MD
Dimitrios C. Papadouris, MD
Kenneth S. Rholl, MD
David J. Spinosa, MD
Keith M. Sterling, MD
Venu Vadlamudi, MD
Arina Van Breda, MD
Jay D. Varma, MD
Steven Nathan, MD
Shahzad Ahmad, MD
Oksana Shlobin, MD
Anne Brown, MD
Christopher King, MD
Nargues Weir, MD
Convenient Access
Inova Heart and Vascular Institute’s convenient network of hospitals across Northern Virginia makes it easy for
patients and families to seek the care they need. All Inova Heart and Vascular Institute locations are seamlessly
connected to our modern, accessible flagship facility on the Inova Fairfax Medical Campus.
Inova Alexandria Hospital
Inova Heart and Vascular Institute
at Inova Alexandria Hospital
4320 Seminary Road
Alexandria, VA 22304
703.504.3000
Inova Fair Oaks Hospital
Inova Heart and Vascular Institute
at Inova Fairfax Medical Campus
3300 Gallows Road
Falls Church, VA 22042
703.776.4001
VASCULAR SURGERY
Behdad Aryavand, MD
Maseer A. Bade, MD
Kapil Gopal, MD
Homayoun A. Hashemi, MD
Dipankar Mukherjee, MD
Richard Neville, MD
Rodeen Rahbar, MD
Avisesh Sahgal, MD
Inova Heart and Vascular Institute
at Inova Fair Oaks Hospital
3600 Joseph Siewick Drive
Fairfax, VA 22033
703.391.3600
Inova Heart and Vascular Institute
Inova Fairfax Medical Campus
Sandeep J. Khandhar, MD
Paul d. Kiernan, MD
Inova Loudoun Hospital
INTERVENTIONAL
PULMONOLOGY
Inova Heart and Vascular Institute
at Inova Children’s Hospital
3300 Gallows Road
Falls Church, VA 2204
703.776.400
Inova Heart and Vascular Institute
at Inova Loudoun Hospital
44055 Riverside Parkway
Leesburg, VA 20176
703.858.6000
Inova Heart and Vascular Institute
at Inova Mount Vernon Hospital
2501 Parkers Lane
Alexandria, VA 22306
703.664.7000
Amit k. Mahajan, MD
Inova Mount Vernon Hospital
Inova Vein and Vascular Center - Gainesville
13575 Heathcote Boulevard, Suite 210
Gainesville, VA 20155
703.468.2610
Inova Fairfax Hospital Cardiac
Diagnostic Services at Prosperity
8505 Arlington Boulevard, Suite 320
Fairfax, VA 22031
703.641.0500
Inova Fairfax Hospital Cardiac
Diagnostic Services at Telestar
2901 Telestar Court, Suite 525
Falls Church, VA 22042
703.852.7750
Inova Loudoun Hospital Cardiac
Diagnostic Services
44035 Riverside Parkway, Suite 150
Leesburg, VA 20176
703.852.7770
Inova Fair Oaks Hospital Cardiac
Diagnostic Services
3580 Joseph Siewick Drive, Suite 301
Fairfax, VA 22033
703.852.7760
Inova Alexandria Hospital Cardiac
Diagnostic Services
4660 Kenmore Ave, Suite 1203d
Alexandria, VA 22304
703.852.7740
Important Clinic Numbers
Heart Transplant/VAD Clinic
703.776.6168
Lung Transplant/Advanced Lung
Disease
703.776.6168
Inova Valve Clinic
703.776.3135
G34592/3-16/15,000
inovaheart.org |
51
Leaders at
Heart
Inova Heart and Vascular Institute
Learn more about Inova Heart and Vascular
Institute at inovaheart.org
2015
Cardiac
Outcomes