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Highlights Week 4-28-2019

We had the 6th Annual Duke Sports Cardiology & Sudden Death in Athletes Symposium this week 4/27/19

Course directors: Jim Daubert, MD and Bill Kraus, MD

Guest keynote speakers: Mark Link, MD (Director of Cardiac EP at UTSW) and Jonathan Kim, MD (Chief of Sports Cardiology at Emory, and Team Cardiologist for the Falcons, Braves, Hawks, Dream, Sports Medicine at Emory and Georgia Tech)

Duke speakers/panelists: Jim Daubert, Bill Kraus, Al Sun, Salim Idriss, Beth Miller, Hap Zarzour, Igor Klem, Tracy Ray, Rich Krasuski, Andrew Wang, Chris Kontos

(plus panelist John Symanski from Atrium Health in Charlotte)

144 attendees registered (a new record for this event) – about 80 in person, and the rest for the webinar/enduring material (representing 12 states and 3 countries)

Special appearances by the head of the Duke Integrative Performance Excellence Group, and the Duke Football head coach. Incredible dialogue around challenging sports cardiology cases, football and cardiac health, ECG screening, commotio cordis, cardiomyopathies, Afib in athletes and physical activity guidelines. Program is partially funded by a generous gift from the Davis Family Foundation and the Duke Center for Prevention of Sudden Cardiac Events in Athletes, as well as Abbott, Medtronic, Boston Scientific, AtCor Medical, Sports Endeavors, and Ambry Genetics. The agenda is attached for reference.


Faculty win – Medicine Resident vs. Faculty Basketball Game at Cameron Indoor

The faculty pulled out a 55-51 win against the residents In a hard fought full court game the stretched the capacity of the faculty’s physician ability (thankfully we had three shifts of 5).  Game highlights included Azalea Kim and Will Yancy doing some great point guard work, Don Hegland and Steve Smith playing some important frontcourt time, and Rob Mentz with a break away that way almost perfect….

Importantly no one was injured.


Rich Krasuski works with NC State students to win Innovation Award

Rich worked with a  group of college students from NC State School of Textiles over the last year.  The group won an innovation award demonstrating their new technology at a Senior Design Showcase. Their project won 2nd place overall in Product Innovation and won the one and only Innovation Award from John Calvert, a retiree from the US Patent and Trademark Office.   You can see a photo of the students who helped with the  warp knit septal occluder.





Ngeno , Gersh, Granger at Africa STEMI in Nairobi

Titus, Bernard Gersh and Chris Granger were helping set up systems of care for STEMI in the Africa STEMI meeting this last week.  See photo attached.

Larry Jackson also received a REACH Equity research award and there is a post below from earlier in the week.

Larry Jackson receives Duke REACH Equity Career Development Award

Duke REACH Equity Center Names 2019 Career Development Awardees

The Duke Center for REsearch to Advance HealthCare Equity (REACH Equity) has selected the second cohort of Career Development Awardees – REACH Equity Scholars.  Targeting junior faculty, these two-year awards support mentored research projects focusing on the REACH Equity theme: addressing racial and ethnic disparities in health by developing and testing interventions that improve the quality of patient-centered care in the clinical encounter – a setting in which racial and ethnic disparities are well-documented. The awardees will begin their time as REACH Equity scholars in July, 2019:

Larry Jackson II, MD, Assistant Professor, Department of Medicine, Cardiovascular Medicine, Adult Cardiac Electrophysiology was awarded this prestigious award in the last week for the following project:

Project Title: Decision Support Tools in Reducing Racial Disparities in Oral Anticoagulation use in Atrial Fibrillation

Dr. Jackson’s overall research aim is to apply the principles of shared decision-making to enhance patient-centered care and ultimately reduce disparities in the treatment of atrial fibrillation in racial and ethnic minorities. His REACH Equity project will determine patient (African American and white) and provider factors associated with acceptance or refusal of oral anticoagulants (OAC) for stroke prevention in patients with nonvalvular atrial fibrillation and develop an evidence-based decision support tool to reduce racial disparities in OAC use.    When you see Larry please congratulate him.

The REACH Equity Career Development Award program is directed by Dr. Laura P. Svetkey, MD, Professor of Medicine and Associate Director of the REACH Equity Center. Scholars engage in mentored research and a career development program provided by the REACH Equity Center that includes a core curriculum, a works-in-progress seminar series, and an annual disparities research colloquium. Prior to the end of the 2-year award period, each scholar is expected to submit a grant application for next-stage funding.

Dr. Kimberly S. Johnson, MD, Director of the REACH Equity Center, said Duke selected these four scholars from an impressively competitive pool of applicants.  “Our inaugural group of REACH Equity scholars (https://sites.duke.edu/reachequity/funding-opportunities/career-development-awards-program/cda-awardees/) has made impressive progress in their first year. I am extremely excited to welcome this outstanding second cohort of scholars.  Their proposals provide creative solutions to developing and testing interventions that address health disparities in the clinical encounter across disciplines, diseases, and age groups.  I look forward to working with them over the next 2 years of their REACH Equity support and beyond.”

The REACH Equity Center is one of twelve Specialized Centers of Excellence, funded by the NIH through the National Institute on Minority Health and Health Disparities (NIHMD, https://www.nimhd.nih.gov/)

Request for Applications for the third cohort of scholars will be announced later this year for awards beginning July 1, 2020.


Highlights of Week: 4-21-2019

Hope everyone had a peaceful and passover and Easter weekend.  Unfortunately, hate crimes especially on these holidays against people based on faith, race, or background around the world remind us of the value of our families, friends, and most importantly our safety and freedom.

Judy Hochman Visit to Duke

We were especially fortunate to have Judith Hochman visit Duke Heart this week where she provided several informative and engaging lectures, interacted with faculty and fellows, and most importantly demonstrated what a lifetime of curiosity, scientific inquiry, and leadership looks like.  She is clearly a role model for us all – and we were happy to host her.

She gave the  Cardiology Grand Rounds on “The Role of Revascularization – from Acute Shock to Stable Occlusion After MI to Stable Ischemic Heart Disease.  We look forward to the conclusion of the Ischemia trial and she provided a great overview.

She also gave the Jerry Reves Heart Canter Lecture is Wednesday at 7 am in the Searle Conference Center.  The title of her talk there was  “Cardiogenic Shock Complicating Acute Myocardial Infarction: Can We Improve Outcomes?”  She provided the rationale for several ongoing studies and the possibility of the CABG Shock RCT.


MARVEL 2 – first two patients enrolled at Duke

A special congratulations to Dr. Frazier-Mills, Dr. Piccini, Susan Gerstl and the research team at Duke in enrolling patients into the Micra Atrial TRacking Using A Ventricular AccELerometer 2 (MARVEL 2) Clinical Study!

We applaud the work that Susan (and team did) to get this study up and running.  We activated in 95 days.  Susan actually had IRB approval in 60, and we had to wait on the budget to get approved. In addition, the RCs screened  250 Micra implants at Duke and accomplished in 2 days.

Great work.

EPIC – SEC coming Up

Please consider joining us for our annual collaborative meeting with other academic groups in the southeast at Emory.

Anita Kelsey to join Duke Heart as Vice Chair for Non-invasive Imaging

We are excited to welcome Anita M. Kelsey, MD, back to Duke as the Vice Chief of Noninvasive Cardiac Imaging.  Anita is currently Associate Chief of Cardiology at Saint Francis Hospital in Hartford, CT.  She will join us July 1st and will help build a platform by which we can determine the appropriateness, measure the quality, and ensure we learn from the way in which we care for our cardiovascular patients using noninvasive imaging modalities across the Duke Health System.

Anita Kelsey first came to Duke as an undergraduate in Biomedical Engineering working with Olaf Von Ramm.  She completed Medical School and residency at the University of Connecticut and returned to Duke from 1995-1998 as a Cardiology fellow under the mentorship of Tom Bashore and Tom Ryan.

Kelsey returned to CT in 1998 where her clinical career has centered around Echocardiography, education, heart disease in women, and leadership.  She has served as Director of Echocardiography in Hartford integrating quality practices and education throughout the Trinity Health Of New England hospitals and medical groups.  She began the interventional echo program at Saint Francis and built an accredited school of cardiac sonography that boasts 15 winners of ASE national student awards. Kelsey serves on the Board of the Joint Commission for Accreditation of Cardiovascular Technical Schools.  She has designed an innovative echocardiographic reporting tool for use throughout the Trinity Health system structured to improve compliance with accreditation guidelines and reduce physician burnout.

Kelsey has served as Site Director for the University of Connecticut Cardiovascular Fellowship Program A, councilor for the CT Council of the American College of Cardiology, and past President of the CT Board of the American Heart Association.  She began a Women’s Heart Program at Saint Francis that has reached 11,000 women with special focus on the highest-risk, underserved, inner-city women.  Kelsey is program director for a Women’s Heart symposium, now in its 13th year and associate program director for the Robert M. Jeresaty symposium, now in its 55th year. She is also currently pursuing her MBA in the Weekend Executive Progam at the Duke Fuqua school with certification in Health Sector Management.  Kelsey is thrilled to be joining her daughter, a first-year Duke Cardiology fellow, Michelle.  We are thrilled that Anita is returning to Duke to help us as at Duke Heart.  Please welcome Anita when you see her around campus over the next few months.


Introducing Duke Heart Incubator

We would like to introduce a new resource within Heart – THE DUKE HEART INCUBATOR.

Have an idea or see something that could be better? Our team is here to help navigate the innovation process and get your ideas off the ground. LEARN MORE with our 1 minute video below. Let’s change the world!

Email:  heartincubator@duke.edu

About: https://www.dukeheartincubator.com/video

We want to especially thank our team – Maggie Meyer, Maria Carroll, Marat Fudim, and Muath Bishawi

Chief’s Message: Peter Smith to transition from Division Chief of Cardiothoracic Surgery After 25 years of Service and Leadership

Allan Kirk, chair of the Department of Surgery has announced that Peter Smith, chief of the Division of Cardiovascular and Thoracic Surgery has requested that Kirk begin a process to recruit his successor as division chief. In the announcement, Kirk said, “In keeping with his remarkable stewardship of the division for the past 25 years, this approach has been carefully considered and determined to be in the best interests of the institution, the faculty, and the Thoracic Residency.”

Peter said,  “I have asked Dr. Kirk to begin a process to identify my successor as your Division Chief. Although this has been a difficult decision, I believe this to be in the best interest of the Division and its faculty, and will provide new opportunities for my personal growth. This process is the logical continuation of the delegation of leadership that I have promoted for several years. By proceeding now, from a position of strength, we should be able to have a smooth transition that all of our cardiothoracic surgeons and the institution well deserve.”

Peter has served as the Chief of the Division of Cardiothoracic Surgery since 1993-1994.  During his time, Peter has carried forward and enhanced the legacy of Duke CT surgery – a legacy has clearly seen the Division as an international leader in training the world’s best surgeons, surgeons that are engaged in excellence in clinical care, research aimed at improving human health, and perhaps most important from the my viewpoint – a legacy of team based care in which cardiology and anesthesia has partnered with CT Surgery in patient care.

Kirk further stated that he will begin this process with careful consideration, as it is expected that this will be one of the most sought-after positions in academic Thoracic Surgery, and there will be many strong candidates. Smith currently holds one of the most important positions in the Health System, therefore we must seek the highest quality individual possible. Identifying and recruiting the best candidate and ensuring a smooth transition will take as much time as is necessary, but certainly will occur no sooner than July, 2020.

We will find a time to recognize the numerous and substantial contributions to cardiovascular medicine and surgery that Peter Smith has made.  In the interim, please recognize and thank Peter for his leadership when you see him.

Highlights of the Week: 4-7-2019

39th ISHLT Held in Orlando

Several Duke Heart team members attended the 39th annual International Society for Heart and Lung Transplantation meeting and scientific sessions in Orlando this past week. The event took place from April 3-6 at the Loews Meeting Complex. Shown here are Carmelo Milano, MD, Sara Alexander NP, Miranda Flowers NP, Alicia Ploeger NP, Vincent Lee, NP.  Carmelo Milano is seen providing a update on LVAD care.

 Duke Heart Center’s Joe Rogers will be the ISHLT president in upcoming years. We also had several great presentations.  Jacob Schroder presented the EXPAND Heart Trial and the FDA Approved US DCD protocol for the first time.  This is the exciting perfusion system that keeps the heart perfused outside the body. It was associated with a low rate of graft dysfunction and can expand the regional donor pool.  Duke Heart Fellow Lauren Truby also had her work highlighted by the Journal of Heart Lung Transplantation as some of the year’s most important. There were many more important presentations by CT surgery, CT Anesthesia, and a host of Duke Heart Faculty and Fellows.


AHA Quality and Outcomes Care meeting 2019

The AHA QCOR meeting was also held this last week and was lead by Adrian Hernandez and Tracy Wang in Duke Heart.  This meeting highlighted many of the real-world advances ongoing in the implementation and improvement in care in Heart Care.  The meeting has become the center of where outcomes research and innovation around how we capture clinical practice data and intervene to improve outcomes are presented.  Amy Abernathy, former Duke Faculty, now with the FDA in charge of  Real-World Data to inform our therapies and practice also presented.

Important Paper on TAVR and Operator Outcomes – In NEJM this week

Study lead by Sreek Vemulapalli and others from around the country

Clinical Kudos: David Manly

A big shout-out to cardiology fellow David Manly who was the subject of a warm letter of recognition from anesthesiologist Nate Waldron. While Waldron was the intensivist in the CTICU, one of their TAVR patients started having difficulty overnight. Manly was available to troubleshoot and, despite a busy caseload of his own, repeatedly checked on the patient throughout the night and engaged regularly with the CTICU team for follow ups during what proved to be a challenging set of issues.

Waldron stated, “I truly appreciate Dr. Manly’s help last night—especially considering that he was concomitantly managing his own busy service. One of the many benefits of working in the Heart Center is the tremendous collaboration between Cardiology, Cardiothoracic Anesthesia, and Cardiothoracic Surgery. Last night exemplified this collaborative spirit, and I am sincerely grateful for his help.” Great job, David! Exemplary teamwork all around.


Duke Sonographer Recognized as ASE Volunteer of the Month

Alicia Armor, one of our amazing Duke sonographers, has been recognized by the American Society of Echocardiography as their volunteer of the month. Outstanding! You can read about her efforts and why she volunteers with ASE here.

Shout-out to Drew Flammia

Special thanks to Dayle (Drew) Flammia, RN, for responding quickly and taking appropriate steps to rescue a federal prison guard who was on site to monitor a forensic patient. The story was shared with us by Heather McKinney, one of our nurse managers for 3100. She stated “A first responder had been activated to the patient’s room, where a federal prison guard had been choking and breathing with stridor. Flammia, who was the patients’ primary nurse, entered the room and performed the Heimlich maneuver on the guard until he stopped choking. “If he hadn’t been there so quickly, the guard may not have had the positive outcome that was made possible by Drew.” Excellent job!

Good catch award: Amanda Rooney, DMP 7E

Nice job, Amanda Rooney, RN, on 7 East in the DMP! She caught that a team member had not yet pulled up the needed medication at the time of dual-sign off/verification. Good that we have each other’s backs – way to go! Thank you again for living the Duke Values and helping us drive towards our goal of “Zero Harm.”

Upcoming Conference: Duke Heart participated and co-sponsors the Emory Cardiovascular Conference EPIC SEC coming up next month.  Please consider attending if you can.