Clinical training serves as the cornerstone of the Interventional Cardiology Fellowship. Trainees serve as the primary assisted operator during procedures and work one-on-one with faculty. The program strives to provide the proper balance between autonomy and supervision. Emphasis is placed on procedural indications, appropriate use criteria, fundamental and advanced procedural skills, techniques and decision-making, and post-procedural care. In addition to cath lab-based training, Fellows also spend one-half day per week in the outpatient clinic, which provides the opportunity to evaluate patients prior to and following procedures.
Coronary Artery Disease
The University of Rochester is a high-volume PCI center where both “routine” and complex interventions are performed. As an urban medical center with a busy emergency room, there is an active primary PCI program for the management of acute MI. The University of Rochester also is as a tertiary referral center serving a large portion of New York State. The vast majority of our coronary procedures are performed via the radial artery approach, allowing Fellows to obtain expertise in this technique. Advanced coronary therapeutic and diagnostic modalities are available, including optical coherence tomography (OCT), intravascular ultrasound (IVUS), Fractional Flow Reserve (FFR), as well as atheterectomy, thrombectomy and investigational devices. We have active programs for chronic total occlusion (CTO) percutaneous coronary intervention as well as complex high-risk indicated PCI procedures (CHIP).
Peripheral Vascular Disease
Patients with the full spectrum of peripheral vascular conditions are evaluated and undergo treatment in the catheterization laboratory. During training, particular emphasis is placed on knowledge of indications, therapeutic alternatives (medical, endovascular, and surgical), and technical skills for performance of angiography and percutaneous revascularization.
Structural Heart Disease
Endovascular management of structural heart disease has become a standard therapeutic alternative to surgical therapy for a variety of conditions, and represents a key component of the training program at U of R. Fellows currently participate in a variety of cath lab-based procedures for the treatment of structural heart disease, including:
- Transcatheter Aortic Valve Implantation (TAVI)
- Transcatheter Mitra Valve Replacement (TMVR)
- ASD/PFO closure
- Aortic, mitral and pulmonic balloon valvuloplasty
- Embolization procedures for acquired and congenital cardiac anomalies
- Watchman left atrial appendage closure
Alcohol septal ablation is integral in the management of hypertrophic cardiomyopathy. Dr. Christopher Cove has established a busy alcohol septal ablation program and Interventional Fellows have the opportunity to actively participate in these procedures.
Cardiogenic Shock and Advanced Heart Failure
The University of Rochester serves as the sole cardiac transplant center in Central and Western New York, runs a high-volume ventricular assist device (VAD) program, and has a busy mechanical circulatory support (MCS) program for patients with acute cardiogenic shock. Interventional fellows actively participate in percutaneous LVAD, RVAD and ECMO implantation.