The clinical programs are very active at the VCU Medical Center and the Hunter Holmes McGuire VA Medical Center, allowing fellows to gain experience with a diverse patient population and a broad array of complex inpatient and outpatient cares. Fellows also have an opportunity for a weekly outpatient clinic to follow select post-revascularization patients. Notable clinical strengths include a wealth of varied patient problems, the team approach to complex patients, and the dedicated shock team involving a multidisciplinary group to address complex clinical situations. The fellows are involved and exposed to all different associated devices involved in interventional cardiology, including FFR, IFR, IVUS, OCT, CTA, MRI as part of their imaging tools. From a device stand point, rotational atherectomy, CSI atherectomy, filter protection, aspiration devices are all part of daily procedures. The fellows are also exposed to significant number of high risk intervention, protected PCI and complex CTO including re-entry devices and retrograde approach. LVAD are also very often used including, Impela 2.5, CP and 5.0, Impela RV and ECMO.
From the PAD stand point, procedures from the interventional cardiology team and the interaction with the vascular surgery team makes the experience very broad and attractive. All types of devices and techniques are used including CSI, SilverHawk, and laser atherectomy. Filter protection, drug coated balloons, drug eluting stents are part of the daily practice. Antegrade and retrograde approach including pedal access interventions for patients with critical limb ischemia are some of the advance techniques
During the clinical activities, fellows are encouraged to participate in ongoing research projects and to publish on topics of clinical interest. Current laboratory investigations are focused on prevention of contrast induced nephropathy, radiation exposure to operators and patient, P2Y12 receptor inhibitors in liver failure patients undergoing PCI, P2Y12 receptor inhibitors in low platelets patients undergoing PCI and CTO interventions in CHF populations, among many others.
Fellows also participate in quality improvement projects. Each year a dedicated quality improvement project is selected based on specific topic of concern or interest. Current projects include same day PCI and prevention of CIN.
The laboratory has a long history of evaluating new technologies as well as drug used as adjunctive treatment in association with coronary intervention. Fellows interested in a second specific-research year should make the program aware of this desire, and every attempt will be made to accommodate such an interest.