The Interventional Fellowship at Wake Forest University School of Medicine is a fourth year of training subsequent to a conventional three-year General Cardiology fellowship to prepare the individual for a career in Interventional Cardiology. Applicants should be eligible for Cardiovascular Disease specialty boards.
The program is offered to three fellows per year.
Interventional Cardiology Welcome and Overview
Sanjay Gandhi
One of the constants in the training program and the program itself has been the commitment both to providing the best possible care we can for our patients, and also providing the best possible training that we can for our fellows. Within that context, we've certainly seen a lot of growth within the program itself as it's evolved.
Manrique Alvarez
Fellows are exposed to a wide range of procedures that span the whole breadth of the field, and that includes all our subspecialties.
Matthew Belford
It's one of the rare programs that in a one-year program you'll be clinically competent in a large number of things.
Manrique Alvarez
We have large procedural volumes, which is critical for our fellows to become proficient operators, and they do so within the span of one year of sub-fellowship for interventional cardiology and two years for EP.
Matthew Belford
We did about 1,300 PCIs last year. Each of our graduating fellows last year ended up with about 300 stents in the last year. Interestingly, we have a higher case mix in this day and age in terms of complex procedures, so CTOs, mechanical support, a rich volume of STEMI, which is predominantly radial things like structural cardiology. We've had an incredible growth in that program across the board in the last year. Each of the fellows ended up with over 50 TAVRs last year. We have a full mix of mechanical support, including balloon pump, Impella, ECMO, Tandem Heart, as well as a very active PE program with both FlowTriever and ECOS as well.
Manrique Alvarez
We have a relatively small group, but they have full-time appointments and are quite dedicated to teaching. This exposure to different styles and strengths and weaknesses for that matter result in a well-balanced and strong training experience for our fellows at Wake Forest.
Matthew Belford
It's important that our fellows feel like they're part of a team. We have a rich team from the general fellows that they work with, the APPs, but also the clinical faculty. I think all of our faculty feel like they're really a colleague with the interventional Fellows, and that relationship is actually really important to us.
Sanjay Gandhi
And now we have that unique opportunity of taking advantage of many of the wide resources available within the Atrium Health System. And just like this gives us an opportunity to really advance care within our region, this also gives us an opportunity to compliment and supplement the already rich layer of training that we have for our fellows.
Manrique Alvarez
What I cherish most about the program here at Wake Forest is the collegial learning environment throughout the entire heart and vascular space. That includes CT surgery, vascular surgery, along with all of the cardiology subspecialties in addition to the teaching from the dedicated faculty, resulting in friendships made with faculty fellows and staff alike. Camaraderie among our fellows is high. They learn, train and worked together closely and form quick bonds from shared experiences and cases. Moreover, being a small group allows for building valuable and long-lasting relationships that continue well beyond their years of training.
Program Goals and Objectives
The primary focus of the program is to achieve a high level of excellence in clinical judgment, case selection and technical expertise with a variety of interventional equipment. There is a strong emphasis on appropriate inpatient and outpatient management to provide the highest level of effective care and follow-up for patients undergoing interventional procedures. By the end of the year graduates will be able to perform as an independent operator and contribute in either clinical practice or an academic setting and be viewed as leaders in their specific medical community.
The Fellowship program includes treatment of
- Coronary artery disease: PCI of stable ischemic heart disease, acute coronary syndromes, complex and high-risk CAD including CTO, rotational/orbital atherectomy, IVL, Excimer laser atherectomy
- Structural/valvular heart disease: TAVR, TEER, TMVR, TPVR, PFO and ASD closures and LAAO
- Pulmonary embolism: UACDT, mechanical thrombectomy
- Cardiogenic shock: mechanical circulatory support including IABP, percutaneous LVAD and RVAD (Impella and Tandem Heart) and ECMO
- Peripheral arterial disease
These treatments include
- Minimally invasive heart surgery/ hybrid cases to replace mitral valves,
- Implant clip in mitral valve to redirect blood flow
- TAVR (transcatheter aortic valve replacement) for severe aortic stenosis
- Ventricular assist devices
- CTO PCI
