Coffee + Cardiology

In this episode we have Maziar "Maz" Khorsandi, MD a cardiothoracic surgeon at the UW Medicine Heart Institute.  Dr. Khorsandi is originally from Iran and now an MCS/Transplant surgical specialist.  In addition, he helps run our weekly multidisciplinary coronary conference.

0:00 - Iran to the UK
3:40 - Why Cardiac Surgery
6:30 - Transplants in UK vs. USA
9:20 - Evolution in Mechanical Circulatory Support
12:27 - "Don't suffer in Silence"
14:06 - LVAD Operation (Left Ventricle Assist Device)
19:45 - LVAD Patient Care
21:40 - End of Suction Events
29:15 - DCD - Donation after Circulatory Death
33:45 - OCS - Organ Care System
40:00 - Haggis
42:00 - Weekly Multidisciplinary Coronary Conference
44:20 - FAME3 from Cardiac Surgeon
52:10 - Low ejection fraction coronary revascularization

LVAD Operation Video Link:
https://www.youtube.com/watch?v=-Ze7e-u-6rw

DCD Press Release:
https://newsroom.uw.edu/news/patient-receives-regions-1st-dcd-heart-transplant

Haggis:
https://en.wikipedia.org/wiki/Haggis

Grand Rounds:
Low ejection fraction coronary revascularization: A surgical perspective
https://youtu.be/tz2l8Fe1e1s

Dr. Maziar Khorsandi Profile - https://www.uwmedicine.org/bios/maziar-khorsandi
Email: [email protected]

In this episode we sit down with Kate Kearney, MD an interventional cardiologist with a specialization in high risk coronary artery treatments.  This specialization is a fellowship training pathway at UW Medicine Heart Institute called a CHIP fellowship, in which Dr. Kearney thrived in 2018 and now teaches.  She is also focused on SCAD (Spontaneous Coronary Artery Dissection) as well as the diagnosis and treatment of women's coronary artery disease.

1:34 - Background
3:15 - Choosing Intervention
4:40 - Unique Make-up of Fellowship
6:00 - Specialization within Interventional Cardiology
9:10 - The draw to Chronic Total Occlusions
10:45 - Impact of Work
13:00 - Benefits of academic team culture - shout out Cath Lab team
14:00 - Better every year
16:10 - CHIP * Complex High-Risk Indicated PCI.
17:35 - Collaboration between surgeons and interventionalists
19:25 - Hybrid Coronary Interventions
24:35 - Devices in Circulatory Support + Stenting
30:10 - Coronary and other device evolution
32:40 - STAR (Subintimal tracking and reentry)
37:10 - The MONGO Story - To be discussed in a future episode
37:30 - A growth mindset
40:15 - SCAD (Spontaneous Coronary Artery Dissection)
45:32 - Women + Chest Pain
52:28 - Teaching the Mindset
54:50 - Past-Fellow Shout Out
58:50 - Work-Life Balance (Boundaries)

Contact Dr. Kearney - [email protected]
Fellowship Program
22:50 - Dr. Kirkpatrick Grand Rounds - Cardioethics of Heart Procurement after Cardiac Death

In this epidsode April S. Stempien-Otero, MD, FACC sits down to discuss her path the UW Medicine Heart Institute the disparities between women and men in cardiovascular care and the goals in developing a fully integrated Women's Heart Health Program.

0:30 - East Coast to West Coast
2:32 - Disparities in care between men and women
4:40 - Diabetes and Women
5:50 - Heart failure with preserved ejection fraction (HFPEF) and Women
7:42 - Diagnosis disparity reasons
9:52 - Public vs Clinical Education
11:00 - Treatment disparities
13:10 - Take care of yourself
15:17 - Impact and current development of studies specific to women
18:05 - History of Estrogen in Cardiovascular Disease
22:40 - Approximately 20% of new investigators are Women
26:05 - Need for Women's Heart Health Program
28:55 - Program's impact on research
30:55 - A personal passion for the PNW
32:48 - Integration of Advanced Practice Providers - Tracy Fowler

You can learn more about the program and contact Dr. Stempien-Otero here:
UW Medicine
@Heart_Dr_April
[email protected]

In this episode we sit down with Jordan M. Prutkin, MD, MHS, FACC, FHRS who directs our ambulatory clinic for the UW Medicine Heart Institute.  He is also an Electrophysiologist with a passion for sports cardiology and at the forefront of understanding how wearables and other patient data centered technologies might support cardiovascular care.

2:00 - The Journey
4:14 - What is the best part of Electrophysiology - Supraventricular tachycardia (SVT)
6:20 - Implantable Challenges
9:22 - Collaboration and camaraderie
11:05 - Director of Ambulatory Clinic during Covid
15:28 - Wearables and data in patient care
19:30 - Managing remote monitoring
23:24 - Data Ownership
24:00 - Sports Cardiology
27:12 - Sports and Sudden Death
31:04 - Navigating risk of sudden death
Kayla Burt's Story
36:15 - Leading the Covid-19 Return-to-Play * Follow the data
41:40 - Mental health

You can reach Dr. Prutkin here:
@jordanprutkin
[email protected]

In this episode we sit down with Jeanne E. Poole, MD, FACC.  She led our Cardiac Electrophysiology section from 2000-2021 and currently Editor-in-Chief of HeartRhythm O2 Journal. http://heartrhythmopen.com.

We get into all where implantable defibrillation has come and where it's headed.  In addition we talk about what characteristics make an exceptional electrophysiologist and how journals can better include allied professionals.

0:38 - A child of Boeing
1:57 - Impact of Dr. Leon Green
4:15 - Development of Implantable Cardiac Monitoring
8:11 - Collaboration with Harborview
11:40 - Patients and Uncertainty
12:35 - How implantable defibrillators work
14:25 - Discussion with patients and use of defibrillators
18:35 - End stage terminal disease and implantable conversations
20:50 - Cardiac Resynchronization Therapy (CRT)
25:30 - Non-response reasons
29:00 - Avoiding long leads
33:18 - Indications for advanced technologies
36:45 - Building and leading the Electrophysiology team
43:00 - Identifying a good candidate for Electrophysiology career track
46:00 - Founder and Editor in Chief of Heart Rhythm Society O2 Journal
50:00 - Allied Professionals access to journal - APP Publishing Resources

You can reach Dr. Poole here:
@jepoolemd
[email protected]

In this episode we sit down with Karen K. Stout, MD, FACC the founder of our Adult Congenital Heart Disease (ACHD) program at the UW Medicine Heart Institute and currently our associate chief of cardiology.  

She has helped formalize the ACHD sub-specialty and now is leading our team creating a culture in a rapidly changing work environment.  Her thoughts on all that and much more.

1:12 - History of formalizing Adult Congenital Heart Disease
4:11 - Adult vs. Pediatric Care
7:07 - Seattle Children's and UW Medicine Relationship
9:55 - Transitions in Care
12:55 - Day in the life of an ACHD Cardiologist
16:16 - General Cardiology's role in congenital disease care
19:15 - Partnerships with Multidisciplinary teams
22:44 - Outreach Clinics in PNW Region
25:14 - Living in a van down by the river
29:00 - Arizona
33:15 - Leadership and Culture

Adult Congenital Heart Disease at UW Medicine
[email protected]

In this week's episode we sit down with Nazem Akoum, MD, MS, FACC, FAHA, FHRS.

Dr. Akoum is now the UW Medicine Heart Institute's Electrophysiology Section Chief.   Before he made it to this incredible accomplishment, he was a child that grew up through the Lebanese Civil War and experienced loss of his brother with an aortic dissection from Marfan syndrome.  As the director of our Atrial Fibrillation clinic, he will be helping lead the way into its future as our section chief.

1:28 - How the journey began
8:08 - Passion for EP
11:45 - Math and EP
13:30 - Adjunct Professor in Bio-Engineering
22:10 - Multidisciplinary Research
23:49 - Atrial Fibrillation
26:13 - AFib Treatment Decision Making
30:28 - What imaging tells us
33:10 - Scarring and Ablation
36:12 - Lone Afib 
38:38 - Embolic Stoke of Undetermined Source
41:21 - Stroke Prevention hitting close to home
43:05 - EP Leadership 
45:35 - Future of UW EP

You can contact Dr. Akoum at [email protected]

In this week's episode we sit down with Christine Chung, MD. 

Dr. Chung's early interest in teaching evolved into an academic medicine career that is now helping to teach the next generation of interventional cardiologists.   She is excited to have a procedural focus with so much opportunity for innovation.  As a part of our structural heart team, she will be helping lead the way into its future.

0:40 - From the beginning
3:18 - Ms. Chung the Teacher?
4:04 - Drawn to Procedural Cardiology
5:15 - Why Structural Heart
7:30 - The path to Structural Heart
9:20 - Mentorship
10:48 - Role as a Mentor
13:10 - "Not just mentorship, but also sponsorship"
14:50 - The other career and mental health
19:25 - Anticoagulation and TAVR
23:20 - Valve-in-Valve
25:41 - Anatomic Considerations
29:12 - Aortic Regurgitation
32:35 - Shout out to Robert Lederman and Adam Greenbaum
33:35 - Risk of mortality vs. benefits of intervention
39:25 - Unpacking deal-breakers
42:01 - Left Atrial Appendage Closure/Occlusion (LAAC/LAAO)
45:00 - Good Candidates for LAAO
50:20 - Industry Education (Commercial Referenced)

Dr. Chung can be reached at her email:
[email protected]

In this week's episode we sit down with David T. Linker MD, FACC, FESC, FASE. 

Dr. Linker's career has uniquely tied his engineering background with cardiology to help design the future of cardiac diagnostic technologies.  His commitment is to ensure these critical tools are accessible to everyone who needs it.   From speaking 6 languages to building new technologies, the common thread is his aspiration of mastery.   This aspiration is now focused on his mastery of teaching complex topics like transesophageal echocardiography with his recently published book High-Quality Transesophageal Echocardiography.

Timestamps:
0:40 - Cardiology & Engineering
4:08 - Development of Ultrasound Imaging
7:45 - European and American Models
8:30 - Icelandic, English, Spanish, French, Norwegian, & Dutch
9:44 - World-wide Collaboration
14:10 - Aspiring for Mastery * High-Quality Transesophageal Echocardiography
18:30 - The why rather than just the how
19:45 - Learning how to teach better "Cognitive Load"
21:20 - Detection of Atrial Fibrillation
26:35 - Democratization of Diagnosis
27:25 - Contributions to the Seattle Heart Failure Model
32:10 - Commercialization without preventing access
34:14 - David Linker's television travelogue series available on Smithsonian Digital Catalog
39:00 - Impact of Legacy
42:15 - Mental Health through  the outdoors

Please feel free to reach out to Dr. David T. Linker directly here:
[email protected]

Others Mentioned:
Bjorn Angelsen
Dr. Wayne Levy

Dr. Jill Steiner, an Adult Congenital Heart Disease (ACHD) cardiologist at UW Medicine, sits down this week to talk about what palliative care really means, understanding and supporting resilience for a unique patient population, and how she has created resiliency for herself.

Timestamps:
0:30 - Career at a glance
2:40 - All things ACHD 
3:54 - Palliative Care and ACHD
4:36 - "I just think it's cool."
6:00 - Impact of palliative care in ACHD patients
8:49 - Palliative care research
11:00 - What is Resilience 
16:00 - Multi-morbidity and Frailty
20:32 - Transitions from pediatrics to adult
25:10 - An ACHD's cardiologist special sauce
34:47 - ACC Cardiology Palliative Care Working Group and CMEs
38:47 - Tools for tough conversations
40:50 - Supporting yourself after
45:43 - "Life is not worth surviving, it's worth living" 

You may find resources mentioned in the episode below:

• Palliative Care Work Group: https://www.acc.org/Membership/Sections-and-Councils/Geriatric-Cardiology-Section/Get-Involved/Pallitive-Care-Work-Group
• Dr. Steiner's Bio: https://www.uwmedicine.org/bios/jill-steiner
• Dr. Steiner's Twitter: https://twitter.com/steiner_md
• Dr. Steiner's email: [email protected]