Home » Uncategorized » Duke Heart Pulse — February 25, 2024

Duke Heart Pulse — February 25, 2024

By Tracey Koepke in Uncategorized on February 25, 2024.

Highlights of the week:

Heart Team Implants 1500^th Durable VAD

Congratulations to our Duke Ventricular Assist Device (VAD) Program for reaching a program milestone: a total of 1500 durable VAD implants have been completed at Duke University Hospital (DUH) as of this past week. The first durable VAD placed at DUH occurred in 1994.

“Achieving 1500 VAD implants is a testament to the unwavering dedication, clinical expertise, and commitment of each member of our multidisciplinary team and the community partners who identify patients that may benefit from this therapy, said Carmelo A. Milano, Joseph W. and Dorothy W. Beard Distinguished Professor of Experimental Surgery and division chief of cardiovascular and thoracic surgery at Duke Health in a statement to team members.

“As one of the first VAD centers certified by The Joint Commission, we are proud of the high standards and quality care provided to each VAD patient at Duke,” Milano adds. “Each implant represents a life impacted and a step forward in delivering comprehensive advanced heart failure care to the patients of our region.”

VADs are durable mechanical circulatory support devices used in patients who have reached end-stage heart failure. They are mechanical pumps that help a patient’s failing heart continue to pump blood through their body. Some patients receive a VAD as a “bridge-to-transplant” therapy while waiting for a heart transplant; others receive VADs as “destination therapy” — long-term placement without receiving a heart transplant. Early VADs were devices that were solely meant to keep people alive in a hospital until a donor heart could be found for them. Now, the devices have improved so much that many patients can not only leave the hospital but potentially live on VAD support for the rest of their lives.

“When this technology became available, we were fully in it from the beginning because we saw a much-needed gap in available treatments,” says Laura Blue, DNP, nurse practitioner and Duke’s lead VAD coordinator since 2003. “We had the resources and the desire to help more patients and it has been awesome to see people get chunks of their life back. To see them have more time to meet their dreams and have their lives improved. Giving people the ability to complete things they want to do and have more time with their families and accomplish goals has been the best part of this process.”

Milano attributes our VAD success to the many people who have been part of the VAD team over the years, especially those who led the way at the very beginning, including thoracic surgeons Peter van Trigt, MD (now at Moses Cone) and Kevin Landolfo, MD (now at Mayo Jacksonville). The entire current team has great synergy and drive and Milano attributes a lot of that to the two surgeons who are currently driving the VAD program – Jacob Schroder, MD, and Jeffrey Keenan, MD, and cardiology partners including Stu Russell, MD, and lead VAD coordinator Laura Blue, who, he says, has probably put more time into the VAD program than anyone.

VAD technology has evolved from large pulsatile devices to smaller rotary flow pumps over the years and Duke has been a leading site for clinical research in the development of many of the devices. Duke was the leading enroller for the HeartMate II LVAD clinical trial, the HVAD HeartWare clinical trial, and the MOMENTUM HeartMate 3 clinical trials, according to Milano.

“These three devices are probably the most common VADs we’ve used in reaching this 1500^th milestone,” said Milano. “And we were leaders in the clinical trials that led to the FDA approval of those devices.”

Stu Russell, MD, Duke’s regional director for advanced heart failure agrees. “If you look back over the years at the kinds of pumps that have been studied, that led us to the ones we’re using today, Duke has been one of the highest enrollers in all of the clinical trials. Our patients have helped pave the way for VADs getting better and better over time.”

Russell says physicians are seeing fewer strokes occurring with VADs and less clotting – that the pumps have gotten better, and smaller, the batteries last longer, and the devices are more reliable than ever.

“Heart failure is the number one discharge diagnosis in most hospitals in America,” Russell says. “It’s everywhere and here in the south, with the rates of hypertension and coronary disease, there is even more of it. There are a ton of people developing and a lot of people dying of heart failure every year. As good as we’ve done and as high a number of VADs as we have implanted — it’s just a drop in the bucket compared to how many more people could probably benefit.”

The team sees reaching this milestone as an accomplishment that goes beyond Duke. They stress the partnerships with referring physicians across the region who choose to send their patients for an evaluation at Duke.

Regionally, the southeast has a very high prevalence of heart failure — higher than anywhere else in the United States,” says Stephanie Barnes, MSN, AGNP, CHFN, clinical director for Advanced Heart Failure at Duke. “Based on our transplant and durable VAD volumes combined, while they’re high and we are leading the way in providing advanced heart failure care to patients, we anticipate there are many patients out there who are not receiving these therapies, simply because they’re not making it to the door of advanced heart failure centers, or they’re making it too late.”

Duke’s durable VAD program has developed alongside its heart failure program, which reached a program milestone of 2000 completed heart transplants in December. The team hit a program and U.S. record of 161 heart transplants completed in 2023.

“Advanced heart failure patients are some of the most severely ill patients we see as cardiologists,” says Chetan Patel, MD, Duke Heart’s Vice Chief for Outreach and Network Development. “Not many heart centers can say they have achieved such a milestone and it’s due to the work of an amazing team over the years.”

We are so proud of this team and the thousands of lives they’ve touched. Congratulations!

Support Frazier-Mills, Duke Health’s 2024 AHA Woman of Impact!

Please join us in supporting electrophysiologist Camille Frazier-Mills, MD, one of the Triangle American Heart Association’s Women of Impact in her campaign to raise funds to support Go Red for Women.

Frazier-Mills is representing Duke Health as a Woman of Impact in the 2024 campaign and we want to help her reach her campaign goal. By donating, each of us can support her campaign and help ensure more women have equitable access to cardiovascular care and better representation in critically needed medical research.

Check out Camille Frazier-Mills’ campaign page and please donate by April 4.

Every year across the country, a select group of individuals are nominated to be a part of Woman of Impact because of their passion and drive to make a difference. This 9-week blind competition is relentlessly focused on women’s heart health. The campaign launched on National Wear Red Day (Feb. 2) and closes on April 4. During this time, the nominees work to build campaign plans, recruit Impact teams, and inspire their networks to support the American Heart Association’s lifesaving mission.

At the end of the campaign, this special group of changemakers will be celebrated for the overall impact they have on the AHA’s mission and the Triangle community. The nominee who makes the greatest impact and raises the most funds locally will be named a local 2024 Woman of Impact Winner.

Additionally, the nominee who makes the greatest impact nationwide will be named the American Heart Association 2024 National Woman of Impact Winner.

Let’s help her reach and exceed her goal – let’s help her WIN! Go, Camille!

Rymer Accepted to ACC Emerging Faculty Leadership Academy

Congratulations to Jenn Rymer, MD, assistant professor of medicine in cardiology! We learned this week that she has been accepted into the 2024 American College of Cardiology (ACC) Rick Nishimura, MD, MACC and Patrick T. O’Gara, MD, MACC Emerging Faculty Leadership Academy.

Established in 2005, the ACC Emerging Faculty Leadership Academy supports early-career academic cardiologists who strive to become clinician educators. Participants learn evidence-based teaching strategies and core skills along with other members of their cohort at Heart House in Washington, DC.

Duke cardiologists recently selected for this highly competitive opportunity include Nishant Shah (2023), Tony Gutierrez, MD (2022), and Adam DeVore, MD (2019).

Congratulations, Jenn! We are so excited for you!

USNWR Best Hospitals Voting Now Open

USNWR voting for Best Hospitals by specialty is now open in Doximity. If you are board-certified in the U.S. and have claimed your Doximity profile already, please log into your account by March 27 to complete the brief survey: submit your nominations.

New to Doximity? Find and register your profile to vote. Just go to Doximity’s login page, scroll to the bottom and click on “find your profile” – find yours and claim it/register. You can participate in the survey as long as you register on Doximity prior to the survey closing on March 27.

The survey allows you to list up to five hospitals as Best Hospital in the specialty in which you are board-certified. Your ballot counts even if you vote only for one hospital.

As with primaries and national elections, every vote is important!

Seriously, stop reading and go vote for Duke University Hospital — best of the best for cardiology and heart surgery! We’ll be here when you’re done – there’s more news below!

Armed and Dangerous Drills, Feb. 26-29

Jonathan Bae, MD, CPPS, Chief Quality Officer for Duke University Hospital, announced last week that Duke University Hospital will conduct Armed and Dangerous Drills this coming week (Feb. 26^th – 29^th). The drills will be discussion-based with the goal of reinforcing education and encouraging preparedness conversations with your teams.

Trained facilitators will present a scenario and questions for participants to think through as well as verbalize what they would do. Throughout the week there will be sessions conducted in-person on units at various times. Before each session, facilitators will round and gather any staff who are available. If you are available during a session in one of your work areas, you are welcome to participate in that session.

We understand that participation in on-unit sessions can be challenging for physician teams, so Zoom options are also available. If this works better for your schedule, please register for a time below:

Tuesday, Feb. 27^th at 7 a.m. — Click here to register for this time
Tuesday, Feb. 27^th at 12 p.m. — Click here to register for this time
Wednesday, Feb. 28^th at 5 p.m. — Click here to register for this time
Thursday, Feb. 29^th at 7 a.m. — Click here to register for this time
Thursday, Feb. 29^th at 12 p.m. — Click here to register for this time
Thursday, Feb. 29^th at 5 p.m. — Click here to register for this time

All sessions will last approximately 30 minutes. While we aim to provide accessible opportunities, with a drill of this scale, we will not be able to incorporate everyone. If you are unable to participate we do encourage refreshing your knowledge via the virtual Armed and Dangerous Training available online via LMS Course Number 00073596.

If you have questions about the drills, please email workplaceviolenceprevention@duke.edu.

Please take some time this week to refresh your preparedness and/or participate in any session for which you’re available.

Feb. 27: Before They Were Stars Series – Perspectives from Dean Mary Klotman

We know this is a busy week, but… here’s a great event to consider: the Program for Women in Internal Medicine (PWIM) continues the popular Before They Were Stars series, now open to ALL in the Department of Medicine. This series highlights the career paths of prominent women physicians, capturing the successes, challenges and opportunities facing women in medicine.

This month PWIM is joined by Dean Mary Klotman! Dean Klotman will describe her career journey in academic leadership through her roles as Chair of Medicine and now as Dean of the School of Medicine.

All faculty and trainees are welcome and encouraged to attend. There will be food and beverages provided outside of the meeting venue beginning at 6 p.m. Conversation with Dean Klotman will start promptly at 6:30 p.m. on Tuesday, Feb. 27 in Duke Hospital North 2002.

Please join if your schedule permits. We’d love a great showing from Duke Cardiology if you can stay – this event immediately follows CGR in DN 2002!

NC Primary is March 5; Early Voting Ends March 2

Early voting for the March 5 Primary Elections is open through 3 p.m. on Saturday, March 2.

Duke University has an early voting location on campus at Karsh Alumni and Visitors Center. During the early voting period, voters can cast their ballot at any early voting location in the county where they are registered. Other early voting locations across NC can be found here. Voters who missed the registration deadline last week can also register and vote on the same day at early voting locations.

On Election Day, Tuesday, March 5, voters must cast a ballot at their assigned polling location.

Additional information on registering to vote, voting, and voter ID requirements can be found on the Duke Votes website.

Upcoming Events & Opportunities

February is Heart Month and Black History Month.
March is National Nutrition Month
March 8 is International Women’s Day
USNWR Best Hospitals Voting is open (through March 27). Please check your Doximity account and vote!

Cardiology Grand Rounds

Feb. 27: CTEPH…The Challenges We Face with William Auger, MD. 5 p.m., DN 2002 or via Zoom.

March 12: Arrhythmias in Myocardial Infarction: Beyond the Substrate with Ching Zhu, MD. 5 p.m., DN 2002 or via Zoom.

March 19: Beyond the Bump: Navigating the Interplay of Cardiovascular Health and Obstetrics in the Modern Era with Sarah Snow, MD. 5 p.m., DN 2002 or via Zoom.

March 26: Topic TBD with Brittany Zwischenberger, MD. 5 p.m., DN 2002 or via Zoom.

All Duke Cardiology Grand Rounds recordings are housed on Warpwire. To access recordings please visit:

NET ID and password required. Enjoy!

CD Fellows Core Curriculum Conference

Feb. 28: HF/Txp Case Presentation with Seamus Hughes. Noon. DMP 2W96 (in-person only).

March 1: EKG Review with Neil Freedman. Noon. Zoom only.

Upcoming CME Symposia for Spring, 2024

March 8: Cardio-Oncology/Amyloid Symposium

The Southeastern Cardio-Oncology Conference, The Future is Now will take place on March 8 at the JB Duke Hotel in Durham, NC. Event registration is open; the registration deadline is March 5.

Duke cardiologists Michel Khouri and Ravi Karra of Duke’s Precision Cardiomyopathy Program will be presenters during the symposium.

Keynote to be provided by Avirup Guha, director of cardio-oncology and assistant professor of medicine at Augusta University’s Georgia Cancer Center.

The symposium is presented by Duke Cancer Network (DCN) in collaboration with Duke Cancer Institute. For more information, please contact Beth Tanner of DCN.

April 12: Duke Sports Cardiology & Sudden Death in Athletes

May 4: Duke Heart Failure Symposium

Registration is not yet open for the April 12 or May 4 symposia, but if you have questions about either event, please reach out to Christy Darnell.

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:

February 16 — Duke University Hospital/Health System

Becker’s Hospital Review

24 most reputable US academic medical centers

February 18 — Carmelo Milano and Jacob Schroder

Innovando News (Italy)*

Fifty million euros for the first Italian artificial heart

*mention is in photo caption

February 19 — Duke Health

Medical Economics

How to keep your patients happy: 6 steps to reduce long wait times and improve patient satisfaction

February 20 — Duke University (biomechanical engineering)