Parallax by Ankur Kalra

Heart surgery is not the best option for every patient suffering from structural heart disease. This was recognized by interventional cardiologist Anmar Kanaa’N and cardiac surgeon Joseph Lahorra who decided to unify their skillsets and bring the Structural Heart Program to life. Their vision was to offer patients with heart valve diseases all available options at Cleveland Clinic’s Akron General.

In this week’s Parallax, Dr Kanaa’N, the director of the program, and Dr Lahorra, chairman of the Heart, Vascular & Thoracic Department of Akron General introduce the listeners to the foundations of their program and the paradigm shift brought by TAVR.

Tune in to hear host Ankur Kalra ask Dr Kanaa’N and Dr Lahorra to share the practicalities of setting up the state-of-the-art program.

Questions and comments can be sent to “[email protected]” and may be answered by Ankur in the next episode. Guests Anmar Kanaa’N and Joseph Lahorra, hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO.

The State of Ohio reported its first coronavirus cases on March 9. Prior to that, on February 28, the Cleveland Clinic announced that they are prepared to open 1,000 additional hospital beds if needed. Ohio was one of the states to follow recommendations and intervene quickly.

Ankur Kalra asks Grant W Reed, Director of the Cleveland Clinic’s STEMI program, to reflect on the actions they took and the challenges of delaying cardiovascular procedures in the wake of the coronavirus pandemic. Dr Reed offers insight on the factors that influenced the Cleveland Clinic’s STEMI policy for COVID-19. Ankur and Grant discuss the triage considerations for patients with structural heart disease and the steps the clinic took to protect its healthcare workers.

In this week’s Parallax Dr Kalra and Dr Reed are addressing questions in the wake of Cleveland Clinic’s decision to reopen services for essential procedures. Which cardiac operations should be performed? What is the impact of COVID-19 outbreak on cardiac surgery? How can healthcare institutions address the safety concerns of their patients?

Tune in to listen to this week’s episode of Parallax. Hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO.

Submit your questions to Ankur via: [email protected].

Related Sources

https://www.washingtonpost.com/national/health-science/did-ohio-get-it-right-early-intervention-preparation-for-pandemic-may-pay-off/2020/04/09/7570bfea-7a4f-11ea-9bee-c5bf9d2e3288_story.html

http://interventions.onlinejacc.org/content/early/2020/04/05/j.jcin.2020.04.001

This week Ankur Kalra talks with Lisa Rosenbaum, national correspondent for The New England Journal of Medicine and cardiologist at Brigham and Women’s Hospital.

Lisa Rosenbaum has been writing extensively about the human face of medicine. Her articles have been widely circulated by publications like The New York Times, The New Yorker and The New England Journal of Medicine.

In this edition of Parallax Dr Kalra asked Dr Rosenbaum about the influences that shaped her choices as a writer and as a healthcare professional. Dr Rosenbaum opens up about her childhood and how she connected to her grandfather through writing and medicine. We learn about Lisa’s first day at medical school and her latest writing project.

Tune in to learn about a doctor’s path to medical journalism.

Hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO.

Connect and submit your questions to Ankur via: [email protected].

Related sources:

https://www.nejm.org/doi/full/10.1056/NEJMms2009984

https://books.google.co.uk/books/about/A_Taste_of_My_Own_Medicine.html?id=N5ppQgAACAAJ&redir_esc=y

A week after Jag Singh had tested positive for COVID-19, he became a patient in his hospital’s intensive care unit. This week he joins Ankur Kalra, MD to tell us about his journey as a clinician-scientist.

Jagmeet P Singh, a Professor of Medicine at Harvard Medical School, a renowned Clinical Trialist, and the past Clinical Chief of Cardiology at Massachusetts General Hospital joins Ankur Kalra for a deep conversation about his journey across three continents. Dr Singh talks about the importance of choosing fulfillment over success. We gain more insights on the recent late-breaking clinical trial, MADIT-CHIC focusing on cardiac resynchronization therapy. Ankur asks Jag about his experience of being on the other side of the healthcare system as a patient and his participation in an investigational drug study.

What is Dr Singh’s advice for young cardiologists? How does he balance his responsibilities? How did his hospitalisation shape Dr Singh’s outlook on his role as a medical professional? Tune in to listen to this week’s episode of Parallax. Hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO.

Submit your questions to Ankur via: [email protected].

In this episode they discuss:

[02.09] Becoming a clinician-scientist

[06.41] Boston and Massachusetts General Hospital

[08:58] Creating balance and finding fulfilment as a cardiologist

[19.05] The MADIT-CHIC trial

[27.02] Experiencing COVID-19 as a patient

[35:38] The emotional impact of COVID-19

[36:58] Investigational medications for the treatment of COVID-19

[39.55] Closing remarks

Additional Resources:

https://jamanetwork.com/journals/jama/article-abstract/2754793

https://twitter.com/NoopurRajeMD/status/1246905651491717122

“It’s a tsunami not just a wave. The worst tsunami you can imagine”

Prof Michele Senni is Director of Cardiology at Papa Giovanni XXIII Hospital, Bergamo Italy. He contracted COVID-19 himself and in this latest podcast he meets with Ankur Kalra, MD to discuss his personal experience in dealing with patients and COVID-19 in Europe’s outbreak epicentre.

Hear them discuss the burden on healthcare, patient selection, the importance of testing and PPE and how COVID has resulted in a reduction of acute myocardial infarction and heart failure in patients.

Submit your question to Ankur via: [email protected]. Hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO.

What to listen for:

In this episode they discuss:

• [03.00] Personal experience from the front line in Bergamo, Italy

• [19.45] ACS and COVID-19 patients

• [24.00] Myocarditis reduction in COVID-19 patients

• [25.30] Acute onset heart failure and cardiomyopathy in COVID-19 patients

• [29.40] Increased pulmonary pressure in COVID-19 patients

• [30.00] Closing remarks

“We are at war with a pandemic and the enemy is not each other, it’s the virus.”

In this latest episode, Ankur Kalra, MD meets with Andrew Sauer, MD, co-author of upcoming paper in US Cardiology Review on COVID-19 and Cardiovascular Disease that provides a concise and current summary of cardiovascular complications from COVID-19.

Hear them discuss the latest issues surrounding the pandemic, the known cardiac implications and the rapidly emerging data.

Submit your question to Ankur via: [email protected]. Hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO.

What to listen for:

In this episode they discuss:

[00.00] Introductions

[05.55] The importance of lessons learned from other countries and the importance of social distancing

[09.25] Troponin elevation in COVID-19 positive patients

[13.15] Receptor mechanisms and treating COVID-19 patients with hypertension

[19.19] Cardiac arrhythmia mechanisms in COVID-19 patients

[23.00] Fulminant myocarditis, congestive heart failure and BNP in COVID-19 patients

[26.47] Treatments and risks: antiviral therapy, infection markers, complications

[28.59] HCPs, PPE and the importance of social distancing

[32.52] Antimalarial drugs in treating COVID-19 patients

[34.54] Transplant patients, donors and testing for COVID-19

[39.35] The importance of surveillance biopsies

[42.18] Pressure rooms for at-risk patients

[45.05] Closing remarks

In these unprecedented times, we provide an early release episode to gain insight on dealing with the COVID-19 pandemic from Deputy Editor in Chief of US Cardiology Review, a BDG interventional cardiologist, Bill Gogas, MD, PhD practising in East Asia.

Hear Bill’s take on how East Asia responded to and successfully managed the pandemic and how they are now seeing a significant reduction in cases outside the epicentre. Hear how the strategy resulted in only 93 patients in Bill’s city of Nanjing, testing positive for coronavirus with a city population of 8 million.

Learn about effective responses, the importance of early control and how as a cardiovascular physician your life and practice may be impacted from the virus.

Submit your question to Ankur via: [email protected]. Hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO.

What to listen for:

In this episode they discuss:

[02.45]: Opening thoughts

[03.35]: What consequences should we expect?

[04.43]: Containment

[06.08]: Policy adherence: execution and management

[11.20]: The impact on a cardiologists’ everyday clinical practice and scheduling

[18.00]: Summary for cardiologists treating patients during the outbreak

[20.30]: HCP prophylaxis procedures

[21.36]: The importance of negative pressure rooms

[22.20]: Examining the results

[26.10]: Handling lockdowns and mass closure

[27.32]: CV effects of COVID-19

[28.35]: Closing thoughts

We can count on our fingertips how many “interventional intensivist” exist in the US.

In this episode Ankur Kalra, MD meets with Dr Ann Gage, Cleveland Clinic’s first “interventional intensivist”. She discusses her unique skill set, what it means to be an interventionalist in the cath lab but also an expert in cardiovascular intensive care and advocates why such a unique skill set and critical care training are required in today’s modern medicine.

Submit your question to Ankur via: [email protected]. Hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO.

What to listen for:

In this episode they discuss:

• [03.00] Becoming an interventional intensivist: a look back

• [05.05] Roadblocks and pathways to becoming an ‘interventional intensivist’

• [13.30] Scholarly research on the pathway of the ‘interventional intensivist’

• [15.00] An interventional intensivist is not a critical care doctor

• [17.30] Is a direct training pathway coming for the interventional intensivist?

• [20.45] The changing demographic of the cardiac intensive unit

• [21.20] The growing population of co-morbidities in ICU patients

• [22.08] Do data exist to compare the cardiologist vs the intensivist in critical care?

• [27.00] How to pursue this unique training: here and now, and the future of cardiac intensive care.

• [30.45] Closing remarks

Dr Cavalcante meets with Ankur Kalra, MD to discuss his recent review published in US Cardiology Review 13.2; on a new aortic stenosis staging system that has important implications for clinical outcomes following aortic valve replacements

to aid the treatment of aortic stenosis.

Listen to this, as well as an overview on his interesting childhood and his views on the future of cardiac imaging to treat TAVR.

Submit your question to Ankur via: [email protected]. Hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO.

The first female cardiac surgeon qualified in the 1960’s. Today there are only 4.5% women in cardiology and only 4% in thoracic surgery. Ankur Kalra meets with Dr Kendra Grubb, the first women to be trained at the University of Virginia, US, on cardiothoracic surgery and the 250th board certified women in thoracic surgery.

Her recent post on social media went viral. It was a photo of an all-women surgical team carrying out a complex structural heart procedure. It had over 100,000 views and was seen by people in over 75 different countries. It’s clear from this online reaction, that now is the time for women to be recognised for the work they are doing in medicine.

Listen to this engaging discussion between them on the challenges of being a woman in cardiovascular medicine today.

Submit your question to Ankur via: [email protected]. Hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO.