Highlights of the week:
Welcome New Cardiology Fellows!
Each academic year starts with new fellows joining us — and is a reminder of the amazing people we have at Duke, and the impact we have on so much of the future of the field with our training program.
Our brand-new class of Cardiovascular Disease Fellows is listed below. Please give a warm welcome to the following individuals:
- Jawan Abdulrahim, joining us from Duke’s residency program
- Aubrie Carroll, Duke, joining us from Duke’s residency program
- Jonathan Hanna, joining us from Yale’s residency program
- Seamus Hughes, joining us from UT Southwestern’s residency program
- DaMarcus Ingram, joining us from Duke’s residency program
- Ivan Nenadic Wood, joining us from the University of Michigan’s residency program
- Josh Rushakoff, joining us from Cedars Sinai’s residency program
- Husam Salah, joining us from the University of Arkansas residency program
- Aarti Thakkar, joining us from the Johns Hopkins residency program
- Eric Xie, joining us from the Johns Hopkins residency program
Please also welcome our incoming Interventional Fellows:
- Todd Looney
- Sameer Prasada
And our incoming Structural Heart Disease Fellow:
- Ezequiel Munoz
We’re thrilled to have them joining us. Our new team started with us on Saturday. A huge THANK YOU to Bradi and Chris Granger who hosted the fellows’ welcome party at their home last night! The cardiovascular disease fellows have orientation and bootcamp activities this week and will start on their services Saturday, July 8.
Transition and Welcome to DHIP!
As we kick off July and a brand-new fiscal year, we’re also entering into a Health System milestone: the Duke Health Integrated Practice (DHIP) launched yesterday.
Our deep gratitude to all team members for their patience during this transition, and to those who have been closely involved in the planning and rolling-out of DHIP. This was not an easy effort. The future is indeed bright at DUHS, and we are blessed to be part of the great Duke Heart team!
Klotman Named Exec. VP for Health Affairs
In a message sent to all Duke University and Health System faculty and staff on Friday, Vincent Price, president of Duke University, announced the appointment of Mary Klotman, MD, as Executive Vice President for Health Affairs, effective July 1.
In this newly-created role, Klotman will report to Price and will serve as the university official providing strategic oversight of university academic health affairs, in close coordination and collaboration with the Provost, Executive Vice President, and CEO of Duke University Health System (DUHS). She will be the chief academic officer of Duke Health, responsible for strategic, academic, and budgetary oversight and authority for the School of Medicine and its affiliated academic institutes and programs, and will also oversee the Duke-NUS Medical School in Singapore and, with the Provost, oversee other relevant interdisciplinary centers including the Global Health Institute and the Margolis Center for Health Policy.
In this role, Klotman will continue to serve as Dean of the School of Medicine, a position she has held since 2017. In that capacity, she will report to the Provost; Vincent Guilamo-Ramos, Dean of the School of Nursing, will also report to the Provost.
In the announcement, Price stated, “Mary is an exceptional physician-scientist, leader, and colleague who is deeply committed to advancing biomedical science and human health through education, research, and patient care. As Dean, she has overseen advancements in research, teaching, and administration that have propelled the School of Medicine to new levels of national recognition and research activity. Under her leadership, the school has implemented significant new programs to advance diversity, equity, and inclusion; assure scientific integrity; and recruit, retain, and reward outstanding faculty. Mary is also a quadruple Duke alumna, having earned her undergraduate and medical degrees, and completed both her medical residency and fellowship, here at Duke.”
Klotman’s appointment follows a restructuring of the leadership model for Duke Health’s academic and clinical missions, which were previously consolidated under Gene Washington, MD, who served as Chancellor for Health Affairs of Duke University, and President and CEO of DUHS.
As part of the announcement of the transition in leadership, Price also recognized Dr. Washington’s many contributions, and thanked him for his distinguished service to Duke over the past eight years.
Under the new leadership structure, Klotman will oversee Duke Health’s academic mission, and Craig Albanese, who was named CEO of DUHS earlier this year, will oversee the clinical enterprise, reporting jointly to the DUHS Board of Directors and to President Price. The new leadership structure, Price stated, will help position Duke for success in the face of the challenging landscape for academic medical centers, including the changing healthcare marketplace, the need for more efficient and effective patient care models, and the ongoing imperative to support high quality medical research. The health system and university governing boards will regularly monitor the effectiveness of this new leadership structure.
Klotman and Albanese will work in close partnership to build deep alignment between Duke’s academic and clinical missions, and will establish shared goals and strategies, closely aligned organizational performance metrics, and other mechanisms to ensure effective connectivity and coordination across Duke Health. Each of them will be accountable for building a shared culture that capitalizes on the ways in which health science research and discovery and health delivery benefit each other, including agreed-upon goals and strategies that will be reflected in their individual performance assessments and incentives.
In the coming weeks the two will be in touch with the Duke Health community to provide more specific updates about how they will operationalize the new leadership structure, Price added.
Their partnership will be informed by the recommendations of a consultative committee that recently worked on behalf of the Office of the University President to seek expert input and advice regarding the new Duke Health leadership structure.
“I am grateful to the members of the consultative committee, as well as the individuals they interviewed, for their valuable perspectives and thoughtful guidance,” Price said. “I am confident that, with Mary joining my leadership team as Executive Vice President for Health Affairs, we will be well positioned to meet the challenges and realize the opportunities ahead, and I hope you will join me in congratulating her on her appointment.”
Congratulations, Dr. Klotman!
TAVR Procedures Added to DUH Cath Lab; Lead Extractions to EP Lab
Congratulations to our interventional teams! The first transcatheter aortic valve replacement (TAVR) procedure to be conducted in the Duke University Hospital Cath Lab occurred on Wednesday. We are incredibly excited to celebrate this milestone and all those who made it possible.
A multidisciplinary team of TAVR cardiologists and surgeons, cath lab nurses and CV invasive specialists, anesthesiologists and CRNAs, members of Duke Heart’s Center of Excellence, Cardiac Diagnostic staff, Cardiac OR and Cath schedulers, CVSSU and 7West nurses, Heart APPs and operational leaders met weekly for months to map and test workflows, and performed dry runs in preparation for this day, according to Jill Engel, VP for Duke Heart Services.
“It is a really exciting time for our patients that are presenting now for TAVR because with the addition of the procedural space in the cath labs being able to perform TAVR safely for them we’re able to get them in quicker, said Anna Mall, MSN, Assistant Nurse Manager, Adult Cardiac Cath Lab.
Mall says the Duke team had been seeing patient volume that exceeded the capacity of the current traditional TAVR process that is done in the OR. By adding the ability for the cath lab team to do these procedures on patients who are at low-risk for their TAVR procedure will allow patients to move through the care system faster, so they can get the care that they need quicker – which is important for this patient population.
“Although there may be other cath labs within NC with the capability to perform low-risk TAVRs, I think what sets Duke apart from other facilities is that now we have a greater ability to care for the patients that have complex needs and require the high-risk TAVR procedure in the OR, as well as the space for patients that are low-risk, as well,” Mall says. “We can be more all-encompassing now in our approach to ensuring that we’re able to care for any patient in need of TAVR in the most equitable way possible.”
To create a successful foundation for the discussions that began earlier this year, an interdisciplinary team of leaders was called together. By engaging different stakeholders from across the clinical space and the IT space, the team was able to get everyone on the same page to make sure that all of the processes for outpatient visits, the inpatient procedure, and transfer to the inpatient unit were all addressed.
“Major kudos to the entire Duke Heart Cath lab team for their tremendous effort as part of our commitment to expand services for patients. This initiative, led by Dr. Andrew Wang and Anna Mall, was masterfully planned and executed, said Engel. “This expansion of TAVR procedures to the Cath Lab demonstrates the tremendous skill and dedication of the entire team that makes Duke Heart a great place for our patients, families and staff.”
Great expertise from a talented multidisciplinary Duke Heart team is ensuring our patients can navigate cardiovascular care without major roadblocks.
“Our team was incredibly committed to getting this done for the patients. So much work went on behind the scenes to enhance how quickly patients can come for care to Duke. With this team and creating this process, the patients were completely at the center of everything that we did; everyone talked about ‘how can we improve care for the patients,’” Mall added.
“The process was amazing – the team was amazing – everyone working together to get this done. And then to see it in action this week and for it to go off so smoothly was an incredible testament to everyone’s contributions. The engagement of our teams is such a strong suit here at Duke Heart.”
Shown here are members of our cath lab recovery team, L-R: Mackenzie Sbashnig, Grace Eckler, Caroline Jenkins, and Anna Mall:
Great teamwork! L-R: J.D. Serfas, MD; Brad Cash, CVIS; Jeff Gaca, MD; Dylan Skiscim, RN; Todd Kiefer, MD; Gordon Pusateri, RN; Cassidy Johnson, RCIS; Wanda Cooley, CVIS; Seth Hanson, CRNA; Kevin Yardley, RN; Andrew Wang, MD; Crosby Culp, MD; Anna Mall, RN, and Miriam Nguyen, RN.
And, in another great example of multidisciplinary teamwork in Duke Heart, we’ve formally added laser lead extraction capability in the EP Labs at DUH.
Due to the increasing volume of patients we are seeing in need of laser lead extractions, we’ve developed a process to identify low-risk candidates in need of laser lead extraction through a partnership across our electrophysiology, CT surgery and cardiac anesthesiology teams. Together, they developed a protocol and policy to permit low-risk laser lead extractions to occur in the electrophysiology lab. Traditionally, laser lead extractions are done in the Hybrid OR with perfusion and CT surgery on standby, said Shawn Johnson, nurse manager for adult cath/EP and the Short Stay Unit. “This addition expands the EP lab’s ability to serve a broader patient base.”
To qualify as a low-risk patient case, the individual would require an infection as the primary indicator for the lead extraction; a prior sternotomy; an implant dwell-time of less than five years; no high-risk CT scan findings, and agreement between CT surgery and electrophysiology to proceed as a low-risk candidate.
Amazing job, everyone! Congratulations to all!
Graduating IC Fellows, Structural Fellow Celebrated!
Our Duke Interventional Cardiology Fellowship graduates and Structural Heart Fellowship grad were celebrated at our annual End-of-Year dinner for them on Thursday evening, June 29, at The Rooftop of the Durham Hotel in downtown Durham. It was another wonderful evening of accolades and reminiscing! We wish each of our fellows the best as they transition as follows:
- Caitlin Drescher, MD, who is entering into private practice with Prisma Health Carolina Cardiology Consultants.
- D. Serfas, MD, who is joining the faculty at the University of Kansas and Children’s Mercy Hospital in Kansas City.
- Doosup Shin, MD, who will enter research/advanced fellowship at Saint Francis Hospital in Roslyn, NY.
- Zachary Wegermann, MD, is joining the Duke Heart faculty. He was out of town and missed the dinner, unfortunately, but we celebrated him nonetheless!
Congratulations, Caitlin, J.D., Doosup, and Zach!
Barnes Inducted into AAHFN
Congratulations to Stephanie Barnes, MSN, AGPCNP-C, CHFN, PCCN, Clinical Director for Advanced Heart Failure Services here at Duke! She was inducted to the Board of the American Association of Heart Failure Nurses (AAHFN) during the annual meeting of the AAHFN held this weekend in Boston. Barnes has chaired the annual meeting for the past two years; she will serve a four-year term with the Board.
“She represents the best of Duke’s Heart Failure team,” said Robert Mentz, MD, section chief for Heart Failure. “She’s a national leader in HF and we’re proud of her leadership.”
Way to go, Stephanie!
Palma, Swaminathan Recognized at ASE
Congratulations to Richie Palma, Director of the Duke Cardiac
Ultrasound Certificate Program and Madhav Swaminathan, MD cardiothoracic anesthesiologist, for their well-deserved recognition at the 2023 American Society of Echocardiography Scientific Sessions, held June 23-26 in National Harbor, MD. Palma received ASE’s Cardiovascular Sonographer Distinguished Teacher Award, while Swaminathan received their Outstanding Achievement in Perioperative Echocardiography Award.
Congratulations! We’re so proud of you both and glad to have you on the Duke team!
Fox to Serve as Clinical Nurse Specialist, Effective July 3, 2023
Duke Heart is pleased to announce that Allison Fox, MSN, APRN, AGCNS-BC, PCCN will become Clinical Nurse Specialist for the DUH Heart Stepdown Units, Cardiac Diagnostic Unit, and Cardiac MRI effective Monday, July 3. As Clinical Nurse Specialist, she will collaborate across Heart Services to identify patient care problems, implement approaches to these problems, and evaluate the effectiveness of the approaches.
Allison joined the Duke Heart team in 2018 as a Clinical Nurse I on the DUH Cardiology Stepdown Unit, 7100. During her time at Duke, Allison advanced to a Clinical Nurse III, served as a preceptor, charge nurse, diabetes champion, Tikosyn champion, and on the Orientation Committee. In 2021, Allison transferred to the Adult Cardiac Electrophysiology Lab. Allison is also a member of Heart Rhythm Society (HRS), American Association of Critical Care Nurses (AACN), and the National Association of Clinical Nurse Specialists (NACNS). Allison serves on the graduate education committee of the NACNS.
Allison earned a Bachelor of Science in Nursing from George Mason University in 2018 and a Master of Science in Nursing- Adult Gerontology Clinical Nurse Specialist from East Carolina University in 2023. Her credentials include Progressive Care Certified Nurse and Adult Gerontology Clinical Nurse Specialist.
Please join us in congratulating and welcoming Allison to her new role!
Dial Named ANM for Adult Cath Lab
We are pleased to announce Rebecca Dial, RN as the new Assistant Nurse Manager of the Adult Cath Lab here at Duke University Hospital. Rebecca has worked in the Cath Lab at DUH since 2020 and previously served as a Charge Nurse. Please welcome Rebecca to our HC Leadership Team!
Mall Named Clinical Nurse Specialist, Effective July 3, 2023
Duke Heart is pleased to announce that Anna Mall, MSN, APRN, ACCNS-AG, CCRN, CNL will become Clinical Nurse Specialist for the DUH Heart Center effective Monday, July 3, 2023. As Clinical Nurse Specialist, she will collaborate with Heart ICUs, Invasive Labs, CVSSU, and Patient Response Program to drive practice changes throughout the organization, and ensure the use of best practices and evidence-based care to achieve positive patient outcomes.
Anna joined the Duke Heart team in 2014 as a Clinical Nurse III in the Adult Cardiac Cath Lab. She has served in the department as the Assistant Nurse Manager since 2019. She leads the department’s Cath Lab Nursing Research Group and serves as a Principal Investigator on several study teams. Anna is highly engaged in the American Association of Critical Care Nursing as a member of the Clinical Advisory Workgroup. She is also a member of the National Association of Clinical Nurse Specialists.
Anna earned a Diploma in Nursing from Watts School of Nursing in 2008 and a Master of Science in Nursing – Health Care Systems from UNC Chapel Hill in 2019. She then earned a Post-Masters Certificate – Adult-Gerontology Clinical Nurse Specialist from East Carolina University in May 2023.
Please join us in congratulating and welcoming Anna to her new role!
MURDOCK Samples Accelerate Heart Failure Discovery
The ease and speed of obtaining samples and data from a groundbreaking community-based biorepository at Duke Kannapolis helped to accelerate a recent heart failure discovery by Duke researchers.
A Duke Pathology research team led by Salvatore Vincent Pizzo, MD, PhD used biospecimens and more than 13 years of corresponding data from 690 MURDOCK Study participants to determine that serum pro‐N‐cadherin is an early marker of heart failure. The discovery has the potential to identify patients who would benefit from intervention before they show signs of disease, as reported in the Journal of the American Heart Association.
The Duke Clinical and Translational Science Institute (CTSI) is making thousands of biospecimens and associated clinical outcomes data available to all Duke researchers through the MURDOCK Biorepository Transformation Initiative. Duke Kannapolis is part of the CTSI and directed by Svati H. Shah, MD, MHS.
With just a few clicks, a data exploration tool developed by CTSI enables Duke investigators to easily explore the 12,526-participant longitudinal cohort based in Kannapolis and encompassing Cabarrus County. The MURDOCK storefronts summarize data and samples at a glance.
“The demographics and outcomes of the participants over time is critical, and that is what sets MURDOCK apart from other biorepositories,” said Paul Ferrell, who manages Pizzo’s lab and quantified the new biomarker. “We would not have been able to correlate the biomarker with any meaning if we didn’t have that downstream outcome data.”
Tapping into the MURDOCK Biorepository
About a year ago, preliminary research indicated the protein could be a marker for heart failure. Pizzo’s team needed to expand their study and reached out to Duke Kannapolis, hoping to accelerate their research by tapping into the MURDOCK biorepository.
“Our goal was to understand the role of the biomarker effectively and rigorously without waiting a decade for a new, prospective study to accumulate years of data,” Pizzo said. “MURDOCK already had thousands of samples and years of follow-up, saving us an incredible amount of time while delivering the same level of rigorous data collection. The responsiveness of Duke Kannapolis saved us even more time.”
Total time from completing a brief interest form to the conclusion of the study was six months. By comparison, requesting and receiving samples from other biorepositories can take up to two years.
“MURDOCK has been the springboard,” said Kristi Oristian, the postdoctoral research consultant on the team. “We asked a question about the predictive nature of how something might work in the future, but we answered it using previously collected samples and data showing how health has changed over time, thanks to MURDOCK participants who had been completing annual follow-up for years.”
With the publication of the discovery, the research has drawn interest from collaborators and venture capitalists. The team’s next steps include repeating their initial findings in a different population, with additional techniques and a clinical approach.
Ultimately, they want to bring the biomarker to market and see it used in clinics and hospitals. The test for the biomarker is easy to administer and easy to understand, reducing the reliance on specialized equipment or expertise.
“Right now, there is no established community screening for heart failure,” Oristian said. “There are biomarkers that catch it at a later stage, but we are talking about detection well before people start to show symptoms.”
Duke Kannapolis provided Pizzo’s team with two cohorts from the MURDOCK Study. The participants all reported no heart failure when they enrolled in MURDOCK, and the two groups had very similar comorbidities and demographics. The participants who eventually suffered heart failure had the elevated biomarker. Those who never developed heart failure did not.
“It’s really important for us to see that against a background of common American comorbidities like high blood pressure and obesity, the biomarker was able to add additional predictive value to identify the folks who would develop heart failure,” Oristian said.
Providing More Evidence
Using such closely matched cohorts provided more evidence that the biomarker is an independent predictor of heart failure, Ferrell added.
“They have such a large amount of MURDOCK data and samples that they were able to match the cohort of people who did not develop heart failure with those who did,” Ferrell said. “That was a lot of the difficult work that Duke Kannapolis completed and then provided to us.”
The MURDOCK Biorepository Transformation Initiative makes thousands of biospecimens and associated clinical outcome data available to all Duke researchers. Investigators should complete this brief interest form as a first step toward.
Duke Statement Re: Affirmative Action Ruling
As you are aware, the U.S. Supreme Court struck down race-conscious admissions plans at Harvard and UNC-Chapel Hill, citing a 14th Amendment violation. The decision will undercut long-standing admissions policies at colleges and universities across the U.S. that use race as one of many factors in evaluating applicants.
In a statement released on Thursday afternoon, Vincent E. Price, president of Duke University, stated:
“Duke’s position continues to be that diversity is absolutely vital to our educational mission—everyone in our community, and the work they do, benefits from differing perspectives, opinions, and life experiences. We remain steadfastly committed to cultivating a racially and socially equitable Duke to the fullest extent permitted by the law. Over the coming weeks we will review the decision closely and determine what, if any, changes need to be made to our admission processes. We have already been planning for the many potential procedural implications. As this process unfolds, we remain committed to doing everything we can to foster a vibrant and diverse academic community.”
Shout-out to Clinic 2F/2G
A big shout-out to our team members in Clinic 2F/2G for taking time to support Pride Month at Duke Health! We have a diverse community throughout the Triangle and within Duke Health and Duke Heart – it takes all of us, together, to provide amazing care to our patients – thanks for having pride in each other.
Shown L-R are: Quivetta, Pat, Susan, Joey, Anna, Julie, Carolyn, Claire, Teressa, Chelsea, and Hannah of our 2F/2G care team.
Way to go!
Quick Reminders & Updates
“Real Talk” Year-in-Review: In the latest episode of the Real Talk video series, Craig Albanese, MD, MBA, Chief Executive Officer, DUHS, reflects on all that we’ve been through together. His message of gratitude highlights some of our greatest achievements and innovations over the past year. To view the recording, please visit: https://duke.is/m/jy94.
Upcoming Events & Opportunities
Cardiology Grand Rounds is on hiatus for the summer. We’ll be back in the fall!
Watch this space for dates and times of upcoming CD Fellows Core Curriculum Conferences starting next weekend.
Duke SOM Call for Applications: Restorative Justice Pilot Program
The Office for Faculty, in partnership with the Office of Equity, Diversity, and Inclusion, is now accepting applications for a pilot program that will provide training and support for implementation of Restorative Justice interventions in the School of Medicine. Restorative Justice (RJ) is an ethical framework that focuses on building community by living our shared values of respect, honesty, responsibility, empathy, and inclusivity. RJ has its roots in indigenous traditions, which uphold the belief that people are interconnected and that focus on the role of community. Restorative practices can create the environment necessary for building and sustaining relationships, maintaining shared accountability, repairing damage caused by harmful behaviors, and ultimately improving team culture.
About the program: Pilot participants will take part in an intensive RJ training program in fall 2023. Working with their teams and with support from experienced RJ practitioners, participants will develop and implement restorative interventions within their individual units in spring 2024. Participants will become part of a longitudinal learning community of individuals interested in exploring the use of restorative practices in the School of Medicine to shape culture and improve well-being. Participation will require significant time, including in-person classroom training sessions and asynchronous reading and reflection. There will be no charge to the participants or departments that participate. Participants will receive a stipend for participation and completion of activities.
Who should apply: Applications should come from groups of 2-4 faculty and staff from the same organizational unit (department, division, program, etc.) within the School of Medicine. All applicants must have the support of their manager/leader and be able to commit to attending all training dates in person (view dates).
- Team members have a demonstrated commitment to improving institutional culture and climate within the unit, including diversity, equity and inclusion efforts.
- Team collectively has enough capacity, reach and local support to implement RJ practices within the unit.
- Potential ideas for the application of RJ within the organizational unit.
- Faculty and staff representation where possible
- Senior leadership support, including a statement confirming protected time for participants to attend all training sessions and participate in evaluation activities. The letter should confirm support for participants’ implementation efforts in the spring and address likely receptivity of the local unit to restorative interventions/mindset.The letter must be signed by the department chair or division chief for faculty applicants, and the manager(s) for staff applicants.
Because this project is a pilot, program evaluators expect participants to provide feedback about their experience.
Complete program information and application details are available online: https://medschool.duke.edu/shifting-paradigm-restorative-justice-framework-workforce-well-being
Applications are due August 7.
Questions? Contact Jessica Schonberg, MEd, Director of Educational Programs in the Office for Faculty, at email@example.com
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 firstname.lastname@example.org. 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:
June 23 — Adam DeVore
June 23 — Adam DeVore
News & Observer
June 23 — Robert Mentz
June 25 — Jacob Schroder and Jason Banner
CBS Eye On America
Revolutionary technology is making more heart transplants possible
June 26 — Neha Pagidipati
June 27 — Lynne Koweek (Radiology)
Diagnostic and Interventional Cardiology
June 27 — Neha Pagidipati and Christopher Granger
June 27 — Neha Pagidipati
June 28 — Nishant Shah
June 30 — Duke/NUS CVMD Program
Lab & Life Scientist (AU)