Duke Heart Pulse – week ending September 18th 2022 – The Pulse

Highlights of the week:

Swaminathan Named Section Chief of Cardiology, Durham VAMC

The Durham Veterans Affairs Medical Center (DVAMC) recently announced the appointment of Rajesh (Raj) Swaminathan, MD, FACC, FSCAI to the role of Section Chief of Cardiology, effective August 29, 2022.

As the Durham VAMC Cath Lab Director, he has helped initiate and grow numerous clinical programs including CardioMEMS for advanced heart failure patients, novel therapies for treatment of calcified lesions and CTOs, and advanced coronary physiology and integrated/co-registered imaging platforms (IVUS/OCT) which are now utilized in >90% of PCIs at the VA. He has also been instrumental in piloting and innovating systems to reduce occupational hazards in the cath lab through robotic PCI and implementation of the new Rampart radiation shielding system allowing operators and staff to perform cardiac catheterizations without wearing lead.

Raj has also strengthened the cardiology research portfolio at the VA and has ensured that the DVAMC has been a top enrolling site in numerous national, multicenter studies including ACCELERATION, ECLIPSE, OPTIMIZE, MINT, DISRUPT CAD III, and FUSION. A new trial, TARGET BP1, was recently launched to evaluate a novel renal denervation system for hypertension.

He has contributed in many ways to the VA’s clinical, research, and educational mission. He organized quarterly educational events for cardiology staff, hospital-wide general cardiology CME symposiums, delivers periodic lectures to residents and trainees, and serves on the DVAMC Radiation Safety Committee and the national VA-CART Research & Publications committee. Raj has been instrumental in developing pathways for same day discharge after PCI and teaching transradial techniques in VA hospitals around the country. Starting this year, he will serve as the VA’s VISN-6 Lead Cardiology consultant.

In addition, Raj is deeply involved in our cardiology professional societies and was recently elected to the Society for Cardiovascular Angiography & Interventions (SCAI) Board of Trustees. He also continues to support Duke University as past co-chair of the Duke Asian Alumni Alliance Board and is on the Board of Duke Triangle and the Duke Annual Fund Advisory Board.

“I am excited to continue building on the successful vision that Sunil Rao has fostered over many years of service to our Veterans, says Swaminathan. “I look forward to working with world-class physicians, APPs, and staff at the Durham VA as this is a pivotal time for Veteran care locally and nationally.

“Veterans have more opportunities to access care and many VAs are in the process of modernizing their facilities and expanding their services to areas of population growth,” he added. “I look forward to helping shape this next critical phase in Veteran care while continuing to work on pathways to optimize quality of care.”

Raj is a Duke alumnus (BS ’00, MD ‘04, HS ‘05). He completed his residency in Internal Medicine at Massachusetts General Hospital and was a research affiliate at the Harvard-MIT Health Sciences and Technology Center, where he studied coronary stent design and led preclinical studies which supported the initial FDA approval of the Xience V Everolimus Eluting coronary stent. He completed his general and interventional cardiology fellowships at New York Presbyterian Hospital-Weill Cornell Medical Center and continued as interventional faculty there before returning home to NC.

Congratulations, Raj!

Ken Morris Retiring from Durham VAMC

Hard as it may be to believe, Dr. Ken Morris has announced he will officially retire from the Durham Veterans Affairs Medical Center. His official end-date was still unknown at the time of our interview with Ken but is “imminent” and dependent upon the government processing of all paperwork. He’ll remain in the area and working with fellows one day a week.

When asked about his early years and what brought him to Duke, we learned the following:

“I was an intern resident and then chief medical resident at Ohio State, and then I came here in 1976 for my cardiology fellowship with the intent of returning to Ohio State to join the faculty. But then Joe Greenfield hired me. One can certainly argue that hiring me was an error, despite what a smart guy he was. Back then, he says, when you drove into Durham, the smell of tobacco curing in barns was everywhere.

“I didn’t figure I’d be tenurable here but I also figured that four or five years on the Duke faculty would look awfully good on a resume. I decided I wanted to be on the academic side of medicine — specifically cardiovascular medicine. I thought, “Okay, this will be good for me — I’ll learn a lot more things while I’m at Duke and then I can find some other place where they will love me. But it turned out that Joe loved me here, so I stayed.”

“I chose to become a cardiologist in the first month of my internship at Ohio State. I was rounding with an attending by the name of Dr. Charlie Wooley. He was an amazing clinical scientist and an amazing clinician at Ohio State. There were four of us – two students, a resident and me. The resident was a guy named Tom O’Dorisio who subsequently became a very important collaborator with a number of people here at Duke — he could teach a rat how to make an antibody to anything; there was me, and the two students were Jeff Crawford, who eventually became the director of the Duke Cancer Center and Willa Hsueh, who went on to become the president of the American Federation for Clinical Research (now the American Federation for Medical Research). The four of us were eager and hungry to learn and Wooley was this great attending who was very willing to feed us. By the end of that rotation I knew I wanted an academic career in cardiology. So that’s how it happened. Originally I planned to become a primary care internist in Elyria, Ohio.”

Morris has been involved in many things while at Duke, but his principal clinical responsibility was as an interventional cardiologist both at Duke and the Durham VAMC. He says he got into this area of cardiology when it was still at ‘ground zero’.

“Most people don’t remember this but Harry Phillips, Richard Stack and I were all over here at the VA trying to figure out coronary angioplasty. Not a lot of cases were being done on either side of the street — not until the TAMI trials (Thrombolysis and Angioplasty in Myocardial Infarction) started up at Duke and we had the helicopter and large clinical trials going on. I never had a clinic on the Duke side; I just did emergency angioplasty and I was in the cath lab over at Duke Hospital one day a week. I got involved in a lot of the VA clinical trials — COURAGE probably being the most important of all of those.”

Over the course of his career, he says he has enjoyed having the opportunity to study a variety of things.

“Fred Cobb, who was my immediate mentor at the VA, and Joe Greenfield were interested in coronary circulation. I went to the VA initially to spend a research year learning about coronary physiology, so I worked in the animal laboratory with them. I then worked to take what we learned there and move it to the human cath lab, which dovetailed nicely with interventional work.

“I then worked with a variety of forms of cardiac imaging to learn how to get physiologic information out of an image — not just anatomy, but physiologic information. I worked with a number of collaborators on that — most notable is probably Jack Cusma. It was a blast! I was privileged to live through what I consider the ‘glory days’ of myocardial infarction therapy and getting a better understanding of coronary physiology and ischemic heart disease. I mean, there were two decades — from 1985 to 2005 — where it was just one development after another where we took what we learned in the basic lab, applied them in the clinical arena and then demonstrated the life-saving value of what we were doing. It was really cool. And there are days like that ahead for people who are moving into the right areas today.”

Over his time at Duke, he says the fact that he’s been able to contribute to the education of a large number of fellows and faculty has been his biggest accomplishment.

“I have always loved what I do. The old adage, ‘Love what you do and you’ll never work a day in your life,’ has certainly been true for me.”

What will he do in retirement? Morris says his avocation is music — vocal music in a choir setting and percussion music. He plans to spend a lot more time engaged in these, and since Tom Bashore keeps trying to get him to go fishing with him, he may also get to do that, too. He and Bashore were in the same medical school class at Ohio State.

“I’ve enjoyed the friendship of my colleagues here for a long time. I hope the mythological “ideals” of Duke continue to remain a reality. The tripartite mission of taking care of patients, educating clinicians and conducting the best research should remain alive and well here — I hope it will. Change is inevitable, but if change is managed well and ideals are kept, change can still honor the foundation of what has been built here.

We asked some of Ken’s closest colleagues to share their thoughts with us. Here is what they said:

From Sunil Rao, MD:

“Ken Morris is a Durham VA institution. He took over the Cardiology Section from Joe Greenfield MD. Under Ken’s leadership, the Durham VA significantly expanded its clinical enterprise. He presided over the addition of key faculty and the modernization of the cardiac catheterization lab. He is the consummate clinician, always keeping the best interests of the veterans in mind. Ken’s reading of nuclear cardiology studies is legendary – his reads were always precise and accurate. I was lucky enough to be mentored by him and will always remember the question he asked me whenever I came to him with a clinical dilemma – “what is the goal of therapy?” It was his laser focus on what is best for the patient that made the Durham VA cardiology section the best in the country. He will be greatly missed, but we are hoping that he will continue to maintain a connection to the Durham VA and continue to work with Duke fellows.”

From Tom Bashore, MD:

“I have known Dr. Ken Morris since we were medical students in the same class at Ohio State 50 years ago this year. In those days Ken was known as a “free spirit,” and I suppose he still fits that description in some, pretty much modified, ways even today. After his chief residency at Ohio State, Ken came to Duke as a Cardiology Fellow and has remained here as a faculty member since; so, his retirement now is truly the end of a remarkable era for Duke and especially for the Durham VA. All the cardiology fellows and housestaff during that long period have benefited from his great sense of humor, hearty, unmistakable laugh, great teaching skills, and outstanding clinical judgement. Just as remarkable, he figured out how to actually get things done in the complicated and, at times, frustrating bureaucracy common to all VA Medical Centers. He taught generations of cardiology fellows how to correctly cath and perform coronary interventions, although he once had a cardiology fellow who just did not have it in the cath lab. Always quick with one-liners, I never forgot his comment on the fellow’s cath rotation review where he noted that “he should never enter anyone’s room with anything sharper than his elbows.” Where Ken will undoubtedly be missed the most from the fellows’ standpoint will be that he basically has been the major consistent teacher in our cardiovascular nuclear medicine program over these many years. We all wish him the very best in retirement, where I am sure he will continue singing (he has a great voice), fly fishing (he takes each grandkid when they turn 8 to Yellowstone) and spending more time with his ever-growing family. He leaves a sparkling legacy at the VA that will be impossible to fill.”

From Mark Donahue, MD:

“I met Ken Morris on the first day of my Duke Cardiology Fellowship July 1, 1999. In those days we were assigned in 6 month blocks for our Cath Lab rotation and I was going to be at the VA for 6 months. Ken was wearing a cath lab uniform designed by Krucoff. He looked like a barber from the 50s and acted like a character straight out of an episode of M*A*S*H. That 6th month block was invaluable for me and so when I had the opportunity to leave fellowship a few months early to join the VA faculty in 2003, I took it and have been there since. Ken’s father was a navigator on a B-17 in World War II flying numerous missions over Germany. When I started at the VA these WWII vets were everywhere and I came to realize that Ken really took care of each and every one of them like a family member. He has always been able to really relate to the veteran population and their trust in him was clear. The number of anecdotes and stories about Ken could fill a book; Sunil Rao and I may someday write one. Ken made no assumptions, always looked for the truth, put the patient first and above all made it fun. He is the single most important influence on my professional career and I will miss him.”

From Raj Swaminathan, MD:

“Dr. Ken Morris has served many roles at Duke and the VA including former Cath Lab Director and Chief of Cardiology. His early research in coronary physiology and myocardial perfusion laid the foundation for future invasive assessment and treatment of coronary lesions. He has taught numerous residents and fellows and has been a role model for staff and physicians. His contributions to Veteran care and shaping the positive culture at the VA is of immeasurable importance.”

It has been a pleasure working with you, Ken! We wish you all the best in retirement and we are thrilled for our fellows that you’ll continue to work with them.

Gersh, Granger Deliver Cardiology, Medicine Grand Rounds

Chris Granger and special guest Bernard Gersh were our CGR presenters on Tuesday evening. They provided an excellent recap of ESC 2022, held Aug. 26-29 in Barcelona. Excellent discussion! Lots of great trials and commentary putting the studies in perspective. In short, more data for SGLT-2, surprising results around rheumatic heart disease and afib anticoagulation with DOACs, and some deeper dives needed to understand how to revascularize low EF patients when CABG is not an option.

Photography Fundraiser to Support AHA Team Got Heart!

Join Stephanie Barnes for a fall mini-photography session fundraiser in support of the American Heart Association Triangle Heart Walk and Team Got Heart.

Dates: October 9 and 16, 2022 at Fearrington Village in Chapel Hill. Each session will be 15 minutes. Cost is $150, all of which goes to our fundraiser. Registration required.

This is a great opportunity to get your holiday family portraits done ahead of Thanksgiving. Can be couples, just your kids, small families of 2-4, maybe even with your pets! You will receive full access and rights to all of your digital photos via a private web portal. Expect about 20 photos total.

Editor Note: Stephanie is a very talented photographer and this is a great price for a private photo shoot. This is an excellent opportunity to support the AHA Heart Walk by supporting our Got Heart team. You’ll get some beautiful photographs of people you love and they will make great gifts!

A big shout-out to Stephanie for donating her time and energy to this cause. If you have questions, please send an email to: Got Heart Fundraiser/Photoshoot. Sample photos shown here are used with client permission.

Heart Walk is Next Weekend! Sunday, Sept. 25

One week remaining!! The American Heart Association Triangle Heart Walk is taking place next weekend on Sunday, September 25 at PNC Arena. Please plan to join us. Let’s make sure we have plenty of Duke Blue visible out there!

The annual Walk is a great opportunity to come together to celebrate one another, to represent Duke Health, and to reinvigorate the commitment we have for living a heart-healthy lifestyle. We are so appreciative of all of our team members who are taking time to plan for this event and raise funds.

Thank you to everyone who has already signed up to participate. It’s not too late! If you’d still like to register, visit the DUHS team page for the Walk and/or contact Sangeetha Menon from the AHA at sangeetha.menon@heart.org.

If you can’t join us in person, please consider a contribution of any amount to one (or more!) of the teams representing Duke Heart.

If you met the August 24 registration t-shirt deadline, you are eligible for a t-shirt. They will be available through your team captain this week, starting on Tuesday. Each team captain will be contacted via email to alert them where to go (and when) for pick-up. Walkers will need to get their shirt from their team captain.

If you missed the deadline for a shirt, please wear your favorite Duke Blue t-shirt or golf style shirt to the Heart Walk. You can even wear a shirt from a past Heart Walk. NOTE: T-shirts will NOT be distributed at the Walk.

Thank you! If you have questions, email Tracey Koepke.

Nursing Open House, Sept. 29

Coming up! Duke Heart’s nursing team is hosting an open house on Thursday, Sept. 29 for new and experienced nurses as part of our recruitment efforts. The Open House will allow participants to take part in unit tours, shadowing and interviews.

Interested participants can meet our Duke Heart nursing staff and leaders anytime between 8 a.m. and 5 p.m. in Duke Medicine Pavilion. Greeters will be located at the front entrance (near valets) to meet attendees and direct them to the event throughout the day.

Please share this information with anyone you think might be a good candidate for us! They can register by scanning the QR code shown here.

Congratulations to Tannu!

Congratulations to Manasi Tannu! Last weekend, Manasi was married to Alex Commanday, a first-year infectious disease fellow at UNC. They held a fusion ceremony in Charlotte, NC combining aspects of Hindu, Baha’i and Jewish wedding traditions. They had a three-day long weekend of wedding festivities with many performances, including a dance by Duke Cardiology fellows Mark Kittipibul, Nkiru Osude and former fellow Ijeoma Eleazu. It was a weekend to remember!

Congratulations and best wishes, Manasi and Alex. We are so happy for you!

Photos of the Week

More great photos captured on Twitter this week – our selection today is from the Mentz family – all of them sporting their Duke blue yesterday in Durham. We especially like the ‘Know Your Numbers’ shirt from last year’s Triangle Heart Walk. Way to go!!!

Saturday was both a home football game and employee appreciation day at Wallace Wade Stadium. The weather was gorgeous and we’re happy to report that the Blue Devils beat the NC A&T Aggies 49-20!

We hope all who were able to attend had a great time!

Additional Reminders:

September is Atrial Fibrillation Awareness month!
The DUHS annual flu vaccination campaign began on Thursday and will continue until mid-November. Vaccination sites for faculty and staff can be found here: https://flu.duke.edu/vaccination/employees/
The Duke Health Integrated Practice (DHIP) Town Hall has been rescheduled for 7 a.m. on Wednesday, Sept. 28. This will be a Duke Health community-wide event. Questions you would like answered during the Town Hall can be sent ahead of time to DHIP@duke.edu.
Open Enrollment is October 17-28. This is your opportunity to review your medical, dental, vision, and reimbursement account benefit elections and make any changes necessary to ensure your choices continue to meet your needs. Watch your email and home mail delivery for more information.
Duke Health has closed its dedicated COVID Nurse Triage line for questions from patients, employees, students and families as of Sept. 1 due to the decrease in calls and a significant increase in community resources. The Duke Health COVID hotline for employees (919-385-0429) remains operational.

Upcoming Events & Opportunities

Cardiology Grand Rounds

September 20: Pressure and Volume Management in Heart Failure with Marat Fudim. 5 p.m. Webex only: https://duke.is/rr8x5.

CME & Other Events

September 20: Duke Caregiver Community Event, Virtual Sessions. Details here: https://duke.is/nzbcp.

September 22: Multimodality CV Imaging Conference. Topic: Mitral Regurgitation with Fawaz Alenezi. 12-1 p.m., Zoom: https://duke.is/58kut

September 25: Triangle Heart Walk. PNC Arena, Raleigh. Check-in and festivities start at 11 am. Walk begins at Noon. Join us!

September 28: DHIP Town Hall. 7 a.m. Links/location forthcoming. Watch your email.

September 29: Nursing Open House. Duke Heart’s nursing team is hosting an Open House as part of recruitment efforts. 8 a.m. – 5 p.m., DMP. To register: https://duke.is/mhah5

October 14: Cardio-Oncology in the Era of Precision Medicine. Symposium to be held at the J.B. Duke Hotel, Durham, NC. Registration is open: https://bit.ly/CardioOnc22. Email Beth Tanner with questions: beth.tanner@duke.edu.

October 17-28: Open Enrollment period for 2023 for all Duke faculty members and staff.

October 28: Duke Caregiver Community Event, in-person conference. Details here: https://duke.is/nzbcp.

November 4: 14th Annual NC Research Triangle Pulmonary Hypertension Symposium. 7 a.m.-4 p.m. This will be an in-person event at the Durham Convention Center. Registration required. To learn more and register, visit: https://duke.is/jag2b

November 14: Prostate Cancer & CVD Symposium, Webinar 4. Final of a four-part webinar series. Collaboration between the International Cardio-Oncology Society & Duke Heart. Noon, Eastern. Free. To register visit https://duke.is/ptjbs.

Have news to share?

If you have news to share with the Pulse readership, please contact Tracey Koepke, director of communications for Duke Heart at tracey.koepke@duke.edu. We would love to hear about your latest accomplishments, professional news, cool happenings, and any events or opportunities that may be of interest to our Duke Heart family. Please call with any questions: 919-681-2868. Feedback on Pulse is welcome and encouraged. Submissions by Noon, Wednesdays, to be considered for weekend inclusion.

Duke Heart in the News:

September 1 — Harry Severance

Medpage Today’s Kevin MD

Monkeypox: Should the hospitality and transportation industries worry?

https://duke.is/y2j8q

September 9 — Shahzeb Khan

tctMD

Older Adults See Rebound in Rates of HF-Related Death: CDC Data

https://duke.is/r78tu

September 9 — Jonathan Piccini

HealthDay.com

COVID May Help Trigger A-Fib in Some Patients*