MonashHeart Annual Review 2015 by MonashHeart

HEART OF THE STRONG MonashHeart Annual Review 2014–15

MonashHeart Monash Medical Centre 246 Clayton Road, Clayton Victoria, 3168

MonashHeart Dandenong Hospital David Street, Dandenong Victoria, 3175

Andrew Heine MonashHeart Casey Hospital 62-70 Kangan Drive, Berwick Victoria, 3806 Enquiries: 1300MHEART

www.monashheart.org.au

Age 38 Cardiac arrest on the golf course Implantable cardioverter defibrillator inserted

CONTENTS In 2014, MonashHeart enjoyed a year of growth. Our clinical, research, and educational successes were triumphs for our patients and staff. However, the sudden passing of two much-loved colleagues devastated the MonashHeart team. As we enter into 2015, we are reminded of the strength of our work and the commitment we have to our patients and our community. 4

WHO WE ARE

2014 AT A GLANCE

DIRECTOR’S MESSAGE

ACTIVITY REPORT

CLINICAL SERVICE SUB-SPECIALTIES REPORTS 18 ACUTE CARDIAC SERVICES 19 CARDIAC CT SERVICES 20 CARDIAC RHYTHM MANAGEMENT SERVICES 21 INTERVENTIONAL SERVICES 22 NON-INVASIVE IMAGING SERVICES 23 PAEDIATRIC CARDIOLOGY & ADULT CONGENITAL HEART DISEASE

FUNDRAISING REPORT

OUR FINANCES

MONASH CARDIOVASCULAR RESEARCH CENTRE REPORT

OUR ORGANISATION 37 MANAGEMENT TEAM 40 OUR PEOPLE

2014 MEDIA HIGHLIGHTS

VALE

THE HEART HOSPITAL

ACKNOWLEDGEMENTS

“For when there is victory, when battles are won, when burdens are lifted, when bright shines the sun, when struggling souls gather where heroes belong, they find in themselves the heart of the strong.” Tom Krause, Musician, 1934–2013 2

WHO WE ARE

MonashHeart is Victoria’s largest cardiology service provider with more than 300 committed multidisciplinary team members operating across three sites, providing over 80,000 episodes of cardiological care to the community each year. We thrive on providing a diversified, leading cardiology healthcare service to patients of all ages, from in-utero and newborns right through to our mature citizens. We are a part of Monash Health, the largest public health service provider in Victoria, Australia.

OUR MISSION

To improve community wellbeing through outstanding cardiovascular healthcare services and provision of exceptional quality education, training and research opportunities for healthcare professionals.

OUR VISION

To be the leading cardiovascular healthcare provider in Australasia. We put our vision into action through our: • commitment to provide the best possible experience, atmosphere and environment for our patients. • relentless drive to innovate and continually improve through research and technology development • emphasis on real teamwork and authentic relationships.

Visit our website 4

2014 AT A GLANCE

PATIENT CARE

MEDICAL PROCEDURES & TESTS

RESEARCH

EDUCATION

70 published papers in high-impact journals.

11 subspecialty fellowships provided to cardiologists from Australia and overseas (India and UK).

More than 80,000 episodes of cardiological care provided in 2014 across our three service sites.

20,747 ambulatory CRM tests were performed.

17,661 private consulting room consultations

16,812 echocardiograms performed on

Numerous presentations made at national or international meetings.

children and adults (an increase of 8 per cent in one year).

36 national and international clinical trials

provided (an increase of 20 per cent in 12 months).

5,602 cardiac catheterisation laboratory

7,206 people admitted to inpatient cardiac

procedures performed.

care beds.

3,068 cardiac CT scans performed. 1,970 patients attended the MonashHeart

4,296 patients seen in the Rapid Assessment Chest Pain Clinic by a cardiologist (an increase of 93 per cent in 12 months).

1,239 children seen in the MonashHeart paediatric clinics (an increase of 24 per cent in 12 months).

767 online patient satisfaction surveys completed across our three service sites.

cross-site device surveillance clinics (an increase of 12 per cent in 12 months).

387 emergency heart attack (STEMI) cases treated.

hosted.

6 PhD candidates. 5 Deakin University postgraduate critical care

2 research scholarship positions created from

students specialising in interventional cardiac nursing.

a generous donation. Dr Dennis Wong awarded a National Health and Medical Research early career fellowship and a Heart Foundation post-doctoral fellowship. Dr Brian Ko awarded a post-doctoral fellowship by the Heart Foundation. Professor Ian Meredith and team wins the best poster prize at the prestigious 63rd Annual American College of Cardiology Conference 2014.

5 advanced cardiology trainees and 2 general medicine trainees. 1 Masters by thesis cardiac technologist. 1 cardiac CT course in May 2014 attended by eight specialist consultants along with ongoing cardiac CT mini fellowships provided throughout the year.

MEDIA

Over 65 positive media articles.

ONLINE PRESENCE

The number of unique visitors to the website up by 60% and sessions up by 52%, with an increase of 38% in total page views.

At least one positive media article each month, up to 15 media stories in one month (November).

Visitors to the website from 147 countries.

2 visits by the Liberal Health Minister, the Hon. David Davis to MonashHeart, including one visit by the Premier Denis Napthine.

Celebrated third twitterversary in December 2014 with over 1,200 tweets to date and 683 followers.

1 visit by the Opposition Leader Daniel Andrews and his wife Catherine to announce Labor support for the Heart Hospital.

Commencement of MonashHeart Instagram in May 2014 with 249 followers by December 2014. Initiation into Facebook with MonashHeart account in late October 2014, with 313 fans by December 2014.

1st ever clinical nurse educator, cardiac catheterisation laboratory position created in Australia. Mr Kevin White winner of the Australian College of Critical Care Nurses prize for the best critical care student of all of the 2014 Deakin University student cohort. Live case transmission from the cardiac catheterisation laboratory to national and international conferences including TAVI Summit in Korea, World Congress of Cardiology in Melbourne and ANZET Conference in Melbourne.

“The opportunity to care for others is a privilege, not a right.”

DIRECTOR’S MESSAGE

2014 will be remembered, on reflection, as both a bitter and sweet year for MonashHeart. One in which we experienced inexplicable tragedies yet a few remarkable triumphs, unexpected sadness yet critical success. A year, in a sense, of two distinct halves – turmoil then tranquility, upheaval followed by recovery. Tragically, 2014 will be remembered for the sudden and incomprehensible loss of not one but two of our most loved, respected and admired staff members, Dr Paul Antonis and Ms Brylie Vines. Both Paul and Brylie were known for their kindness, generosity and their unswerving dedication and commitment. Both leave behind loving families and adoring young children. We have, and will continue to, extend our heartfelt sympathy and support to their respective families and loved ones. Paul and Brylie will be sadly missed but never far from our thoughts. It was a year from which I believe we will emerge more galvanized, more insightful, more tolerant and more understanding and, most likely, as an even more compassionate team through our shared sadness and grief. While working continuously in healthcare it is all too easy to focus on a particular patient’s procedure or the process and delivery of their care and less on their feelings and needs. While I have always been impressed by our culture of kindness and compassion, I suspect the events of 2014 will, at the very least, increase our collective insight and sensitivity to our patients and families needs. After all, care is at the heart of what we do. The year definitely ended brighter with the dawn of new opportunities and possibilities most notably with the bipartisan State Election announcements in favour of a heart hospital development in Victoria. The announcement did, as expected, bring with it some uncertainty and angst but change, any change, inevitably does this. Importantly, change inevitably happens. One thing is for sure, if we are to make the new heart hospital promise a reality, we will require the broader cardiology community, our research and education partners, our staff, our patients and their supportive families to embrace the heart hospital and to work shoulder to shoulder to bring this project to fruition.

Professor Ian Meredith AM Director of MonashHeart, Monash Health

We face many challenges ahead not the least being the need to meet the demands of a growing and ageing population in a timely and caring manner, to continue to develop new treatment paradigms and develop better, more efficient and less intrusive ways of treating our patients and community, and to continue to compete internationally in our clinical and basic research endeavours. As you read thorough this report, I hope you will appreciate that our clinical service and care statistics as well as research metrics show a consistent pattern of growth and achievement driven largely by a culture that recognises the importance of excellence in clinical care embedded in an environment that fosters world-class clinical research and education. There are so many people to thank for their tireless work, organisational support, personal strength and dedication in 2014. While there is not space here to acknowledge all of the team, I would like to make special mention of Professor James Cameron, Ms Kirsten Garner, Mr John Koutsoubos, Ms Anne Mennen, Ms Kara Zantuck and Mr Peter Maloney (Chair of the MonashHeart Strategic Advisory Board) whose sage counsel, dedication, energy and drive continue to amaze and inspire me. It is a great honour and privilege to have the position of Director and work alongside such a talented group. I warmly encourage you to review MonashHeart’s 2014 clinical and research achievements in cardiovascular health. We remain passionately committed to the delivery of the highest quality, patientcentered care and to be of wider service to the community. Achieving world’s best practice across the full spectrum of cardiovascular disease and delivering expert care in a timely, accessible and equitable manner is the foundation on which MonashHeart is based. Professor Ian Meredith AM Director of MonashHeart Monash Health

ACTIVITY REPORT

1. Cardiac admissions to inpatient bed (public and private)

7,206 17,661

2. Private Consulting Room consultations

Private Consultation Attendances 2014 2013 2012 2011 2010 2009 2008 1267 0

Echocardiogram 2014

14723 12392 8630

15000

20000

3,068

5000

1774

e. 6-minute walk tests

281

3000

4000

15000

20000

2014 2013 2012 2011 2010 2009 2008

15,101 852 1,598 2,959 237

1970 1762 1594 1339 1244 1142 744

500

1000

1500

2000

770 720

8. Cardiac Rhythm Management – new niche clinic attendances

730 715 732

9. MonashHeart Paediatric Clinic attendances

678

650

700

a. Complex Atrial Fibrillation Clinic b. Cardiac Inherited Diseases Clinic

701

600

We diagnose, manage and treat cardiac arrhythmias including bradyarrhythmias and tacharrhythmias in paediatric, adolescent and adult patients.

d. Holter and loop monitoring

1085

2000

10000

5. Cardiac Rhythm Management – ambulatory ECG services

c. Exercise stress testing

1415

1000

8158

b. Ambulatory blood pressure monitoring

2701

324

1,970

Device Surveillance Clinics

10408

2008

a. 12-lead electrocardiograms (ECG)

3068 2995

i. Permanent pacemakers ii. Implantable cardiac defibrillator iii. Loop iv. Watchman device

Device Implant (PPM/ICD)

12633

2009 10000

770

a. Device implants

b. Electrophysiology studies

13702

2010

5000

7. Cardiac Rhythm Management – device surveillance clinic attendances (PPM/ICD)

14301

2011

4254

6. Cardiac Rhythm Management – cardiac catheterisation laboratory services

15511

2012

6765

Cardiac CT

16812

2013

A cardiac CT allows doctors to non-invasively, quickly and easily view the structure and function of the heart. It provides a view of thin cross sections of the anatomy of the heart including the coronary arteries, the heart muscle and heart valves.

An echocardioagram is a sonograph of the heart. Echocardiography uses ultrasound to capture images of the heart. We offer different types of echocardiograms including exercise stress echocardiogram and Dobutamine stress echocardiogram.

17661

3. Cardiac CT scans

2014 2013 2012 2011 2010 2009 2008

16,812

4. Echocardiograms

750

800

1,239

a. Paediatric Murmur Clinic b. General Cardiology Clinic

Electrophysiology Study 2014 2013 2012 2011 2010 2009 2008 0

324 283 276 209 249 200 228

100

150

200

250

300

350 11

ACTIVITY REPORT

“Early intervention and patient education are the keys to preventing chronic heart failure and avoiding recurrent hospitalisation.” Dr Siobhan Lockwood &

10. Interventional Services — cardiac catheterisation laboratory services

3,228 1,280

a. Coronary angiography b. Percutaneous cardiac interventions Coronary Angiography 2014 2013 2012 2011 2010 2009 2008 3000

3228 3176 3179

2014 2013 2012 2011 459 2010 24

Ms Caroline Bowman Early Intervention Systolic

Rapid Assessment Chest Pain Clinic

3227

4,296

11. Rapid Assessment Chest Pain Clinic attendances

Heart Failure Clinic

4296 2231 1960

1000

2000

3000

4000

5000

3298 3172

12. Early Intervention Systolic Heart Failure Clinic attendances

3059

3100

3200

3300

3400

428

(commenced March 2014)

Percutaneous Cardiac Intervention (PCI) 2014 2013 2012 2011 2010 2009 2008 1000

1280 1279 1199 1165 1188 1216 1130

1100

1200

1300

“Our clinical service and care statistics as well as research metrics show a consistent pattern of growth and achievement driven largely by a culture that recognises the importance of excellence in clinical care embedded in an environment that fosters world-class clinical research and education.” - Professor Ian Meredith AM

“You hear bad things about public health, but I have nothing but praise.” Andrew Heine 38-year old Husband and father of two

Ever since he was a child, Andrew had always enjoyed playing golf – playing for many years at the National Golf Club, Cape Schanck. He joined the Kingston Heath Golf Club in 2012, enjoying all 125-hectares of its stunning fairways and traps. On 25 May 2014, Andrew was enjoying a round with friends. Between swings, a friend asked about his health, after recent investigations for heart palpitations. “All is well. Nothing to worry about,” he replied. Andrew slipped out of work early the next day to fit in an afternoon round of golf, hoping to get all 18 holes in with a friend, before sunset. He collapsed suddenly at the 17th hole. Rolling him over, his friend saw he was unconscious and without a pulse. Calling 000, the emergency operator talked him through how to commence cardiopulmonary resuscitation (CPR), and keep him oxygenated until emergency services arrived. Trying to find the 17th hole was a challenge for the MICA ambulance team, which arrived about 12 minutes later. They proceeded to work on Andrew for 40 minutes before they were able to stabilise his heart rhythm, bringing him out of a state of ‘ventricular fibrillation.’ After a full hour of intensive resuscitation, they brought Andrew to the Monash Medical Centre for emergency management.

An urgent coronary angiogram at MonashHeart found no evidence of a heart attack or coronary artery narrowing. Andrew was transferred to the intensive care unit, where his family were told to prepare for the worst, as chances of survival after 40 minutes of being in cardiac arrest were less than 10 per cent. Thankfully, Andrew recovered within six days and was moved from the intensive care unit to the cardiac care unit. He remembers the four weeks he spent there fondly, where he says he experienced public healthcare at its finest. “Professional, knowledgeable, helpful and positive; never once did I doubt I wouldn’t make it… They were a young, vibrant team – there was fun and humour which made my recovery an enjoyable time.” Under MonashHeart’s care, he had a defibrillator implanted and was transferred to Kingston for two weeks of rehabilitation, before going home to his wife and sons aged 4 and 6. At the time of this publication (nine months after his cardiac arrest), Andrew is working part-time and adjusting to life after recovery. His prolonged cardiac arrest had caused the loss of vision in his right eye and limited vision in his left eye. Despite the challenges, Andrew is hopeful and already has his mind set on his next goal. “I am alive and so very thankful to everyone. Hopefully I can give golf a try in the next few weeks back at Kingston Heath.”

CLINICAL SERVICE SUB-SPECIALTY REPORTS

ACUTE CARDIAC SERVICES

CARDIAC CT SERVICES

Group leader profiles

2014 highlights

Community activity and outreach

Group leader profile

2014 highlights

Professor Ian Meredith AM

• We provided care to over 7,200 patients.

• Throughout Atrial Fibrillation Awareness Week in November 2014, MonashHeart Clayton CCU nursing staff provided free pulse checks and advice to hospital visitors in the foyer.

Associate Professor Sujith Seneviratne

• The team performed 3,068 cardiac CT scans.

Associate Professor Sujith Seneviratne (Sene), an Australian leader in cardiac CT, is the cohead of the luminary site 320-slice cardiac CT facility at MonashHeart where he also practices as an interventional cardiologist. Sene’s knowledge, expertise and enthusiasm for cardiac CT has seen our service develop into the largest in Australia. Our facility is well known around the world for its cutting-edge research and development and is undoubtedly the most published cardiac CT service in Australia. Sene leads the faculty team providing the cardiac CT course and mini fellowships. These programs have trained more than 100 cardiologists and radiologists from Australia, New Zealand and Asia since the facility was first established over six years ago. Sene is also a member of the conjoint committee for the recognition of training in CT coronary angiography which is the main governing body for specialist cardiac CT accreditation.

• We continue to maintain close collaboration with the Toshiba research team in Japan in developing world-first software and advances in cardiac CT technology.

After the sudden passing of Dr Paul Antonis, Professor Ian Meredith acted as the head of Acute Cardiac Services for the remainder of 2014. Mss Kerrie Aldridge, Elaine Davis, Claire McDonald, Chris Rasmussen and Pauline Ryan. Kerrie, Elaine, Claire, Chris and Pauline are the nurse unit managers of the public and private cardiac care units across Monash Medical Centre and Dandenong Hospital. This dynamic group of women leaders have more than 80 years of cardiac nursing experience between them. Combined they manage over 300 nursing staff to provide exceptional nursing care to our patients 24 hours a day, seven days a week. What we do Acute Cardiac Services provide coordinated healthcare to acute cardiac patients admitted to cardiac beds across Monash Health hospitals. With 21 beds in the Cardiac Care Unit (CCU) and 8 beds in the combined Cardiology and Cardiothoracic Unit at Monash Medical Centre Clayton (32 South) as well as 26 beds in the CCU at Jessie McPherson Private Hospital (31 North) and 12 to 16 CCU beds at Dandenong Hospital, this is the largest inpatient cardiac service in Victoria.

• In 2014 Monash Health was successfully accredited as part of the new National Safety and Quality Health Service standards. This accreditation process saw the development of new documentation and communication tools. All aspects of the patient journey were revisited leading to changes in clinical handover, environmental cleaning and new falls prevention strategies. • MonashHeart Clayton CCU introduced criteria led discharge to expedite patient discharge based on a set of evidence-based criteria. This empowers nursing staff to facilitate and streamline the discharge process in order to ensure patients return home as safely and quickly as possible. • Four new consultants joined the Acute Cardiac Services ward service roster, Drs Ko, Dundon, Wong and Sapontis. • MonashHeart Dandenong CCU was invited to participate in the pilot Acute Coronary Syndrome Ambassador Program. Sponsored by the Department of Health and led by the Heart Foundation, the program was designed to improve nursing confidence in delivering cardiac education to patients. • We refurbished two-day procedure beds in the Clayton CCU to help meet the growing demand for day case angiography and reduce waiting time. • At Clayton CCU, the MonashHeart registrars commenced performing ‘hot’ bedside echocardiographs using a portable echocardiogram machine. Through this project, we were able to expedite bedside diagnoses with 84 echocardiograms performed in the space of 10 months.

• The MonashHeart Clayton CCU team helped brighten Christmas time for over 110 families, including 165 children by donating items to the 2014 Salvation Army Christmas Appeal. Plans for 2015 • MonashHeart Clayton will upgrade all cardiac monitoring systems through the Department of Health’s Medical Equipment Replacement Program. • In February 2015 we will be introducing a new ‘red team/white team’ two-ward consultant cardiologist model at MonashHeart Clayton. This will result in enriched patient care, improved response times and the opportunity for meaningful on-round teaching of staff and students. • We are undertaking work to fund all 16 CCU beds at Dandenong Hospital to reduce elective waiting times and facilitate prompt transfer of country patients for interventional procedures. • We are seeking approval to replace and upgrade our existing BiPAP machines for CCU Clayton, CCU Dandenong Hospital and 32 South in order to provide optimised care for critically ill cardiac patients requiring noninvasive ventilation.

What we do Cardiac CT Services provide non-invasive angiography to diagnose coronary artery disease and assess structural and congenital heart disease. A cardiac computed tomography (CT) scan is a painless, non-invasive test using an x-ray machine to take clear, detailed pictures of the heart, which are then composed into a 3D picture. Cardiac CT scans are generally performed for patients with chest pain or shortness of breath who are considered to be at low to intermediate risk of coronary artery disease.

• Another cardiac CT course designed to satisfy Australian Level A accreditation was successfully conducted this year for both cardiologists and radiologists. In addition, we offered a mini 25-live-case fellowship program throughout the year. • We have had another excellent year with a number of outstanding research and publication achievements including: 1. American College of Cardiology Young Investigator Award – Finalist – Dr Dennis Wong. “Comparison of diagnostic accuracy of combined assessment using adenosine stress CT perfusion (CTP) + computed tomography angiography (CTA).” 2. Two MD theses submitted on cardiac CT research (by Drs Brian Ko and Dennis Wong). 3. PhD thesis submitted by Dr Arthur Nasis on his cardiac CT research. 4. National Health and Medical Research Council (NHMRC) Early Career Fellowship based on cardiac CT research awarded to Dr Dennis Wong. 5. Heart Foundation postdoctoral fellowships awarded to Drs Brian Ko and Dennis Wong based on cardiac CT research. 6. Robertson Family Research Fellowship awarded to Drs Brian Ko and Dennis Wong based on cardiac CT research.

2014 highlights (Cont.) 9. Two book chapters on cardiac CT written by MonashHeart staff as invited authors. 10. Thirteen publications in high impact factor journals including three publications in Journal of American College of Cardiology (JACC). 11. Multiple national and international presentations including an oral presentation at the European Society of Cardiology (ESC) conference in Spain. Community activity and outreach • Throughout 2014 we continued to conduct talks to educate general practitioners and other cardiologists including cardiologist trainees in the appropriate use of cardiac CT and calcium score. • We helped other Australian bodies set up cardiac CT services by hosting on-site educational visits to our facility. We also shared our systems, processes and protocols through mini fellowships. Plans for 2015 • In addition to expanding our clinical service, we will maintain a strong focus on our research activities particularly in the area of assessing functional significance of coronary stenosis detected by cardiac CT. • We also aim to establish our facility as a core laboratory for multi-centre international studies and further expand research collaborations with our international partners.

7. Dr Andrew Talman “Epicardial fat and atherosclerotic plaque progression” – Winner of the Medical Student Research Prize, Melbourne University. 8. Two International multi-centre research studies, where MonashHeart was the lead site for Australia, completed (HeartFlow NXT and GLOBAL).

CARDIAC RHYTHM MANAGEMENT SERVICES

INTERVENTIONAL SERVICES

Group leader profiles

2014 highlights

Community activity and outreach

Group leader profiles

2014 highlights

2014 highlights (Cont.)

Dr Jeff Alison

• We performed a total of 1,094 cardiac catheterisation laboratory procedures.

• We expanded our proﬁle as a demonstration and training site for visiting cardiologists both nationally and internationally particularly for cardiac interventional procedures such as catheter balloon-based ablation procedures for atrial fibrillation and percutaneous left atrial appendage occlusion. Dr Alison travels to other specialist centres across Australia to proctor these procedures.

Dr Yuvaraj Malaiapan

• We performed 4,508 interventional procedures.

• In conjunction with Deakin University, clinical nurse educator Kevin White co-authored a manuscript which was accepted for publication in the Australian Critical Care journal. Kevin was also invited to speak on interventional cardiac nursing education at the inaugural Victorian Interventional Cardiac Nurses Day and the Interventional Cardiovascular Nurses Affiliates session at the 2014 ANZET meeting.

Dr Jeff Alison has served as the head of the Electrophysiology Program, Monash Medical Centre, Clayton since 1996 and the head of Cardiac Rhythm Management (CRM) Services, MonashHeart since 2007. Under Jeff’s leadership, MonashHeart’s CRM service continues to grow both in the number and range of services provided. Dr Emily Kotschet Dr Emily Kotschet was the acting head of CRM Services in the first half of 2014, during Jeff Alison’s long service leave. She commenced her training in electrophysiology in 2002 as a fellow with Monash Cardiology, followed by a further two-year fellowship in Canada. She ensured the smooth running of CRM services during Jeff’s leave, including leading the commencement of new clinical services and important research. Mr Nick Youngs Nick Youngs is the lead cardiac technologist for MonashHeart’s CRM services. Armed with a science degree and subspecialty training in cardiac technology both from Victoria and the UK, Nick leads a team of 20 cardiac technologists who focus on cardiac rhythm catheterisation laboratory procedures and electrocardiographic (ECG) service provision. What we do CRM Services diagnose, manage and treat cardiac arrhythmias (irregular rhythm or rate of the heartbeat). We provide consulting and pacing clinics, including a specific clinic for atrial fibrillation (AF). Patients are seen quickly and further investigations are arranged promptly to help manage AF symptoms, and importantly, prevent stroke. This is a first for Victoria. Each year we provide two fellowships to cardiologists wanting to further train in the sub-speciality of electrophysiology and pacing. We also offer two industry based learning (IBL) placements to undergraduate Swinburne

• We launched dedicated clinics for the investigation and management of cardiac inherited diseases and complex atrial fibrillation. • We established a mobile pacemaker check unit (Medtronic Carelink) at MonashHeart Dandenong, (another first for Victoria) to enable nursing staff to download pacemaker checks and transmit them to MonashHeart Clayton for checking. This has helped facilitate prompt discharge of patients post procedure by eliminating the need to wait for personnel to come from other sites to check the device. • We continued to regularly implant WATCHMAN left atrial appendage occlusion devices, and now serve as a training centre for other doctors to learn this procedure. • In November 2014, Dr Stewart Healy and Dr Jeff Alison successfully implanted Victoria’s first transvenous, left ventricular endocardial pacing lead in a patient requiring biventricular pacing for management of refractory heart failure. • In December 2014, Dr Jeff Alison performed the first two subcutaneous implantable cardiac defibrillator (ICD) implants in Australia with great success. • We are involved in several multi-centre trials including investigating the best management of atrial fibrillation with heart failure and how to manage the risk of sudden death after a heart attack.

• Former patient and world champion, triathlete Ms Emma Carney joined the MonashHeart Strategic Advisory Board as an Ambassador in mid-2014. Emma was involved in various media events in relation to MonashHeart building Australia’s first dedicated heart hospital.

Dr Yuvaraj Malaiapan has been the head of MonashHeart’s Interventional Services since 2005. He has actively pursued improvements in the care provided to all patients undergoing procedures in the interventional cardiac catheterisation laboratories. Ms Kara Zantuck Ms Kara Zantuck began her career in cardiothoracic nursing 12 years ago before joining the cardiac catheterisation laboratory nursing team in 2006, where she found her niche. In 2014 Kara was appointed as the Nurse Unit Manager for the Cardiac Catheterisation Laboratories and the Cardiac CT Service. What we do

Plans for 2015 • We hope to explore funding opportunities to enable the appointment of a part-time research CRM fellow. This will ensure continuity of oversight of clinical trials already in progress and additional support for new projects. • We fully endorse MonashHeart seeking to establish a fourth much needed cardiac catheterisation laboratory at MonashHeart Clayton, with capacity for additional CRM sessions. • With funding allocated from the 2013 fundraising Port to Port Cycling Tour along with private funds, we anticipate the purchase of a replacement Holter monitoring system early in 2015. • In conjunction with HeartKids, Professor Ian Meredith will participate in Super Boss Day on 19 February to help raise funds to purchase two additional Holter monitors.

• We treated 387 emergency heart attack cases. • We saw the completion of Reprise II and III TAVI extension trials. • Globally, we were the ﬁrst to begin in-human trials of the next generation Lotus™ Heart Valve device, presenting 30-day data at the 2014 London Valves meeting. • We performed Australia’s ﬁrst LV Recover case – a percutaneous procedure to reduce functional mitral valve regurgitation and improve heart function. • We were privileged to transmit a number of live cases at various esteemed cardiology meetings including: >

World Congress of Cardiology meeting, Melbourne, May 2014

with catheter-based interventions for the

TAVI Summit, Seoul, Korea, August 2014

diagnosis and treatment of heart disease

Australia & New Zealand Endovascular Therapies (ANZET) meeting, Melbourne, August 2014

Interventional cardiology is a specialised branch of cardiology that deals specifically

including coronary artery and structural heart disease. We provide a 24-hour emergency service for people suffering a heart attack. Interventional cardiologists assisted by the cardiac catheterisation laboratory team, perform emergency angiographies to visually assess and if required, treat the arteries to the heart muscle. Our state-of-the-art facilities, located within MonashHeart Clayton, offer advanced, high volume interventional cardiology services via two dedicated cardiac catheterisation laboratories.

• Our team of cardiologists and trainees published over 40 articles in high impact medical publications. • Dr Yuvaraj Malaiapan, Dr Brian Ko and Dr Dennis Wong completed and submitted their Doctor of Medicine thesis to Monash University. • Cardiac catheterisation laboratory Nurse Unit Manager John Koutsoubos was seconded to the MonashHeart Operations Manager role and we were delighted to appoint Kara Zantuck into this important leadership role. • Our partnership with the postgraduate nursing team at Deakin University provided new academic opportunities for our nursing staff. Registered nurses Jade Geer, Stella Floros and Judy Williams completed a postgraduate graduate certificate in critical care (interventional nursing) and Kevin White and Dianne D’Rosario completed a postgraduate graduate diploma in critical care (interventional nursing).

• Kevin White was awarded the Australian College of Critical Care Nurses Award for Best Critical Care Nursing Student for the 2014 Deakin University student cohort. Community activity and outreach • Our cardiologists continue to facilitate onsite IVUS and rotablation workshops for the wider cardiology community. • In partnership with the East Timor Hearts Fund, MonashHeart provided lifesaving mitral valvuloplasty to three East Timorese patients suffering from critical mitral stenosis. • The ABC TV Foreign Correspondent ﬁlmed the heartwarming story of young East Timorese patient Jeca, on his journey to Australia to undergo a mitral valvuloplasty procedure with MonashHeart. Viewers witnessed him going from a desperately ill 11-year-old to a smiling, healthy child. Plans for 2015 • The interventional team are preparing to transmit live transcatheter aortic valve implantation cases via satellite to the SCRIPPS course in San Diego, US in February 2015. • We hope to receive approval for the establishment of a fourth cardiac catheterisation laboratory at MonashHeart Clayton.

University of Technology students.

NON-INVASIVE IMAGING SERVICES

Group leader profiles

2014 highlights

2014 highlights (Cont.)

Group leader profile

2014 highlights

Plans for 2015

Associate Professor Philip Mottram

• We performed 16,812 echocardiograms in 2014.

• We continued to expand our echocardiogram services to patients with Friedreich’s ataxia and commenced involvement in a large multi-centre study of these patients. We also commenced collaboration with the Menzies Research Institute for the SUCCOUR study.

Associate Professor Sarah Hope

• We moved our consulting services into purpose built consulting rooms, significantly improving the environment for our patients.

• We will see the commencement of a specifically designated adult and adolescent congenital heart disease clinic.

• We were delighted to play a part in the commencement of a multidisciplinary cardiac inherited disease clinic involving combined consultations with both cardiology and genetic services.

• We expect to strengthen our fetal cardiology services by the appointment of a paediatric cardiologist with extensive experience in leading and developing such services.

Associate Professor Philip Mottram is a clinical cardiologist and non-invasive imaging specialist with expertise in all forms of echocardiography as well as in cardiac CT. Phil is the head of Non-Invasive Imaging Services, MonashHeart, the largest echocardiography service provider in Victoria, performing close to 17,000 echocardiograms per year. Mr Anthony Wald Mr Anthony Wald received his qualifications as a cardiac technologist in South Africa, expanding and consolidating his skills in Europe and Australia. With a postgraduate qualification in health management, Anthony leads the cardiac technologist team of 40 staff providing services across three sites. What we do Echocardiography uses sound waves to create moving images depicting the shape and size of the heart, heart valves and cardiac chambers. Each year MonashHeart’s non-invasive imaging service continues to grow, performing the latest and complete range of echocardiography procedures including transthoracic, transoesophageal and dobutamine stress echocardiography. The service is staffed by a dedicated team of sub-specialty trained echocardiologists, many of whom have PhD’s in echocardiography. Our sonographers are trained to the highest standards and a number are examiners for Australian cardiac ultrasound courses.

• We opened an additional echocardiogram room at MonashHeart Dandenong and implemented a new system which reduced the echocardiogram machines idle time. • Echocardiogram services at MonashHeart Casey increased from three days per week to five. • The waiting time for an outpatient transthoracic echocardiogram reduced from over four months to six to 10 weeks. • The non-invasive imaging team presented numerous abstracts at the 2014 World Congress of Cardiology scientific meeting. • Associate Professor Philip Mottram delivered an invited lecture on the quantification of left ventricular systolic function with echocardiography at the World Congress of Cardiology, Melbourne. • Dr Arthur Nasis excelled as a ﬁnalist in the Ralph Reader presentations with a paper which was was subsequently published in the Journal of the American Society of Echocardiography, accompanied by a high profile editorial. • Drs Stuart Moir and Arthur Nasis were both successful in gaining training opportunities at the Heart Hospital in London – one of the leading cardiac MRI facilities in the world. • Sonographer Rikki Bailey graduated from her course in cardiac echocardiography through Queensland University of Technology, whilst Eileen Nah finished the theoretical component of this same course with a high distinction average. • Two sonographers, Christie Whatley and Bernadette Stouthamer, successfully sat the Diploma of Medical Ultrasonography Part 1 exam. Furthermore, cardiac technologist, sonographer Stuart Cox is close to completing his Master’s thesis. • Drs Alan Japp, Wayne Childs, and Keagan Moneghetti gained expert skills in all aspects of echocardiography and cardiac CT through our non-invasive imaging fellow program. The consultants and fellows were also involved in the successful mentoring of a BMedSci student.

PAEDIATRIC CARDIOLOGY & ADULT CONGENITAL HEART DISEASE

• We expanded our educational activities with several hands-on practical echocardiogram training sessions for the MonashHeart registrars. The non-invasive imaging cardiologists also contributed to cardiac rhythm training and to teaching at the MonashHeart cardiac CT Level A course.

Associate Professor Sarah Hope graduated from the University of Edinburgh and trained in paediatric cardiology in both the UK and Australia. She is also trained in and has trained many others in cardiac CT. Sarah is head of Paediatric Cardiology Services in MonashHeart and Monash Children’s Hospital. Sarah practices as a paediatric cardiologist and also adult congenital heart disease cardiologist. What we do

• The echocardiography service was integral to the expansion of the percutaneous mitral intervention program. We supported the MitraClip and LV RECOVER programs.

MonashHeart offers a comprehensive

• We continued to provide clinical and imaging support to the our world renown TAVI program, as well as several collaborative projects with the Monash Health haematology and renal units and MonashHeart PhD students.

include consultations, echocardiography

cardiology service to patients from fetal life through to the age of 18 years, and also to adults with congenital heart disease. Services in children and also in adults with complex

Sonographers Catherine Mylrea and Stuart Cox, used their annual leave to provide probono services in Tonga and the Cook Islands, including echocardiographic screening of school-aged children for rheumatic heart disease.

• We also saw a 24 per cent increase in paediatric and adult congenital heart disease echocardiography services across MonashHeart sites. Community activity and outreach

congenital heart disease, interventional rhythm management (for patients weighing more than 30kg), interventional cardiology services for adolescents and adults with

Community activity and outreach

• We are focused on continuing to increase the timeliness of services we provide, and have seen further improvements with a 24 per cent increase in our outpatient consultations in 2014.

congenital heart disease, cardiac CT services and fetal echocardiography. Inpatient services are provided primarily at Clayton through both Monash Newborn and Monash Children’s.

• We expect to welcome Dr Cameron Seaman to our team as a short-term locum during the first half of the year before he goes overseas to further his training in interventional procedures for congenital heart disease. • We hope to see a further increase in our senior medical staff in the middle of the year to facilitate the expansion of regular consulting services at MonashHeart Dandenong. • We hope to expand consulting and echocardiography services at MonashHeart Casey to reduce patient wait times.

• We continue to support and involve the members of our team in the Rheumatic Heart Disease screening programme ‘Mafu Sai’ in Tonga. • We were pleased to support the interventional cardiology treatment of children from East Timor with severe complications of rheumatic heart disease, including 14-year-old Ana and 11-year-old Jeca.

Plans for 2015 • We will again offer three fellowship positions for cardiologists to train with MonashHeart in non-invasive imaging including echocardiography and cardiac CT. • We will work with our emergency department and intensive care colleagues to establish a new cross-site educator position to provide training in rapid transthoracic echocardiography. • This successful incumbent will also contribute to the training of MonashHeart registrars in hands-on and rapid cardiac echocardiography.

“I really love when you’ve looked after somebody in a critical phase, and then continue to care for them in the weeks and months and years that follow.” Bennett Sheridan Paediatric Cardiologist Cardiac Intensivist Husband and father of two

Bennett Sheridan is both a paediatric cardiologst and a cardiac intensivist. It wasn’t until he was well into his training as a paediatrician that he discovered his love for intensive care. “The first time I worked at an ICU, I was blown away by how fascinating it was. I was rostered to do a night shift and saw babies who had just come out of surgery for problems that were so complex.” That first night on duty, the challenges were so great that it was immediately both enticing and deeply interesting to Bennett. Inspired, he pursued specialisation in cardiology and intensive care. “I really love when you’ve looked after somebody in a critical phase, and then continue to care for them in the weeks and months and years that follow – that’s one of the things that most non-paediatric intensivists don’t get to do.”

Bennett has been with many parents and families through what can only be described as the hardest moments of their lives. It’s not difficult then, to understand why Bennett who is himself a father of two, doesn’t have any hobbies. “My hobby is my children. All my spare time – my pastimes have become what the kids do. Going to gymnastics and netball training!” To Bennett, his colleagues are the best part about practicing cardiology at MonashHeart. The environment is a stark contrast to what he remembers it was like when he first started practicing medicine. “One of the things I disliked was the apparent ownership of patient care. I would see my mentors and doctors saying things like ‘that’s my patient!’” The approach at MonashHeart however, is entirely different. “At MonashHeart we work together. It’s very much a team effort and we look after our patients as a group.”

FUNDRAISING REPORT

Thanks to the commitment of our generous supporters, MonashHeart has been fortunate to increase fundraising by 150 per cent over the last two years, from $121,000 in 2012 to $385,000 in 2014. Our patients, partners, and staff are the heart of this success. Their support has allowed us to purchase specialised equipment so that we can continually improve the quality of care we provide our patients. This makes a difference: the funds we receive from government ensures good cardiac services; the funds we receive from our community ensure we build a great service. TOTAL RAISED

$385,000

In 2014, we were especially delighted to receive a donation of $160,000 from a donor who wished to remain anonymous. This was the second such donation from this gentleman over two years (totalling $360,000). His generous investment has allowed us to set up a research scholarship which was awarded to Drs Brian Ko and Dennis Wong, who are now tirelessly leading cardiac CT research projects to change the way we treat and manage cardiac patients. This investment has allowed MonashHeart to continue to provide patients with the best care possible while also continuously researching how to improve our patient care and outcomes. Our community has provided incredible support as well. After seeing the ABC News story of how the East Timor Hearts Fund brought 11-year-old Jeca to MonashHeart for a life-saving mitral valve procedure, the Rotary Club of Ballan made a generous $25,000 donation to ensure that other young people like Jeca received this crucial support. With the help of the Rotary Club, MonashHeart has purchased a general anaesthetic (GA) machine. Dr Mark Adam, Director of Anaesthetics said, “Purchasing this new machine will not only ensure better monitoring of East TImor children during their procedures, but for all GA patients. Often our sickest cardiac arrest patients need intensive support and having access to a new GA machine will help our anaesthetists do their best job in the toughest of situations.”

MonashHeart is incredibly thankful for:

OUR FINANCES

MonashHeart services are principally funded by the Department of Health, private health

• Our community of supporters. The mums and dads, pensioners and children, retirees and workers, who have helped support MonashHeart through monthly donations or during the Monash Health Christmas mail appeal. Your continued commitment to MonashHeart is saving lives.

fund rebates, Monash Cardiovascular Research

• Our December 2014 Golf Day supporters who raised $55,000 during this eight-hour event.

invasive imaging and cardiac CT services as

• Legacy donors who include MonashHeart in their estate planning. Your legacy will build a better, heart healthy future for all Victorians. • Family members who, in their darkest hour, asked for in-memorial donations to be made to MonashHeart in lieu of flowers. Your incredible investment in the MonashHeart community has a lasting impact on our patients.

Centre research activities and charitable donations. Funds received are used to deliver services to patients through procedures conducted in the cardiac catheterisation laboratories, tests offered through our nonwell as outpatient consultation services.

Revenue

Outlook

During 2013–2014 MonashHeart generated $24.6 million in revenue, which was 4.5 per cent higher than originally forecasted. This positive outcome in revenue was achieved under increasing demands on MonashHeart’s physical resources and at-capacity infrastructure.

In the coming years, MonashHeart expects to see a growth in demand for quality cardiology services, due to a growing and ageing population. MonashHeart has made a commitment to continually promote improved cardiovascular wellbeing in the community even as demands for care grow. MonashHeart’s current strategic plan addresses challenges of expanding services to meet increased demand, and explores opportunities to increase selfsustaining models of clinical, educational, and research services to assure the long-term viability and growth of MonashHeart.

Expenditure Total expenditures during 2013–2014 were $23.3 million, or 7.6 per cent more than forecast. Salary and wage increases were 2.6 per cent above forecast, as a result of increases awarded via enterprise bargain agreements and increased activity. This growth in activity as well as changes in the public and private ratio of patients resulted in a five percent increase in medical consumables and prostheses used during the fiscal year.

Support our work 26

“No matter what happens, you have to bounce back.” Margaret Wood 69-year old Wife Mother of two Grandmother of four Amateur writer

A line that helped Margaret get through some of the toughest times in her life was one that her late father was fond of repeating, “No matter what happens, you have to bounce back.” Margaret grew up in England, where her father worked as a miner. He passed away at the young age of 53, leaving behind his 40-year old wife and a young family, including 12-year-old Margaret. Margaret and Terry married in 1965 and 15 years later, decided to take a rather big risk and fulfil their dream of coming to Australia to live. They arrive at Springvale Migrant Hostel with two young children and eight suitcases – what a culture shock it was! Despite the huge culture shock, they soon thrived – living at the hostel, learning rudimentary communication skills to communicate with the 1,500 Vietnamese who were also seeking a new life in Australia. They knew no one in Australia but with true grit and ‘bounce’ they carved out a new life for themselves. Soon, Terry gained work in Ferntree Gully, they bought a house in Wantirna and Margaret began working at Box Hill Hospital. Years later, they retired to a lovely home on the Mornington Peninsula, at Fisherman’s Beach where life was wonderful. One day they had a surprise letter in their letterbox making an

offer on their Mornington home. Margaret at that stage had not been well, so they decided to sell and move closer to their son who lived in Berwick, and to be closer to good medical facilities. And it was these medical facilities, which Margaret desperately needed in 2014, when she was admitted to Casey Hospital with fluid overload and heart failure. She was diagnosed with severe aortic stenosis and was so unwell that she was admitted directly to Monash Medical Centre’s Cardiac Care Unit for treatment. The cardiac surgeons were concerned about operating as she had multiple medical issues, including liver and kidney failure and a history of lung disease. However, Margaret reminded her husband and kids “no matter what happens, you have to bounce back.” Margaret remained in intensive care for six days after her aortic heart valve surgery. After two transient strokes, she was very thankful to be discharged home. Seven months after her life-saving heart surgery, “Margaret is progressing very well,“ says heart failure cardiologist, Dr Siobhan Lockwood, “her heart size and function have returned to normal and I am delighted to see her doing so well.”

MONASH CARDIOVASCULAR RESEARCH CENTRE REPORT

“Our translational research aims to bridge the gap between laboratory research and clinical medicine in the important and evolving field of structural heart disease.” Dr Robert Gooley Cardiologist and PhD Fellow

RESEARCH CENTRE REPORT

Monash Cardiovascular Research Centre (MCRC) is the research arm of MonashHeart

BASIC RESEARCH

bridging Monash Health and the Faculty of Medicine, Nursing and Health Sciences at Monash University.

PROTOTYPE DISCOVERY & DESIGN

MCRC provides international leadership in cardiovascular research through:

EARLY CLINICAL TRIALS

• presence in cardiovascular innovation, particularly in cardiac CT and the management of chest pain

LATE CLINICAL TRIALS

• leadership in clinical and ﬁrst-in-man studies as well as the evolution of new treatment strategies

HEALTH TECHNOLOGY ASSESSMENT HEALTH SERVICES RESEARCH

• recognised presence in international clinical forums

KNOWLEDGE MANAGEMENT

• leadership in the assessment of central haemodynamics, arterial mechanics/function and mechanisms of cardiovascular risk.

HEALTH CARE DELIVERY

The MCRC research goal is to support translational cardiology research as this leads into high quality clinical practice and policy development. 30 >median IF <median IF

25 20 15 10 5 0

Cardiovascular Systems

Hypertension

Medical Imaging

2014 MCRC published papers per field of study The IF (Impact Factor) is a way of measuring the number of citations per article in an academic journal.

2014 highlights

Strategic overview

MCRC profile

Translational research

• Dr Siobhan Lockwood was awarded $180,000 by the Victorian Department of Health to establish a heart failure initiative with the ‘Model of Care Heart Failure Program’. This has resulted in the very successful establishment of an identifiable MonashHeart heart failure service.

The economic cost of cardiovascular conditions including acute and chronic coronary syndromes, cerebrovascular disease, renal disease and heart failure will grow exponentially unless effective strategies for targeting treatment, identifying individuals at risk and assessing response are established. Research into optimal strategies for prevention and treatment of coronary, cerebral and peripheral arterial disease and an improved understanding and assessment of large artery pathophysiology and secondary dysfunction will aid identification of risk, guide choice of appropriate therapy and help assess response to treatment.

MCRC academic/research staff: • 4 Professors • 4 Associate Professors • 5 senior lecturers • 2 post-doctoral/early career researchers • 1 post-doctoral clinical fellow • 6 PhD candidates • 11 clinical fellows.

Through the active collaboration of cardiologists and cardiothoracic surgeons within MCRC, we have made substantial international contributions to the field of cardiovascular medicine and surgery. Our interventional cardiologists are world leaders in new approaches to percutaneous coronary and cardiac intervention and have published widely in the field of interventional devices in percutaneous, transluminal treatments for structural heart disease. The MonashHeart structural heart disease team are national leaders in structural heart disease, and have been rapid adopters of percutaneous technology. Professor Ian Meredith is leading worldwide development and the evaluation of the LOTUS™ percutaneous aortic valve.

• Dr Dennis Wong was awarded a National Health and Medical Research Council (NHMRC) early career fellowship and Heart Foundation Australia post-doctoral fellowship. His research will be based on the assessment of vulnerable plaque on intravascular ultrasound (IVUS), optical coherence tomography (OCT) and computed tomography (CT). He also presented at the European Society of Cardiology meeting in Barcelona, Spain and was the young investigator finalist at the American College of Cardiology meeting held in Washington, DC. • Dr Brian Ko was awarded a postdoctoral fellowship by the Heart Foundation ($60,000 per year for two years) and appointed adjunct senior lecturer, Monash University School of Clinical Sciences at Monash Health. • Mr Kevin White established an Australianfirst postgraduate interventional nursing education program at Deakin University. Kevin and and Ms Dianne D’Rosario completed post-graduate critical care certificates within this program and are now undertaking Masters of Nursing Practice studies. • Mr Kevin White was awarded the prestigious Australian College of Critical Care Nurses prize for graduating students of 2014. • Dr Arthur Nasis was awarded a Victorian Government Victoria Fellowship (Life Sciences) travel grant to enable him to attend clinical and postdoctoral research training at the London Heart Hospital and University College London, UK. Arthur also won the gold poster award at the 9th Clinical Update on Cardiac CT & MRI Scientific Meeting, Cannes, France, for “Diagnostic accuracy of second generation 320-detector computed tomography coronary angiography at elevated heart rate”.

MCRC operates a commercially based business plan independent of traditional grant income. We have the infrastructure to undertake internationally recognised translational research in disease management, health service delivery and applied clinical cardiology as well as coronary physiology research. MonashHeart and MCRC undertake investigator initiated and sponsored clinical trials, predominantly first-in-human or early phase device trials in cardiology. All research is fully self-funded, operating within a budget of approximately $1.2 million per annum. MonashHeart is involved in the establishment of national and international guidelines for the management of clinical conditions including acute coronary syndromes and chest pain evaluation. More broadly, consortium leaders play a leading role in the development of health policy and funding via involvement with the Heart Foundation, National Health and Medical Research Council, Cardiac Society of Australia and New Zealand, and state and federal governments.

Research support staff: • 1 research manager • 6 research coordinators • 3 translational research nurses. Industry links/collaborators include: • large multinational medical device companies > Abbott Australasia > Boston Scientific > Medtronic • biotechnology start-ups/ﬁrst-in-human studies • medical imaging > Toshiba Medical Systems Australia > Toshiba Japan. Collaboration We are recognised internationally as a centre of excellence in cardiac device trials, cardiac CT, in vivo human coronary physiology and central haemodynamics research. MonashHeart and MCRC collaborate with groups and centres to assist with clinical and research activities. This includes clinical departments within Monash Health (e.g. Respiratory Medicine), Monash University groups (e.g. Monash Institute of Medical Engineering), local partners (e.g. Alfred Hospital, Monash Partners Academic Health Science Centre), national projects (IMPROVE study, national primary investigator in multi-centre studies), international projects (international primary investigator in multicentre studies, The GLOBAL genomics study) and collaborative research with overseas institutions such as the Brighton and Sussex Medical School, The International Centre of Circulatory Health at Imperial College, London and Kuwait University.

MonashHeart and MCRC are also world leaders in cardiac CT having established one of the largest international clinical services as well as an international cardiac CT training centre. As a luminary site with Toshiba (the first centre to be so acknowledged in the southern hemisphere) and as the implementation site for CT perfusion and dose reduction techniques, MonashHeart has significantly influenced the applicability of 320-slice multidetector cardiac CT. PhD projects We are focussed on exceptional quality research and education. The following is a list of postgraduate (PhD) projects undertaken at MonashHeart in 2014. • “The inﬂuence of TAVI on myocardial and aortic structure and function”, Dr Robert Gooley. • “The MonAMI 12-lead ﬁeld triage of STEMI patients project”, Dr Adam Hutchison. • “Multi-modality assessment of the aortic root and ascending aorta-implications for the diagnosis and treatment of cardiac disease”, Dr Siobhan Lockwood. • “Use of novel imaging techniques for the diagnosis of coronary artery disease and myocardial ischaemia: implications for the assessment of patients with chest pain”, Dr Arthur Nasis.

RESEARCH CENTRE REPORT

PhD projects (Cont.)

noninvasive fractional flow reserve derived from coronary computed tomography angiography in suspected coronary artery disease: The NXT trial (analysis of coronary blood flow using CT angiography: next steps). J Am Coll Cardiol. 2014;63:1145-1155.

• “In vivo studies on vasculo-vascular coupling and the role of aortic pressure wave morphology on coronary blood flow”, Dr Om Narayan. • “Longitudinal assessment of coronary plaque by computed tomography coronary angiography, intravascular ultrasound and optical coherence tomography”, Dr Kiran Munnur.

Research outputs 2013/2014 Our researchers published more than 70 high impact peer reviewed articles in international cardiovascular scientific literature in 2014, including: 1.

Wong DTL, Ko BS, Cameron JD, Leong DP, Leung MCH, Malaiapan Y, Nerlekar N, Crossett M, Troupis J, Meredith IT, Seneviratne SK. Comparison of diagnostic accuracy of combined assessment using adenosine stress computed tomography perfusion + computed tomography angiography with transluminal attenuation gradient + computed tomography angiography against invasive fractional flow reserve. Journal of the American College of Cardiology. 2014;63:1904-1912.

2. Narayan O, Davies JE, Hughes AD, Dart AM, Parker KH, Reid C, Cameron JD. Central aortic reservoir-wave analysis improves prediction of cardiovascular events in elderly hypertensives. Hypertension. 2014. 3. Narayan O, Casan J, Szarski M, Dart AM, Meredith IT, Cameron JD. Estimation of central aortic blood pressure: a systematic meta-analysis of available techniques. Journal of Hypertension. 2014;32:1727-1740.

Meredith IT, Walters DL, Dumonteil N, Worthley SG, Tchetche D, Manoharan G, Blackman DJ, Rioufol G, Hildick-Smith D, Whitbourn RJ, Lefevre T, Lange R, Mueller R, Redwood S, Allocco DJ, Dawkins KD. Transcatheter aortic valve replacement for severe symptomatic aortic stenosis using a repositionable valve system 30-day primary endpoint results from the REPRISE II study. Journal of the American College of Cardiology. 2014;64:1339-1348.

6. Ben-Shlomo Y, Spears M, Boustred C, May M, Anderson SG, Benjamin EJ, Boutouyrie P, Cameron J, Chen CH, Cruickshank JK, Hwang SJ, Lakatta EG, Laurent S, Maldonado J, Mitchell GF, Najjar SS, Newman AB, Ohishi M, Pannier B, Pereira T, Vasan RS, Shokawa T, Sutton-Tyrell K, Verbeke F, Wang KL, Webb DJ, Willum Hansen T, Zoungas S, McEniery CM, Cockcroft JR, Wilkinson IB. Aortic pulse wave velocity improves cardiovascular event prediction: an individual participant meta-analysis of prospective observational data from 17,635 subjects. Journal of the American College of Cardiology. 2014;63:636-646. 7.

White AJ, Smith RR, Matsushita S, Chakravarty T, Czer LSC, Burton K, Schwarz ER, Davis DR, Wang Q, Reinsmoen NL, Forrester JS, Marban E, Makkar R. Intrinsic cardiac origin of human cardiospherederived cells. European Heart Journal. 2013;34:68-75.

4. Norgaard BL, Leipsic J, Gaur S, Seneviratne S, Ko BS, Ito H, Jensen JM, Mauri L, De Bruyne B, Bezerra H, Osawa K, Marwan M, Naber C, Erglis A, Park SJ, Christiansen EH, Kaltoft A, Lassen JF, Botker HE, Achenbach S. Diagnostic performance of

8. Meredith IT, Worthley SG, Whitbourn RJ, Antonis P, Montarello JK, Newcomb AE, Lockwood S, Haratani N, Allocco DJ, Dawkins KD. Transfemoral aortic valve replacement with the repositionable Lotus Valve System in high surgical risk patients: the REPRISE I study. Eurointervention. 2014;9:1264-1270. 9. Ko BS, Wong DT, Cameron JD, Leong DP, Leung M, Meredith IT, Nerlekar N, Antonis P, Crossett M, Troupis J, Harper R, Malaiapan Y, Seneviratne SK. 320-row CT coronary angiography predicts freedom from revascularisation and acts as a gatekeeper to defer invasive angiography in stable coronary artery disease: a fractional flow reserve-correlated study. Eur Radiol. 2014;24:738-747. 10. Nasis A, Ko BS, Leung MC, Antonis PR, Nandurkar D, Wong DT, Kyi L, Cameron JD, Troupis JM, Meredith IT, Seneviratne SK. Diagnostic accuracy of combined coronary angiography and adenosine stress myocardial perfusion imaging using 320-detector computed tomography: pilot study. European Radiology. 2013;23:18121821. 11. Chen Y, Rothnie C, Spring D, Verrier E, Venardos K, Kaye D, Phillips DJ, Hedger MP, Smith JA. Regulation and actions of activin A and follistatin in myocardial ischaemiareperfusion injury. Cytokine. 2014;69:255262. 12. Papademetriou V, Tsioufis CP, Sinhal A, Chew DP, Meredith IT, Malaiapan Y, Worthley MI, Worthley SG. Catheterbased renal denervation for resistant hypertension 12-month results of the enligHTN I first-in-human study using a multielectrode ablation system. Hypertension. 2014;64:565-572

“I feel blessed each day to unlock new scientific research that will improve patient’s cardiac care.” Dr Dennis Wong Cardiologist NHMRC Early Career Researcher

Learn more about our research 34

OUR ORGANISATION

MANANGEMENT TEAM

OFFICE OF THE DIRECTOR

RESEARCH & EDUCATION

FINANCE OPERATIONS

MONASH CARDIOVASCULAR RESEARCH CENTRE

ACUTE CARDIAC SERVICE

NON-INVASIVE IMAGING SERVICE INTERVENTIONAL SERVICE

CARDIAC CT SERVICE

PAEDIATRIC CARDIOLOGY & ADULT CONGENITAL HEART DISEASE SERVICE

CARDIAC RHYTHM MANAGEMENT SERVICE

Operations Manager, Procedural & Diagnostics

Operations Manager, Acute & Cardiothoracics

Mr John Koutsoubos

Ms Kirsten Garner

John changed careers from computer systems engineering to nursing and went on to find his niche as the Nurse Unit Manager of the Cardiac Catheterisation Laboratories and Cardiac CT Services. In this role he led significant changes including expansion of the laboratories and establishment of cardiac CT, now the biggest such service in Australia. John is the national affiliate representative of the ANZET executive committee and is co-chair of the Interventional Nurses Council of Australia and New Zealand. In 2014 John took up the challenge of Operations Manager, Procedural and Diagnostics.

Kirsten has an extensive background in cardiothoracic and intensive care nursing, and has led significant improvements in cardiac patient access as the Cardiac Liaison Coordinator for MonashHeart and Cardiothoracics. Kirsten has also undertaken secondment as Deputy Director of Nursing, Monash Medical Centre, the largest public hospital in Melbourne. Kirsten was appointed the MonashHeart Operations Manager, Acute and Cardiothoracics, in 2014.

Director of MonashHeart

Business Manager

Professor Ian Meredith AM

Mr Ying Chan

Ian has been the Director of MonashHeart, Monash Health since 2005 and is Adjunct Professor of Medicine and Cardiology at Monash University. He has worked as a cardiologist since 1990, and despite a demanding national and international speaking schedule, he has a deep commitment to patient care, maintaining a busy clinical load. Ian is the co-lead of the Monash Partners Academic Health Science Centre (cardiovascular theme), the Executive Director of the Monash Cardiovascular Research Centre, CSANZ board member since 2009 and Heart Foundation board member since 2011.

Ying studied accounting at the South Australian Institute of Technology, before relocating to Melbourne to live. Ying has worked for Monash Health for many years, and has been the Business Manager in a number of diverse health areas including acute services, primary care, aged care and allied health. More recently Ying undertook the role of Business Director, Monash Sector. Ying has been the Business Manager for MonashHeart since 2009.

Associate Director of MonashHeart Professor James Cameron Jim is the Associate Director of MonashHeart and also the Director of the Monash Cardiovascular Research Centre encompassing MonashHeart research and education programs. Jim’s background includes having been Professor of Electrical Engineering (Biomedical), Latrobe University and since 2006 (adjunct) Professor of Medicine, Monash University. He is internationally known for his work on arterial function and dysfunction in health and disease.

”I look around and feel that I am surrounded by some really amazing people.” Kirsten Garner Operations Manager for Acute Cardiac Services and Cardiothoracic Surgery World-traveler

Kirsten Garner is one very busy person. In her role as the Operations Manager, Kirsten looks after the flow of patients who come in for acute cardiac services, elective work and cardiothoracic surgery. She also manages operations for the cardiac care units, the administration team, reception, private consulting rooms, billing, bookings as well as the registrars. Essentially, Kirsten’s main aim every day is to ensure that every single patient who seeks help receives that help as soon as possible. Not an easy task considering the numerous time, resource and space constraints she has to overcome on a daily basis. “Even though the hours are long and challenging, to know that you’re going to send someone home again to their loved ones after they’ve received cardiac care – that’s what makes you get up, and come in every day.”

As a graduate nurse, Kirsten did three rotations. The first was in orthopaedics. The second was a mixed surgical ward and her final rotation was in the cardiothoracic unit, 32 South – where she immediately felt at home. “I think we really make a difference for our cardiac patients even with the smallest changes that we make to improve their experience, their care and their family’s care.” In her role, Kirsten is required to assign work– sometimes, a lot of work – to the medical staff. However, she feels that the team always rises to any challenge thrown at them. “The whole team is so passionate and committed. I look around and feel that I am surrounded by some really amazing people.” When she’s not working, Kirsten loves spending time with family and friends. She has a passion for seeing the world and experiencing different cultures. Her most recent travels brought her to New York and Spain. She’s currently planning her next escape to Alaska.

OUR PEOPLE

Our people come from all parts of the globe, with a broad diversity of educational and professional backgrounds – bound by a shared passion to continually strive to make a real difference in the lives of our patients.

Administration Business Manager Ying Chan Cardiac Liaison Coordinator Kirsten Garner Director of Development Anne Mennen Information Technology Manager Val Koval

Operations Managers Kirsten Garner John Koutsoubos Billing Supervisor Lorraine Mitsikas

Bookings Supervisor Brooke Wallace Bookings Officers Lauren Jones Craig Pike

Billing Clerks Linda Farrugia May Garcia Kelly Grigg Sheree Harris Nina Harris Janna Kivi

Cardiac Catheterisation Laboratory Booking Officer Julie Lukacs

Cardiac Rehabilitation Staff Sarah Bond Charis Brown Angela Erginay Meredith McMillan Kim Tucker

Lee Manu Madhav Silvi Matthew Vasantha Munasinghe Emma Owen Maryann Pang Michael Romero Leanne Rudd Carmen Scully Kara Watt Anne Weber Lindy Whelan Cindy Wong Mei Zheng Sally Zou

Clinical Applications Manager Pei Lee See

Personal Assistants Jennielyn Capungcol Charmaine Martis Kate Moroney Private Consulting Rooms Practice Manager Maree Jones Private Consulting Rooms Booking Officers Kaye Chapman Georgia Georgiou Narelle Rollings Brylie Vines (dec)

Reception Supervisor Margaret Beddoe Receptionists Karen Chipperfield Jenni Corrie Shellie Hardman Gillian Martin Leigh Stewart Natalija Tsotsoros Kylie Vervark Typing & Distribution Annette McIvor

Cardiac Care Unit Clayton Nurse Unit Managers Claire McDonald Pauline Ryan Clinical Nurse Educator Yasmine Ivankovic Associate Nurse Unit Managers Liezyl Bogaoan Sara Coldicott Kelly Findlay Karen Harrington Rebecca Hoskin Crystal Hutton Sia Roussos Linore Ryan Kirsten Salvas Loren Wilkes

Clinical Nurse Specialists Deidre Ambrose Shannon Barrett Clarissa Bermundo Kaye Cavanagh Helen Chilton Sybil Chong Stephanie Dawson Melissa Harvey Katie Hogan Jo Jeffs Michelle Jones

Critical Care Students Rachel Nichol Lani Caballero Sheejamol Thomaskutty

Graduate Nurses Emily Leslie Melissa Graham Registered Nurses Jinci Antony Damian Atherton Irene Backo Angelica Barreno Danny Carey Beata Csupor Debra Dai Melissa DiCesare Judith Jachmann Leslie Jay Nisha Kumar Annie McCurrach Louise Mollet Jin-Chiueh Morrison Jane Mountfort

Cindy Nhao Bindu Ratnavally Nair Eulinette Rulla Mandy Seward Melanie Stockdale Rhiannon Thomas Shannon Tonkins Maren Vong Wendy Wallace-Mitchell Sammi Wang Ward Clerks Linda Johnston Maree Kerr Elizabeth McGrath

Cardiac Care Unit Dandenong Nurse Unit Manager Chris Rasmussen Associate Nurse Unit Managers Carol Cheng Judy Koh Sue Laughton Kerry Morten Mariusz Tragarz

Registered Nurses Taisi Antony Rose Arcamo Minimol Austine Patricia Brindley Claudette Brown Jason Chong Graeme Coad Julie Dines Michelle D’Lima

Sushma Fernandes Shainy Jose Kavitha Joseph Minimol Joseph Suchitra Laxman Chin Lee Suying Liu Sobhana Maharaj Cathy Martin Reena Moncy

Teresa Page Jo Panicker Anitha Phillip Charlie Quach Carlo Salvador Liz Seyer Vicki Syjongtian Teny Thomas Karin Walburgh Sue Wall

Mary Watson Rosemary Xia Xeumei Zhang Sally Zhou Ward Clerk Sharma Sangeeta

OUR PEOPLE

Monash Cardiovascular Research Centre

Cardiac Catheterisation Laboratories & Cardiac CT Nurse Unit Manager Kara Zantuck Clinical Nurse Educator Kevin White Associate Nurse Unit Managers Rebecca Dean Nadia Jhoomun Anna Petrakos

Clinical Nurse Specialists Meiling Balintong Sogee Chand Jade Geer Alison Hutton Geraldine McBean Cath Pemberton Kathy Ruan Erin Vogt Rebecca Woodley

Enrolled Nurse Shannan Gamble Registered Nurses Alana Agnew Lauren Bryce Janine Castillo Julia Cvetovac Diane D’Rosario Marie Louise Fitzgerald

Stella Floros Mariel Jacob Kelly Keir Bridgit Nogic Heidi Roe Ami Tan Sarah Taylor Judith Williams

Theatre Assistants Marcus Hamilton Grant Short Rob Tyers

Deputy Chief Cardiac Technologist Chris Hunter Cardiac Technologist Educator Catherine Mylrea

Lead Cardiac Rhythm Technologist Nick Youngs

Director of MonashHeart Ian Meredith

Cardiac Technologists Karen Anderson-Weller Necia Azagra Rikki Bailey Julie Banks Mario Blitzman Duc Bui Thi Bui Angela Coumountouros

Stuart Cox Jessica Cseh Shona Evans Steve Farrell Gill Farrell Matthew Farrugia Damian Haldane James Harley Rhonda Hassam Julie Hong Fleur Koval Qin Li

Connor McCarthy Lauren Mills Eileen Nah Daniel Nicolici Lucy Rudolph Bernadette Stouthamer Meena Sumathy Karen Versteege Amanda Way Christie Whatley Lynette Wilkinson Jing Zhang Robert Zirafi

IBL Students/Cardiac Technologists Tara Ng Don Pathirana Secretaries Katherine Tompkins Sandra Howorth

Clinical Nurse Educator Samantha McPhee Associate Nurse Unit Managers Jatinder Bhagat Alyce Bowtell Susan Gussenhoven Amanda Hulley Danneil Kitchin Laura Matthews Melinda Norman Aimee Querijero Pauline Ryan Jane Smith Sarah Smith Sarah Speakman

Maria Tsatsaris Kristy Vos Sarah Warwarek Pre Admission Coordinator Joanne Lillie Clinical Nurse Specialists Mei Yi Cai Beth Callow Sally Anne Giordano Casey Halloran Kimberley Hansby Anna Hillenga Radhika John Frances Kenyon Nicole Mann Tara March Stacey Neill Liliana Padilla

Glenn Porter Leanne Rudd Lourdes Scurry Grace Simsir Lauren Tassone Enrolled Nurses Irene Dowling Michelle Drane Cardiac Rehabilitation Claudia Street Graduate Nurses Jasmin Briscoe Alexandra Schikora Patient Service Assistants Merron Abdeta Ying Fuk Perina Marolda

Registered Nurses Laura Barry Rochelle Bates Emily M Coote Colleen M Coutts Aleisha Cowie Lisa Danher Lucy Fitzpatrick Jacqueline Flanagan Katrina Hayes Emily Heke Ann-Alyce Hill Maiyue Huang Megan Huybens Rebecca Jedwab Alice Jones Annette Kennedy Dannielle Kerwick Julie McDowall Rebecca Morgan

Associate Director of MonashHeart James Cameron Head of Cardiac Rhythm Management Services Jeff Alison Head of Acute Cardiac Services Paul Antonis (dec) Head of Paediatric Cardiology Services Sarah Hope Head of Interventional Services Yuvaraj Malaiapan

Cardiology and Cardiothoracic Unit, Monash Medical Centre Clayton (32 South) Nurse Unit Manager Kerrie Aldridge

Research Manager Julie Plunkett

Data Manager Janise McEwan

Clinical Coordinators Caroline Bowman Maree Lawrence

Medical Scientist Michael Zhang

Head of Non-Invasive Imaging Services Philip Mottram

David McGaw Stuart Moir Roger Peverill James Sapontis Bennett Sheridan Tony White Dennis Wong

Research Assistants Kerrie-Lea Allen Therma Katticaran

Research Coordinators Mary Anne Austin Mauro Baldi Bernadette Gravina Adele Manzoney Wendy Wallace-Mitchell

PhD Fellows / Cardiologists Robert Gooley Adam Hutchison Siobhan Lockwood Kiran Munnur Om Narayan Arthur Nasis

Interventional Services Fellows Liam McCormick Peter Psaltis Vimal Shanmugam Sarah Zaman

Medical Staff

Cardiac Technologists Chief Cardiac Technologist Anthony Wald

Director of Monash Cardiovascular Research Centre James Cameron

Emily Painter Tracy Richards Emma Robinson Nikita Rouse Sarah Rowland Annelise Stephenson Melanie Stewart Clair Tonkin Amanda Wasley Deborah Welsh Ward Clerks Jacqueline Van Heer Shirley Papalie

Head of Cardiac CT Services Sujith Seneviratne Emeritus Director Richard Harper Cardiologists David Adam Wally Ahmar Garry Barron Logan Bittinger Ben Dundon John Gelman Betty Ho Brian Ko Emily Kotschet Jack Krafchek Michael Leung Siobhan Lockwood

Cardiologists (Honorary/ Locum) Tim Barton Andrew Davis Stewart Healy Sue Ling Liew Jonathon Lipshutz Remi Kowalski Andreas Pflaumer

Paediatric Cardiology Services Fellows Nitin Arora Melanie Hanson Cardiac Rhythm Management Services Fellows Ben Pang Matthew Tung Non-Invasive Imaging Services Fellows Wayne Childs Alan Japp Kegan Moneghetti

Advanced Cardiology Trainee (2nd year) Sarah Gutman Advanced Cardiology Trainees (1st year) Philip Ngu Ian Matthews Advanced Cardiology Trainees (3rd year) David Tong Bo Xu Cardiac Clinical Psychologist (Honorary) Marlies Alvarenga

“MonashHeart is an extraordinary place to work because of the strength and depth of the multidisciplinary talents, the dedication, commitment and collegiality of the staff and the all-pervasive desire to be the best.” - Professor Ian Meredith AM

2014 MEDIA HIGHLIGHTS “I’ll be thankful for the rest of my life for what was done for me.” Dr Edward Vaughan Age 74 Cardiac arrest Implantable cardioverter defibrillator inserted

JANUARY

FEBRUARY

MARCH

APRIL

MAY

JUNE

JULY

AUGUST

SEPTEMBER

OCTOBER

NOVEMBER

DECEMBER

With temperatures in Melbourne soaring into the 40s, Professor Ian Meredith was interviewed on National Nine News. Professor Meredith warned of the dangers of dehydration, heat exhaustion, and heart attack, as well as the need to stay safe when temperatures rise. His key message for heart patients was to think about how to take care of themselves before braving the heat.

At the launch of the Victorian Government $22 million Cardiac Care Plan to improve cardiac health for Victorians, former MonashHeart patient, Gary Ellis shared his story with Nine News of suffering a heart attack and cardiac arrest, and of his new found appreciation for life.

Health Victoria published Victoria’s cardiac care plan, which was launched at MonashHeart, Monash Medical Centre, by the Health Minister, the Hon. David Davis. The launch featured speeches by MonashHeart’s emeritus director and co-clinical lead, Cardiac Clinical Network, Professor Richard Harper, and Chief Executive Officer of the Heart Foundation, Ms Mary Barry.

‘From The Heart’ was the title of the Nine News segment sharing the joy MonashHeart’s first LOTUS™ heart valve golden girls have experienced since having their heart valve replaced two years ago; summing up that life is so wonderful and only gets better with good heart health.

Seven News featured the story of Laurie who suffered a cardiac arrest while driving in Gippsland. Thanks to the quick action of other motorists who found him and immediately started CPR. He was successfully resuscitated by Ambulance Victoria and at MonashHeart, was found to have coronary artery blockages requiring open heart surgery.

The Herald Sun reported on young mum Samantha, who suffered a cardiac arrest at her gym, but was saved by the quick thinking and CPR skills of the gym owner, along with the use of an automatic defibrillator. MonashHeart could not find a cause for Samantha’s cardiac arrest but implanted a permanent defibrillator as a precaution.

Last November Nina had a life-saving mitral valve procedure with MonashHeart as part of the East Timor Hearts Fund Timor-Leste project. The Age featured a fit and healthy Nina returning to participate in Run Melbourne, raising funds to bring more of her community out to Melbourne for a second chance at life.

There wasn’t a dry eye after viewing ‘The Clinic’ by ABC Foreign Correspondent. MonashHeart plays just a small part in the humanitarian medical aide given to East Timor patients like maths teacher Tomas who was close to death before being selected for a mitral valvuloplasty.

Professor Ian Meredith talks to the Star Tribune, an online daily newspaper based in Minneapolis, USA. Reporter Joe Carlson interviews Professor Meredith on the Transcatheter Cardiovascular Therapeutics Meeting in Washington about the positive results of the Reprise II study into the LOTUS™ heart valve system.

All major Melbourne news outlets including TV, print and online, featured both major Victorian political parties pledging to build Australia’s first dedicated heart hospital at Melbourne’s MonashHeart, boosting cardiac capacity along with a self-sustainable solution for the health system.

In a project worth more than $350 million, Labor announced $150 million to build the Heart Hospital in Melbourne’s southeast at Monash University, Clayton campus. The Heart Hospital would house a comprehensive cardiac facility incorporating cardiology and cardiac surgery care, along with research and education.

Retired Monash University lecturer Edward Vaughan wrote ‘This (merciful) life’ published in The Australian, thanking his rescuers for giving him back his life, his disbelief at being a heart patient and a newfound appreciation of the impressive public hospital system he experienced as a MonashHeart patient.

In the Media In 2014, the work done by MonashHeart for the community was showcased in print, and online publications, TV and radio, and through a robust social media presence. 44

Like us on Facebook

Access our 2014 media archives 45

VALE

Dr Paul Antonis, 1971–2014

It is with immeasurable sadness that we mourned the sudden and unexpected passing of our much loved colleague Dr Paul Antonis in June 2014.

pacing, he began training in interventional cardiology in 2003, showing immediate talent, skill, passion and an uncanny judgement for rapid and practical decisions.

Paul excelled in his work with Monash Health, having completed his undergraduate medical training at Monash University in 1994 with honours. Paul worked first as an intern at Monash Medical Centre and then as a resident and general medical registrar. After a short term as renal fellow, he found his true home in cardiology, undertaking advanced cardiology training at Box Hill Hospital and then at Monash Medical Centre in 2000-2001. Following subspecialty training in electrophysiology and

Paul was appointed consultant cardiologist with MonashHeart in 2005, and it was his leadership, dedication, kindness and communication skills which saw him quickly promoted to head of Acute Cardiac Services, MonashHeart in 2007. Paul was an outstanding clinician and one of the first cardiologists in Australia to be accredited to implant the new percutaneous heart valves. He developed an enviable national

Ms Brylie Vines, 1983-2014 and international reputation over the last nine years. Paul was a great and loyal mate, thoughtful cardiologist, skilled interventionalist, charismatic friend, loving father and a remarkably generous, uniquely empathetic and caring man. Paul will be remembered for his love of his family, as a caring, devoted and doting father, as a truly gifted, compassionate and caring cardiologist and as a kind, loyal, tolerant and great-humoured friend. He will never be far from our thoughts.

MonashHeart was truly blessed when Brylie began working as a receptionist across MonashHeart sites in 2009. Brylie took to her new job with great enthusiasm and her big cheery smile was always a welcome greeting for patients and staff alike. She quickly proved herself to be great addition to the MonashHeart team; polite, diligent, reliable and always respectful of the patients and team members. Brylie revelled in her new position and despite her medical concerns; she was so committed to the role that she worked from her dialysis chair! It was her work ethic that made Brylie one of the most respected members of the MonashHeart team.

Shortly after the birth of her son in September 2011, Brylie suffered severe heart failure. Faced with an uncertain future and a new baby, Brylie met her new challenge with grace, positivity, and stubborn grit – it was clear that she wasn’t going to let health concerns beat her. When it became evident that Brylie would need be on long-term dialysis, she accepted it without question and with her usual smile. The offer of a kidney transplant brought a new energy to Brylie’s fight to be healthy again. The transplant came to fruition and her new kidney worked beautifully but unfortunately, despite her tireless, brave and truly inspiring fight things Brylie passed away in August 2014.

Brylie taught us humility, resilience, grace, and an unwavering commitment. MonashHeart fondly remembers Brylie. It was a pleasure to work alongside, and for some of us, an honour to care for her. Without question, it was an absolute privilege to call Brylie our friend and member of the MonashHeart family.

THE HEART HOSPITAL

OUR VISION FOR THE FUTURE

At MonashHeart we have one goal: to be the leading cardiovascular healthcare provider in Australasia. A key part of this vision is to build Australia’s first dedicated heart hospital. We are incredibly grateful to the Victorian Labor Government for pledging $150 million to build a state-of-the-art Heart Hospital at Monash University, Clayton Campus. This unparalleled, patient-centered university hospital will focus only on one thing: cardiac care. The Heart Hospital will combine innovative cardiovascular clinical excellence with embedded translational research to offer patients cutting-edge cardiac treatments, while its focus on education assures the future expertise of our cardiac healthcare providers.

Like the dedicated cancer hospital model already established Australia-wide, the Heart Hospital will be singularly focused on cuttingedge care in one highly specialised area – cardiac care; from early childhood to advanced adult life. The establishment of the Heart Hospital will transform cardiac care in Victoria and Australia, and exemplify MonashHeart’s existing commitment to cardiac care, including:

The Heart Hospital will be comprised of strategically planned and purpose-built floors to significantly expand current models of patient care. The hospital is being deliberately planned to accommodate the expected ‘epidemic’ of cardiovascular disease predicted by 2020, and to enable a flexible and proactive approach to new treatments and evolving technology.

1. excellence in cardiac patient care including clinical cardiology, interventional cardiology and cardiothoracic surgery

The Heart Hospital will be both patient-centered and service oriented in order to enhance the experience of every patient, and create a seamless treatment flow. Located less than 2.5 kilometres from the Monash Medical Centre, the biggest public hospital in Victoria, the Heart Hospital will be a hub of cardiac care where patients have access to the best cardiac treatment available.

2. innovative, ground-breaking translational research 3. world-class education and training 4. robust cardiovascular health care policy development.

“Our vision is no less than to create one of the great heart care institutions of the world.”

We are indebted to the MonashHeart Strategic Advisory Board, led by chair Mr Peter Maloney, for their passion and drive to make the Heart Hospital a reality. They are the true heroes of the heart hospital vision, giving their time, energy and skills to help us on this journey to build Australia’s first heart hospital.

Mr Peter Maloney, Ms Sarah Newton & Ms Anne Mennen

Learn more about the heart hospital 48

“I am very grateful I am alive.” Pamela Afara Age 27 Heart Attack (Anterior STEMI) Emergency Angioplasty, Early Intervention Systolic Heart Failure Clinic

We gratefully acknowledge the following generous individuals and organisations for their contributions in supporting MonashHeart. Abbott Vascular Above Par Commercial Joinery Alex Theodorakis Appaloosa Films Bendigo Bank, Moorabbin Biggin & Scott Real Estate Biotronik Australia Pty Ltd Defries Industries East Timor Hearts Fund Edwards LifeSciences Kiwanis Club, Elwood

HeartKids, Victoria Iron Mountain Australia Johnco Constructions Life Systems Medical Pty Ltd Lonsec Ltd Medtronic Melbourne Convention Bureau Monash University Moonee Furnishings Natalia Firsoua Perfusion Services Pty Ltd

Special thanks to the individual donors who made contributions of more than $1,000 in 2014 including: Anonymous Cecil Heal Julie Khalid Despina Kyprianou James McMillan Peter and Celia Maloney Nirmala Pande Mai Pham John Pizzey Valmond Wilson

Physio-Control PriceWaterHouseCoopers Ricoh Australia Pty Ltd Romac Rotary Club of Ballan Toshiba Pty Ltd Yarra Yarra Golf Club Zouki Group of Companies Zouki Monash

We also thank our regular donors who make significant on-going donations throughout the year – a true commitment to making a difference. Rose Camenzuli Manuel Dominquez Twanny Farrugia Jim and Rita Fernandez Wilfred Gartner Biroaj Gherghe Sok Eng Taing Lim Muriel Satchwell Saminathan Satkunam Halina Szyszko