GME : Fellowship : Interventional Cardiology

Program Overview

The interventional cardiology fellowship program at Winthrop University Hospital is a one-year ACGME accredited program that prides itself on selecting and ultimately producing the finest interventional cardiologists in the country. The Program emphasizes clinical and research areas relevant to interventional cardiology and provides trainees with experience in all aspects of cardiac and vascular intervention. The objective is to train competent, compassionate Interventionalists who will be leaders in their field.

Winthrop University Hospital is prepared to meet the needs of the Interventional Cardiology Fellow by providing a comprehensive curriculum that expands their knowledge base, while exposing them to innovative technology and research at the point of care. The experience is enriched and enhanced by active participation in the general Cardiology Fellowship Program. The fellows are immersed in a one year program that emphasizes superb guideline-based clinical care combined with technical expertise and high procedural volume. The entire range of interventional cardiology is represented, including coronary, peripheral and structural procedures. The program also benefits from a growing national reputation and an established regional status highlighted by superior and consistent PCI outcomes within New York State.

There are dedicated conferences that emphasize interventional topics, involving local as well as guest speakers in addition to journal clubs, dedicated research and other multi-disciplinary conferences. Fellows have been successful in presenting research and cases at national meetings, and following through to publication. Faculty, both voluntary and full-time, take an active role in fellow education and support, including one-on-one teaching, research and career mentoring. The fellowship program also gains specialized expertise from its affiliation with Winthrop’s Hypertrophic Cardiomyopathy Center, Aortic Aneurysm Center, and Heart Failure Center, which bring patient populations to the lab for unique procedures oftentimes unavailable at other hospitals.

Program Director

Dr. Srihari S. Naidu, MD, FACC, FSCAI, FAHA, is skilled in all aspects of interventional cardiology including ASD and PFO closure, alcohol septal ablation for hypertrophic cardiomyopathy, aortic and mitral valvuloplasty, percutaneous ventricular assist devices, as well as peripheral and coronary intervention. Prior to joining Winthrop he was Assistant Professor of Medicine in the Division of Cardiology at New York Presbyterian Hospital-Weill Cornell Medical Center, where he was a high volume operator and developed their Hypertrophic Cardiomyopathy Center, performing Cornell’s first series of alcohol septal ablations. His post-graduate training included fellowships in interventional cardiology and general cardiology at the University of Pennsylvania Medical Center in Philadelphia, where he received the 2004 Outstanding Teaching Award. He completed his residency in internal medicine at New York Hospital-Cornell Medical Center, and received his medical degree from Brown University.

A Fellow of the American College of Cardiology (FACC), a trustee of the Society of Cardiovascular Angiography and Intervention (FSCAI) and the American Heart Association (FAHA), Dr. Naidu is also one of approximately 15 nationally-appointed members to the prestigious Cardiac Catheterization and Intervention Committee of the ACC, currently sits on the Guideline Writing Committee for Hypertrophic Cardiomyopathy, and regularly serves as Invited Faculty for the ACC, AHA, TCT and SCAI scientific sessions. Dr. Naidu has published extensively on angioplasty outcomes, new technology and innovative procedural modifications. He is Associate Professor of Medicine, SUNY Stony Brook School of Medicine.

Chief of Cardiology

Dr. Kevin P. Marzo, M.D, is a world recognized expert in Gp IIb/IIIa receptor antagonists, myocardial ischemia and Vascular Biology. Dr. Marzo is an accomplished interventional cardiologist skilled in all aspects of vascular interventions, including coronary stenting, vascular brachytherapy, intravascular ultrasound, rotational atherectomy, peripheral vascular and renal artery stenting and percutaneous balloon valvuloplasty. An esteemed member of the Winthrop faculty since 1992, Dr. Marzo has played an integral role in transforming the Hospital's cardiology program into a state-of-the-art cardiac care service.

Dr. Marzo is a Diplomate of the American Board of Internal Medicine, Subspecialty of Cardiovascular Disease and Interventional Cardiology. Dr. Marzo earned his M.D. at Northwestern University Medical School. His postgraduate clinical training included fellowships in interventional cardiology and clinical cardiology at the Hospital of the University of Pennsylvania and a residency in internal medicine at Columbia-Presbyterian Medical Center.

Dr. Marzo is an Associate Professor of Medicine at the State University of New York (SUNY) Stony Brook School of Medicine. A Fellow of the American College of Cardiology and active in cardiovascular research, he has presented papers at many professional conferences, published numerous articles in medical journals and is presently a principal investigator involved in a host of clinical trials focusing on acute myocardial infarction, unstable angina and new interventional techniques

At-a-Glance

1. 4 state-of-the-art digital (flat-panel) dedicated cath labs including 2 fully-capable peripheral cath labs.
2. Modern 18 bed recovery room and additional 6 bed short-stay unit
3. Efficient lab with excellent turnaround times, high staff morale, and minimal staff turnover (20 nurses, 12 CV-technologists and 6 PAs/NPs)
4. Open lab with full-time and voluntary faculty
5. Latest technological advances, including laser atherectomy, integrated tableside IVUS/FFR, intracardiac echo, and Impella entricular assist device and TAVR.
6. All coronary, peripheral and structural procedures represented, with consistently high and growing volume.
7. Computerized physician order entry. State of the art Cardiology PACS system allowing for database mining, case review, remote access and quick, efficient procedural report generation.
8. Growing regional and national reputation, with leadership at the national level
9. Track-record of ongoing multiple clinical trials, including cutting-edge technical advances such as LAA closure.
10. Active and highly successful multi-disciplinary STEMI door to balloon program.
11. Fellowship training exclusively at Winthrop University Hospital, ranked consistently by Health Grades and New York State for superior cardiac and procedural outcomes.
12. Generous house staff benefits, including heavily subsidized housing within walking distance from hospital.

Curriculum Summary : A brief description of the Interventional Cardiology Fellow Curriculum is shown below.

Clinical

1. Fellows will spend the majority of their time in the interventional laboratories, where they will be responsible for the pre-procedural, procedural, and post-procedural care of all patients. They will be assisted by the cath lab PAs /NPs(6), CV-technologists (12) and recovery room nurses (20). Fellows will understand the indications and contraindications to all planned procedures, and be directly involved in the decision-making process and technical aspects of all diagnostic and interventional procedures. The post-procedure management will be discussed after each case.
2. Fellows will be responsible for an outpatient office experience, where they will see pre-procedure and post-procedure interventional patients, as per ACGME requirements.
3. Fellows will be responsible for initial inpatient consultations on specialized procedures such as ASD/PFO closure.
4. Procedural volume is anticipated to be between 250 and 500 interventions per fellow, with additional 75 peripheral interventions and 25 structural interventions per year.
5. Fellows will learn from both the full-time and voluntary staff, with an expectation that they will therefore learn a multitude of techniques and styles.
6. Fellows will be responsible for teaching and supervising the general cardiology fellows on rotation in the lab.
7. Fellows will be responsible for interventional peer review of cases that surface through the Cardiology Quality Improvement process, presenting cases at regularly scheduled monthly sessions.

Research

1. Fellows are expected to participate in ongoing clinical trials, of which there are typically 3-5 at any time. Fellows serve as sub-investigators on individual trials, and assist with recruitment and enrollment of patients, and with the follow-up process as required.
2. Fellows are expected to pursue scholarly activity towards the presentation of original research or case reviews at national meetings. In addition, at least one publication per fellow is expected. There is adequate attending mentorship to facilitate this requirement, as past fellows have presented routinely at AHA, TCT, ACC and SCAI scientific sessions.
3. Fellows may take part in database analysis projects through Winthrop’s affiliation with the NHLBI Dynamic Registry, New York State PCI Database and the Long Island Angioplasty Database.

Didactic Conferences

1. Cath Conference: Held every Wednesday throughout the year, these conferences focus on didactic sessions of various relevant interventional topics. Lectures are given by general cardiology fellows, interventional fellows, cardiology attendings, and visiting physicians. There are also regularly scheduled film review sessions at both the general cardiology and interventional cardiology level.
2. Journal Club and Research Meetings: Held regularly as per ACGME requirements, to review ongoing clinical trials and discuss manuscripts of particular and timely relevance.
3. Vascular Conference: Weekly conference held with interventional radiology, vascular surgery and interventional cardiology, to discuss endovascular case selection, and procedural techniques.

Regional Conferences and National Meetings

• Fellows participate in the Long Island Cardiology Fellows Forum, which brings together cardiologists and fellows from all regional cardiology fellowship programs to discuss cases and review management at dinner. The best cases are selected for submission to national meetings including TCT and SCAI.

Vacation and National Meetings

• Four (4) weeks vacation, as one or two-week blocks. Not permitted during July or during the final two weeks of June.
• National meeting attendance (AHA, ACC, TCT) based on selection for national presentation of research or case reviews.
• Fellow Conferences: One meeting allowed per fellow, to enhance board preparedness.

Files for Download

• Download the Full Interventional Cardiology Fellow Curriculum
• Criteria for Selection of Interventional Fellows
• Download the 2011-2012 Conference Schedule

FACILITIES AND PROCEDURES

The John D. Miller Interventional Cardiology Pavilion houses 4 cardiac catheterization laboratories, two of which are fully peripheral capable with larger image acquisition and digital subtraction angiography. These labs are not shared with any other service. The 4 labs are combined with a 18 bed dedicated invasive cardiology recovery room, and a separate 6 bed overnight stay unit. All four labs are fitted with integrated tableside IVUS and FFR. The interventional program performs over 5000 procedures annually, including 1500 coronary interventions, 200 peripheral interventions, and 50-100 structural interventions per year. The lab also sees approximately 200 acute ST elevation myocardial infarctions per year, and runs an active and successful door-to-balloon program. The full range of interventional techniques and technology are represented, with the fellow typically performing 250-500 coronary interventions per year, 25 structural interventions per year, and over 75 peripheral interventions per year. Most importantly, fellows leave feeling comfortable to perform independently and at a high level post-fellowship.