The Ohio State University Heart and Vascular Center
Advances in Patient Care, Research and Education |
2009
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The Ohio State University Heart and Vascular Center
Advances in Patient Care, Research and Education |
2009
|
3......................................................... Welcome from Thomas Ryan, MD 4......... Ohio State’s Heart and Vascular Center Program Highlights 8.............................................................. Richard M. Ross Heart Hospital 10..................... Dorothy M. Davis Heart and Lung Research Institute 12...................................... Advances in Research in Vascular Medicine 14................................................... Cardiovascular Magnetic Resonance 16.............................................................................................. VAD Therapy 18.......................................................................................... STEMI Program 20................................. Cardiovascular Regenerative Therapy Program 22............................................................. Robotic Cardiovascular Surgery 24................................................................................................ Heart Failure 26................................................................................. Sleep Heart Program 30........................ The Chair of Excellence in Cardiovascular Medicine 32.................................................................................... Nursing Excellence 34.............................. Heart and Vascular Center Fellowship Programs 38............................................................... Continuing Medical Education 39....................................................................................... Heart Partnership 40........................... Friends of Ohio State’s Heart and Vascular Center 42.................................................................................. Contact Information
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Dear Colleagues and Friends,
Thomas Ryan, MD
The year 2009 has been outstanding for The Ohio State University Heart and Vascular Center. Our dedication to advancing the field of cardiovascular medicine and surgery has helped us achieve national recognition while implementing successful life-saving regional programs and forging local partnerships. Our commitment to excellence in patient care begins with our focus on personalized health care. From our universal bed model to subspecialization of hospital floors, our highly specialized care is designed to improve outcomes and enhance patient satisfaction. We’re gratified to be recognized as one of America’s best cardiac care hospitals. In addition, our faculty’s commitment to groundbreaking research has resulted in a significant number of advancements in the cardiovascular field this year. From promising clinical trials to breakthrough technology, we are discovering effective new treatments for heart and vascular patients. We’re pleased to share with you in this Accomplishments Report the exciting progress we’ve made this year toward improved treatment and outcomes for cardiovascular disease. We invite you to discover firsthand the leading-edge technology, exemplary patient care and hands-on training programs at our Heart and Vascular Center. Thank you for your interest, and please feel free to visit our clinical and research areas at any time.
Sincerely,
Thomas Ryan, MD Director, Ohio State’s Heart and Vascular Center John G. and Jeanne Bonnet McCoy Chair in Cardiovascular Medicine
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Ohio State’s Medical Center Rated One of America’s Best Heart and Heart Surgery Hospitals in U.S.News & World Report Annual Ranking One of 21 Hospitals Named to Elite Honor Roll Ohio State’s Richard M. Ross Heart Hospital was recognized a leader in heart care in the 2009 U.S.News & World Report, ranking 37 out of 4,861 hospitals around the country. The annual “America’s Best Hospitals” issue is used as an indicator of quality care and performance at hospitals throughout the United States. U.S.News & World Report uses measurements such as mortality index, patient safety index, patient volume, staff levels, reputation and technology to determine the best hospitals in the nation. The Ohio State University Medical Center was also among only 21 hospitals in the country named to the U.S.News & World Report’s elite Honor Roll, demonstrating a hospital’s high scores in at least six specialties.
In addition to the Ross Heart Hospital’s ranking, Ohio State’s Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute was named 18th in the nation for cancer treatment. Other OSU Medical Center specialties included in U.S.News & World Report list are: w w w w w w w w
Ear, nose & throat Diabetes and endocrinology Gynecology Kidney disease Orthopaedics Respiratory disorders Rehabilitation Urology
Ohio State’s repeated presence in U.S.News & World Report’s annual survey is a direct reflection of faculty, staff and University teamwork.
“Our success is guided by many, many people who each day make the Medical Center a special place for our patients.” Dr. Thomas Ryan, Director, Ohio State’s Heart and Vascular Center
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Back row: from left, Charles Bush, MD; Terry Elton, PhD; Jay Kasey; Larry Anstine; Linda Paxton, RN; William Abraham, MD; Front row: from left, Patrick Vaccaro, MD; Lorri Sayre-Fowler; Benjamin Sun, MD; Thomas Ryan, MD.
OSU National Distinction – Dramatic Growth The Ohio State University Heart and Vascular Center: A Driving Force in Advancing Cardiovascular Medicine and Surgery The Ohio State University Medical Center Heart and Vascular Center comprises three academic divisions – Cardiovascular Medicine, Cardiothoracic Surgery and Vascular Surgery – with two dedicated facilities, the Dorothy M. Davis Heart and Lung Research Institute and the Richard M. Ross Heart Hospital. Our facilities are located on The Ohio State University Medical Center campus, which occupies the southwest quadrant of The Ohio State University’s main Columbus campus. This permits the Heart Center to draw upon the resources of this 1,200-bed, 4.5-millionsquare-foot medical campus, as well as the largest student campus in the country.
nuclear and echo-based exercise stress tests to MRI exercise stress tests utilizing a new MRIcompatible treadmill. • The volume and complexity of robotically assisted mitral valve repair and coronary revascularization procedures has grown dramatically in the past year, resulting in significant decreases in length of stay and fewer overall complications. • The Sleep Heart Program is developing pioneering diagnosis and treatment algorithms of sleep disordered breathing in patients with heart failure and arrhythmias.
Overview of 2009 Heart and Vascular Accomplishments
• The Heart Failure Program is participating in a new National Institutes of Health-sponsored protocol studying noninvasive hemodynamic techniques to detect volume overload in heart failure patients.
At Ohio State’s Heart and Vascular Center, we foster excellence in research and patient care, which has led to international recruitment, collaboration between specialists and cutting-edge research.
• The Division of Vascular Disease and Surgery is working on stem cell therapy for advanced chronic limb ischemia.
Our nationally recognized faculty and their groundbreaking research efforts in cardiovascular clinical care have brought Ohio State’s Heart and Vascular Center into the national spotlight as a center of excellence.
• As part of a Clinical and Translational Science Award from the NIH, the Regenerative Therapy Program was granted $5 million to conduct three pivotal trials studying stem cell therapy in the treatment of cardiovascular and peripheral vascular disease.
Highlights of our innovative programs and research efforts include: • The Regional STEMI Program has achieved an average door-to-balloon time of 28 minutes when activated by local EMS, bringing the overall average down to 55 minutes. We’ve saved more lives because of our ability to beat the current national standard by an average of 35 minutes. • The Cardiovascular Magnetic Resonance Program is conducting clinical trials comparing standard
Investing in Faculty, Facilities and Technology to Enhance Patient Care The Heart and Vascular Center represents one of the six Signature Programs identified for selective investment and growth by The Ohio State University Medical Center. Along with Cancer, Critical Care, Imaging, Neurosciences and Transplantation, the Heart and Vascular Center leverages this support to
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recruit and retain nationally recognized physicians, scientists and other healthcare experts.
Pioneering Personalized Health Care for Improved Outcomes
Facilities have also been a focus with the construction and continued expansion of the Ross Heart Hospital and the $1 billion ProjectONE expansion that includes a critical care and cancer patient tower.
Research, education and patient care all benefit from the Medical Center focus on personalized health care. The Ohio State University Medical Center is earning an international distinction through its leadership in this emerging application of knowledge and technology.
The Dorothy M. Davis Heart and Lung Research Institute is joined by the continued build-out of the 10-story, 400,000-square-foot Biomedical Research Tower in support of the research mission of the Medical Center. Adding to the functionality of the facilities is the ongoing investment in state-of-the-art technology to leverage the skills of the faculty and staff in improving people’s lives.
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By assessing a patient’s personal genetic makeup and lifestyle, personalized health care will continue to offer patients more opportunities for individualized approaches to disease prevention and treatment.
Ohio State’s Heart and Vascular Center has experienced dramatic growth, necessitating continued expansion of personnel and facilities.
Ohio State’s Heart And Vascular Center growth
2005-06
2006-07
2007-08
2008-09
Total Faculty
60
69
81
85
Active Clinical Trials
79
106
131
144
Cardiac Surgeries
718
722
774
802
Catheterizations
4,475
4,695
4,642
5,329
PTCAs/Stents
1,744
1,953
1,814
2,043
EP Studies
1,966
3,648
4,732
4,794
Vascular Surgeries
1,685
1,751
1,732
1,781
10,055
11,268
10,077
10,591
Inpatient Admissions (Total Heart)
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Richard M. Ross Heart Hospital Combines State-of-the-Art Facilities With Personalized Patient Care The Richard M. Ross Heart Hospital, located within The Ohio State University Medical Center, is one of the few dedicated academic heart hospitals in the United States. The 290,000-square-foot facility with 150 beds provides state-of-the-art-care for patients with cardiovascular disease, including heart and peripheral vascular disorders. The Ross Heart Hospital is recognized as a leader in heart care, ranking 37 out of 4,861 hospitals in U.S.News & World Report’s annual “America’s Best Hospitals” survey. Ohio State’s Medical Center has also been named one of the top U.S. hospitals for inpatient cardiovascular care by Thomson Reuters.
Ohio State’s Heart Program Continues Growth Trend The Richard M. Ross Heart Hospital continued its upward growth trend in 2009 with increases in patient admissions, outpatient visits and surgical procedures. Significant growth continues to occur in the electrophysiology program where the number of procedures increased from 1,966 to 4,794, or 141 percent, between 2006 and 2009. Ohio State’s Ross Heart Hospital now has one of the nation’s highest-volume ablation programs with equally high patient outcomes. Despite a national downturn in catheterizations and angioplasties, the Ross Heart Hospital’s interventional cardiology program experienced a 20-percent increase in procedures between 2006 and 2009. Our heart surgery program has become a national leader for implantation of ventricular assist devices (VADs), as evidenced by a 179-percent increase in the same three-year period. This growth is attributable to transfers of extremely ill heart failure patients who benefit from our team approach to care, which includes a coordinated approach among the surgeon, electrophysiologist and heart failure specialist to achieve the best possible patient outcomes.
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The Patient Care Difference The Ross Heart Hospital employs an innovative approach to cardiovascular care that utilizes a patient-centered universal bed concept. We are proud that this concept has served as a design and operational model for more than 200 institutions throughout the United States and beyond. Our universal bed concept accommodates all specialized cardiovascular equipment and allows most patients to remain in a single, private room throughout their hospitalization. This provides greater convenience, comfort and safety for patients and their families, and allows us to flex the Hospital’s mix of critical care and step-down rooms to meet current patient care demands. The universal bed model is a holistic approach to patient care that not only focuses on clinical outcomes, but addresses psychosocial and family needs to enhance a patient’s health. Additional benefits include reduction of medical error and reduced operating expenses due to the elimination of frequent patient transfers. Another success factor in the operation of the Ross Heart Hospital is the subspecialization of the hospital floors. Each floor of Ohio State’s Ross Heart Hospital is dedicated to a specific service, ensuring highly specialized, personalized care. Specific services include:
w An acute coronary floor supporting the cardiac catheterization labs
medicine and vascular surgery, and the open vascular surgeries
w The electrophysiology floor supporting EP procedures
w The medical cardiology floor primarily serving the heart failure population
w The cardiac surgery floor adjacent to the cardiac ORs
In addition to taking full advantage of adjacencies, this model supports consolidation of like patients for ease of physician coverage and the development of specialized skill sets by the staff, which enhances both performance and satisfaction.
w The vascular floor supporting both the catheter-based procedures by cardiovascular
Ross heart hospital patient satisfaction
91st Percentile Nationally
95th Percentile Nationally
82nd Percentile Nationally
FY2007
n HCAHPS Overall Satisfaction*
FY2008
FY2009
*Percentage of patients rating the hospital a 9 or 10 on 0 to 10 scale. 9
Dorothy M. Davis Heart and Lung Research Institute The Ohio State University Dorothy M. Davis Heart and Lung Research Institute (DHLRI) is one of the nation’s few free-standing facilities devoted entirely to the research of diseases affecting the heart, lungs and blood vessels. Ohio State’s Davis Heart and Lung Research Institute is a premier, nationally and internationally recognized center of excellence for medical research, whose findings have broad-based applications to other diseases and conditions. More than 500 faculty, researchers and support staff are working each day here to develop innovative strategies to prevent and cure heart and lung diseases.
A Research First for The Ohio State University Medical Center The National Institutes of Health funded a T32 Training Grant titled, “Training in Congenital and Acquired Heart Disease,“ a joint effort between the Davis Heart and Lung Research Institute and The Research Institute at Nationwide Children’s Hospital. This is the first cardiovascular training grant awarded between the two institutions. The total amount of the award is $1.3 million over five years.
“The DHLRI uses a translational approach to science which combines genetics, biochemistry, cell biology, patients and clinical trials,” says Terry Elton, PhD, interim director of the DHLRI. “Our scientists and physicians work closely together to provide personalized health care that utilizes gene-based information to understand each person’s requirements for maintaining health, preventing disease and tailoring therapies.”
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Investing in Ongoing Research Programs The DHLRI has four major thematic programs. The programs were established in 2005 by the Director’s Executive Cabinet and are periodically reviewed. The programs received an initial $10 million investment over the past four years to further basic and clinical research developments in their respective areas. The investment was distributed equally among the programs with each receiving $2.5 million. w Ischemia and Metabolism Director, Jay Zweier, MD w Inflammation, Fibrosis and Immune Function Director, Clay Marsh, MD w Regenerative Medicine Director, Chandan Sen, PhD w Myocyte Biology & Disease Director, Muthu Periasamy, PhD The Institute is financially supported by various University and non-University sources. The majority of University support is generated by the Dorothy M. Davis Endowment, which supports the general operational functions of the institute.
DHLRI Grants & Contracts funding
$35,000,000 $30,000,000 $25,000,000 $20,000,000 $15,000,000 $10,000,000 $5,000,000 $0
2006
2007
n Indirect Costs
2008
2009
n Direct Costs
2009 Accomplishments w Publications from DHLRI thematic programs totaled more than 200. w DHLRI was awarded an estimated $30 million in external funding. w DHLRI was awarded two major NIH American Reinvestment and Recovery Act awards totaling $2.3 million. w DHLRI was a joint partner with Nationwide Children’s Research Institute on the funding of a $1.3 million cardiology training grant. This is the first collaborative training grant between the two institutions. w DHLRI made significant investments in the creation of a stroke laboratory and a myocardial repair and stem cell program. w The DHLRI-based Antioxidants & Redox Signaling journal rose to become the #1 nationally ranked journal in the field of free radical and redox biology. 11
Advances in Research Innovative Care The Division of Vascular Diseases and Surgery The Division of Vascular Diseases and Surgery is one of eight specialty divisions within the Department of Surgery at The Ohio State University Medical Center. The Division continues to strengthen its reputation as a leading vascular surgery program in the region.
Conducting Groundbreaking Studies at Ohio State The Division of Vascular Diseases and Surgery is heavily invested in clinical and basic science research. Highlights of our clinical research projects include: • The Abbott Vascular HERCULES (Herculink Elite Cobalt Chromium Renal Stent Trial to Demonstrate Efficacy and Safety) study, a trial of the RX Herculink Renal Stent System • The Boston Scientific ORION study, a trial of the EPIC Nitinol Stent System in the treatment of atherosclerotic lesions in iliac arteries • Ongoing follow-up for patients enrolled in the Cleveland Clinic Foundation/Medtronic PIVOTAL Study, the Cook Zenith Study and the Boston Scientific SONOMA Study On the basic science front, the Division of Vascular Diseases and Surgery welcomed Cameron Rink, PhD, assistant professor of Surgery, to the team. Dr. Rink’s research is designed to identify the specific and unique role of oxygen in vascular disorders, including stroke. By employing novel preclinical models of ischemic injury and the latest techniques in noninvasive oxymetry, Dr. Rink is working to identify and characterize oxygensensitive gene networks in vascular disease.
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“Understanding the biochemical and biological significance of oxygen in vascular disease such as stroke is critical to developing the next generation of therapeutic strategies for the clinic,” says Dr. Rink. Bringing Innovative Treatments to Vascular Patients This past year has brought continued success to the Division of Vascular Diseases and Surgery. Our clinical volumes remain high and our achievements in clinical care include: • Ongoing participation in post-marketing carotid stent trials • Use of all available thoracic aortic stent grafts to treat aortic pathologies ranging from aneurysmal disease, to trauma, to aortic dissection • Expertise in the open surgical treatment of aortic pathologies • Expertise in the open and endovascular treatment of renal and visceral vascular disease • Offering of outpatient clinic varicose-vein treatment instead of hospital-based treatment
Patient care services include: w a comprehensive general vascular surgery clinic treating arterial diseases, venous diseases including iliocaval pathology and pelvic congestion syndrome, lymphatic diseases and thoracic outlet syndrome w a full complement of endovascular services including the most progressive aortic, visceral, peripheral and venous interventions currently available w a venous diseases clinic offering office-based endovenous laser treatments and radiofrequency ablation for varicose veins and venous insufficiency We are proud of our continued high patient satisfaction scores with an overall 91.2 percent satisfaction rating as of April 2009.
Our Division is committed to: w delivering the highest quality of care to patients suffering from peripheral vascular disease w contributing to innovations in medicine through research and clinical outcomes studies w educating medical students and postgraduate trainees
OSU Fellowship Trains the Next Generation of Vascular Surgeons The Division of Vascular Diseases and Surgery remains deeply engaged in the education and training of our residents and medical students. “Our two-year accredited vascular and endovascular fellowship is the crown jewel of our Division and the oldest vascular fellowship program in the country,” says Michael Go, MD, assistant professor of Surgery. “We offer a comprehensive training program in routine and complex vascular surgical reconstructions using both open and endovascular reconstructions.”
clinical trials. Fellows are selected from a highly competitive pool of candidates who have completed the requirements for certification in general surgery by the American Board of Surgery. The first year of the fellowship emphasizes diagnostic angiography, endovascular therapeutic techniques and clinical research projects. In the second year, fellows acquire extensive experience in open procedures and advanced endovascular procedures. The fellowship also offers extensive experience in noninvasive laboratory techniques and participation in the noninvasive vascular lab.
The program attracts top-of-the-class surgeons interested in specialized training, research and 13
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innovation in
Cardiovascular Magnetic Resonance Exercise stress testing has been an essential tool in the detection of heart disease for both diagnostic and prognostic applications. After maximal exercise, cardiac images at peak stress are typically acquired using nuclear scintigraphy or echocardiography. Although cardiac magnetic resonance (CMR) offers several advantages, the lack of MRI-compatible exercise and monitoring equipment has prevented the realization of treadmill exercise CMR. This problem has been successfully addressed at The Ohio State University Medical Center, which has become the only facility in the world where treadmill exercise stress tests are performed inside the MRI scanner room.
OSU Medical Center Revolutionizes MRI Stress Testing
MRI-Compatible Treadmill Improves Test Accuracy
Demonstrating Ohio State University interdisciplinary collaboration at its best, researchers from Cardiovascular Medicine and the Department of Engineering modified a treadmill for use near an MRI device. Nonmagnetic stainless steel and aluminum equivalents were installed, allowing the treadmill to be positioned in the MRI room.
An ongoing clinical trial, comparing exercise stress CMR to conventional stress imaging, is headed by Subha Raman, MD, medical director for Cardiac MR/CT at Ohio State, and associate professor in the departments of Internal Medicine and Biomedical Informatics. The trial compares standard nuclear- and echo-based exercise stress tests to MRI exercise stress utilizing the new MRI-compatible treadmill.
Because the first prototype did not completely solve the problem of time lag between end of stress and start of imaging, it led to the ongoing development of a totally MRI-compatible treadmill with a hydraulic motor that can be placed next to the scanner table. “In the past, we were constrained by the time lapse between the completion of exercise and capturing the images,” said Orlando Simonetti, PhD, associate director of Cardiac Imaging Research at the Dorothy M. Davis Heart and Lung Research Institute. “We now have the ability to exercise patients to peak stress and obtain a high-definition image of their heart within 60 seconds, which helps us more accurately identify exercise-induced abnormalities.”
In March 2009, Dr. Raman presented the initial clinical trial results at the American College of Cardiology annual meeting. Results of the study have shown: w Exercise stress CMR (wall motion + perfusion) inside the MRI room is feasible in patients with suspected ischemic heart disease. w Initial results suggest favorable accuracy and prognostic value of this new stress imaging system compared to SPECT imaging. w Further technical modification to complete imaging within 60 seconds of peak stress is ongoing. “With resources to complete a multicenter trial based on these promising results,” Dr. Raman says, “we hope to improve diagnostic accuracy and outcomes for patients with known or suspected heart disease.” 15
VAD Therapy
Advancing Treatments for Heart Failure Heart failure affects 5.7 million people in the United States and is responsible for more hospitalizations than all cancers combined. Rehospitalization rates six months postdischarge approach 50 percent. Ohio State’s Richard M. Ross Heart Hospital is deeply committed to research efforts to treat this complex health problem.
High Volume Center Leads to Improved Results Demonstrating its commitment to advancing the field of heart failure, The Ohio State University was one of the largest enrollers in a trial studying the efficacy and safety of a continuous flow left ventricular assist device (VAD) in the treatment of patients with advanced heart failure who were ineligible for transplantation. Results, which were published in the Nov. 17, 2009, issue of The New England Journal of Medicine, revealed two-year survival rates of 58 percent, almost doubling the survival of the best alternative currently available. Though these statistics are promising, the true importance of the study is the continued dedication to seeking alternative approaches to cardiac function replacement. The breakthrough results from the study found a promising alternative treatment for these patients using a continuous-flow ventricular assist device (VAD), which received FDA approval in January 2010. These results immediately translate into improved care.
Heart Failure Program’s Unmatched Multidisciplinary Patient Care Team No technology yields results on its own, however. “The success of the HeartMate study, as well as the success of the Ross Heart Hospital heart failure program, is largely due to the patient care teams involved’, says Benjamin Sun, MD, associate professor of Surgery. 16
“We’ve seen a 179-percent increase in the growth of VAD procedures for Ohio State’s VAD program over the past three years,” says Dr. Sun. “The volume increase continues. We have a seamless partnership between the heart failure cardiologists and the surgical team. While many programs are either medically or surgically driven, a deep program such as ours at Ohio State sustains itself through an ongoing partnership.”
A Leader in Mechanical Device Placement Further evidence of the mechanical support program’s multidisciplinary approach and commitment to the aggressive treatment of heart and lung failure is the program’s very successful use of extracorporeal membrane oxygenation in the treatment of H1N1 patients with severe respiratory failure as well as other patients in acute cardiogenic/respiratory shock. As heart failure becomes more pervasive and new therapies become more effective, it will be important to continue to increase awareness and education targeting the public and professionals alike. The Ross Heart Hospital consistently achieves the best outcomes for its heart failure patients. That, coupled with a full spectrum of options for heart failure patients, makes the Ross Heart Hospital a national leader in the treatment of this condition.
Pati e n t sto ry: The Heart of It All ‑ Patient finds second chance through Ohio State’s participation in clinical trial
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n May of 2006, heart failure patient Linda Helmes and her family received devastating news from her doctors: it was time to call in hospice. Almost four years later, Linda is playing Wii and throwing around a football with her grandson, thanks to cutting-edge technology available at The Ohio State University Medical Center. Linda’s battle with breast cancer began in 2003, when she underwent a mastectomy and chemotherapy to aggressively treat the disease. When the cancer recurred in 2005, radiation and chemotherapy successfully eliminated the cancer—but it also caused Linda to go into heart failure. Linda’s medications failed to improve her condition, and her cancer history prevented her from being eligible for a heart transplant. The doctors told Linda’s family that nothing more could be done. “At the time, I didn’t realize the severity of my heart failure,” says Linda. “But there was never a time that I believed I was going home to die. My family was there for me and we didn’t give up.” Linda’s determination encouraged her doctors to look into experimental treatment options. They discovered that The Ohio State University Heart and Vascular Center was participating in a clinical trial for the
HeartMate II® Left Ventricular Assist System (LVAS). The HeartMate II LVAS offers a long-term treatment option to advanced heart failure patients like Linda who do not qualify for heart transplants. Ohio State’s team of cardiovascular surgeons implanted Linda’s HeartMate II in June 2006. With only one moving part, the device is designed to take over the pumping ability of the weakened heart’s left ventricle. Linda also wears an external system that includes a battery-operated controller. “I’ve had my HeartMate II for almost four years, and it’s great,” says Linda. “I do everything I want to do—I can even bowl and walk my dog.” Ohio State’s Heart and Vascular Center is one of the select cardiac centers in the nation to offer this state-of-the-art therapy to patients like Linda. The HeartMate II received FDA approval as a long-term treatment option for advanced-stage heart failure in early 2010. While Linda will be cancer-free for five years this December and possibly eligible for a heart transplant, she has no plans to part with her HeartMate II. “Why mess with something that is working great for me?” asks Linda. “I wouldn’t be here today if it weren’t for this machine. This thing is amazing.” 17
EMS/FIELD STEMI ALERT ACTIVATIONS
30 25
REFERRAL HOSPITAL STEMI ALERT ACTIVIATIONS
26
20 15
300
10
250
5 0
0 2007
200
5 2008
281
150 2009
100 50 0
101 8 2007
2008
2009
Patient sto ry:
K
arl Knisley, 71, was washing his truck in his Ashley, Ohio, driveway when he realized the back pain and nausea he was experiencing was a heart attack. He immediately stopped what he was doing and called 911. “The ambulance folks did an EKG on me and when they saw the strip they called MedFlight. The ambulance met the helicopter at a local park, and the MedFlight team immediately knew that I needed to go to Ohio State’s hospital.” Through coordination of services with crews like the Ashley EMS and the MedFlight team, Karl was quickly transferred to Ohio State’s Ross Heart Hospital where STEMI team members were ready in the cath lab to quickly open his blocked artery. “After our helicopter landed on the hospital’s roof, they took me straight to the cath lab. Within minutes they had the catheter in me and had cleared out the blockage, which was almost 100 percent,” Karl explained. Today, Karl is back to washing his truck and encourages everyone to call 911 as soon they have any symptoms. 18
Regional Stemi Program offers
Unique Approach to Heart Attack Patients In 2006, Ohio State’s Heart and Vascular Center committed to reducing mortality and improving outcomes for patients suffering from ST-segment elevation myocardial infarction (STEMI). In response to this regional quality improvement initiative, Ohio State’s Richard M. Ross Heart Hospital formalized a plan of care to improve rapid access to treatment for this difficult patient group.
The Ohio State Difference Unique to the STEMI Program is a progressive protocol and integrated team approach. Because Ohio’s regional EMS agencies possess the skill and technology needed to perform ECGs on their patients, they are able to identify STEMI patients from the field. Through a donation to Ohio State’s Ross Heart Hospital, the hospital provided EMS agencies with the technology to transmit ECGs directly from the field to the Emergency Department. By transmitting this information and calling a STEMI alert, EMS personnel are able to activate the interventional cardiology team. This key innovation saves valuable time by giving EMS personnel the authority to bypass triage through the emergency room and to transport patients directly to the cardiac catheterization lab. The result is an overall average door-to-balloon time of 55 minutes, well below the American College of Cardiology and American Heart Association guidelines of 90 minutes or less. The STEMI Program’s impact on heart patients in the area has been tremendous, with STEMI alert volume increasing by 600 percent in the two-year period between 2007 and 2009.
The Secret to STEMI Program Success Ernest Mazzaferri, Jr., MD, director of Ohio State’s Heart and Vascular Center STEMI Program, says the success of the program is
primarily due to a positive team approach. “No egos get in the way of patient care,” Dr. Mazzaferri explains. “The cath lab attending and techs just make themselves available.” In addition, the STEMI program has the only dedicated STEMI nurse coordinator in the region, demonstrating its outstanding commitment to patient care and positive outcomes.
Next Steps for STEMI As part of a vigorous education and awareness effort, the team has provided two-hour STEMI and 12-lead ECG training to more than 600 EMS providers, nurses and physicians in Ohio. The team is working closely with other hospitals, EMS agencies and the American Heart Association to evaluate the possibility of developing a statewide STEMI system. Goals for 2010 include a robust community awareness campaign focusing on public service announcements and heart-attack education, taking full advantage of marketing resources and social media for maximum impact and reach. With the continued success of innovations such as the STEMI Program, Ohio State’s Heart and Vascular Center has become a driving force in the advancement of discovery, innovation and knowledge transfer throughout the state and beyond.
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Cardiovascular regenerative therapy program
Advances from Bench to Bedside The Ohio State University’s Cardiovascular Regenerative Therapy Program is at the forefront of science and clinical application. Utilizing a bench-to-bedside approach to patient care, the Cardiovascular Regenerative Therapy Program translates groundbreaking laboratory research into clinical application, with the goal of improving outcomes for seriously ill heart patients. “The strength of our program is its capacity for science and research as supported by a high-enough volume to do the research,” says Vincent Pompili, MD, director of Cardiovascular Cell-Based Therapies. In the past two years, the Ross Heart Hospital has experienced a double-digit increase in volume, largely attributable to the success of the Ross Heart Hospital STEMI program. Due to these achievements, continued research efforts are currently under way.
Engineering Technologies for Positive Outcomes As part of a Clinical and Translational Science Award from the National Institutes of Health, The Ohio State University has recently granted the program $5 million for the initiation of three pivotal trials. The trials will study the use of stem cells in the treatment of cardiovascular and peripheral vascular disease. Along with a handful of centers across the country, the program is enrolling patients in a phase II randomized trial evaluating the safety and efficacy of adult stem cell therapy in patients who have suffered acute heart attack.
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Although still a few years away from conventional clinical application, stem cell therapy appears to be a promising venture, and one in which Ohio State continues to invest. In support of this vast research endeavor, the catheterization lab continues to expand under Dr. Pompili’s leadership. As OSU’s Cardiovascular Regenerative Therapy Program continues to grow, it will also continue to engineer technologies to further positive outcomes for heart patients.
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Patien t sto ry:
B
ob Stelzer, 73, had robotic heart surgery at Ohio State. His cardiologist discovered a probable blockage during his annual stress test, and a heart catheter later confirmed the blockage and showed that it was too large to be resolved by a stent. He needed bypass surgery. Because Bob had suffered a stroke several years earlier while having surgery on a carotid artery, his cardiologist recommended the less-invasive and lower-risk route of robotic heart surgery, either at Ohio State or at a hospital in New York. After a quick online search, Bob felt Ohio State was the best place for his surgery. After a consultation with cardiothoracic surgeon Juan Crestanello, MD, Bob was sure he made the right choice. “Dr. Crestanello had already reviewed my medical records and he carefully explained the surgery in detail until I was comfortable with what was going to happen,� Bob said. Less than three months after his surgery, Bob was back to working out three times a week.
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Changing the Landscape of
Cardiovascular Surgery Ten years ago, the surgeons at Ohio State’s Medical Center performed the first robotic heart procedure in the country. To further advance the field, the Richard M. Ross Heart Hospital hosted the FDA clinical trials for mitral valve repair and coronary bypass surgery, with a significant volume of patients enrolled in the trials. Robotic-assisted mitral valve repair, coronary artery bypass and total endoscopic coronary bypass are now performed at the Ross Heart Hospital.
Robotics Program Experiences Significant Growth in 2009 In the past year, the Cardiovascular Robotics Program has experienced considerable growth. Juan Crestanello, MD, assistant professor of Surgery for the Division of Cardiothoracic Surgery, states, “The volume and complexity of robotic-assisted mitral valve repair and coronary revascularization procedures have grown dramatically in the past year, resulting in a significant decrease in length of stay and fewer overall complications.” The system’s ability to eliminate the need for cardiopulmonary bypass circuit and avoidance of median sternotomy results in faster recovery time and fewer intraoperative and postoperative complications. According to Dr. Crestanello, some 60 totally endoscopic coronary revascularization procedures were performed in 2009 with good results. Some patients are able to return to work in as little as 10 days postsurgery.
Well-Tuned Surgical Team
The Ross Heart Hospital is one of just 21 centers in the country with a comprehensive training program for robotic-assisted surgery. The curriculum covers introductions for administration and medical systems professionals as well as hands-on training for the surgical team. In addition, the allied health profession training program is the first of its kind in the world, providing real-time instruction and didactic sessions for operating room staff, nurses and anesthesiology staff.
Continued Advances in Robotic Surgery Research efforts continue to further advance robotics in the treatment of cardiovascular disease, including a hybrid approach to coronary revascularization undertaken by Dr. Crestanello and his colleagues. This protocol combines robotic coronary artery bypass with percutaneous coronary intervention with stents in the treatment of multivessel coronary artery disease, allowing complete revascularization of complex lesions in selected patients.
Building a successful robotics program requires seamless cooperation from each member of the team as well as administrative support. The Ross Heart Hospital surgical team is a sophisticated group of experienced surgeons and operating room and nursing staff whose successful approach to each robotically assisted procedure is the result of a carefully coordinated effort. 23
Making strides toward Early detection of
Heart Failure With millions of Americans hospitalized each year due to heart failure, clinicians and researchers at The Ohio State University believe identifying patients at an early stage of decompensation could considerably reduce hospitalizations and costs associated with heart failure morbidity and mortality. As congestive symptoms are responsible for more than 90 percent of heart failure hospitalizations, The Ohio State University has been involved in a number of clinical trials studying the efficacy of various devices and techniques for detecting pulmonary congestion.
Wireless Heart-Failure Monitoring System As part of the CHAMPION trial, Ohio State’s Medical Center is testing the safety and efficacy of an implanted wireless pressure-sensor that may allow for more rapid identification and treatment of these patients. Implanted in the pulmonary artery via catheterization, the device allows data on pulmonary artery pressures to be transmitted to a continuously monitored secure Web site. Physicians can access the data at any time on a handheld computer. The next step for Ohio State’s Heart Failure Program is to lead a national multicenter trial designed to test the ability to use information collected from a noninvasive transcutaneous monitoring device to help direct medical management of heart failure. Because this device is noninvasive, risks associated with its placement are not significant. Garrie Haas, MD, professor of Medicine, section director for Heart Failure and Cardiac Transplantation and medical director of the Clinical and Translational Research Organization in the Division of Cardiovascular Medicine, believes exploring the concept of using more sensitive
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methods to monitor fluid status means “we’re moving in the right direction and using sensitive techniques to detect volume overload.”
Multidisciplinary Collaboration Is the Essence of Heart Failure Program The Cardiovascular Program at The Ohio State University has made significant advances in clinical care due to its involvement with research. Housed under one roof, the research and clinical teams collaborate closely on more than 100 clinical trials. At any given time, the Heart Failure Program at The Ohio State University is participating in 20 to 25 clinical trials. Ohio State continues to make strides in multidisciplinary collaboration. Dr. Haas, medical director of the Cardiovascular Clinical and Translational Research Organization, believes there’s been continued improvement in collaboration and knowledge within the group in 2009. “Bringing together groups from both sides of the bench has definitely moved the program forward and has set the stage for continued collaboration,” he says.
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The ohio state university Medical Center sleep Heart Program
Delivering Advanced Diagnostic and Treatment Modalities Recognizing the role of sleep apnea in inducing and worsening cardiovascular disease, The Ohio State University Medical Center Sleep Heart Program was initially established to deliver universal and expedited screening and treatment for all patients with heart failure. Since its inception in 2005, the Program expanded its clinical activity to include all patients with cardiovascular disease at The Ohio State University Medical Center Richard M. Ross Heart Hospital. Currently, Ohio State’s Ross Heart Hospital is the only hospital in the nation to provide near-universal screening with sleep studies to all patients hospitalized with heart failure. The mission of the Sleep Heart Program is to deliver and test new concept and treatment modalities of sleep disordered breathing in patients with cardiovascular disease.
Nationally Recognized Algorithms Improve Sleep Disordered Breathing Treatments Several pioneering diagnosis and treatment algorithms of sleep disordered breathing in patients with heart failure and arrhythmia were developed by the clinicians and investigators of this program in collaboration with leading industry partners. These algorithms have become nationally recognized, and clinicians from around the country have undergone preceptorships in the Sleep Heart Program in order to reproduce its activities in their respective states.
Bringing Progressive Diagnostic and Treatment Modalities to Sleep Heart Patients From 2006 to 2009, the Sleep Heart Program served more than 1,000 patients hospitalized with decompensated heart failure. Additionally, all patients with heart failure who are cared for in Ohio State’s Richard M. Ross Heart Hospital Ambulatory Care areas receive universal
screening with questionnaires or home sleep testing. Partnership with leading home health companies and international companies have brought our patients the best and most advanced diagnostic and treatment modalities in the field. The clinicians and investigators of the Sleep Heart Program have participated in the development and testing of two of the most advanced treatment devices for central sleep apnea. One treatment device is equipped with advanced sensing capability and delivers a variable type of pressure for different types of apnea. The second device is an implantable stimulating device that functions like a pacemaker for patients with central sleep apnea. The Sleep Heart Program is a multidisciplinary program that involves The Ohio State University Medical Center’s Division of Cardiovascular Medicine, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine and the Richard M. Ross Heart Hospital. The program is co-led by William Abraham, MD, and Rami Khayat, MD. 27
Preceptorship Event Highlights New Approaches to Sleep Disorders The Sleep Heart Preceptorship is an educational event with a didactic and a practical component offering training on implementation of innovative diagnostic and treatment systems for sleep disorders in patients with obstructive sleep apnea. These systems were developed exclusively by the Sleep Heart Program in partnerships with leading industry organizations. Sleep Heart Preceptorship attendees are exposed to the Sleep Heart Program and our approach to the interaction between sleep disorders and heart diseases. Specific screening and treatment programs are explained and participants are provided with technical and administrative training. The event targets cardiologists, sleep physicians, administrators and industry personnel. The Sleep Heart Program has hosted seven ongoing programs since June 2008 with attendees from states that include Indiana, Texas, Missouri, Virginia and Nevada.
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Sleep Heart Program research projects in 2009 included: w Mechanism of endothelial dysfunction in obstructive sleep apnea (OSA) funded by The Ohio State University Center for Clinical and Translational Science: This project evaluates the impact of having OSA on early, preclinical vascular changes that precede the onset of hypertension. The project addresses the causative relation between OSA and hypertension. This is a collaborative effort between the Sleep Heart Program and The Ohio State University Medical Center Comprehensive Wound Center. w The role of obstructive sleep apnea in the acutely decompensated heart failure funded by the National Institutes of Health: This is the largest trial of early identification and treatment of obstructive sleep apnea in patients hospitalized with decompensated heart failure. The study is also the largest trial evaluating the impact of positive airway pressure on cardiac function. In 2009, the study is in its second year and close to enrollment target. w Phrenic nerve stimulation for the treatment of periodic breathing funded by Cardiac Concepts, Inc: This study evaluates a pioneering implantable device and algorithm in the treatment of periodic breathing. Ralph Augostini, MD, leads the development team for the implantation procedure. Investigators at Ohio State’s Sleep Heart Program have further enhanced this algorithm. The Ohio State University is the largest site for this study in the United States. w Evaluation of the utility of cardiac monitors for in-hospital screening for sleep disordered breathing funded by General Electric: This project evaluates a unique sleep diagnostic system that is built on the platform of the typical hospital cardiac monitor.
Industry Leaders Support Ohio State Sleep Heart Research Projects The research arm of the Sleep Heart Program has two full-time research coordinators and three part-time research assistants. Our research is fully funded by external sources that include the National Institutes of Health and industry leaders in the area of cardiac disease and sleep disorders.
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The Chair of Excellence in Cardiovascular Medicine William Abraham, MD, appointed inaugural chair holder The Chair of Excellence in Cardiovascular Medicine became fully endowed in 2009, thanks to the generous support of key benefactors.
the director of the Division of Cardiovascular Medicine at The Ohio State University College of Medicine.
Dimon and Darlene McFerson, Elizabeth “Libby” Ross, Sarah “Sally” Ross Soter and John McCoy and his late wife, Jeanne Bonnet McCoy, made the Chair of Excellence in Cardiovascular Medicine possible through their vision and commitment to the success of the Cardiovascular Medicine program. The chair position fosters innovation and excellence in the cardiovascular field, helping to provide cutting-edge cardiac care to members of the community.
Under Dr. Abraham’s guidance, the Division of Cardiovascular Medicine has entered an era of clinical and academic growth, with the development of new programs and services.
William Abraham, MD, FACP, FACC, was appointed the inaugural chair holder Sept. 18, 2009, by the Board of Trustees of The Ohio State University. Dr. Abraham was selected for this honor as a result of his leadership as
From left: Thomas Ryan, MD; Dimon McFerson; Darlene McFerson; D’Arcy Ralph; William Abraham, MD; Sally Soter; Steven G. Gabbe, MD
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The Division of Cardiovascular Medicine now has one of the largest electrophysiology programs in the nation, as well as excellent cardiovascular training programs. In addition, Dr. Abraham’s leadership has helped to develop innovative approaches that incorporate the latest technology to cardiac echo, CT and MRI.
William Abraham, MD, FACP, FACC Director, Division of Cardiovascular Medicine Deputy Director, Dorothy M. Davis Heart & Lung Research Institute Chair of Excellence in Cardiovascular Medicine Professor, Internal Medicine, Physiology and Cell Biology
William Abraham, MD, FACP, FACC, is professor of Internal Medicine and director of the Division of Cardiovascular Medicine at The Ohio State University College of Medicine. He also serves as deputy director of the Dorothy M. Davis Heart and Lung Research Institute and is the designated Chair of Excellence in Cardiovascular Medicine. Dr. Abraham earned his medical degree from Harvard Medical School in Boston, after which he completed his residency in Internal Medicine and fellowships in Cardiology and Heart Failure/Cardiac Transplantation at the University of Colorado Health Sciences Center. Dr. Abraham previously held faculty appointments at the University of Colorado, the University of Cincinnati and the University of Kentucky. He is board certified in Internal Medicine and in Cardiovascular Diseases. Dr. Abraham’s research interests include the role of the kidney in heart failure, neurohormonal mechanisms in heart failure, sleep disordered breathing in heart failure
and clinical drug and device trials in heart failure and cardiac transplantation. Dr. Abraham has received grants from the National Institutes of Health, the American College of Cardiology and the Aetna Quality Care Foundation, and has participated as principal investigator in more than 100 multicenter clinical drug and device trials. In addition to authoring more than 600 original papers, abstracts, book chapters and review articles, Dr. Abraham has co-edited a leading textbook on heart failure titled Heart Failure: A Practical Approach to Treatment. Dr. Abraham serves on the editorial boards of several major journals including Congestive Heart Failure and Journal Watch Cardiology. He is also a scientific reviewer for such publications as Circulation, the European Heart Journal and the Journal of the American College of Cardiology. Dr. Abraham has been recognized one of the “Best Doctors in America” for seven consecutive years.
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Nursing Excellence Ohio State Nursing Program Receives Magnet® Redesignation
University Hospital Ross Heart Hospital
Four years ago, The Ohio State University Medical Center’s University Hospital and Richard M. Ross Heart Hospital became the first hospitals in central Ohio to be Magnet® certified. In June 2009, both hospitals were redesignated as Magnet® facilities, an honor that only 2 percent of hospitals nationwide have achieved. The American Nurses Credentialing Center uses the Magnet® Recognition Program to distinguish healthcare organizations that provide nursing excellence. “The entire Ohio State Health System shares a culture that drives us to keep doing things better and better, that encourages us to never be satisfied with the status quo,” says Linda Chase, RN, MA, NEA-BC, chief nursing officer of University Hospital and Ross Heart Hospital. “In a nutshell, that’s what Magnet is: having a nursing staff – from nurse leaders to the bedside nurses – that strives for excellence and works as a team to go above and beyond what patients expect.”
“The quality of our nurse managers, the high skill level of our direct patient care providers and our nursing mid-level providers such as nurse practioners and clinical nurse specialists helped us reach the Magnet standard of excellence,” says Linda Paxton, BSN, director of Cardiovascular Services at the Ross Heart Hospital. “We are very proud of this accomplishment.” 32
A key component to Magnet® redesignation is certification. Ross Heart Hospital nurses have a 39-percent certification rate in areas such as cardiac and vascular surgery, progressive care, medical surgical, critical care and electrophysiology. This certification validates that Ross Heart Hospital nurses provide unparalleled care to a patient’s specific cardiac needs. “When patients are making healthcare decisions, they should expect to see a much higher level of care from the nursing staff in a Magnet hospital,” says Paxton. “These nurses meet the highest level of expectations, which is a core part of our mission at the Ross Heart Hospital.” Hospitals must re-apply every four years to be designated a Magnet® facility. In 2009, 15 of the top 21 medical centers in the United States were Magnet-recognized organizations.
In 2009, 4 Ross staff earned recognition for their achievements in excellence in patient care, practice and outcomes in treating adult cardiac patients.
Ohio State’s Ross Heart Hospital Honored with Beacon Award for Critical Care Excellence
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he American Association of Critical Care Nurses awarded the Richard M. Ross Heart Hospital’s cardiothoracic unit with the Beacon Award for Critical Care Excellence in June 2009. The Beacon Award recognizes the Ross Heart Hospital for achieving excellence in patient care, practice and outcomes in adult cardiac patients on 4 Ross, the hospital’s open heart-recovery unit. All open-heart, LVADs and heart transplant patients are on 4 Ross. “One distinguishing feature of Ross Heart Hospital and 4 Ross is our dedication to interdisciplinary meetings with a patient’s entire medical team,” says Traci Mignery, RN, 4 Ross nurse manager. “Everyone involved in the patient’s care—from doctors to nurses to respiratory therapists and family members—helps plan out the patient’s care to ensure that everyone is on the same page.”
The Ross Heart Hospital also operates on the acuity-adaptable bed model. Patients are admitted into their rooms at the beginning of their visit, and they stay in that room the entire hospital visit. The patient’s level of nursing care is continually adjusted based on their needs. These factors, as well as criteria like recruitment, retention, leadership and evidence-based practice, all contributed to Ross Heart Hospital and 4 Ross’s achievement of the prestigious Beacon Award. “Patients who are critically ill with extensive heart disease or who need open-heart surgery will get the highest quality of nursing care in a Beacon Award-recognized facility,” says Mignery. “This award is based on the outcomes of the direct patient care that the nurses provide on 4 Ross.”
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Ohio State’s Heart and Vascular Center Fellowship Programs A Commitment to education and training Ohio State’s Heart and Vascular Center offers seven fellowships to train physicians in the field of cardiovascular medicine. These fellowships are designed to provide in-depth training to help young physicians develop both clinical and research skills. Our fellowship programs are recognized for their exceptional hands-on clinical training, exciting research opportunities and unique collaboration with staff and mentors. Ohio State’s Heart and Vascular Center offers the following fellowship programs:
Cardiovascular Fellowship Program The Cardiovascular Fellowship Program is accredited by the Accreditation Council for Graduate Medical Education, offering in-depth clinical training to achieve board eligibility within the subspecialty of cardiovascular medicine as well as a broad program in basic and clinical research, which provides many opportunities for a career in academic cardiology.
Cardiovascular Interventional Fellowship The fully accredited, fourth-year Cardiovascular Interventional Fellowship offers advanced training in interventional cardiology to individuals who have completed three years of standard cardiology training and who are currently eligible for board certification in cardiovascular diseases.
Integrated Clinical and Research Cardiovascular Imaging Fellowship We offer a one-to-two year Integrated Clinical and Research Cardiovascular Imaging Fellowship program that is designed to train the emerging generation of multimodality and multidisciplinary cardiovascular imagers. This is in addition to a training fellowship program in cardiovascular magnetic resonance and computed tomography.
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Fellowship Programs | 2009 – 2010
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n Cardiovascular n Electrophysiology 15
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n Adult and Congenital Programs n Cardiovascular Interventional
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n Clinical and Research Cardiovascular Imaging n Heart Failure
Heart Failure Fellowship The one-to-two year Heart Failure Fellowship offers training in the management of patients with congestive heart failure and pre- and postcardiac transplant patients, as well as device therapy for heart failure.
Electrophysiology Fellowship The two-year Electrophysiology Fellowship offers training in the management of patients with complex arrhythmias and corresponding device placement and management.
Adult Congenital Heart Disease Fellowship The five-year Adult Congenital Heart Disease Fellowship offers training in the management of children and adults with congenital heart disease as well as pulmonary hypertension.
Adult and Congenital Cardiothoracic Surgery Fellowship A two-year Adult and Congenital Cardiothoracic Surgery Fellowship program, accredited by the American Board of Thoracic Surgery, provides extensive exposure to all facets of adult and congenital cardiothoracic surgery. Two positions are available to residents who have completed training and are board eligible in general surgery. A third-year, non-accredited fellowship is offered in the areas of cardiac transplantation and mechanical support devices.
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Graduated Responsibility of Care Essential for Cardiothoracic Surgery Fellowship Program Patrick McConnell, MD, a recent graduate of the Cardiothoracic Surgery Fellowship program, credits The Ohio State University Heart and Vascular Center with providing him excellent training in surgical and nonoperative patient management. “The collegiality of Ohio State makes it a great place to train,” says Dr. McConnell. “It’s a teaching institution with involved and enthusiastic faculty, making it an ideal place for fellows to learn and for patients to receive complex care.” Dr. McConnell believes that Ohio State’s Heart and Vascular Center provides three key requirements for an excellent fellowship program: plenty of patients, clinical mentorship and graduated responsibility. The final point
was a key factor in Dr. McConnell’s decision to come to Ohio State. “The fellows in the Ohio State program have a graduated responsibility of patient care, both for operative and nonoperative care,” says Dr. McConnell. “By the time you have completed the fellowship program, you’ve received excellent hands-on training in surgical therapy for lung, vascular and heart disease, helping you care for patients independently.”
My interest is to further artificial heart technologies in the pediatric population, an interest that was nurtured during my training at Ohio State. –Patrick McConnell, MD
Since completing the fellowship program in fall 2009, Dr. McConnell has joined Nationwide Children’s Hospital in Congenital Heart Surgery. “The complex heart disease exposure that I received at Ohio State lends itself to the neonates and pediatric patients I see at Nationwide,” says Dr. McConnell. “My interest is to further artificial heart technologies in the pediatric population, an interest that was nurtured during my training at Ohio State.” Dr. McConnell’s experience at Ohio State will carry throughout his professional career. “The fellowship training at Ohio State provided excellent opportunities,” says Dr. McConnell. “This is a place that will take you to the next level.“
Patrick McConnell, MD 36
Fellows Carve Out a Niche Thanks to Cardiovascular Fellowship Program John Phillips, MD, had some very specific goals in mind for a cardiovascular fellowship program. He was looking for an uncommon opportunity: a program that would, at the very least, teach him how to become an excellent clinician, but one that would also provide him with an extensive array of academic challenges. After considering a number of opportunities, Dr. Phillips found one that met his objectives: the Cardiovascular Fellowship program at Ohio State’s Heart and Vascular Center. Commitment to Clinical Training and Research Richly steeped in faculty experience, commitment to training and volume of patients, the Cardiovascular Fellowship program reflects growth possibilities and access to one of the leading research facilities in the area of cardiovascular disease. “I searched for a program that would unveil the entire spectrum of cardiovascular disease, both in the clinical setting and in the research realm,” says Dr. Phillips. “Ohio State is unique in that perspective.”
The program provides you with good clinical exposure. – John Phillips, MD
The level of collaboration and cooperation between fellows and faculty at The Ohio State University is unmatched. In addition to the diversity of offerings in the cardiovascular specialty, fellows have the opportunity to participate in ongoing clinical trials, broadening their clinical training through exposure to complex disorders. “The program provides you with good clinical exposure,” says Dr. Phillips.
John Phillips, MD
Working closely with the interventional faculty, Dr. Phillips is involved in a pilot study evaluating the safety and efficacy of stem cell therapy in the treatment of cardiovascular disease. “Clinical training combined with research interests allows fellows to get involved with a lot of projects and mentors,” Dr. Phillips explains. “It encourages a strong camaraderie with faculty members.” In addition to working closely with faculty within the Division of Cardiovascular Medicine, Dr. Phillips has also collaborated with the Department of Biomedical Informatics in conducting a research project to assess how outpatients manage their prescription medications. “This team looks at how health information is stored and transmitted and the management of patient prescriptions in an effort to reduce medical errors.” Dr. Phillips believes it’s this exposure to a diversity of specialties that allows a fellow to “carve out a niche.” 37
Contemporary Multidisciplinary Cardiovascular Medicine Symposium First of Its Kind for Ohio State Ohio State hosted its first national continuing medical education conference, Contemporary Multidisciplinary Cardiovascular Medicine, in Orlando Oct. 16-18, 2009. For two-and-a-half days, cardiologists, cardiologists-in-training, physicians and allied health professionals joined together for an intense learning opportunity focusing on both clinical application and the latest advances in the field of cardiovascular medicine. Consisting of didactic lectures, debates and case presentations, healthcare professionals from diverse disciplines collectively refined their expertise in the areas of heart failure, coronary artery disease, electrophysiology, vascular disease and cardiovascular surgery.
Nationally Recognized Speakers Boost Attendance Program director Mani Vannan, MBBS, attributes the success of the 2009 program to its nationally recognized speakers and high quality content, although program participation might be the best indicator of success. “I was pleasantly surprised,” says Vannan. “At a time when meeting attendance is down 30 to 40 percent elsewhere, attendance thrived at the multidisciplinary meeting.”
Regional CourseS
Continue to Grow Highlights from our upcoming 2010 programs include:
Ohio State’s Center for Continuing Medical Education continued to provide strong programs in central Ohio in 2009. Close to 800 medical professionals attended programs in 2009, including: • • • • • • • • • 38
Mid Ohio Endovascular Club OSU Sleep Heart Program Cardiovascular Care in African-Americans Cardiology Grand Rounds featuring Elizabeth Ofili, MD Women’s Heart Health: The Evolution of Biology to Disease Warren Lecture/Internal Medicine Grand Rounds, featuring Robert Simari, MD Electrophysiology Exam Review Vigoda Visiting Professor, featuring Robert Califf, MD Acute Myocardial Infarction 2009
September 17: 2nd Annual Acute Myocardial Infarction Conference 2010: Raising the Bar on Therapies and Outcomes, Columbus, OH October 15-17: Contemporary Multidisciplinary Cardiovascular Care, Orlando, FL November 12: 9th Annual Heart Failure Update, Columbus, OH For a complete listing of courses scheduled for 2010 or to register for one of these programs, visit www.ccme.osu.edu.
• National Medical Association: Acute Myocardial Infarction • 8th Annual Heart Failure Update • Imagine 2009 • Klassen Research Day
The Heart Partnership Expands Cardiac Care in Marysville In August 2009, The Ohio State University Medical Center and Memorial Hospital of Union County announced The Heart Partnership, a unique relationship that offers expanded cardiac care to the Marysville, Ohio, community. Under The Heart Partnership, Ohio State cardiac specialists Douglas Magorien, MD, and Sharon Roble, MD, provide cardiac assessments, treatment and follow-up care in a Marysville office. Their cardiac expertise helps to diagnose and treat thousands of patients in the area, enabling them to receive excellent cardiac care close to home.
catheterizations. Now the Memorial Hospital and Ohio State cardiac medical teams work together to make the treatment process seamless for patients and families. “We have had a longstanding relationship with Memorial Hospital, as well as the physicians and patients of Union County,” says Thomas Ryan, MD, director of Ohio State’s Heart and Vascular Center. “We have been impressed with the level of care and expertise Memorial Hospital provides to the local community.”
A Continuum of Cardiac Care
Top-Notch Cardiology Services
Three members from Memorial Hospital and OSU Medical Center’s senior leadership teams oversee The Heart Partnership. This advisory board manages the full spectrum of cardiovascular services offered through The Heart Partnership, from diagnostics to cardiac treatments and rehabilitation programs. The goal is to provide a full continuum of cardiac care to patients in the Marysville community.
Partnering with Ohio State’s Medical Center is the perfect way for the 107-bed independent hospital to offer expanded cardiology care to the area. In the past, many Memorial Hospital cardiac patients had sought treatment at Ohio State for pacemakers, open heart surgery and interventional
Memorial Hospital currently offers diagnostic services through the Cardiopulmonary Department, including stress tests, EKGs, echocardiograms, vascular ultrasounds, tilt studies and TEE. Future plans for The Heart Partnership also include a catheterization laboratory in Marysville.
“Our objective with The Heart Partnership is to continue strengthening Memorial Hospital’s cardiovascular program,” says Tom Blincoe, associate executive director for Outreach at Ohio State’s Medical Center. “We want to keep as many patients as possible in their home community.”
Patient story: Memorial Hospital and Ohio State Medical Center Saved My Life
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ongevity runs in Barb Bushong’s family. Her 102-year-old mother is living proof. So when Barb’s physician caught three blockages during a routine stress test, she knew it wasn’t her time to go. Thanks to the joint efforts of Memorial Hospital of Union County and Ohio State’s Medical Center, Barb will have many more birthdays of her own. “I received excellent care,” says Barb. “Everyone was very good at explaining things to me, like why I need to do specific exercises during recovery, and each staff person was very helpful.” Barb and her husband Bob took comfort in the partnership between Barb’s local physician, the expertise of Ohio State’s Medical Center and the skilled staff at Memorial Hospital. Barb was able to smoothly transition from her physician’s care to Ohio State’s Medical Center, where she received a heart catheterization and three stents, and back to Memorial Hospital for cardiovascular rehab. This comprehensive care plan allowed her to get back to everyday living and her family. 39
Friends of Ohio State’s Heart and Vascular Center 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 Ohio State Heart and Vascular Center’s Generous Donors Ohio State’s Heart and Vascular Center’s mission of advancing cardiovascular science is made possible by significant donations from the following individuals: • William H. Davis, Dorothy M. Davis and William C. Davis Foundation for the Dorothy M. Davis Heart and Lung Research Institute • Ann and Ari Deshe, Huntington Bank and Nationwide Foundation for the Richard M. Ross Heart Hospital
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 medical professionals and researchers, thanks to the support of our generous donors. The Heart and Vascular Center chairs and professorships include:
• Elizabeth M. “Libby” Ross and the Ross Family for the Richard M. Ross Heart Hospital
• Chair of Excellence in Cardiovascular Medicine
• Schooler Family Foundation to create fellowships to train cardiologists in Adult Congenital Heart Disease
• John G. and Jeanne Bonnet McCoy Chair in the Heart Center
• Jay and Jeanie Schottenstein for the Jay and Jeanie Schottenstein Prize in Cardiovascular Sciences
• Joseph M. Ryan, MD, Chair in Cardiovascular Medicine
• Dr. Philip and Louise Vigoda for the Vigoda Family Lecture Series
• Karl P. Klassen Chair of Thoracic Surgery
• James W. Overstreet Chair in Cardiology
• Sarah Ross Soter Endowed Chair for Women’s Cardiovascular Health • William D. and Jacqueline L. Wells Chair in Imaging Research • James Hay and Ruth Jansson Wilson Professorship in Cardiology • John W. Wolfe Professorship in Cardiovascular Research Fund
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Jay and Jeanie Schottenstein Prize in Cardiovascular Sciences Award Ceremony From Left: President E. Gordon Gee, EdD, JD; Pascal Goldschmidt, MD (inaugural award winner); Jeanie Schottenstein; Jay Schottenstein; Steven G. Gabbe, MD
The annual Vigoda Family Lecture Series From Left: Philip Vigoda, MD; Robert Califf, MD (2009 Vigoda Lecturer); Thomas Ryan, MD
The Ohio State Heart and Vascular Center Corporate and Foundation Supporters The following organizations generously provide fellowship support within the Heart and Vascular Center: • Abbott Laboratories • Boston Scientific • Medtronic Corporation • Respironics • Society for Cardiovascular Angiography and Intervention • St. Jude Medical Foundation • Thoratec
Donate Today For more information on how to become a friend of Ohio State’s Heart and Vascular Center, please contact: Julie Dials Director of Development The Ohio State University Heart and Vascular Center Davis Heart and Lung Research Institute, 110 V 473 W. 12th Ave. Columbus, OH 43210 614-292-5065 Julie.Dials@osumc.edu 41
Contact Us Physician-to-Physician Consultation Line 800-293-5123, option 1
Appointments 888-293-ROSS (7677) 614-293-ROSS (7677)
Ohio State’s Center for Continuing Medical Education 614-293-8061 | ccme.osu.edu
Ohio State’s Heart and Vascular Center Faculty Members Thomas Ryan, MD Director, Ohio State’s Heart and Vascular Center John G. and Jeanne Bonnet McCoy Chair in Cardiovascular Medicine Division of Cardiothoracic Surgery Benjamin Sun, MD Director, Division of Cardiothoracic Surgery; Director, Cardiac Transplantation and Mechanical Support; Associate Professor of Surgery Juan Crestanello, MD Michael Firstenberg, MD Mark Galantowicz, MD Edmund Kassis, MD Pawel Kwiatkowski, MD Louis Louis IV, MD Susan Moffatt-Bruce, MD, PhD Sampath Parthasarathy, PhD, MBA Alistair Phillips, MD Patrick Ross Jr., MD, PhD C.B. Sai-Sudhakar, MD John Sirak, MD Paul Vesco, MD Thomas Williams Jr., MD, PhD Division of Vascular Diseases and Surgery Patrick Vaccaro, MD Director, Division of Vascular Diseases and Surgery; Program Director, General Vascular Surgery; Professor of Clinical Surgery B. Mohan Das, MD Michael Go, MD Cameron Rink, PhD Bhagwan Satiani, MD, MBA William Smead, MD Jean Starr, MD Blair Vermilion, MD
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Division of Cardiovascular Medicine William Abraham, MD Director, Division of Cardiovascular Medicine; Deputy Director, Dorothy M. Davis Heart and Lung Research Institute; Professor, Internal Medicine, Physiology and Cell Biology, Division of Cardiovascular Medicine Ralph Augostini, MD Alex Auseon, DO Ragavendra Baliga, MD Dennis Bauman, MD Philip Binkley, MD, MPH Konstantinos Boudoulas, MD Vincent Brinkman, MD Charles Bush, MD Patricia Caldwell, MD Quinn Capers IV, MD Yeong-Renn Chen, PhD Stephen Cook, MD Glen Cooke, MD Curt Daniels, MD Emile Daoud, MD Hiranmoy Das, PhD Steven Dean, DO Jennifer Dickerson, MD Evan Dixon, MD David Feldman, MD, PhD Mary Beth Fontana, MD Theodore Fraker Jr., MD Veronica Franco, MD Ronald Frazier, MD Rodney Graber, MD Richard Gumina, MD, PhD Garrie Haas, MD Charles Hardebeck, MD David Hart, MD Ayesha Hasan, MD
Guanglong He, PhD Heather Horton, MD, PhD Mahmoud Houmsse, MD William Houser, MD John Hummel, MD Govindasamy Ilangovan, PhD Rami Kahwash, MD Steven Kalbfleisch, MD Mahmood Khan, PhD Albert Kolibash Jr., MD Periannan Kuppusamy, PhD, MD (Hon) John Larry, MD Carl Leier, MD Haitao Li, PhD Xiaoping Liu, PhD Zhenguo Liu, MD, PhD Charles Love, MD Douglas Magorien, MD Raymond Magorien, MD U. Krishnan Marar, MD Ernest Mazzaferri, Jr., MD Laxmi Mehta, MD David Orsinelli, MD Vincent Pompili, MD Min Pu, MD, PhD Sanjay Rajagopalan, MD Subha Raman, MD John Robinson, MD Sharon Roble, MD Paul Ruff, MD James Ryan, MD Alexandre Samouilov, PhD Stephen Schaal, MD Orlando “Lon” Simonetti, PhD Mani Vannan, MBBS Raul Weiss, MD Yong Xia, MD Jay Zweier, MD
Ohio State Heart and Vascular Center Locations Columbus Area Locations
Regional Locations
Richard M. Ross Heart Hospital 452 W. 10th Ave. Columbus, OH 43210 614-293-ROSS or 888-293-ROSS
OSU Heart Center at Marysville 660 London Ave., Suite B Marysville, OH 43040 937-642-5490
University Hospital East 1492 E. Broad St. Columbus, OH 43205 614-257-3000
OSU Heart Center at Bellefontaine 2223 Timber Trail Bellefontaine, OH 43311 937-599-6105
OSU CarePoint at Gahanna 920 N. Hamilton Road Gahanna, OH 43230 614-293-1965
OSU Heart Center at Cambridge 1210 N. Clark St. Cambridge, OH 43725 740-435-2700
OSU Heart Center at Stoneridge 3900 Stoneridge Lane Dublin, OH 43017 614-889-5001
OSU Heart Center at Lancaster 125 N. Ewing St. Lancaster, OH 43130 740-653-5668
OSU Women’s Cardiology Clinic at Stoneridge 3900 Stoneridge Lane Dublin, OH 43017 614-889-5001
Opening Fall 2010 OSU CarePoint at Lewis Center 6515 Pullman Drive Lewis Center, OH 43035
Outpatient Cardiac Rehabilitation at the Center for Wellness and Prevention Martha Morehouse Medical Plaza 2050 Kenny Road, Suite 1010 Columbus, OH 43221 614-293-2800 Outpatient Cardiac Rehabilitation at University Hospital East (Phase II only) 1492 E. Broad St. Columbus, OH 43205 614-257-3974
Community Partnerships Memorial Hospital of Union County— The Heart Partnership 500 London Ave. Marysville, OH 43040 937-578-4343
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© 2010 The Ohio State University Medical Center – 02