Cardiovascular Disease Fellowship
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The Henry Ford Heart and Vascular Institute at Henry Ford Hospital is one of the nation’s top centers for heart and vascular disease. We believe that patient care, teaching, and research are all essential missions, and the Cardiology Fellowship underscores these missions with a program designed to provide excellent training in all aspects of modern cardiology. We are proud to offer one of the largest, most comprehensive fellowship programs in the nation with 37 cardiology fellowship positions in every major subspecialty of cardiology:
- 3 year General Cardiology Fellowship: 7 positions per year
- 1 year Interventional Cardiology Fellowship: 3 positions per year
- 2 year Electrophysiology Fellowship: 2 positions per year
- 1 year Advanced Heart Failure and Transplant Cardiology Fellowship: 2 positions per year
- 1 year Advanced Cardiac Imaging Fellowship: 1 position per year
- 1 year Structural Heart Disease Fellowship: 1-2 positions per year
- 1 year Complex, High-Risk and Indicated Coronary Interventions and Advanced Hemodynamic Care (CHIP) Fellowship: 1 position per year
- 1 year Structural Heart Disease Imaging Fellowship: 1 position per year
- 1 year Critical Care Cardiology Fellowship: 1-2 positions per year
The Cardiology Fellowship Program is designed to prepare fellows for academic or clinical practice in general cardiology or a subspecialty. With an emphasis on evidence based clinical training with robust volumes, a diverse patient base, and exposure to every stage of cardiovascular disease, the program provides an unmatched training experience in competitive fellowship programs. Fellows benefit from instruction and mentorship by over 50 full-time senior staff cardiologists who are leaders in their fields. Highlights of our program include:
- Overall an outstanding fellowship program with highest ACGME accreditation status recognizing the quality of instruction provided to fellows
- Henry Ford Hospital recognized by the ACGME as one of the best teaching institutions in the country, winning the 2019 ACGME Baldwin Award
- Active teaching agenda provides fellow education through structured didactics and exceptional clinical and procedural training
- General cardiology fellows all given opportunity to gain independent proficiency (level 2 training) in cardiac catheterization, comprehensive echocardiography, and nuclear cardiology
- Daily general cardiology fellow conferences, in addition to conferences in subspecialty fields, are designed to cover topics needed for general as well as echo and nuclear boards
- Frequent grand rounds with visiting scholars from all over the world
- Multiple opportunities for interaction with and teaching medical students and residents
- Daily teaching sessions with small groups, including faculty, on every rotation
- Extensive and vigorous research in peer-reviewed journals with numerous presentations annually at national and international meetings. In 2020, over 240 articles and abstracts were produced from our program.
- Fellows provided with time and faculty mentors for research as well as biostatistics support and institutional grants for research
- No 24-hour overnight call- program utilizes a night float system that is distributed among the 3 years of fellowship
- Program places an emphasis on fellow well-being and quality of life in addition to an outstanding training experience
- Prestigious alumni and faculty networks actively assist fellows in career placement after training
Henry Ford Hospital
Training takes place at Henry Ford Hospital, which is the flagship hospital and research center of the Henry Ford Health System, one of the largest health systems in the nation. Our program is affiliated with Wayne State University School of Medicine and Michigan State University. The hospital is a comprehensive, 877 bed urban tertiary and quaternary care hospital and regional referral center. As an integrated health care system and non-profit institution, we provide exposure to managed care, fee-for-service and indigent/uninsured patients. Other highlights include:
- One of largest intensive care unit complexes in the country with over 160 adult beds
- Center for clinical excellence in many fields including cardiology, cardiovascular surgery, neurology, neurosurgery, orthopedics, sports medicine, organ transplant, and oncology.
- One of three level 1 trauma centers in the region.
- One of the largest teaching institutions in Michigan – 50 ACGME accredited programs with more than 675 residents and fellows in training, and over 900 medical students annually.
- Strong institutional commitment to academic medicine and medical education.
- 116 residents in our IM residency, which is one of the most innovative programs in the country
Henry Ford Medical Group
The faculty at Henry Ford are members of one of the nation’s largest, best organized, and most respected medical groups, the Henry Ford Medical Group. Our staff consists of more than 1,500 physicians and researchers in more than 40 specialties who have trained at the best academic institutions in the world. Our self-governed, employed physician practice program has been praised because of our continuing success. The brightest minds in medicine are attracted to become part of the Henry Ford Medical Group because our organization provides physicians the independence to pursue advanced clinical care while undertaking research as well as academic educational initiatives.
- There are no private patients at Henry Ford Hospital - all patients are served by the Henry Ford Medial Group
- Physicians are dedicated to evidence-based medicine
- We are a national leader in health care and education – faculty have recently been presidents of the ACC, ABIM, ACGME, and AMA.
- Our faculty include the recent national ACC Chair of the Board of Governors and President of the Michigan Chapter of the American College of Cardiology in 2016-2019 (Dr. Akshay Khandelwal) and 2022-2025 (Dr. Karthik Ananth).
- 40% of all physicians in Michigan received training at Henry Ford Hospital at some point in their career, and our post-graduate medical education enterprise is among the largest in the country.
Henry Ford Heart and Vascular Institute
The Heart and Vascular Institute is a leader and innovator in comprehensive cardiac care, research and education. Our volumes are among the highest in the Midwest, giving us the experience to set protocols that become national standards. Our services include world-class heart failure, transplant, structural heart disease, advanced imaging, electrophysiology, interventional, cardiac and vascular surgery, and preventive cardiology programs. Other highlights of the training experience include:
Clinical cardiology training
- Inpatient service includes a superb 32-bed Cardiovascular Intensive Care Unit and a large cardiology inpatient service with 65 telemetry beds
- Large cardiology consult service provides care for hospital medical and surgical services as well as the Henry Ford Emergency Department
- Busy outpatient clinics serving a base population of more than 4.5 million people in Southeast Michigan.
- Very diverse patient base with exposure to both urban and suburban settings
- Extremely busy interventional program serving the Detroit metropolitan area and Southeastern Michigan with many regional, national, and international referrals
- Fellow-centric, fellow-friendly cath lab environment with outstanding full-time Interventional Faculty with national involvement as proctors, COCATS authors, ACC/SCAI/CRF faculty, and ACCSAP/CathSAP authors.
- Active research program participating in national and investigator-initiated trials
- More than 100 acute ST elevation myocardial infarctions and greater than 1,000 percutaneous coronary interventions performed yearly
- Five newly renovated state of the art cardiac catheterization laboratories at Henry Ford Hospital including 2 hybrid OR-cath lab suites.
- In addition to simple and complex coronary disease, fellows are exposed to peripheral vascular interventions, myocardial biopsies, intra-aortic balloon counterpulsation, pulmonary embolism interventions, and percutaneous left ventricular assist devices(including Impella, Tandem Heart, and ECMO)
- 70% transradial/distal transradial cath and PCI
- Fellows serve as primary operator in all diagnostic and most interventional cases
- Revascularization referral center of last resort for the Midwest due to our expertise
- Training in right heart catheterization including physiologic/vasodilator challenge and hepatic wedge pressure evaluation in evaluation of advanced heart failure/transplant/LVAD, pulmonary hypertension, and congenital heart disease
- Nationally recognized cardiogenic shock program
- World renowned chronic total occlusion intervention program
- Hospital performs over 400 cardiac surgeries per year, many of them complex.
- Henry Ford offers one of the only dedicated complex, high risk percutaneous coronary intervention (CHIP) sub-fellowship to train fellows in the most complex coronary interventions including chronic total occlusions and hemodynamic support devices
- Comprehensive training in all aspects of echocardiography in a busy laboratory performing more than 25,000 studies annually with electronic data mining capabilities for research projects
- In depth exposure to 3D transthoracic and transesophageal echocardiography and 2D strain imaging with the latest equipment and software
- Dedicated echo teaching curriculum with an emphasis on fellows working early on with sonographers to master scanning skills
- Training in the full spectrum of nuclear cardiology studies with all the latest protocols for stress perfusion imaging including CT attenuation correction, amyloid imaging, SPECT/PET imaging for ischemia/viability and PET sarcoidosis imaging and MUGA scans
- Outstanding nuclear didactic curriculum, led by current ASNC national board review chair and future ASNC president (Dr. Karthik Ananth), also includes interpretation basics of PET stress and viability and myocardial blood flow analysis with PET
- Advanced cardiac imaging training opportunities in cardiac CT and MRI
- Coronary CT angiography performed with state of the art 256-slice dual source CT scanners
- Robust cardiac MRI program with 3T and 1.5T magnets in routine clinical use
- Extensive research opportunities with ability to participate in single and multicenter noninvasive trials in addition to fellow driven projects with mentorship by nationally renowned noninvasive cardiologists
- We offer a multimodality advanced cardiac imaging fourth year fellowship opportunity as well as one of the nation’s first dedicated fourth year structural heart disease specific interventional imaging fellowships
State of the art electrophysiology facilities
Over 3000 studies performed annually including over 700 ablations; excellent exposure to consultative EP, pacemaker insertion and evaluation,and ICD implantation.
Very active VT ablation and high-risk lead extraction program with frequent referrals from around the region
State of the art magnetic navigation laboratory for complex ablations
Training in implantation of leadless pacemakers and conduction system (His bundle) pacing
The arrhythmia section is actively involved in clinical research and participates in national multi-center trials as well as on-going investigator initiated studies
Many notable recent accomplishments including first in Michigan to implant a subcutaneous defibrillator to treat patients at risk for sudden cardiac arrest without touching the heart, and the nation’s first program to implant the commercially available Watchman left atrial appendage closure device, and one of 2 centers in Michigan implanting the Remede system for central sleep apnea
Heart failure training
- Only hospital in Detroit metropolitan area performing heart transplantation or left ventricular assist devices, and only 1 of 3 in the state of Michigan
- Busy advanced heart failure services
- 25-30 heart transplants and 50 LVADs performed yearly
- Number one heart transplant program by volume in Michigan
- Chronically following over 200 heart transplant patients and over 150 LVAD patients
- Active research program including clinical trials, genomics and precision medicine, mechanical circulatory support, exercise physiology and pre-clinical/ basic laboratory studies.
- Mentors are active in heart failure and transplant societies and national registries. Heart Failure program generates about 50 publications per year.
- Extensive experience in intensive care including invasive hemodynamic monitoring and temporary mechanical circulatory support
- Pre-transplant evaluation including heart failure risk stratification, optimization, ambulatory invasive hemodynamic monitoring, and cardiopulmonary stress testing
- Post-transplant management including immunosuppression, and myocardial biopsy performance and interpretation
- Management of all forms of implanted ventricular assist devices (including temporary support) and artificial hearts
- Training in pulmonary hypertension management and participation in catheterization studies unique to patients with PH and RV failure
- Our team performs multiorgan transplants (e.g. heart lung, heart kidney)
- Multidisciplinary amyloid, sarcoid, and genetic cardiomyopathy program
Structural heart disease training
- One of the most active and innovative Structural Heart Disease (SHD) Programs in the world with:
- more than 2,500 patient encounters per year
- over 350 transcatheter aortic valve replacements per year (the largest volume in Michigan and one of the largest in the country). We performed our 1000th TAVR procedure in 2017 and 2000th on February 11, 2021!
- over 100 percutaneous left atrial appendage closures per year and over 600 to date
- over 100 mitral intervention procedures annually with over 400 MV-TEER (Transcatheter Edge to Edge Repair), 120 Transcatheter Mitral Valve Replacements, and 100 Percutaneous Mitral Valvuloplasties to date
- Review a complete listing of our Center for Structural Heart Disease procedure volumes.
- Our program receives the most complex referrals from other in-state and out-of-state structural programs
- Over 1000 patients treated with the aid of 3-D printing
- Multiple first in country and first in human successful SHD interventions including:
- First percutaneous mitral valve replacement in the world
- First hospital in the world to perform transcaval (from IVC to aorta) TAVR when traditional approaches are not available
- First percutaneous tricuspid valve replacement in the United States
- First-in-man late partial recanalisation after LARIAT suturing of the left atrial appendage successfully treated with an AMPLATZER™ septal occluder device.
- First-in-man experience with cryoplasty during graded balloon atrial septostomy to reduce spontaneous closure in a patient with severe pulmonary arterial hypertension.
- First fully percutaneous placement of a 5 liter Impella left ventricular support device via transcaval access
- First intentional percutaneous laceration of the anterior mitral valve leaflet to prevent outflow tract obstruction during transcatheter mitral valve replacement- LAMPOON procedure
- Novel use of Watchman in ascending aorta for embolic protection
- First ever transcarotid Lotus Valve TAVR procedure
- Multiple firsts in the state of Michigan including first Lariat percutaneous left atrial appendage closure, trans-apical TAVR, percutaneous trans-apical paravalvular leak closure, percutaneous transcatheter mitral valve-in-ring, first non-surgical mitral valve repair and commercial LOTUS Edge TAVR valve implantation
- SHD Director, Dr. Bill O’Neill, was the first cardiologist to perform a percutaneous aortic valve replacement in the United States (done prior to joining Henry Ford)
- Developed and lead the Detroit and now National Cardiogenic Shock initiative
- Developed, patented and published the Left Ventricular Outflow Tract Modeling protocol to assess for obstruction post mitral valve replacement. Now recognized as standard modeling protocol
- Developed and published left atrial appendage sizing algorythm: decreases procedure time and procedural complications
- Helped develop the use of Electrocautery transcatheter treatments
- LAMPOON: intentional laceration of the Anterior Mitral Leaflet to prevent outflow obstruction during TMVR
- BASILICA: intentional laceration of aortic valve leaflets to prevent obstruction during TAVR
- First institution in Michigan to perform over 350 Watchman (left atrial appendage closure) procedures
- Developed intentional right atrial exit insufflation to facilitate needle entry into the pericardial space
- Core lab for 3 major clinical trials: CT lab for MITRAL Trial, CT Lab for NIH Mitral trial and Echo lab for NIH Mitral trial
- Wide variety of transcatheter structural heart disease interventions including PFO/ASD/VSD closure, alcohol septal ablation, percutaneous aortic and mitral valvuloplasty, transcatheter valve replacement (all valves), percutaneous left atrial appendage closure, percutaneous repair for mitral regurgitation, balloon atrial septostomy, and percutaneous paravalvular leak closure
- One of the few programs in the state to perform MitraClip for mitral regurgitation
- One of few hospitals in the Midwest with access to both transcatheter tricuspid repair and tricuspid replacement clinical trials
- Fellows benefit not only from clinical and procedural exposure to SHD interventions but also from novel training in advanced structural heart imaging (e.g. 3D TEE in structural heart interventions, cardiac CT and MRI) that few programs are able to provide
- Partnership of our advanced cardiac imaging specialists with the Henry Ford Innovation Institute has resulted in the first 3D imaging program and 3D modeling of cardiac valves and structures to help make structural procedures safer and more effective.
- Henry Ford offers one of the first dedicated SHD fellowships in the nation and trains 1-2 fellows per year
- SHD fellows are primary operators on our broad range of SHD procedures. SHD training includes a comprehensive curriculum and participation in highly educational multidisciplinary conferences
Thank you for taking the time to learn about our program, and we hope that you will consider applying. As you can see the framework for our fellowship is strong, but the most important aspect of our program is our fellows. They are our colleagues and friends, and are clearly what makes our program so special. We hope to see you on the interview trail in Detroit, and please do not hesitate to contact us if you have questions.
Bob Rabbani, M.D., F.A.C.C.
Cardiovascular Disease Fellowship Program
Henry Ford Hospital