Goal of Interventional Cardiology Fellowship
The program is structured to give graded autonomy to the trainee commensurate with their level of training with a significant emphasis on performing the procedure as the primary operator. The expectation is that the interventional fellow will be capable of performing a coronary intervention independently (with direct supervision as required) within the first 6 months.
Training Facilities & Locations
UNC Medical Center; Chapel Hill, NC
The C.V. Richardson Cardiac Catheterization Laboratory at the University of North Carolina, Chapel Hill is a state of the art facility. The laboratory was completely renovated and fully refurbished in 2012 and again in 2016 with the latest Philips Allura Xper FD20 and FD10 systems. The center is a high volume, regional referral center with the distinction of receiving the AHA Mission: Lifeline initiative’s Gold Plus Performance Achievement Award for excellence in STEMI care.
UNC Rex Hospital; Raleigh, NC
Interventional fellows will also spend 4 months of the academic year at UNC Rex Hospital (UNC Health Care) in Raleigh, working with the North Carolina Heart & Vascular Group in a high volume percutaneous coronary intervention and peripheral vascular intervention center. UNC Rex’s new North Carolina Heart and Vascular Hospital opened in 2017.
Interventional fellows will easily exceed the ACCF COCATS training minimum of 250 PCI procedures and will typically perform at least 350 coronary interventions as primary operator during the 12-month period. All fellows will be eligible for the American Board of Internal Medicine (ABIM) Interventional Cardiology Board examination. There has been a 100% pass rate amongst graduates from the program to date.
In addition to gaining expertise in complex coronary interventions, fellows will gain receive extensive training in peripheral interventions. Fellows will easily exceed competency requirements for diagnostic and interventional peripheral procedures and will become proficient in the percutaneous treatment of peripheral arterial disease. This includes training in orbital, laser, and directional atherectomy, distal embolic protection, and treatment of critical limb ischemia, including acute limb ischemia. Most fellows will complete well over 100 peripheral interventions and over 150 diagnostic peripheral cases, including the following:
At the end of the 12-month training, Interventional Fellows will be comfortable independently performing the following procedures:
- Primary PCI
- Aspiration Thrombectomy
- Trans-radial diagnostic and interventional cases (including STEMI and complex trans-radial)
- FFR, IVUS, OCT
- LV Support Device insertion including Impella and IABP
- Distal embolic protection devices
- Rotational Atherectomy
- Laser Atherectomy
- Orbital Atherectomy
- Complex PCI including Chronic Total Occlusion, Unprotected Left Main, and Bifurcation PCI
- Vascular Closure Devices: Perclose, Angioseal, Mynx
- Superficial Femoral
- Below the knee run-off
Interventional fellows cover call only while at UNC Medical Center in Chapel Hill. It is home call, and the frequency is 1 in 3, averaged out over the course of the year. The fellow on call will be available for STEMI, high-risk NSTEMI, hemodynamic support, and assistance with bedside procedures such as IABP and temporary pacing wires in the critical care unit. The interventional fellows determine their own call schedule. There is no call requirement while rotating out at UNC Rex Hospital.
Interventional Cardiology Case Conference (Thursdays, 7 am)
A review of interesting cases with specific emphasis on interventional aspects and techniques.
Interventional Boards Core Curriculum (Thursdays, 7 am)
A core didactic lecture series directly following the ABIM Interventional Cardiology Board examination syllabus with a review of board style questions with each session.
Diagnostic & Hemodynamic Review (Wednesdays, 7 am)
A review of interesting diagnostic and hemodynamic cases from the previous week.
Quarterly Regional Interventional Case Conference
A regional conference organized by UNC with participation from all the major teaching institutions in the greater Triangle area and beyond, providing an opportunity for interventional fellows to present interesting cases at a regional level and learn from valuable discussion with other interventional cardiologists.This is a very popular and always educational event.
Fellowship Research Highlights
Arora S, Misenheimer JA, Jones W, Bahekar A, Caughey M, Ramm CJ, Caranasos TG, Yeung M, Vavalle JP. Transcatheter versus surgical aortic valve replacement in intermediate risk patients: a meta-analysis. Cardiovasc Diagn Ther. 2016; 6(3): 241-249.
Yadav PK, Kaul P. Fellows-in-Training & Early Career Page–The First Anniversary: A Vision, a Motivation, an Opportunity. J Am Coll Cardiol. 2015 Jul 7;66(1):88-9.
Iyer S, Bauer T, Yeung M, Ramm C, Kiser AC, Caranasos TG, Vavalle JP. A heart team and multi-modality imaging approach to percutaneous closure of a post-myocardial infarction ventricular septal defect. Cardiovasc Diagn Ther. 2016 Apr;6(2):180-4.
Escaned J, Echavarría-Pinto M, Garcia-Garcia HM, van de Hoef TP, de Vries T, Kaul P, Raveendran G, Altman JD, Kurz HI, Brechtken J, Tulli M, Von Birgelen C, Schneider JE, Khashaba AA, Jeremias A, Baucum J, Moreno R, Meuwissen M, Mishkel G, van Geuns RJ, Levite H, Lopez-Palop R, Mayhew M, Serruys PW, Samady H, Piek JJ, Lerman A; ADVISE II Study Group.JACC Cardiovasc Interv 2015. 8(6): 824-33.
Yadav PK, Halim SA, Vavalle JP. Training in structural heart interventions. J Am Coll Cardiol. 2014; 64(21):2296-8;
Kaul P, Federspiel JJ, Dai X, Stearns SC, Smith SC Jr, Yeung, M, Beyhaghi H, Zhou L, Stouffer, GA. Association of inpatient vs outpatient onset of ST-elevation myocardial infarction with treatment and clinical outcomes. JAMA 2014; 312(19): 1999-2007.
Dai X, Bumgarner J, Spangler A, Meredith D, Smith SC, Stouffer GA. Acute ST-elevation myocardial infarction in patients hospitalized for noncardiac conditions. J Am Heart Assoc. 2013; 2(2):e000004.
Stouffer GA, Dibona GF, Patel A, Kaul P, Hinderliter AL. Catheter-based renal denervation in the treatment of resistant hypertension. J Mol Cell Cardiol. 2013; 62:18-23.
If you have any questions, please feel free to contact Amanda Borland by email at Amanda.Borland@unchealth.unc.edu.