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Interventional

Led by a group of nationally and internationally recognized physicians, the Interventional Cardiology service provides state of the art facilities for a full spectrum of coronary, structural heart, and peripheral vascular interventions (PVI).

Areas of interest include complex coronary angioplasty, structural heart interventions such as transcatheter aortic valve (TAVR) and mitral interventions, and peripheral vascular disease therapies. The peripheral vascular service includes a multidisciplinary limb salvage program and one of the largest carotid programs nationwide.

Focus

Photo by Harold Shapiro

Yale Cardiovascular Medicine Interventional Cardiology Program

The Yale Interventional Cardiology Program has an established history as a leader in cardiovascular catheterization and intervention providing state of the art care for patients in the New England area, and as a national and international referral center for complex percutaneous interventional procedures in the structural heart and peripheral spaces. The Yale Interventional team services Yale New Haven Health System which encompasses (Yale New Haven Hospital, Greenwich Hospital, Lawrence and Memorial Hospital, Bridgeport Hospital), the West Haven Veterans Affairs Medical Center.

Yale Interventional cardiology is focused on global cardiovascular patient care with specialists in complex coronary disease, structural heart disease, and peripheral vascular diseases. We both lead and participate in a variety of clinical trials to develop devices and techniques to manage the unmet patient needs in cardiovascular medicine. Our research team is engaged in clinical investigation locally and also has global reach via our investigational team, infrastructure, and core laboratories with Yale Cardiovascular Research Group (YCRG). We have developed international affiliations with major academic center including The Barts Heart Institute in London, England, the University of Athens Medical School in Greece, providing synergies in clinical medicine, research, and education world-wide. The overall goal of these programs is to provide a framework to enhance research and development by providing an infrastructure and network for academic research and vertical device development, from bench to regulatory approval.

From the early history of interventional cardiology, Yale has been a recognized leader in the field with among the world’s first applications of rotational atherectomy, coronary stents, and brachytherapy to the current era of advanced coronary revascularization, transcatheter valve repair and replacement, and endovascular patient care including limb-salvage and complex peripheral interventions. Through involvement in developing and delivering these technologies, our team at Yale is excited to live in a fun, innovative, and rapidly evolving time in interventional cardiology.

Clinical Environment

Clinical practice, research, and training in interventional cardiology takes place primarily in the catheterization laboratories on the two campuses of Yale New Haven Hospital and at the West Haven Veterans Affairs Hospitals. The flagship Yale New Haven Hospital’s Interventional Suites include 7 adult and pediatric, and 2 hybrid OR-Cath lab suites. Within the interventional cardiology cath labs reside one Phillips FD 10/10 hybrid biplane room (scaled for adult congential-structural, transcatheter aortic valve, and adult coronary procedures), two rooms with ceiling mounted Siemens Artis Zee flat detectors and large 56” multimodality image display, one coronary-peripheral vascular interventional suite with Siemens Artis Zeego with large detector and image display and full peripheral capabilities, and a large flat panel, GE solutions coronary-vascular interventional room.

Yale New Haven Hospital performs ~10,000 diagnostic procedures and ~2000 coronary interventional procedures/cases annually. Yale Interventional cardiology accounts for ~75% of the procedural volume at the flagship Yale New Haven Hospital, and fully supports coronary and peripheral vascular interventions throughout the health system and at the West Haven VA Medical Center. Yale Interventional Cardiology is equipped with state-of-the-art technologies and practices leading edge percutaneous intervention.

Fellowship Program

Fellows reviewing heart pathology specimens with Dr. Henry Cabin.
Training
Fellows reviewing heart pathology specimens with Dr. Henry Cabin.

Directed by Robert Attaran, MD (deputy director Ryan Kaple, MD) the Interventional Cardiology Fellowship is a one-year ACGME-accredited program that is performed upon completion of a three-year fellowship in Cardiovascular Disease. The main objective of the Fellowship Training Program in Interventional Cardiology is to provide an academically and clinically rigorous training program for the cardiology trainee to obtain the necessary skills and judgement in cardiac interventional procedures. To apply, please complete this application for advanced training. The program is undergoing restructuring and will be extended to a 2-year advanced training model in the future. Applicants will have the opportunity to apply to a rigorous training program, the first year of which will consist of interventional cardiology and the second year, a choice of structural, peripheral vascular or research.

The program is comprised of:

  • Four ACGME accredited positions for focused 1-year training in Interventional Cardiology
  • Two Yale Continuing Non-ACGME accredited positions in an Advanced Interventional Cardiology Fellowship in Structural Heart Disease
  • Four Yale Non-ACGME accredited positions in a Peripheral Vascular Interventions Fellowship
The core of interventional fellow training centers on the hands-on experience of performing cardiovascular interventions on a broad range of patients, with a wide spectrum of techniques and clinical scenarios. Yale Interventional Cardiology holds weekly meetings for case review, journal club, and a series of didactic lectures centered on core materials for the Interventional Cardiology Subspecialty Board Exam. Other educational venues include weekly Cardiac Catheterization Conference and Yale Cardiovascular Medicine Grand Rounds.

Interventional trainees participate in all interventional procedures at Yale New Haven Hospital and West Haven VA Medical Center. All trainees have a primary responsibility for inpatient evaluation and management of patients with acute MI, unstable angina, and stable angina. Trainees are also encouraged to participate in the evaluation and management of patients with peripheral vascular disease, including participation of diagnostic and therapeutic procedures for iliac, femoral, renal, carotid, and subclavian disease. Outpatient training occurs through the Branford and Guilford offices of Yale Cardiovascular Medicine. All Interventional trainees see patients one half day a week for primary evaluation and for follow up after hospitalization or after elective interventions.

Interventional fellows may also actively pursue research interests in basic science, with recent trainees involved in angiogenesis, stem cell therapy, and cardiac gene therapy research. Fellow trainees are particularly encouraged to participate in these local protocols; nonclinical research time can be tailored to the individual trainees needs and toward completion of an independent research project. Collaborations with other members of the cardiology section and members of the medical school faculty are strongly encouraged. Opportunities exist for fellows to develop local clinical research projects as well as participate in national research agendas via innovative multicenter trials and/or through Yale Cardiovascular Research Group and core laboratories.

Research

As the first cath lab in the northeast to use rotational atherectomy, and the first in New England to place an intracoronary stent, Yale has a tradition of research innovation. Led by Alexandra Lansky, MD, Director of the Clinical Research Program, Yale participates in a variety of multicenter clinical trials including:

  • Evaluation of novel drug eluting balloons
  • Biodegradable coronary stent and scaffolds
  • Dedicated bifurcation stents
  • Novel therapies for coronary chronic total occlusion
  • Percutaneous valve therapies
  • Intravascular imaging
  • Modalities for cardiac biologic repair
Yale Interventional Cardiology participates in multicenter clinical device development trials in the United States, Europe, and Asia and assists with protocol development, implementation, and regulatory approval via the Yale Cardiovascular Research Group (YCRG) and its associated laboratories.

Faculty