The Ohio State University Heart and Vascular Center 2010 Year in Review by Mary Jones Smith

TH E OHI O STAT E U N IVER S IT Y HE ART AND VA SC U L A R C EN T ER

Advances in Patient Care, Research and Education 2010 Y E A R I N R EVIEW

table of contents 1 2 6 9 11 13 14 16 18 22 24 26 28 30 33 35 37 38 40 44 46 48 enclosed

Welcome from Thomas Ryan, MD Ohio State’s Heart and Vascular Center 2010 Highlights Profile: Peter Mohler, PhD, Director, Dorothy M. Davis Heart and Lung Research Institute Dorothy M. Davis Heart and Lung Research Institute 2010 Highlights Profile: Jill Rafael-Fortney, PhD, Assistant Professor of Molecular and Cellular Biochemistry Heart Failure Research: Pulmonary Artery Pressure Monitor Comprehensive Transplant Center: Heart Transplant Profile: Robert Higgins, MD, Director , Comprehensive Transplant Center Profile: Michael Go, MD, Assistant Professor of Surgery Division of Vascular Diseases and Surgery Profile: Steven Dean, DO, Section Director, Vascular Medicine and Director of Noninvasive Peripheral Vascular Lab Profile: Sanjay Rajagopalan, MD, John W. Wolfe Professorship in Cardiovascular Research Hands-Only CPR—Improving Sudden Cardiac Arrest Survival Rates Profile: Martha Gulati, MD, Sarah Ross Soter Chair in Women’s Cardiovascular Health Outpatient Transradial Coronary Artery Stenting Heart Valve Clinic Nursing Research & Collaboration Young Investigators Grant Fellow Program and Profiles 2010 CME Overview Community Partnerships Supports of Ohio State’s Heart and Vascular Center Faculty Listing & Referral Guide

Dear Friends and Colleagues, At The Ohio State University Heart and Vascular Center, our goal is to improve people’s lives through research, education, and patient care. In 2010, we made substantial progress in each of our three mission areas, building on the accomplishments of the past while we remain excited about the prospects for 2011. We look forward to the challenges and opportunities that lie ahead, confident that our team of faculty, staff, researchers and students are poised for even greater successes. It is my pleasure to present you with the 2010 Accomplishments Report. In the following pages, you will find examples of the diversity of talent and achievements that are represented at the Heart and Vascular Center. I want to draw your attention to our continued growth, our superior outcomes, and our latest research achievements. But I am especially proud and excited about the number of talented, accomplished faculty we have recruited over the past year. We welcome these outstanding individuals to the Ohio State family, confident that our diverse and collegial environment will help propel them to even greater successes in the coming years. As you will see, we have highlighted their stories in this year’s report. I want to thank you for your interest and your support. I hope you will enjoy reading about the progress and accomplishments that 2010 brought to the Heart and Vascular Center, as we continue our quest to improve people’s lives. As always, we invite you for a visit, to see our programs and meet our team. Sincerely,

Thomas Ryan, MD Director, Ohio State’s Heart and Vascular Center John G. & Jeanne Bonnet McCoy Chair in Cardiovascular Medicine Professor, Department of Internal Medicine

2 0 1 0 H E A R T A N D VA S C U L A R C E N T E R Y E A R I N R E V I E W

Year in 2

T H E O H I O S TAT E U N I V E R S I T Y M E D I C A L C E N T E R

Review THE OHIO STAT E UN IVE R S I TY HEART AN D VA SC ULA R C E N TE R At the Ohio State University Heart and Vascular Center, 2010 was a year of continued growth and success. Dedicated to improving people’s lives through research, teaching, and patient care, the faculty and staff at Ohio State pride themselves on being the very best at what they do. Their goal is to provide each patient with the best possible outcome, and in the safest possible environment. In 2010, a number of milestones were reached in care delivery, scientific achievement, and program development. With a very bright future, the Heart and Vascular Center is being increasingly recognized for its dedication to quality patient care and its advances in cardiovascular research.

“ I want to draw your attention to our continued growth, our superior outcomes, and our latest research achievements. But I am especially proud and excited about the number of talented, accomplished faculty we have recruited over the past year.” Thomas Ryan, MD Director, Ohio State’s Heart and Vascular Center John G. & Jeanne Bonnet McCoy Chair in Cardiovascular Medicine Professor, Department of Internal Medicine

2 0 1 0 H E A R T A N D VA S C U L A R C E N T E R Y E A R I N R E V I E W

Ohio State Heart Program Reaches New Heights in National Rankings Increasing national recognition came to Ohio State’s Heart and Vascular Center this year. In July, the heart program was ranked # 20 in the U.S.News & World Report “America’s Best Hospitals. With its reputation for outstanding outcomes, innovative technology, and patient safety, Ohio State has earned its place as one of the nation’s best. The “America’s Best Hospital” issue is considered by many consumers and health care industry analysts as a leading indicator of quality care and performance. OSU Medical Center is the only central Ohio hospital listed in the rankings.

Ohio State’s Medical Center Recognized as Leader in Heart Attack Survival Rates The Ohio State University Medical Center is one of only 95 centers in the nation, and only three

in Ohio, to achieve national recognition by The Centers for Medicare and Medicaid Services as a leader in heart attack patient survival rates. By meeting or exceeding national standards of care for acute myocardial infarction, Ohio State has reduced by half the time it takes for heart attack patients to receive specialized care—well below the national average. In fact, at Ohio State’s Ross Heart Hospital, a blocked heart artery is opened on average within 28 minutes of arrival to the hospital.

The Largest Development Project in Ohio State History A $1 billion construction project including a new James Cancer Hospital and Solove Research Institute and Medical Center expansion broke ground in 2010, representing the largest development project in The Ohio State University’s history. A massive undertaking, the expansion endeavors to build a centralized, ecofriendly health and research environment

T H E O H I O S TAT E U N I V E R S I T Y M E D I C A L C E N T E R

Total Faculty Active Clinical Trials Cardiac Surgeries Catheterizations PTCAs/Stents EP Studies Vascular Surgeries In Patient Admissions (Total Heart)

2005-06

2006-07

2007-08

2008-09

2009-10

60 79 718 4475 1744 1966 1685 10,055

69 106 722 4695 1953 3648 1751 11,268

81 161 774 4642 1814 4732 1732 10,077

85 144 802 5329 2043 4794 1781 10,591

85 200 808 4726 1885 4704 1614 9723

that supports high-quality, patient-centric, personalized medicine—in addition to creating more than 10,000 full-time jobs over the course of the expansion. Once complete, the new Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, a new critical care building, as well as integrated, state-of-the-art research facilities will provide scientists, researchers and clinicians with a single collaborative environment for research, education and patient care. Private rooms bathed in natural light with access to green space will promote healing in a lowstress setting, while critical care floors will accommodate patients’ families who have traveled from distances. Founded on hope, the expansion demonstrates Ohio State’s dedication to its surrounding community as well as to the greater potential for accessible, affordable, effective and cutting-edge health care for patients in Ohio and across the world.

Ohio State Studies Safety and Efficacy of New Wireless Defibrillator for Sudden Cardiac Arrest OSUMC is participating in an FDA-approved, multicenter study evaluating the long-term safety and efficacy of a new implantable defibrillator. Used in patients at risk for sudden cardiac arrest, this “wireless” device has the potential to reduce the risk of infection or lead breakage, resulting in better patient outcomes. By avoiding the placement of electrode wires between the chest muscle and heart tissue, patients are able to resume normal activity following implantation without risk of breaking a lead. In 2010, the first patient in Ohio—one of the first patients in the nation—received this implantable defibrillator at Ohio State’s Richard M. Ross Heart Hospital. Approximately 330 patients will be enrolled in the trial worldwide.

2 0 1 0 H E A R T A N D VA S C U L A R C E N T E R Y E A R I N R E V I E W

SCIENTIST- C LIN IC IA N COL L A B OR ATI ON ATTRACTS N E W D IR ECTOR TO TH E OH I O STATE U N IVE R SIT Y D OROTH Y M. DAV I S HEART A N D LUN G R E S E A RC H I N STI T U TE Peter Mohler, PhD, has been named the new director of The Ohio State University Dorothy M. Davis Heart and Lung Research Institute (DHLRI). As a molecular cardiologist, most recently at the University of Iowa, and prior to that Vanderbilt University and Duke University, Dr. Mohler appreciates the positive impact a collaborative spirit has within a research environment. He saw that spirit at Ohio State’s Heart and Vascular Center and knew the position of DHLRI director presented him a tremendous opportunity. “I’ve had the good fortune to witness the exciting translational outcomes that can result from collaboration between clinicians and basic scientists,” he explains. “When I saw a place with such remarkable clinical programs, combined with an outstanding group of basic scientists, all very excited about working together, I was very motivated to become a part of it,” he says.

“When I saw a place with such remarkable clinical programs, combined with an outstanding group of basic scientists, all very excited about working together, I was very motivated to become a part of it.”

A Leadership Difference But it’s more than a collaborative spirit that sets Ohio State’s Davis Heart and Lung Research Institute apart, says Dr. Mohler. He believes the leadership also offers a differentiating expertise that impacts the Institute’s overall excellence. “There aren’t many places that have internationally respected clinicians and scientists as the senior leaders,” he says. “I believe that with the level of talent at Ohio State, we have a tremendous opportunity to shape the future of translational cardiovascular and pulmonary medicine locally, nationally and globally.” That’s appealing to him not only as a leader, but as a researcher. Dr. Mohler has received national scientific recognition as a Pew Scholar of the Pew Charitable Trusts and a Kavli Fellow of the U.S. National Academy of Sciences, so in addition to his administrative duties, he and his research group will continue their studies of how human gene mutations result in potentially fatal diseases, including cardiac arrhythmias, neonatal diabetes and neurological disorders.

Peter Mohler, PhD

T H E O H I O S TAT E U N I V E R S I T Y M E D I C A L C E N T E R

2 0 1 0 H E A R T A N D VA S C U L A R C E N T E R Y E A R I N R E V I E W

“My fascination with linking clinical medicine with genetics, animal physiology, and molecular biology within my own research program got me excited thinking about what can happen at the institute level where we can match bright and motivated clinicians and clinician scientists with the best basic biomedical scientists,” he says. Dr. Mohler’s vision as director is to facilitate new interactions and collaborations between scientists not only within the Institute, but also between Institute scientists and the greater Ohio State scientific community to promote cuttingedge scientific discovery. His goal is to ensure that “the world—and even people right here in Columbus—know that there are exceptional

people performing groundbreaking research here that can significantly change their lives and those of the people they love.” He believes his transition will be a smooth one due in large part to Ohio State’s best resource – its people. “The elements are already there: tremendous scientists and clinicians who have an attitude that they want something bigger than themselves. It’s a trait of everyone I’ve met at Ohio State,” he says. “Everyone here wants new and exciting things for translational cardiovascular and pulmonary science. I believe the Ohio State DHLRI is the perfect engine to drive innovative discovery.”

T H E O H I O S TAT E U N I V E R S I T Y M E D I C A L C E N T E R

CELEBRATING A DECADE OF DISCOVERY

THE D OROT H Y M . DAVI S HEART AN D LUN G R E SEA RC H I N STI T U TE Ten years ago as the result of a vision for a collaborative, multidisciplinary approach to research and patient care, The Ohio State University opened a unique and transformational facility, the Dorothy M. Davis Heart and Lung Institute (DHLRI). Today the seven-floor, 100,000 sq. ft. facility remains the nation’s only freestanding institute that integrates clinicians and researchers from diverse disciplines to study diseases that affect the heart, lungs and blood vessels. That collaborative approach is at the heart of 10 years of important discoveries at the DHLRI that continue to improve the practice of medicine, and with it human health and lives. Institute members conduct cutting-edge research in an open environment that encourages and enhances innovative, collaborative inquiry, developing strategies to improve the lives of patients who have heart and lung disease. A decade of excellence in biomedical research has positioned the Institute to advance to the next level. Its new director, Peter Mohler, PhD, will lead this new era, working with Medical Center clinical and basic sciences departments to recruit physicians and scientists and to increase National Institutes of Health (NIH) funding. Dr. Mohler will also oversee the Institute’s focus on establishing a translational fellowship program with an emphasis on personalized medicine, which is a central initiative of The Ohio State University Medical Center.

Leading With Groundbreaking Research In 2010, DHLRI was awarded an estimated $25.5 million in extramural funding. Through 200 active clinical trials and over 200 members participating in multidisciplinary research projects, life-changing advances are being made in the prevention, detection and treatment of heart and lung disease. •

Researchers found that exposure to air pollution over a period of 24 weeks exaggerates insulin resistance and fat inflammation in mice, compelling evidence of the strong relationship between air pollution and obesity and type II diabetes.

•

Researchers and clinicians found that “pretreating” adult stem cells with an anti-angina drug allows them to better adapt to the harsh environment of their transplantation site and possibly aid the regeneration of heart muscle. Researchers are studying whether transplanted cells either eliminate or slow tissue deterioration that would lead to heart failure.

•

Sleep medicine and cardiology researchers were the first to evaluate the impact of obstructive sleep apnea on patients admitted to the hospital with heart failure. Study results showed that early identification and treatment of obstructive sleep apnea in hospitalized patients with acutely decompensated heart failure improves heart function.

2 0 1 0 H E A R T A N D VA S C U L A R C E N T E R Y E A R I N R E V I E W

â&#x20AC;˘

Study findings strongly suggest that the absence of a protein from the brain and heart tissues of individuals with Down syndrome is a contributing factor to cognitive problems associated with this condition. Future research may lead to therapies that can reduce and perhaps even reverse some of the effects of Down syndrome.

Recognizing A Researcherâ&#x20AC;&#x2122;s Excellence Subha Raman, MD, associate professor of Internal Medicine and medical director of the CMR/ CT, was named the 2010 Ohio State University Early Career Innovator of the Year. The award recognizes an Ohio State researcher who is working actively to promote commercialization of University intellectual property. Leveraging her background in electrical engineering and her expertise in cardiac imaging, Dr. Raman has focused on the detection of vulnerable plaque through noninvasive, noncontrast magnetic resonance and on the more accurate diagnosis of cardiovascular disease through innovations in stress testing. Both processes have patents pending. She and her coinvestigators have also formed a University technology start-up company (EXCMR Ltd.) to commercialize the treadmill CMR technology.

T H E O H I O S TAT E U N I V E R S I T Y M E D I C A L C E N T E R

CO LLABOR AT IO N AT T HE H E A RT O F RES EARC H ER ’S WO R K When Jill Rafael-Fortney, PhD joined the faculty at The Ohio State University College of Medicine 11 years ago as an assistant professor of Molecular and Cellular Biochemistry, she saw it as an opportunity to further her lifelong pursuit: of better treatments for muscular dystrophy that result in improved quality of life for patients with this devastating disease. “What attracted me to Ohio State,” explains Dr. Rafael-Fortney, now an associate professor, “is the reason I still love it here: the collaboration between basic scientists and clinicians to address human health problems.” Collaboration has been key in her research, which focuses on finding treatments to slow the onset and progression of heart failure, a condition that eventually develops in all people with Duchenne muscular dystrophy, the most common form of the disease. “Ohio State’s Medical Center gives me both a strong neuromuscular group, which also studies the heart as a muscle, and a strong cardiac group,” says Dr. Rafael-Fortney. “My liaison to cardiologists through the Dorothy M. Davis Heart and Lung Research Institute (DHLRI) has been amazingly productive for moving therapeutic approaches forward,” she adds.

2 0 1 0 H E A R T A N D VA S C U L A R C E N T E R Y E A R I N R E V I E W

Collaborating with Paul M. L. Janssen, PhD, associate professor of Physiology and Cell Biology, Dr. Rafael-Fortney found a gene that was uniquely different in mice with muscular dystrophy and heart failure. Questioning whether the change was a common mechanism to all heart failure, she consulted with Phillip Binkley, MD, professor of Cardiovascular Medicine, who gave her access to samples of every heart transplant performed at Ohio State, which represented various causes of heart failure in a diverse population of patients.

Rafael-Fortney again studied slowing the onset and progression of heart failure in people with muscular dystrophy. Dr. Raman found that an MRI can detect heart damage up to three years

Dr. Rafael-Fortney found that no matter the cause, 60 percent of all heart failure patients demonstrate the same protein change. “It really does support the idea that this could be a common mechanism to all heart failure,” she says. Further research over this past year reveals that the change occurs at a very early stage, at a point where the progression of heart failure could be stopped.

before the onset of heart failure. Their current research explores whether initiating standard heart failure medications earlier can prevent further progression of the disease.

In collaboration with Subha Raman, MD, medical director of Cardiac CT and MR and associate professor in the departments of Internal Medicine and Biomedical Informatics, Dr.

“What attracted me to Ohio State is the reason I still love it here: the collaboration between basic scientists and clinicians to address human health problems.”

Jill Rafael-Fortney, PhD

Dr. Rafael-Fortney believes this collaborative approach to research is what sets Ohio State apart. “I can’t imagine this happening at most other places, while here clinicians and scientists can really work together. It’s what everyone aims for and it just happens here on a daily basis so naturally.”

T H E O H I O S TAT E U N I V E R S I T Y M E D I C A L C E N T E R

PULMONARY ARTERY PRESSURE MONITOR:

PI VOTAL ST UDY LE A DS TO N E W H E A RT FAILURE T R EATM E N T O P TI ON Results from a study lead by investigators at The Ohio State University Medical Center show that implantable pressure sensors are a viable treatment option for heart failure that can significantly reduce hospitalization and readmissions for those patients. The multicenter trial showed a 30 percent reduction in the risk of rehospitalization over six months and a 39 percent reduction over an average follow-up of 15 months in heart failure patients implanted with a pulmonary artery pressure monitor. The monitor, implanted via catheterization, measures pulmonary artery pressures and transmits the measurements to a secure website, giving physicians round-the-clock access. Detecting an increase in pressure as early as possible allows physicians to adjust medications, reducing the risk of hospitalization. “Changes in symptoms and weight, indicators of decompensation, occur too late to avert hospitalization,” explains William Abraham, MD, director of the Division of Cardiovascular Medicine and the study’s national coprincipal investigator. “This study revolutionizes how we monitor heart failure patients, moving away from a reliance on symptoms and daily weights and moving toward direct measurement of pulmonary artery pressures,” he says, adding that “it enables physicians to tailor heart failure treatment on an individualized basis.”

William Abraham, MD and Laura Yamokoski, RN

Ohio State a Leader in Heart Failure Device Studies This landmark study, presented at the European Heart Failure Congress 2010 in June, is one of many that have contributed to the emergence of Ohio State’s Medical Center as a leader in investigational device studies in heart failure. Ohio State is among high enrollers for centers conducting similar investigational studies and demonstrates national leadership in studies of many other devices, such as ventricular assist devices. Investigational trials comprise a major piece of the Ohio State’s comprehensive heart failure management program. According to Dr. Abraham, the collaborative, multidisciplinary approach delivers optimum care and treatment for patients. “We’ve developed the whole program of clinical and investigational approaches with a team that includes heart failure specialists, nurses, nurse practitioners, clinical research coordinators, electrophysiologists, interventionalists, and cardiac surgeons,” he explains. “It allows us to optimize standard drug, device and surgical options for heart failure patients and offer alternatives to patients who aren’t responding to standard treatments. Ultimately, it’s the patients who benefit the most.”

2 0 1 0 H E A R T A N D VA S C U L A R C E N T E R Y E A R I N R E V I E W

HEART TRANSPLANT PROGRAM

NEW LEA D E R SH IP G E N E R ATE S A CLEAR VISIO N FO R GROWT H The heart transplant program at The Ohio State University Heart and Vascular Center is one of six solid organ transplant programs within Ohio State’s Comprehensive Transplant Center, which is the only adult transplant center in Central Ohio and is considered a model for what constitutes a distinguished transplant program. Robert Higgins, MD, became the Center’s director in July 2010. With new leadership and a strong foundation of well-regarded transplant programs across the board, Ohio State’s transplant program is poised to advance to a new level of excellence. Dr. Higgins’s vision is to expand upon the program’s strong clinical record and long-standing history in transplantation to become one of the country’s top programs. “I’m here to facilitate a very good program becoming one of the top 10 transplant programs in the country in terms of volumes, outcomes and performance,” he says. “I believe that will occur within three to five years, if not sooner.”

Heart Transplant Program Maintains Excellence The heart transplant program contributes its consistent record of excellent patient outcomes to the Center’s overall success. The OSU Richard M. Ross Heart Hospital, one of the few dedicated academic heart hospitals in the United States and the centerpiece of the heart transplant program, continues to set a high standard of quality in caring for patients with end-stage heart disease through transplantation and post-transplant care. Ohio State’s Heart and Vascular Center is also home to one of the highest-volume mechanical circulatory support programs in the country, treating patients with end-stage heart failure who will eventually be transplant candidates. Over the past year, the program’s comprehensive, collaborative approach to care, which focuses on the physical, psychological, emotional and social needs of patients, has sustained its strength and quality, giving transplant patients excellent outcomes and a higher quality of life.

Heart Transplants LT Ventricular Assist Devices

2005-06

2006-07

2007-08

2008-09

2009-10

17 15

16 39

13 36

10 49

16 52

T H E O H I O S TAT E U N I V E R S I T Y M E D I C A L C E N T E R

Dr. Higgins believes the collaborative nature of transplantation and its infrastructure is extraordinary. “Transplantation is the consummate collaborative effort and spirit: families, organ procurement specialists, nurses, technicians, surgeons, perfusionists, therapists; the list goes on,” he says . “But the whole process starting with an incredible gift - the gift of a loved one’s organs in the face of tragedy,” he notes, adding that “It’s a miracle that we appreciate as transplant specialists. It’s also just as impressive if someone can be a living donor. To give of oneself for the betterment of others is a special human quality; we value and appreciate that.”

Collaboration Key to Growth Dr. Higgins believes collaboration is essential to demonstrating the program’s full capacity and to increasing the number of transplants performed, ultimately achieving the goal of becoming one of the nation’s top 10 transplant programs. “We want everyone in our community and within our referring network to know that we are about serving them as practitioners and their patients. We work with them as a collaborative team,” he explains. The transplant program team has embraced this vision and strategy and is working to develop specific tactics to support them. “There’s a lot of energy and a lot of resources dedicated to moving the program,” says Dr. Higgins. “It’s an exciting time.”

2 0 1 0 H E A R T A N D VA S C U L A R C E N T E R Y E A R I N R E V I E W

T H E O H I O S TAT E U N I V E R S I T Y M E D I C A L C E N T E R

THE OHIO STATE UNIVERSITY COMPREHENSIVE TRANSPLANT CENTER

RO BERT H IG G IN S A P P O I N T E D N E W L E A D E R O F OHIO STAT E T R A N SPL A N T C E N TE R Robert Higgins, MD, was named the director of The Ohio State University Comprehensive Transplant Center (OSUCTC) in July 2010. When Steven Gabbe, MD, CEO of The Ohio State University Medical Center (OSUMC), first approached Dr. Higgins about the opportunity to lead Ohio State’s Comprehensive Transplant Center, he was in a fulfilling position at Rush University in Chicago, where he was chief of Cardiothoracic Surgery and directing a successful transplant “(Ohio State is) a model for any transplant program and mechanical assist device program. However, intriguing aspects of the potential new that wants to distinguish itself at the national level.” role convinced him to investigate further. Robert Higgins, MD With that investigation, Dr. Higgins found what he considered an ideal position, one that offered elements rarely available in combination. “Ohio State’s CTC had a strong clinical record with a longstanding history in transplantation which was well-regarded, and when I looked at Ohio State’s Richard M. Ross Heart Hospital and the potential there I said ‘Wow, what a great place’,” he explains, adding that “Visionary leadership, a desire to be great, with a foundation of very good programs; it was a hard combination to beat.” The unique structure of the transplant program, which coordinates all the activities of Ohio State’s CTC, was also instrumental in attracting Dr. Higgins to Ohio State. “This is a Signature Program that’s not just a schematic. It’s an operational principle, and it operates to effect high-quality programs across the board: inpatient, outpatient, outreach, outcomes, quality assurance, operational integrity, all under one umbrella, with many people contributing to the program’s success,” he explains. “It’s a model for any transplant program that wants to distinguish itself at the national level.” In addition to his administrative duties, Dr. Higgins serves as the director of the Division of Cardiac Surgery and continues to treat and care for patients. “I love being in the middle of the action as well as helping make the infrastructure work to support the activities of everyone involved, and all to benefit the patients,” he explains. “It’s really a remarkable thing to replace the heart, kidney, liver, lungs, or pancreas,” “We have the ability to do it successfully, with patients having a great outcome and a greater quality of life. We’re very blessed to have those opportunities.” Dr. Higgins has an extensive list of accomplishments as both an administrator and surgeon. Prior to his work at Rush, he served as chair of Cardiothoracic Surgery at the Medical College of Virginia and before that he founded a successful lung transplant program at Henry Ford Hospital in Detroit. He was a major in the United States Army Reserve Medical Corps from 1989 to 2004. Among Dr. Higgins’s many national leadership appointments is his 2008-2009 term as chair of the United Network for Organ Sharing, which supports the cause of organ donation and transplantation. In addition to publishing extensively, he is a sought-after speaker nationally and abroad.

2 0 1 0 H E A R T A N D VA S C U L A R C E N T E R Y E A R I N R E V I E W

CONTRIB UT IN G TO T HE F U TU RE OF VASCULA R SURG E RY Michael Go, MD, assistant professor of surgery at OSU Medical Center, returned to The Ohio State Medical Center where he had completed his general surgery residency because “OSU’s Medical Center in general, and the department of surgery and division of vascular surgery in particular, are on the rise from an academic reputation standpoint. And I thought it was important to be a part “OSU’s Medical Center in general, and the of that rising tide, so to speak and be able to contribute to that increasing reputation.” department of surgery and division of vascular

surgery in particular, are on the rise from an

The innovation and collaboration that exists at academic reputation standpoint. And I thought OSU Medical Center are just two of the factors it was important to be a part of that rising tide, Dr. Go cites. “The concentration of high quality so to speak and be able to contribute to that physicians but also high quality investigators increasing reputation.” and researchers make for a really neat transition between cutting-edge research and clinical Michael Go, MD application of those research outcomes. Furthermore, the Heart and Vascular Center and the Ross Heart Hospital houses together all of cardiology, vascular surgery and cardiac surgery in one building, which generates an excitement and energy academically and clinically. “Everybody here is interested in not only just treating patients but also innovating treatments for disease. You can have an effect on the hundreds of patients in your practice, but you can have an effect on the thousands and thousands of patients being treated elsewhere when you innovate.” The ongoing relationships with patients as well as the opportunity to increase his technical skill level are two aspects Dr. Go finds appealing about this specialty. “It’s a blend between primary care and some specialty care—we meet patients, take care of one of their vascular problems and then follow them life-long, because we expect other problems to develop that we also can treat. We get to know the patients.” He also enjoys the challenge of a field that is very technology and innovation-driven. “Vascular surgery presents many opportunities to practice. You can do traditional, open vascular surgery, specialize in some of the more progressive endovascular or minimally invasive techniques or run the whole gamut between those two extremes. That makes for a nice variety in your practice. And because the field is so technology-driven, there is plenty of opportunity to participate in or initiate studies that really test the best ways we can treat patients. That’s an exciting part of it.” The partnership between researchers and clinicians is also a major advantage at OSU Medical Center, encouraging a collaboration that not only advances knowledge but ultimately provides better patient care. The peripheral vascular lab, which is an ICAVL [Intersocietal Commission for

T H E O H I O S TAT E U N I V E R S I T Y M E D I C A L C E N T E R

the Accreditation of Vascular Laboratories] accredited lab, has on staff nine very experienced vascular stenographers, which translates to more advanced testing available to patients, says Dr. Go. “We offer services that are not generally available other than at larger, more academic-oriented vascular labs. Also, our Vascular Lab is not just a clinical lab but heavily invested in research. Our level of participation in these multi-center trials and industry-sponsored trials gives us access to cutting edge technology, enabling us to offer patients who come here equipment and techniques not available to other facilities that may not be participating in these trials.” Current trials include several in the Phase 1 or highly experimental stage, including a locally initiated OSU trial that looks at the use of vascular stem cells to treat patients with Peripheral Vascular Disease, for which Dr. Go serves as principal investigator. Dr. Go also has several dozen articles and close to 40 presentations at state, national and international venues to his credit. In the end, it’s the challenge and the diversity of vascular surgery that hold his attention. “Vascular surgery can range from the most basic— taking care of patients with high cholesterol or varicose veins—to the highrisk/high-reward of aneurysm surgery and complicated visceral surgery,” he says. “Those two different ends of the spectrum offer different but equally satisfying rewards.”

2 0 1 0 H E A R T A N D VA S C U L A R C E N T E R Y E A R I N R E V I E W

THE AORT IC A N E URYS M TRE ATME N T P ROG RA M— P ROV ID I N G FO R BE T T E R OU TCOME S TH ROU G H COLLABO R AT IO N A N D R E S E A RC H Patients with aortic aneurysms can have a host of pre-existing conditions, from hypertension and diabetes to coronary artery or cerebrovascular disease, making treatment challenging both for them and the surgeons involved in their care. But the aortic aneurysm treatment program at The Ohio State University Medical Center improves patient outcomes through a collaborative, multidisciplinary approach and ongoing research and clinical trials. The aortic aneurysm treatment program offers the benefits of the expertise of both cardiac and vascular surgeons, says Patrick Vaccaro, MD, director of the Division of Vascular Diseases and Surgery at Ohio State’s College of Medicine. “In this way, we are refining a multidisciplinary approach to attacking this disease. Getting the expertise of both vascular surgeons and cardiac surgeons allows us to extend what we can do to improve survival for patients.” Traditionally, explains Chittoor Sai-Sudhakar, MD, assistant professor of Surgery, conditions affecting the ascending aorta and the arch are operated on by the cardiac surgery team, while management of the descending thoracic aorta involves a collaborative effort by the vascular and cardiac surgery teams either in terms of a surgical approach or stenting. “In addition, close collaboration with our cardiac anesthesia division in the perioperative period ensures optimal management and provides for excellent outcomes.” The establishment of the aortic program involves close collaboration among the cardiac and vascular surgeons, cardiologists dealing with patients who have congenital vascular diseases, vascular medicine, imaging departments, anesthetists, geneticists and other basic science researchers, explains Dr. Sai-Sudhakar, “andvery importantly, the development of a database devoted to the aortic program.” The program treats a variety of thoracic aortic conditions—although the majority are expected to be aneurismal—utilizing state of the art CT and MRI/MRA available onsite to provide immediate threedimensional imaging, enabling surgeons to select the most appropriate treatment method: open surgery, stent or a combination approach. “Among the many pathologies affecting the aorta (which extends from just above the aortic valve to the aortic bifurcation), dilation of the aorta (aneurysms) and tears in the aorta (dissections) are the most common conditions observed in the patient population,” says Dr. Sai-Sudhakar. “While not all the aortic pathologies need to be operated on urgently, we monitor the size of the aorta in these patients in the out-patient setting at periodic time intervals by a variety of imaging techniques and operate on them when indicated. In the meantime, these patients are counseled on lifestyle changes including avoiding strenuous exercise and control of hypertension.”

T H E O H I O S TAT E U N I V E R S I T Y M E D I C A L C E N T E R

Many thoracic aortic conditions can be treated not only with open surgery but with stent graft surgery or a combination, with surgeons using an endoscope inserted through the groin instead of having to open the patient’s chest, explains Dr. Vaccaro. “By having both treatment modalities available, we can combine them in the same patient in a hybrid procedure—part of it as open surgery and part done endovascularly with stent grafts. This extends the ability to treat the more difficult patients. Patients with higher morbidities can sometimes have a somewhat less morbid operation by going up through the groin and putting in a stent rather than an open repair.” In addition to the collaboration between the cardiac and vascular departments, the aortic aneurysm treatment program also draws on the latest clinical studies and research: a bench-to-bedside approach for which Ohio State’s Medical Center is well known—and what Dr. Vaccaro believes is the “calling of academic centers.” “The physicians in private practice don’t have the facilities to do the ‘bench’ discoveries, so it’s dependent upon us to make those discoveries and develop those [procedures] so other hospitals can benefit from them as well,” he says. But to achieve that, Dr. Vaccaro points out, you need a large treatment volume of patients. “You want every patient to be studied, so we will be able to learn something for the next patient, whether it be at the bench level or the clinical level. All of this helps us predict who to operate on and what to expect.” Currently, Dr. Vaccaro serves as co-investigator on multiple clinical cardiovascular research projects, including two thoracic stent trial studies, one involving the Cook device and the other the Bolton device. Other trials include carotid, iliac and superficial femoral artery stents, with forthcoming results to be published in medical journals. “In addition to the clinical trials, we are currently investigating the pathophysiology of the aortic calcific process in the basic science area, and the pathophysiology of spinal cord ischemia—a dreaded complication of intervention on the descending thoracic aorta that leads to paraplegia and considerable morbidity in this vulnerable patient population—to understand the mechanisms with a goal to prevent this complication,” says Dr. Sai-Sudhakar. “Also, I have several collaborative projects with Dr. Sampath Parthasarathy, the Klassen Chair for Cardiac Surgery Research. Dr. Parthasarathy is a well-known authority in atherosclerosis who has participated in numerous international conferences. He also is the leading authority on Oxidized LDL, which is implicated in the development of atherosclerosis and some cases of aneurismal dilation of the aorta.” With the continued focus on improving treatment options through clinical trials and research, surgeons in the aortic aneurysm treatment program can anticipate continuing to provide better outcomes for patients with thoracic aortic conditions.

2 0 1 0 H E A R T A N D VA S C U L A R C E N T E R Y E A R I N R E V I E W

D IV IS IO N O F VA SC ULA R D I S E A S E S A N D S U RGE RY: P ROGRESSIVE T R E ATM E N T FOR VA SC U L A R D I S E ASES At the Division of Vascular Diseases and Surgery at The Ohio State University Medical Center’s Heart and Vascular Center, patients can benefit not only from the latest in technology and expert staff but also from the ongoing commitment of clinicians and researchers to developing innovative treatments for disease. “Our Division offers a variety of newer, more progressive endovascular or minimally invasive treatments for vascular problems, ranging from the very simple to the most complex,” says Michael Go, MD, assistant professor of Surgery at OSU Medical Center. “For example, peripheral vascular disease (PVD), which has traditionally been treated with bypass surgery, can often now be treated with less invasive techniques, such as angioplasty to dilate blockages in blood vessels, stent placement to keep the blocked areas open, atherectomy to remove plaque, and cryoplasty, which uses a balloon to dilate and then freeze the plaque.” Another minimally invasive technique is thrombolysis, which is used to remove a clot that blocks an artery, Dr. Go explains. “There is traditional or catheter-directed thrombolysis, as well as the more progressive ultrasound accelerated thrombolysis and pharmaco-mechanical thrombolysis—both of which speed up treatment times compared to the traditional method. While these thrombolysis techniques are typically used to treat blood clots in arteries, we have also been using them to treat DVT (deep venous thrombosis).” The Division also offers treatment for more complicated vascular diseases such as tibial, carotid artery, mesenteric and renal diseases as well as for both thoracic and abdominal aortic aneurysms. “Traditionally, treatment for aortic aneurysms involved major operations requiring a week or more of hospital stay and significant morbidities for the patients,” says Dr. Go. “In many cases, we can now treat these aneurysms with minimally invasive approaches by placing a stent graft inside the aneurysm to seal it, which generally just requires an overnight stay.” Radio-frequency ablation or laser ablation, used to treat varicose veins or venous insufficiency, can be performed as an outpatient procedure in an office setting. In addition to offering the most progressive available diagnostic testing, the Peripheral Vascular Laboratory also provides research services to cardiovascular investigators on campus.“For example, other investigators here at Ohio State’s Medical Center are involved in multi-center trials looking at atherosclerotic disease. One of the ways you can measure that disease is by measuring carotid intima-media thickness (CIMT)—a very advanced ultrasound technique that we offer that definitely sets our lab apart,” says Dr. Go. “There’s a lot of innovation and collaboration at Ohio State’s Heart and Vascular Center as compared to other facilities in central Ohio. That’s another aspect of our Vascular Lab—the scholarship and the clinical techniques that we offer—that makes it unique.”

T H E O H I O S TAT E U N I V E R S I T Y M E D I C A L C E N T E R

Other trials in which the Division has been involved include “Cerebrovascular collateral recruitment and remodeling in acute ischemic stroke” and “Laser capture microdissection of cerebrovascular collaterals,” with Cameron Rink, PhD, assistant professor of Vascular Diseases and Surgery and a member of Ohio State’s Davis Heart and Lung Research Institute, serving as principal investigator on both. Dr. Rink’s lab has produced numerous scientific papers, the most recent of which have been published in Investigative Radiology, Journal of Cerebral Blood Flow & Metabolism, Antioxidants and Redox Signaling and Physiological Genomics. While research is critical to advances in treatment, the Division’s first priority is the needs of the patients who rely on its services. In addition to the OSUMC location, OSU vascular surgeons also provide outpatient services at satellite offices around the Columbus and central Ohio area. It is the level of clinical and research experience, combined with the collaborative atmosphere among programs that makes the Division of Vascular Diseases and Surgery unique, says Dr. Go. This provides both patients and the research community the opportunity to benefit from the bench-to-bedside approach that is the hallmark of The Ohio State University Medical Center. Jean Starr, MD

2 0 1 0 H E A R T A N D VA S C U L A R C E N T E R Y E A R I N R E V I E W

THE CHA LLEN G ES A ND RE WA RDS OF VASCULA R M ED IC IN E Steven M. Dean, DO, the director of Ohio State’s vascular medicine program and director of the noninvasive peripheral vascular laboratories for the division of cardiovascular medicine, joined Ohio State’s Medical Center’s staff in 2006. It was a choice that was influenced by William T. Abraham, MD, director of the division of cardiovascular medicine and Patrick Vaccaro, MD, director of the division of vascular diseases and surgery, both of whom, Dr. Dean says, “understood the value of a vascular medicine specialist.” Equally appealing is the hospital’s unique environment that combines a nationally recognized state-of-the-art medical facility in a very collegial, relaxed environment. Dr. Dean’s choice of vascular medicine as his specialty was initially cultivated by his mentors at the Cleveland Clinic Foundation in Cleveland, Ohio, and it is one that he has has since found it to be “very rewarding. It’s a unique specialty that contains a variety of topics that are typically left out of the typical medical school curriculum. I thoroughly enjoy teaching the medical students, residents and fellows that rotate on my service that have never been exposed to vascular medicine related topics, and sharing challenging cases with vascular medicine colleagues throughout the country.” Dr. Dean is also a co-principal investigator in a current trial involving an oral anticoagulant medication (Apiximab) used in the treatment of patients that have developed a previous deep venous thrombosis and will be participating in the largest international trial to date analyzing the efficacy of two types of pneumatic pumps for lymphedema.

T H E O H I O S TAT E U N I V E R S I T Y M E D I C A L C E N T E R

“I think one of the most interesting findings in the field of lymphedema is the intimate relationship between the disease and obesity. However, this relationship remains underappreciated and often unrecognized,” he says. “In my soon-to-be published study on the most severe form of lymphedema, also known as elephantiasis, the mean BMI was an astonishing 56. This underscores that weight loss is critical when treating the patient with lymphedema.” While his primary goals for the Noninvasive Peripheral Vascular Laboratory are to increase the number of ultrasonographers as well as the size of the department, his focus for the Vascular Medicine Program is more extensive. “Our vascular lab is relatively unique in that it’s one of the few vascular labs in the city that can perform a detailed assessment of a patient’s lower “It’s a unique specialty that contains a variety extremity venous function as opposed to simply evaluating for a deep venous thrombosis,” of topics that are typically left out of the typical he explains. With this in mind, he wants to medical school curriculum. I thoroughly enjoy expand the visibility of the program at a local teaching the medical students, residents and fellows and national level and recruit more vascular that rotate on my service that have never been medicine physicians to enlarge the workforce, exposed to vascular medicine related topics, and and, speaking as a true educator, adds, sharing challenging cases with vascular medicine “Ultimately, I want to develop a training program colleagues throughout the country.” in Vascular Medicine at OSU Medical Center.”

Steven M. Dean, DO

2 0 1 0 H E A R T A N D VA S C U L A R C E N T E R Y E A R I N R E V I E W

TAKING A H O LIST IC A P P ROAC H TO CARD IOVA SC ULA R D IS E A S E For Sanjay Rajagopalan, MD, the juxtaposition of research and medical care together with worldclass facilities were the key attributes that drew him to The Ohio State University Medical Center in 2006, when he was honored with the John W. Wolfe Professorship in Cardiovascular Research at The Ohio State University, a position he currently holds. Previously, Dr. Rajagopalan was Chief of Cardiovascular MR and CT at the Mount Sinai School of Medicine in New York City, and had completed a four-year fellowship in clinical cardiovascular medicine and vascular biology and two fellowships in imaging. â&#x20AC;&#x153;The Ohio State University has a breadth of expertise and infrastructure that really rivals many of the prestigious top 10 universities in a very collegial and relaxed atmosphere,â&#x20AC;? says Dr. Rajagopalan, who serves as professor of internal medicine at OSU Medical Center, section director of Vascular Medicine and co-director of the Cardiovascular MR/CT Program.

T H E O H I O S TAT E U N I V E R S I T Y M E D I C A L C E N T E R

Another key factor “is the area’s very favorable climate for entrepreneurial enterprise—the ability to take discoveries in the laboratory and innovate and take them back to the developmental fast-track”—and one that he took full advantage in 2006, when together with two other leading researchers, he also founded InVasc Therapeutics.

“The Ohio State University has a breadth of expertise and infrastructure that really rivals many of the prestigious top 10 universities in a very collegial and relaxed atmosphere.”

Sanjay Rajagopalan, MD

Dr. Rajagopalan’s clinical research is in the area of vascular diseases, atherosclerosis and risk factors that modulate vascular disease, while his second is in non-invasive diagnosis of vascular disease.. “Some of the advanced imaging modalities such as CT and MRI are unrivalled in their capabilities of understanding vascular diseases at a very fundamental level, And that kind of information enables you to treat patients better. Here at OSU Medical Center, we have a world-class cardiovascular MR/CT program coupled with high-field MRI systems that enables us to move from bench-tobedside approach and back again. This also allows development of new diagnostic tools and new ‘theranostic’ applications, so we can use emerging approaches to diagnose vascular disease at a very early stage, help us predict complications and also utilize these kinds of information to simultaneously treat disease.” In the future, the use of theranostic strategies are going to be very common, Dr. Rajagopalan says. He holds a new NIH grant awarded in December of 2010 on a novel theranostic tool that he is currently testing in mice. He has been continuously funded by the National Institutes of Health for over 10 years and currently holds three prestigious RO-1 grants from the NIH, two R21 grants and a center grant from the EPA, has active collaborations with industry and holds three patents jointly with other investigators at OSU on novel therapies in atherosclerosis and in theranostic applications. Dr. Rajagopalan is also interested in environmental and lifestyle factors that modulate vascular tone and alter arterial function and cardiovascular risk, particularly, the link between lung and heart disease, and inhalation of agents that promote vascular diseases. “One of the focus areas in our laboratory is to understand inflammation and how it modulates diseases that affect the artery, and ultimately to come up with approaches and therapies that could favorably affect the disease process so that you could better patient outcomes.” Named one of America’s Best Doctors in 2009, Dr. Rajagopalan also serves on the editorial board for Journal of American College of Cardiology (Imaging), and is currently an ad hoc reviewer for the Journal American College of Cardiology, Circulation, Arteriosclerosis Thrombosis and Vascular Biology and Environmental Health Perspectives. He has published over 200 peer reviewed papers, more than 30 book chapters, 3 monographs and has edited two textbooks on vascular diseases and imaging. A frequent presenter on a variety of cardiovascular topics, he is also chair of the Young Investigator Awards Committee at the American College of Cardiology.

2 0 1 0 H E A R T A N D VA S C U L A R C E N T E R Y E A R I N R E V I E W

HANDS -O N LY C P R— IM P ROV I N G S U D D E N CARD IAC A R R EST SURV I VA L R ATE S For 50 years, cardiopulmonary resuscitation (CPR) involving mouth-to-mouth breathing and chest compressions has been the gold standard for keeping people alive after a sudden cardiac arrest. But in 2010 that changed, and Michael R. Sayre, MD, associate professor of Emergency Medicine at The Ohio State University Medical Center (OSUMC) was key to the process. Dr. Sayre, chair of the American Heart Association’s Emergency Cardiovascular Care (ECC) Committee since July 2009, is also co-author of the new 2010 CPR guidelines, which identify chest compression as the first response to a cardiac arrest. For Dr. Sayre, improving outcomes from sudden cardiac arrest is a career interest awakened when he was medical director for Cincinnati’s EMS service. He joined OSUMC because of its many clinical and research opportunities and because “the City of Columbus EMS system had a reputation of doing good cardiac arrest research even back before the 1990s. And it was the ‘right-size’ system for research: 750,000 people, with 400 to 500 cardiac arrest events a year, enough to evaluate any new procedures we tried.”

From A-B-C to C-A-B — Revising the Guidelines The revision began five years ago when, with new technology, “We were able to see exactly how many chest compressions or breaths a patient was getting when emergency medical professionals were caring for them,” he says.”We were surprised to learn the victim wasn’t getting any chest compressions at all for about half of the cardiac arrest, according to several 2005 studies.” The studies found the lay person spent more time than anticipated shifting from the breathing portion of CPR to the chest compressions. And paramedics or physicians “would get involved with performing other techniques they felt were more important: checking pulses and heart rhythms, giving medications or placing a breathing tube into the patient’s trachea, and they just weren’t paying attention to chest compression. Those missing chest compressions were a big problem.” CPR guidelines were updated in 2005 as part of the regular review cycle, increasing the number of chest compressions and highlighting the importance of the procedure, which improved cardiac arrest survival rates in many cities, including Columbus, from about five percent to about 10 percent. “More interesting,” says Dr. Sayre, “was that studies in 2007 found the survival rates were about the same whether the rescuer performed only chest compressions or combined chest compressions and mouth-to-mouth breathing. And that tipped the balance for the American Heart Association to tell the public they could help via Hands-Only CPR even if they’d never been trained in CPR. The process to change from A-B-C (Airway-Breathing-Compressions) to C-A-B (CompressionsAirway-Breathing)—with the second and third steps reserved for someone trained in CPR—

T H E O H I O S TAT E U N I V E R S I T Y M E D I C A L C E N T E R

underwent intense scrutiny during the three years before it was adopted. The proposed change also was extensively discussed at the International Consensus Conference on CPR and Emergency Cardiovascular Care Science in February 2010. “The conference covered all the issues relating to treating patients with cardiac arrests,” says Dr. Sayre. “Not just CPR, but also medications, optimal methods of care following restoration of a pulse, and techniques for improving responder training. We sought a consensus on these topics so CPR guidelines released in different parts of the world would be similar.” “We also needed to emphasize the importance, to professional and lay rescuers, of chest compressions,” he notes. “So we adopted the C-A-B approach, ensuring that all victims will get chest compression right away, that even untrained rescuers can provide Hands-only CPR, and that professional rescuers will realize that chest compressions are the most important part of CPR.” Dr. Sayre also refers to a recent study in the Journal of the American Medical Association (JAMA) finding that after an aggressive public awareness campaign via television, YouTube and print media, and offering short training courses at public venues, researchers in Arizona documented an increased use of CPR by nearby rescuers from 25 percent to 40 percent of victims getting CPR, with Hands-only CPR increasing from 20 percent to 75 percent of the CPR given by members of the public.

Michael Sayre, MD (center)

“This dramatic increase in the number of victims who got CPR,” he says, “improved survival from four percent to 10 percent, according to the study. Given that sudden cardiac arrest is third leading cause of death in the country, with annual figures estimated at 300,000, even a few-percent increase in survival translates to 10,000 or more people living to return to their families.” Now that “Hands-only CPR” has been formally adopted, the process of educating millions of people to do things differently begins. New courses and materials will be available in Spring 2011 from the American Heart Association. While the first steps of care for someone who collapses suddenly—calling 9-1-1 and sending someone to get an AED—remain paramount, rescuers should then immediately start Hands-Only CPR. “It’s simpler to perform”, summarizes Dr. Sayre. “People are much more willing to do it.” And that translates to lives saved for people who experience sudden cardiac arrest.

2 0 1 0 H E A R T A N D VA S C U L A R C E N T E R Y E A R I N R E V I E W

A PASS IO N FO R T H E H E A RT—A N D A COMMI TME NT TO CARD IAC D ISE A SE P RE V E N TI ON For Martha Gulati, MD, her passion is for the heart—specifically, researching the causes and clues of heart disease especially as it pertains to women. Dr. Gulati is the Sarah Ross Soter Chair in Women’s Cardiovascular Health at The Ohio State Medical Center, an endowment that supports a nationally eminent physician-researcher who specializes in women’s cardiovascular health. She is also an associate professor of medicine in the Department of Internal Medicine—Division of Cardiovascular Medicine and section director for Preventive Cardiology and Women’s Cardiovascular Health at The Ohio State University. A fellow of the American College of Cardiology and board-certified cardiologist and Diplomate from the American Board of Internal Medicine in both Cardiology and Internal Medicine and a licensed physician in Ohio and Illinois, Dr. Gulati’s focus is on researching the causes and clues of heart disease especially as it pertains to women.

“There are few places in the world that are able to build their cardiology division to be the best in every sub-specialty, but OSU, and Dr. Thomas Ryan and Dr. William Abraham, seem to have taken on this challenge and are investing in developing a program that will be one of the best at all cardiac issues.

“It’s only been in the past decade that we have had emerging research on women,” she says, “so we are really at the earliest stages of trying to answer questions about women and women’s cardiovascular health and understanding the difference in the pattern of coronary artery disease in women.” It was not only the center’s overall excellence, but also the opportunity to be at the cutting edge of medicine and cardiology that drew Dr. Gulati to OSU Medical Center. “There are few places in the world that are able to build their cardiology division to be the best in every sub-specialty, but OSU, and Dr. Thomas Ryan and Dr. William Abraham, seem to have taken on this challenge and are investing in developing a program that will be one of the best at all cardiac issues. The foresight to invest in cardiac disease prevention (whether we are talking primary or secondary prevention) is the key step to building any top-tier cardiology program and that really is the goal of any treatment offered here at OSU Medical Center,” she says. Dr. Gulati is the principal investigator of the St. James Women Take Heart Project and the STILETTO Study, a randomized trial of women with Cardiac Syndrome X and co-investigator on the Women Ischemic Syndrome Evaluation (WISE) and had previously served as a co-investigator on the Women’s Health Initiative (WHI). Her previous positions include associate professor of Medicine and associate director of the Center for Women’s Cardiovascular Health at Northwestern University (Chicago, Ill.), and assistant professor of Preventive Medicine and Medicine and Research Director

Martha Gulati, MD

T H E O H I O S TAT E U N I V E R S I T Y M E D I C A L C E N T E R

2 0 1 0 H E A R T A N D VA S C U L A R C E N T E R Y E A R I N R E V I E W

for The Heart Center for Women at Rush University Medical Center in Chicago. In addition to co-authoring the most recent guidelines published by the American Heart Association for heart disease prevention in women, Dr. Gulati has published numerous articles in peer-reviewed publications, and serves as a reviewer for several medical journals, including Archives of Internal Medicine and JAMA. One of Dr. Gulati’s future plans is to evaluate women’s coronary arteries and to use a specific type of stress testing modality to identify endothelial dysfunction, which she says, is harder to recognize but when diagnosed, indicate the earliest stages of coronary artery disease.

“If we have a woman who we suspect has angina or she’s had a heart attack or an abnormal stress test and we do an angiogram and we see normal coronary arteries, we shouldn’t just stop there,” she says. “We should do testing for endothelial dysfunction, because some of the research indicates that women with these symptoms who have ‘normal’ coronary arteries are more likely to have a coronary event or develop cardiac disease.” Dr. Gulati’s plans are to “build the Women’s Cardiovascular Health program and our center into the leader for treating women with heart disease. It is exciting that OSU recognizes that the number one killer of women is not adequately addressed in most cardiology programs and to have the support for both the hospital and the community to build a program here at OSU,” she says. “That is why I wanted to join this group—to be part of something great.”

T H E O H I O S TAT E U N I V E R S I T Y M E D I C A L C E N T E R

O UTPATIE N T T R A N SR A DI A L CORON A RY A RTE RY STENTING —A R E VO LUT I ON A RY A P P ROAC H Since the 1960s, cardiac catheterization through the femoral artery has been the standard procedure used for imaging coronary arteries and diagnosing coronary artery disease, the leading cause of death in the United States. Like diagnostic cardiac catheterization, more than 95 percent of patients having coronary artery stent procedures have it performed by puncturing the femoral artery, located in the upper thigh or groin, says Quinn Capers IV, MD, director of Peripheral Vascular Interventions at Ohio State. “Nationwide, between ten and twenty But while the procedure has a success rate of greater than 95 percent, it was not without potential for complications. This led to the introduction of transradial coronary artery stenting (catheterization via the radial artery in the wrist) twenty-five years ago. The latest innovation currently being evaluated is performing this as an outpatient procedure.

million stent procedures are performed annually, with fewer than five percent of those done from the radial artery, and only a small fraction of one percent are performed on an outpatient basis. We decided to start doing more procedures via the radial artery because of the superior safety and improved quality of life for our patients, which goes along with our mission to improve people’s lives.”

Quinn Capers IV, MD According to Dr. Capers, “stenting via the radial artery is just as successful as performing it via the femoral artery, but much safer. Bleeding complications from the arterial puncture site are the most common complication of cath lab procedures, and some of these complications are fatal. But the risk of a major bleeding complication is reduced 70 to 80 percent when the procedure is performed from the wrist rather than from the groin. Evidence is starting to accumulate suggesting that not only are bleeding complications much lower, but cardiac complications are also lower when the stent procedure is done by accessing the circulation via the radial artery rather than the femoral artery.” The use of the radial artery procedure also offers greater patient comfort, he adds. “Patients are able to sit up or even walk around immediately after the procedure. But when the procedure is performed via the femoral artery, there is a mandatory period of two to six hours of strict bed rest when patients must be flat on their back. Since many of our patients have problems with back pain or difficulty breathing when they lay flat, this is a real problem.” Outpatient coronary artery stenting, currently under evaluation at Ohio State’s Richard M. Ross Heart Hospital, offers the promise of achieving greater patient comfort while reducing risks even more. “Performing transradial coronary artery stenting as an outpatient procedure is a new initiative that we started this year,” says Dr. Capers—a logical next step for the Ross Heart Hospital, given that approximately 30 to 40 percent of the procedures here are performed via the radial artery, compared to zero to five percent for most cath labs in the country.

2 0 1 0 H E A R T A N D VA S C U L A R C E N T E R Y E A R I N R E V I E W

“Nationwide, between ten and twenty million stent procedures are performed annually, with fewer than five percent of those done from the radial artery, and only a small fraction of one percent are performed on an outpatient basis. We decided to start doing more procedures via the radial artery because of the superior safety and improved quality of life for our patients, which goes along with our mission to improve people’s lives,” says Dr. Capers, who estimates that nearly 80 percent of the procedures he performs in the cath lab are via the radial artery. “We decided to offer the procedure on an outpatient basis to further improve the process of coronary intervention and to study the impact on cost and safety. Because of our collection of expert operators in the cath lab and the concentration of all heart-related services in the Ross, we are an ideal location for this new initiative,” he notes. ”This is a leading-edge concept, and we are probably one of only a handful of centers in the country, and perhaps the only one in the state, studying outpatient coronary artery stenting.” Training programs will play an important role in educating new cardiologists in this technique, says Dr. Capers, who also serves as assistant professor of Clinical Medicine (with numerous teaching awards to his credit) and associate dean for Admissions at OSU’s College of Medicine. Currently, Ohio State general cardiology fellows and advanced interventional cardiology fellows are being trained in both the traditional femoral artery and the radial artery approaches. So far, the outcome on this latest innovation from the Ross Heart Hospital has been positive, says Dr. Capers, who will be the principal investigator of the study. “The preliminary results are excellent, and we are preparing for a large study.”

Quinn Capers IV, MD

T H E O H I O S TAT E U N I V E R S I T Y M E D I C A L C E N T E R

OSU M ED I CA L C EN T ER PA RTI C I PATI N G I N PE RCUTANEO US AO RT IC VA LV E RE P L AC E ME N T TRI A L Once again, The Ohio State University Medical Center is at the forefront of cutting-edge medical research—this time, taking part in the CoreValve U.S. Pivotal Trial that will be conducted at 40 medical centers nationwide. Juan Crestanello, MD, associate professor of surgery in the Division of Cardiothoracic Surgery at The Ohio State University, and John Cheatham, MD, director of Cardiac Catheterization and Interventional Therapy at Nationwide Children’s Hospital in Columbus, and clinical professor of Pediatrics and Internal Medicine at The Ohio State University College of Medicine, are the local principal investigators for the trial. “This new technology has the potential to change Together, both physicians will screen and enroll the way we perform aortic valve surgery and provide patients, supervise the overall conduction of the an effective treatment to patients that today are trial, and care for patients before and after the consider non operable.” procedures. Juan Crestanello, MD “At The OSU Heart and Vascular Center we are very excited with our participation on this trial,” says Dr. Crestanello. “This new technology has the potential to change the way we perform aortic valve surgery and provide an effective treatment to patients that today are consider non operable. OSU’s Medical Center has an integrated approach to the management of cardiovascular diseases that is necessary for the performance of this type of procedures.” The trial will test the safety and efficacy of a novel approach to AV replacement, performed using a catheter-based delivery system rather than open heart surgery. Initially, the procedure will only be available to patients considered “very high risk” for conventional surgery. “Surgical aortic valve replacement currently is the only effective treatment for patients with severe aortic valve stenosis,” says Dr. Crestanello. “However, some patients with aortic stenosis are poor candidates for open heart surgery because they are either too old or frail, or have some other complicating medical condition. Percutaneous transcatheter aortic valve replacement may be an option for those patients with symptomatic aortic stenosis who are considered ‘high-risk’ or ‘non candidates’ for conventional surgical therapy.” Enrollment of the 790 patients in the high-risk surgical group is expected to be completed within a year, with all trial subjects followed through five years. Screening studies include echocardiograms, CT angiogram of the thoracic and abdominal aorta, cardiac catheterization. Once the local investigators feel that the patient is a candidate, a national screening committee makes the final determination prior to enrollment.

2 0 1 0 H E A R T A N D VA S C U L A R C E N T E R Y E A R I N R E V I E W

Locally, patients with valvular heart disease are evaluated at The Heart Valve Clinic at The Ross Heart Hospital Ambulatory Care Center. “Once enrolled, the patients will be randomized one-toone to either surgical valve replacement or the percutaneous valve,” explains Dr. Crestanello, with 467 patients in the extreme risk cohort randomized two-to-one to percutaneous valve or optimal medical management. “Potential candidates for the trial will be screened by one cardiologist and two cardiac surgeons, and need to have severe symptomatic aortic stenosis and a high predicted risk of operative morbidity and mortality—greater than 15 percent for the high risk group and greater than 50 percent for the extreme risk cohort.” The Heart Valve Clinic is the ideal location for a trial of this scope, since it provides comprehensive evaluation of patients with valvular heart disease in a single setting to achieve maximal efficiency and optimize patients’ experience, says Dr. Crestanello.

Staffed by cardiologists and surgeons who specialize in the evaluation and treatment of patients with valvular heart disease, the Clinic also offers additional multidisciplinary evaluation by physicians specialized in advance imaging techniques (three-dimensional echocardiography, CT, and MRI) and cardiac hemodynamic and anesthesia. These services are concentrated in a single area of the hospital to provide an efficient and convenient patient experience. The Heart and Vascular Center at The Ohio State University Medical Center provides advanced treatment options for patients with valvular heart disease, from medical management to conventional surgery, minimally invasive surgery, robotic surgery, and percutaneous options for the treatment of heart valve disease. Additional percutaneous procedures offered include mitral and aortic valvuloplasties, pulmonary valve replacement, and atrial and ventricular sepal defect closure.

T H E O H I O S TAT E U N I V E R S I T Y M E D I C A L C E N T E R

NU RS E RES E A RC H E R S CO L L A B ORATE TO O PTIM IZE H E A RT PAT IE N T CA RE A collaborative approach between The Ohio State University College of Nursing and clinical nursing staff led to the publication of an article co-authored by nursing student Matthew Price, MS, RN, NP-C, and Amy Schueler, MS, RN, CNP, a nurse practitioner in cardiology at The Ohio State Medical Center. The two worked together as part of Ohio State’s College of Nursing Master of Nursing degree program, which matches students with nurse practitioners within The Ohio State University Medical Center. “I believe the program speaks to the strong relationship between the Medical Center and the College of Nursing; collaboration is a priority.” Ms. Schueler says. Mr. Price, now a graduate and working as a nurse practitioner at Nationwide Children’s Hospital, was the lead author of the article, “Understanding Clopidogril’s Interaction with CYP2C19 Inhibitors,” as part of his senior project. Published in the October 2010 issue of The Journal for Nurse Practitioners, the article outlined the project and provided a nurse practioner-derived action plan for addressing a recent Federal Drug Administration warning on drug interactions between commonly Matthew Price, RN and Amy Schueler, RN prescribed medications and clopidogril (Plavix), used to treat and prevent acute coronary syndrome, coronary artery disease and peripheral artery disease. The warning asserted that certain medications, including proton pump inhibitors (PPIs) and certain selective serotonin inhibitors (SSRIs), can reduce clopidogrel’s efficacy by up to 47 percent when taken concomitantly. The nurses reviewed evidence-based pharmacology regarding the FDA warning and then developed and implemented an action plan, which included contacting past and current cardiology patients to advise them of the FDA warning. The project highlighted the importance of Ohio State’s collaborative approach to care, with nurse practitioners in an optimal position to coordinate communication and care across disciplines, and in this case, beyond cardiology. “This project was a good example of how advance practice nurses regularly collaborate with physicians, pharmacology and other nursing staff,” says Schueler. “We collaborated not only with patients’ interventional cardiologists, but with disciplines treating patients’ other health conditions.” Ultimately Price and Schueler believe their collaboration will lead to fewer coronary events and ensure the best possible outcomes for patients by optimizing the efficacy of life-saving medications and reducing side effects.

2 0 1 0 H E A R T A N D VA S C U L A R C E N T E R Y E A R I N R E V I E W

YOUNG IN VE ST IG ATOR S E X P LOR E OP P ORTUN IT IE S T H ROU G H STU D E N T UND ERG R A D UAT E R ES E A RC H F E L LOWS H I P The Student Undergraduate Research Fellowship is a collaborative effort between The Ohio State University Medical Center, the Dorothy M. Davis Heart and Lung Research Institute, the Center for Cardiovascular and Pulmonary Research at Nationwide Children’s Hospital, the Undergraduate Research Foundation, a campus-wide initiative to advance undergraduate student interest in research across all disciplines, and The American Heart Association, which funds the young investigators’ research projects. Gifted young undergraduate and medical student scientists have been awarded 11 fellowships and grants at the university and national level and have taken advantage of unique research opportunities in the laboratory of Richard Gumina, MD, PhD, director of Interventional Cardiovascular Research at Ohio State’s Heart “These research opportunities are vital to attracting and Vascular Center. the best and brightest students to scientific research

and academics.” “These research opportunities are vital to Richard Gumina, MD, PhD attracting the best and brightest students to scientific research and academics. Catching what I call ‘the research bug’ will expand their understanding and instill in them critical problemsolving techniques that will be invaluable in their future endeavors,” explains Dr. Gumina. “The AHA has been a strong proponent of funding research projects for investigators at the early stages of their careers, including at the undergraduate and medical student level. The Ohio State University Heart and Vascular Center has been a huge beneficiary of these AHA initiatives,” he says. This past summer five young investigators conducted cardiovascular research as recipients of AHA-sponsored Student Undergraduate Research Fellowships, which fund meritorious summer undergraduate student research positions. One of those students, Zach Huttinger, an undergraduate who has been working in Dr. Gumina’s lab for three years, found that over-expressing a specific molecule on the blood vessel cell lining decreases the size of a heart attack and prolongs the time to thrombosis from 10 minutes to up to 400 minutes. The AHA also awarded Adam Reynolds, now a third-year medical student, a national student scholarship to fund his research, which studied how to prevent protein modifications in the heart in an attempt to improve heart function after a heart attack. All grant recipients had the opportunity to showcase their projects at the Second Annual Young Investigators’ Reception on April 14, 2010. A total of 27 young investigators from Ohio State’s Dorothy M. Davis Heart and Lung Research Institute and Nationwide Children’s Hospital Research Institute presented posters outlining their projects in cardiovascular medicine, showcasing how

T H E O H I O S TAT E U N I V E R S I T Y M E D I C A L C E N T E R

(from left) Richard Gumina, MD; Ali Pervez; William Aurand; Lauren Goodman; Michael Nickoli; Michael Milks; Jessica Hsieh; Debra Wheeler

collaboration is instrumental in launching the careers of young investigators. Collaborating with The Undergraduate Research Foundation, Dr. Gumina wants to “provide a portal to getting talented people into the lab so they have the opportunity to explore research as a career.” He hopes to raise awareness and support to fund up to 20 undergraduate researchers each summer. “If we don’t actively cultivate exceptional students who express an interest in academics and conducting research, then we’re missing the boat,” he says.

2 0 1 0 H E A R T A N D VA S C U L A R C E N T E R Y E A R I N R E V I E W

OS U’S VA SC ULA R SURGE RY F E L LOWS H I P— AN U NPA R A LLE D O P PORTU N I T Y “Precise.” “Simple.” “Organized.” Not terms one ordinarily associates with vascular surgery, but words chosen by Maria Litzendorf, MD, to describe what drew her to this specialty. “There’s a precision and simplicity to vascular surgery that is really appealing. It’s very focused, and you can see your results immediately.” It was those aspects that influenced her to seek a vascular surgery fellowship after graduating from Eastern Virginia Medical School in Norfolk and completing her general surgery internship and residency at Boston University Medical Center. And she was equally specific about her reason for selecting The Ohio State University’s Heart and Vascular Center fellowship program. “I wanted to have a well-rounded education and be part of a top-notch clinical program that had the resources available to train me,” she says. While she had explored other programs, Dr. Litzendorf chose Ohio State’s because “it offers a broad surgical and endovascular experience that I really think is unparalleled throughout the country. The volume, the variety and the surgical expertise of our faculty in both open and endovascular procedures is unrivalled compared to what I have seen and heard from other fellows across the country.”

(from left) C. Jason Rousseau, DO; Maria Litzendorf, MD; and Kavita Phatak, MD

Dr. Litzendorf notes that the interaction among different specialties and departments is a major advantage at The Ohio State University Medical Center. “The collaboration among different specialties plays a positive role, especially in vascular patients. Our patients tend to be more medically complex, and we rely on our colleagues to assist us to get the best outcome for them. The collegial atmosphere that exists here is a definite plus—both for our patients and for us.” Another aspect that influenced her decision was Ohio State’s Richard M. Ross Heart Hospital. “To have an entire hospital dedicated to cardiovascular care: the cardiologists, the cardiac anesthesiologists, the cardiothoracic surgeons, the vascular surgeons—all working together in one hospital setting, collaborating on a day-to-day basis— that, in and of itself, is unique and very rewarding!” Ohio State’s vascular surgery fellowship program provides her with the opportunity to explore the constantly changing environment of the field. “The technology, the new applications of endovascular technology, really seeing the field evolve,” she says, “that is very exciting!”

T H E O H I O S TAT E U N I V E R S I T Y M E D I C A L C E N T E R

OSU’S CAR D IOVA SC ULA R ME D I C I N E F E L LOWS H I P PROGRAM— “T H E O P P O RTU N I T Y OF A L I F E T I ME ” When Kavita Phatak, MD, was evaluating cardiovascular medicine fellowship programs, she sought not only those offering a reputation for strong clinical training and opportunities for research, but also those whose faculty demonstrated a great enthusiasm for teaching. In 2008, she found that and more at The Ohio State University Heart and Vascular Center. “I interviewed at top fellowship programs around the country and many were great programs. But when I first visited here at Ohio State, I could tell that this was the place to be. The Heart and Vascular Center cardiovascular medicine fellowship is a truly unique program and I was amazed at the excellence of the cardiovascular department in all the various subspecialties of cardiology,” says Dr. Phatak. “The cardiology department at Ohio State is at the leading edge in all the major divisions of cardiology, including heart failure, cardiac imaging, electrophysiology, women’s health “The cardiology department at Ohio State is and interventional cardiology, just to name a few. The fellow gets to be a part of this. New at the leading edge in all the major divisions and exciting research is taking place in all of of cardiology, including heart failure, cardiac these areas, and again, the fellow gets first-hand imaging, electrophysiology, women’s health and exposure to this. I also appreciate its deep sense interventional cardiology, just to name a few.” of tradition.” Kavita Phatak, MD Prior to coming to Ohio State’s Heart and Vascular Center, Dr. Phatak had earned her medical degree from Chicago’s Northwestern University Feinberg School of Medicine and completed her internship and residency in Internal Medicine also at Northwestern University. In the past several years, she has co-authored papers and participated in research studies focusing on various aspects of cardiovascular disease. “I have always been interested in cardiology,” she says. “I think it is tremendously exciting. We can help people, both in the acute settings of heart attacks, heart failure and heart rhythm disorders and in the prevention of heart disease. I think we, as cardiologists, are especially blessed with the opportunity to improve peoples’ lives.” While at Northwestern, Dr. Phatak’s mentors in the area of cardiology and internal medicine inspired and encouraged her to pursue a career in cardiology. This positive experience with mentors is continuing at Ohio State. “I have had a great experience working with my research mentor, Dr. Subha Raman, clinical director of Cardiac MRI and CT. Many places are excellent in cardiology, but what I was amazed by was how approachable the faculty and fellows were at Ohio State. I have been impressed by how the directors of the fellowship program have supported my interests and let me tailor my training to the direction in which I wanted to focus.”

2 0 1 0 H E A R T A N D VA S C U L A R C E N T E R Y E A R I N R E V I E W

(from left) Maria Litzendorf, MD; Kavita Phatak, MD; and C. Jason Rousseau, DO

Currently, her primary area of focus is in cardiac imaging, and she is working closely with Dr. Raman, specifically on how imaging relates to patients with Friedriech ataxia, a neurologic disorder. “Patients with Friedriech ataxia often die of cardiac disease, which is traditionally detected after severe heart damage has occurred. We wanted to know if these patients demonstrate early manifestations of cardiac disease prior to overt heart failure and we did find early abnormalities on cardiac MRI,” Dr. Phatak says. “Our hope is that this will lead to early treatment and possible prevention of heart disease in these patients. We presented this exciting research at the American Heart Association Scientific Sessions, and our paper was recently accepted to the European Heart Journal.” Through the fellowship program, Dr. Phatak also works closely with many departments. “Many of our fellows are graduates of Ohio State’s internal medicine residency, and we work daily with the excellent housestaff in the Department

of Internal Medicine. The strength of OSU’s residency is the foundation for top-notch inpatient cardiovascular care. In addition, we work closely with the subspecialties of internal medicine and the various divisions of surgery, obstetrics and gynecology and anesthesia, among others, in the management of patients with cardiovascular disease. This collaborative interaction is very beneficial to all of us; it exposes us to the treatment of the patient as a whole and leads to excellent patient care.” Her rewarding experience at The Ohio State University Heart and Vascular Center has led Dr. Phatak to finalize plans to stay on as a faculty member in the fields of non-invasive and preventive cardiology, cardiac rehabilitation, and women’s cardiovascular health, following completion of her fellowship. “Ohio State has not only met my expectations but exceeded them,” she says. “This fellowship program has been the opportunity of a lifetime for me.”

T H E O H I O S TAT E U N I V E R S I T Y M E D I C A L C E N T E R

CA RD IOTH O R AC IC M E D I C I N E — F ULFILLIN G A C H ILD H OOD D RE A M Career paths can be sparked by a variety of life events. For C. Jason Rousseau, DO, it was the death of his grandfather from a heart attack that started him on the road to cardiothoracic surgery. “As I learned more about his final days, it sparked a great interest in me for thoracic surgery,” he says. After receiving his Doctor of Osteopathic Medicine degree in 2004 from the Nova Southeastern University College of Osteopathic Medicine in Ft. Lauderdale, he completed his internship and residency at Spartanburg Regional Healthcare System in South Carolina, where he served as chief resident in General Surgery. Dr. Rousseau’s next goal was to complete a cardiothoracic surgery fellowship program and for that, he had very specific requirements. “I wanted a program that provided great education within a collegial atmosphere and with an excellent ancillary staff. It was important to me that it offered a diverse cardiothoracic surgery experience and a ‘hands-on’ approach to the surgical and medical management of the patient. I interviewed at several programs, but found that The Ohio State University provided “I wanted a program that provided great education a well-rounded education that would create a within a collegial atmosphere and with an excellent solid foundation for my future career.”

ancillary staff.” Not only does Ohio State’s Heart and Vascular C. Jason Rousseau, DO Center have a long-standing reputation for excellent education in cardiothoracic surgery, it also has “enthusiastic mentoring physicians,” says Dr. Rousseau, who adds that he also values the collaborative approach among departments. “I collaborate closely with multiple departments in an effort to provide the highest quality of care for each patient. The greatest benefit is that there is always open dialogue between departments to ensure quality care.” Following his successful completion of the fellowship program, Dr. Rousseau intends to return to South Carolina, joining a practice where he will perform both general thoracic and cardiac surgery. “Rewarding” is a key word when he talks about his chosen field. “In cardiothoracic surgery, the stakes are high, the standards are high, and the rewards are great. Every ‘stitch’ counts and every detail matters. It combines all aspects of care: medical, surgical and critical care,” he says. “The field of cardiothoracic surgery continues to evolve and diversify. We are incorporating minimally invasive techniques while technology continues to evolve to the benefit of both the surgeon and the patient.” But as exciting as he finds cardiothoracic surgery from a technical standpoint, it is the impact it has on the patients that Dr. Rousseau finds particularly satisfying. “Most of all, I enjoy seeing the improvement in the quality of life that patients have after a successful outcome,” he says, noting that “ It’s incredible to reflect on a childhood dream fulfilled.”

2 0 1 0 H E A R T A N D VA S C U L A R C E N T E R Y E A R I N R E V I E W

OHIO STAT E - H OST ED C ME COU R S E S FEATU RE P RO M IN EN T E X P E RTS The Ohio State University Center for Continuing Medical Education (CME) courses continue to attract medical professionals from throughout the Midwest by hosting prominent guest speakers from across the country as well as featuring Ohio State University Medical Center’s own heart and vascular experts. Ohio State’s Heart and Vascular Center hosted the Second Annual Contemporary Multi-Disciplinary Cardiovascular Medicine course in Orlando. Course attendance doubled, with 230 physicians, nurses and allied health professionals participating in the disease-based learning experience. Guest faculty included Eric Bates, MD from the University of Michigan Health System; Blasé Carabello, MD, from the Baylor College of Medicine and Methodist Debakey VA Medical Center; and Paul Thompson, MD, from Hartford Hospital. A 2011 course is scheduled for October 7-9 and will feature a similar agenda focused on cardiovascular medicine.

2010 Course Highlights Nearly 900 medical professionals attended these programs in 2010: Cardiology Grand Rounds featuring Jeffrey Teuteberg, MD; Charanjit Rihal, MD; Seth Worley, MD; Bradley Knight, MD; Philip Adamson, MD Klassen Research Day Managing Cardiac Implantable Lead Systems and Complications in 2010 Mid Ohio Endovascular Club National Medical Association, Update on AMI Ninth Annual Heart Failure at the ‘Shoe Second Annual Acute Myocardial Infarction Update: Big 10 Topics in STEMI Management Second Annual Cardiovascular Disease in African Americans Second Annual Women’s Cardiovascular Conference Third Annual Vascular Non-invasive Testing Symposium Vigoda Visiting Professor, featuring Jeffrey Popma, MD Warren Lecture and Internal Medicine Grand Rounds, featuring Emile Daoud MD, Eduardo Marban, MD, PhD and Jeffrey Popma, MD

Regional Programs Heart Rhythm Society – Lead Management 2010, Denver, CO Saturday Morning EP Reports in Atlanta, GA; Chicago, IL; Hoboken, NJ; and Los Angeles, CA Second Annual Contemporary Multi-Disciplinary Cardiovascular Medicine, Orlando, FL

T H E O H I O S TAT E U N I V E R S I T Y M E D I C A L C E N T E R

2 011 HEART A N D VA SC U L A R CM E COUR SE LIST IN G We invite you to discover firsthand the leading-edge technology, exemplary patient care and handson training programs at The Ohio State University Heart and Vascular Center. When you attend one of our programs, you are welcome to tour Ohio State’s Richard M. Ross Heart Hospital and Dorothy M. Davis Heart and Lung Research Institute. Find the cardiovascular medicine or surgery course that best fits your practice at The Ohio State University Medical Center. Learn from Ohio State faculty members and leading physicians from top heart and vascular centers from all over the world. April 21

3rd Annual Cardiovascular Disease in African Americans* featuring Clyde Yancy, MD, Chief of Cardiology, Northwestern University Feinberg School of Medicine

May 20-21

Cardiovascular CT/MR: 2011 Update*

September 23-24

3rd Annual Myocardial Infarction Update*

October 7-9

3rd Annual Contemporary Multidisciplinary Cardiovascular Medicine Course, Orlando, Florida*

October 8 Vascular Imaging Course* November 18 10th Annual Heart Failure at the ‘Shoe* All courses will take place on Ohio State’s Medical Center campus in Columbus, Ohio, unless otherwise noted. *Applications for category 1 CME credits pending Learn more about these programs by emailing Ellen Yokoyama at Ellen.Yokoyama@osumc.edu or call 614-247-7448. Ohio State’s Center for Continuing Medical Education offers live and online courses throughout the year. Visit ccme.osu.edu to browse our course catalog.

2 0 1 0 H E A R T A N D VA S C U L A R C E N T E R Y E A R I N R E V I E W

COMMUNITY FEATURE: THE HEALTH PARTNERSHIP

B RINGIN G O H IO STAT E â&#x20AC;&#x2122;S CA RE TO T H E R EG I ON Community Partnerships The Ohio State University Heart and Vascular Center has committed to serving not only the people of central Ohio, but also patients in outlying rural areas, who also need access to the best cardiac and vascular care available, through regional clinics that allow Ohio State physicians to treat patients close to home, with the support of their families and referring physicians.

Collaboration Means Better Outcomes for Marysville Heart Patients The Heart Partnership is a unique collaboration between The Ohio State University Medical Center (OSUMC) and Memorial Hospital of Union County that offers expanded cardiac care to the Marysville, Ohio community. Ohio State heart specialists provide cardiac assessments, treatment and follow-up care at the Ohio State Heart Center Marysville office, giving area residents the opportunity to receive quality care close to home. Because the partnership fully utilizes the resources of both facilities, expert cardiac care goes beyond outpatient services. For Memorial Hospital heart attack patients, vital cardiac catheterization treatment at OSUMC is standard. Following protocols established by the Ohio State cardiology team for diagnosing and treating heart attacks, local and county EMS personnel, Memorial Hospital Emergency Department teams and OSU medical teams collaborate to ensure patients are transferred and receive treatment within 90 minutes, in accordance with the guideline established by the American College of Cardiology and American Heart Association. According to Deb Cramer, RN, director of the Emergency Department at Memorial Hospital, the protocols and processes available through their partnership with Ohio State mean a stronger

T H E O H I O S TAT E U N I V E R S I T Y M E D I C A L C E N T E R

cardiovascular program at Memorial, and most importantly, better outcomes for their patients. “Our results are at an average time of 86.1 minutes to treatment,” she says. “Most patients treated within the 90-minute guideline show no heart muscle damage.” The Memorial Hospital Emergency Department and Ohio State’s regional STEMI program collaborate with local and county EMS personnel to identify STEMI patients in the field and transfer them more than 30 miles to receive treatment within 90 minutes. In 2010, Mike Davis, MD, joined the practice and was named the medical director of the Heart Partnership. Dr. Davis joins Douglas Magorien, MD, who leads the Marysville practice. He is an Ohio State University College of Medicine graduate and recently completed fellowship training there in general and interventional cardiology. Dr. Davis provides general cardiology care, as well as vascular and interventional cardiology care. With experience in respiratory care and hospitalist services, he also is skilled in assisting with critical care management.

Cambridge Heart Center

Bellefontaine Heart Center

Lancaster Heart Center

The Cambridge office provides cardiology care and management for patients in southeastern Ohio. Cardiologists Stephanie Moore, MD, and Anwar Din, MD, collaborate with nurse practitioner Linda Swallie, NP, to provide care.

In 2010, Ohio State’s Bellefontaine Heart Center continued its strong partnership with the local community. Partnering with local hospital and acute care facilities, the office performed several public screening sessions. The practice added a nurse practitioner, June Hinkle, NP, who joins Rodney Graber, MD and William Houser, MD. The Center also renewed ICAEL, ICANL and ICAVL accreditations for the year.

Ohio State’s Heart Center at Lancaster provides cardiology care and management for patients in our community as well as a link to The Ohio State University Medical Center. Paul Ruff, MD provides care and support in this community setting.

2 0 1 0 H E A R T A N D VA S C U L A R C E N T E R Y E A R I N R E V I E W

FRIENDS O F O H IO STATE ’S H E A RT A N D VASCULA R C E N T ER The Ohio State University Heart and Vascular Center relies on the generous philanthropic support of individuals, foundations and corporations to provide cutting-edge cardiovascular care to its patients. “Each donated dollar directly benefits research, patient care and education,” says Julie Dials, director of Development at Ohio State’s Heart and Vascular Center. “These donations help us meet our goal of saving lives and advancing cardiovascular science.” Through the generous support of friends and supporters, Ohio State’s Heart and Vascular Center strives to provide advanced technologies for each patient’s unique cardiac needs.

The annual Vigoda Family Lecture Series (from left) Thomas Ryan, MD,; Philip Vigoda, MD; William Abraham, MD; Jeffrey Popma, MD (2010 Vigoda Lecturer)

2010 Support Shows Continued Commitment to Advancing Cardiovascular Science Over the past year, generous supporters continued to show their commitment to advancing cardiovascular research, education and care.

•

The Heart and Vascular Center raised $2.3 million in private funds in 20092010, supporting a wide range of priorities including patient care, research, fellowship and educational initiatives.

•

With a $1 million gift, The William H., William C. and Dorothy M. Davis Family Foundation completed its $10 million commitment to name The Ohio State University Dorothy M Davis Heart and Lung Research Institute (DHLRI). When it was created, Ohio State’s Davis Heart and Lung Research Institute was one of the first freestanding institutes in the nation devoted solely to studying diseases of the heart, lung and blood vessels. The generosity of Bill and Jackie Wells, along with members of the William H., William C., and Dorothy M. Davis Family Foundation, has been instrumental in the DHLRI’s 10year research achievements on heart and lung diseases.

•

A $400,000 gift by Chuck and Barbara Webb and family created the Charles and Barbara Webb Family Endowment. This endowed fund will support The Ohio State University Heart and Vascular Center for research, resident awards and medical student scholarships.

(from left) William Abraham, MD; Sally Soter; Steven Gabbe, MD

T H E O H I O S TAT E U N I V E R S I T Y M E D I C A L C E N T E R

The Ohio State Heart and Vascular Center’s Generous Foundation, Individual and Corporate Supporters The OSU Heart and Vascular Center’s mission of advancing cardiovascular science is made possible by significant donations from the following foundations, individuals and corporate supporters: William H. Davis, Dorothy M. Davis and William C. Davis Foundation Ann and Ari Deshe Mary H. and J. Churchill Hodges Elizabeth M. “Libby” Ross and the Ross Family Schooler Family Foundation Jay and Jeanie Schottenstein Sally and Bill Soter Dr. Philip and Louise Vigoda Chuck and Barbara Webb William & Jacquelyn Wells Abbott Laboratories Boston Scientific Huntington Bank Medtronic Corporation Nationwide Foundation Respironics Society for Cardiovascular Angiography and Intervention St. Jude Medical Foundation Thoratec

Chairs and Professorships One of the key priorities of Ohio State’s Heart and Vascular Center is to recruit and retain leading research and clinical faculty. The Heart and Vascular Center houses nine privately funded endowed chairs and professorships. These prestigious positions provide an opportunity to attract and retain the world’s leading cardiovascular science and medical professionals and researchers, thanks to the support of our generous donors. The Heart and Vascular Center chairs and professorships include: Chair of Excellence in Cardiovascular Medicine Karl P. Klassen Chair of Thoracic Surgery John G. and Jeanne Bonnet McCoy Chair in the Heart Center James W. Overstreet Chair in Cardiology Joseph M. Ryan, MD, Chair in Cardiovascular Medicine Sarah Ross Soter Endowed Chair for Women’s Cardiovascular Health William D. and Jacquelyn L. Wells Chair in Imaging Research James Hay and Ruth Jansson Wilson Professorship in Cardiology John W. Wolfe Professorship in Cardiovascular Research Fund 49

2 0 1 0 H E A R T A N D VA S C U L A R C E N T E R Y E A R I N R E V I E W

donate today Visit: giveto.osu.edu to support the Heart Center Annual Fund, which supports the priorities of the Heart and Vascular Center. (Fund Number: 312269) For more information on how to become a friend of Ohio Stateâ&#x20AC;&#x2122;s Heart and Vascular Center, visit us at medicalcenter.osu.edu/heart/ways_to_give or please contact us more information on how to become a friend of Ohio Stateâ&#x20AC;&#x2122;s Heart and The Ohio State University Heart and Vascular Center Development Davis Heart and Lung Research Institute, 110V 473 W 12th Avenue Columbus, OH 43210 Julie Dials Director of Development 614-292-5065 Julie.dials@osumc.edu Kelly Stevelt Assistant Director of Development 614-688-4138 Kelly.stevelt@osumc.edu

T H E O H I O S TAT E U N I V E R S I T Y M E D I C A L C E N T E R

O NE GREAT UN IVER SIT Y The Ohio State University is poised at an unmatched moment of potential. All of its colleges and schools, programs and people, are today unified in a single goal: Rising from Excellence to Eminence. To become eminent, Ohio State must work and be perceived as ONE University, rather than a collection of independent departments. Driving this change in our culture are six strategic goals developed by Ohio State President E. Gordon Gee and reflected in the University strategic plan: • ONE University • Students First • Faculty and Staff Talent and Culture • Research Prominence • Outreach and Collaboration • Operational and Financial Soundness and Simplicity

O N E GREAT M E D ICA L C E N T E R As one of the most comprehensive health sciences campuses in the country, with nearly 7 million square feet of research, education and patient care facilities operated by more than 16,000 dedicated faculty, staff and students, The Ohio State University Medical Center plays a pivotal role in helping the University achieve eminence. This shared objective is visible in the mission and vision of the Medical Center, and the core values we share as part of the University.

Our Mission To improve people’s lives through innovation in research, education and patient care.

Our Vision Working as a team, we will shape the future of medicine by creating, disseminating and applying new knowledge, and by personalizing health care to meet the needs of each individual.

Our Values • • • • •

Excellence Collaborating as ONE University Acting with Integrity and Personal Accountability Openness and Trust Diversity in People and Ideas

• • • •

Change and Innovation Simplicity in Our Work Empathy and Compassion Leadership

Our Promise Creating the future of medicine to improve people’s lives through personalized health care.

The Ohio State University Medical Center Ross Heart Hospital 452 W. 10th Ave Columubus, OH 43210 medicalcenter.osu.edu/heart

ÂŠ 2011 The Ohio State University Medical Center ROSS20100088