The Interventional Cardiology Fellowship Program offers a core procedural experience in the following diagnostic techniques: coronary arteriograms, ventriculography, hemodynamics, intravascular ultrasound, intracoronary Doppler flow and pressure monitoring. The program also offers core experience in the following interventional techniques: balloon angioplasty, stent implantation, saphenous vein graft and arterial graft interventions, distal embolic protection during angioplasty, urgent angioplasty for acute coronary syndromes, primary angioplasty for acute myocardial infarction, directional and rotational atherectomy techniques, intra-aortic balloon counterpulsation and other techniques of mechanical circulatory support, intravascular ultrasound and coronary flow-pressure measurement (coronary flow reserve, fractional flow reserve). Additional techniques employed based on the frequency of the cases include laser atherectomy techniques, thrombectomy techniques, cardiac valvuloplasty, endomyocardial biopsy, intravascular radiation therapy and local drug delivery (only as part of investigational protocols).
Management of Procedural Complications
Interventional cardiology fellows will gain extensive experience with the management of procedural complications and the appropriate use of mechanical and pharmacological agents. Such complications include coronary dissection, intracoronary thrombosis, spasm, perforation, slow-flow, no-reflow, cardiogenic shock, left main dissection, cardiac tamponade, peripheral arterial (access site) thrombosis, dissection or embolization, case selection for surgical repair, pseudoaneurysm, arteriovenous fistulae and nerve injury. In addition, all interventional cardiology fellows will receive experience in the full range of arterial vascular access techniques. These should include both transfemoral approaches and approaches from the arm (brachial/radial). Each fellow will acquire experience treating the full range of coronary lesion morphologic subsets. This includes type A, B and C lesions, total occlusions, heavily calcified lesions, saphenous vein graft lesions, and lesions accessed via arterial bypass grafts.
The Interventional Cardiology Fellowship Program is organized in three rotations (level I, level II and level III) that denote the stepping of the fellows from simple cases to more complex cases progressively. Each interventional cardiology fellow will participate in a minimum of 300 and maximum of 500 coronary interventional cases during the one-year program.
In addition to procedure skills, each interventional cardiology fellow will acquire clinical experience in the following areas during the care of patients who are evaluated for interventional therapy:
- Case selection for interventional or surgical cardiac therapy for heart disease in the outpatient setting and longitudinal follow-up after such procedures are performed (outpatient setting, mainly chronic heart disease, comparative experience with medically treated patients will be included).
- Pre- and post-procedure patient care (in-hospital, acute ischemic syndromes).
- Subspecialty consultation
in interventional cardiology in the setting of hospitalized patients,
emergency unit patients, coronary care unit patients and surgical
intensive care or surgical wards.
cardiac catheterization and interventional cardiology conferences,
hemodynamics and interventional cardiology didactic lecture series,
as well as monthly quality assurance conferences; interventional
cardiology-cardiothoracic surgery conferences, endovascular grand
rounds and the clinicopathological conference of the Department
of Medicine will supplement the clinical experience of each fellow.
Clinical Research & Education
Finally, all interventional cardiology fellows will have the opportunity to participate in clinical research projects and a large variety of structured educational activities in relation to the annual international conference on Transcatheter Cardiovascular Therapeutics, which is organized by the teaching faculty. All interventional cardiology fellows are expected to present abstracts and publish scientific papers stemming from their academic work during fellowship.
Email Annemarie Kelley or call 212.305.2708 for further information
2011 / 2012 Columbia University Medical Center Interventional Cardiology Fellows