Educational Curriculum

The Interventional Cardiology Fellowship Program is conducted at St. Joseph’s University Medical Center and at St. Michael’s Medical Center.  The interventional cardiology fellows’ training time will be divided equally between the two sites in order to gain experience treating diverse patient populations as well as the opportunity to learn from a variety of faculty members to gain exposure to varied, strategic approaches, techniques, and technologies.  

In addition to training in the technical aspects of performing interventional procedures, the interventional cardiology fellow must develop a cognitive knowledge base that it is required for determining procedure appropriateness, case selection, technique selection, procedure conduct, and adjunctive therapy selection.  This knowledge will be conveyed via instruction during cases and through weekly interventional and medical/surgical conferences.  Topics to be covered include:

Anatomy: Cardiac, vascular and coronary artery anatomy, including anatomic variants and congenital abnormalities.

Physiology: Basic circulatory physiology, coronary vascular physiology, myocardial

blood flow regulation, myocardial physiology and metabolism.

Vascular biology and pathology: Normal vascular structure and function, response to injury, mechanisms of atherosclerosis and mechanisms of restenosis.

Hemostasis: Intrinsic and extrinsic coagulation cascade and platelet physiology.

Pathophysiology: Myocardial ischemia and infarction, myocardial reperfusion,

circulatory shock, anaphylaxis and cardiac arrhythmias.

Pharmacology: Anticoagulants, antiplatelet drugs, thrombolytic drugs, X-ray contrast agents, myocardial inotropes, vasopressors, vasodilators, antiarrhythmic

drugs and drugs affecting lipid metabolism.

Radiology imaging and radiation safety: Principles of X-ray imaging, quantitative

coronary arteriography, operation of cinefluorographic X-ray equipment, operation of digital video imaging systems, radiation biology and radiation protection.

Intracoronary imaging and coronary physiology: Principles of intravascular

ultrasound imaging and Doppler coronary flow velocity measurements.

Interventional device design and performance: Device materials and characteristics.

Clinical management strategies: Performance and limitations of interventional devices, spectrum of coronary ischemic syndromes, results of interventional cardiology clinical trials, management of acute hemodynamic alterations and mechanical and pharmacological circulatory support

Core Procedure Capability

The training program will offer a core experience in the following interventional techniques:

  1. Conventional balloon coronary angioplasty
  2. Coronary artery stents
  3. Primary angioplasty for acute myocardial infarction
  4. Atherectomy techniques
  5. Intravascular Ultrasound
  6. Intra-aortic balloon counterpulsation and other techniques of mechanical circulatory support
  7. Cardiac valvuloplasty
  8. Endomyocardial biopsy
  9. Coronary flow measurement (including fractional flow reserve)
  10. Transcatheter closure of congenital defects
  11. Laser atherectomy techniques
  12. Rheolytic techniques

Fellows will also experience the full range of arterial access techniques.  These will include transfemoral, transbrachial, and transradial approaches and will also include the cut-down technique when appropriate.

Fellows will treat the full range of coronary lesion subsets including Type A, B, and C lesions; acute and chronic total occlusions; heavily calcified lesions; saphenous vein graft lesions; and lesions accessed via arterial bypass grafts.

 

Didactic Sessions

Our robust didactic sessions are considered the highlight of our Program.  Faculty and nationally acclaimed physicians provide the most up-to-date research and clinical developments.

Wednesday afternoon

Cardiology Cath Conference

Thursday mornings

(lectures reciprocate)

Interventional Cardiology Lecture

Interventional Morbidity & Mortality

Interventional Journal Club

Thursday afternoons

(lectures reciprocate)

Cardiology Cath Conference

Interventional Cardiology Morbidity & Mortality

Friday mornings

Research Meeting - Monthly

 

PGY 7 – First-year fellow

Cardiac Catherization Laboratory

12 months

Vacation (runs concurrently)

  1 month

Weekly Continuity Clinic experience takes place one afternoon every week for approximately four hours.  Fellows will manage approximately 6-8 new and returning patients in each clinic session.  Telemedicine is utilized as appropriate.  All clinic experiences take place under the supervision of our highly-skilled clinical faculty members.