Overview
Cardiac Imaging
Dr. Sayyed and Dr. Higgins while discussing
multi-modality imaging cases with the fellows.

Cardiac Imaging

The echocardiography and advanced cardiac imaging rotations are led by a team of cardiologists with advanced level of training. Our fellows should expect to obtain competence within the first two years of training in TTE, TEE, and stress echocardiography. Our echo lab focuses on myocardial perfusion, a unique technique that our fellows are familiar with and can use to detect myocardial ischemia. Additionally, our program provides robust and growing training in structural and interventional echocardiography. Typical echo guided procedures include transcutaneous mitral valve repair/replacement, Watchman, and intracardiac closure devices. Our multimodality imaging rotations provide robust exposure to nuclear cardiology, cardiac MRI and cardiac CT. Training is individualized to each fellow in order to best suit their ultimate career goals. A dedicated fellow can achieve competence in these areas within three years of training, or additionally plan for a dedicated fourth year of training to meet level 3 requirements. Our fellows who trained in advanced imaging are very well-established, many of them are leading advanced imaging programs at other institutions nationally.

Electrophysiology
Dr. John Windle (middle) is hosting the
bi-monthly meeting of the electrophysiology
interest group. Lalit is starting EP fellowship
at NYU, Nashwa, John and Ahmed are
applying for the 2020 EP fellowship cycle.

Electrophysiology

As a large tertiary referral center, our fellows are exposed to the most challenging cases in electrophysiology. They are expected to achieve independence in interrogation and programming of pacemakers and implantable cardioverter defibrillators. With two dedicated invasive laboratories, trainees will have the option to participate in electrophysiology studies, as well as electroanatomic mapping and catheter ablation (both radiofrequency and Cryo) using the most advanced technologies.  Fellows do also have the opportunity to achieve Level 2 certification (6 months required) in pacemaker implantation, with hands-on instruction in device insertion, advanced programming, and remote monitoring.

 

Cath Lab
Real images obtained from our Cath lab
showing the use of advanced coronary
imaging techniques in the diagnosis of
complex coronary lesions.

Cath Lab

Our Cath lab performs a variety of coronary interventions, including complex high-risk patients (LM, LV supported, bifurcations, and chronic total occlusion cases). We have an extensive intracoronary physiology and imaging program using state-of-the-art technologies (OCT, HD IVUS). Our interventionists also perform peripheral and structural procedures (including TAVR, PFO closure, left atrial appendage closure, and Mitraclip). We have a very active hemodynamic Cath lab that performs over 700 right heart catheterizations every year (including over 500 myocardial biopsies). Our fellows receive extensive training in measuring and interpreting hemodynamics of complex heart failure and pulmonary hypertension patients.

See our new labs here:

 

Advanced Heart Failure and Transplant
Our weekly cardiac transplant meeting.

Advanced Heart Failure and Transplant

With over 40 cardiac transplantation, and about 70 LVAD implants every year, our heart failure program is considered one of the largest in the Midwest. Our fellows obtain extensive exposure to advanced heart failure patients and are very comfortable in dealing with complex hemodynamics and managing mechanical circulatory support devices (including ECMO, intra-aortic balloon pumps, and Intravascular Ventricular Support System). This level of exposure allows our graduates to be confident in treating the most complex cardiac patients independently.

Adult Congenital Heart Disease
Our adult congenital heart disease team of
specialists and advanced practice providers.

Adult Congenital Heart Disease

Cardiology fellows will have a unique opportunity to rotate with a group of board certified Adult Congenital Heart Disease (ACHD) faculty members. The ACHD program at UNMC is one of roughly 30 programs in the United States, and the only program in the region working directly with Adult cardiology fellows, certified as a center of excellence by the Adult Congenital Heart Association (ACHA). In addition to the core curriculum, fellows on the rotation will attend daily ACHD clinics at UNMC and Children’s Hospital. Additionally, fellows will be able to attend complex ACHD cardiac catheterizations and surgeries, as well as to review echocardiography and advanced imaging of these complex patients. Competitive advanced fellowship opportunities are available to cardiology fellows seeking additional training and board certification in ACHD (2 year fellowship via American Board of Internal Medicine (ABIM)).

Immersive Learning and 3D simulation
Dr. Chatzizisis, an interventional cardiologist,
is teaching coronary anatomy to a group of
Cath lab technicians and
cardiology fellows
using a 3-D simulation model.

Immersive Learning and 3D simulation

Our division has an active collaboration with the iEXCEL - a state-of-the-art program and infrastructure on medical simulations. Through our computational simulation and virtual/augmented reality platforms we provide a unique training and education on cardiovascular imaging and interventions to our faculty, fellows and staff. We are building simulation models that will form an essential component of the fellows’ experience during fellowship in a step towards migrating the education out of the conventional lecture rooms to a whole new world that allows the learners to dive within and relate to the educational materials. 
For more information about iEXCEL please visit https://www.unmc.edu/iexcel/index.html

For more information about our new Global Center for Advanced Interprofessional Learning, which is expected to open in September 2019, please visit https://app.truelook.com/?u=ug1485804873#tl_image_archives

Basic Clinical Research
Sonothrombolysis in ST-Segment Elevation
MI Treated with Primary PCI. Presented at the
2019 ACC meeting as a late breaking trial.
The
study is led by Dr. Thomas Porter,
and involved
investigators from 4 centers including UNMC.

Basic and Clinical Research

There is a large variety of research activities that are available at UNMC. Our clinical research is supported by a large database of patients who received advanced level of care at out tertiary center. Our well established electronic medical records system that contains over 2.2 million patients, the ongoing improvements to our data mining capabilities, as well as the high exposure to patients with relatively rare conditions, constitute a huge advantage for those interested clinical outcome research. Our center participates in a large number of multi-center trials for both new pharmaceutical and device therapies. Multiple of our cardiology faculty work on externally (i.e. NIH) as well as internally funded projects.   The Nebraska Cardiovascular BioBank has near 1000 research subjects consented and enrolled.  These BioBank subjects will facilitate the study of most all-cardiovascular questions via chart review and/or tissue-based cellular and molecular studies.  There is a variety of active projects in areas like cardiac perfusion imaging, cardiac genetics, coronary artery disease atherosclerosis pathology and computational models, molecular and cellular immunology, electronic medical records development, and others. 

Cardiology Department Research Activities 

Cardiovascular Biology and Biomechanics Laboratory