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Coming Home Pauley Welcomes Dr. Greg Hundley as First Director

It’s April, and Dr. Greg Hundley, VCU Health Pauley Heart Center’s fi rst-ever director, has started to move into his new offi ce in West Hospital. Around the room are stacks of boxes fi lled with books. A dry-erase board, not yet hung, leans against a wall.

Continued

VCU HEALTH PAULEY HEART CENTER 1 my desired research training,” he said. them to coronary angiograms. The research, “Research-wise, I had the distinct opportunity published by the American Heart Association, About to work with Dr. Hermes Kontos as well as gained significant international attention. He Drs. Joseph Levasseur, Enoch Wei and Joe also devised protocols for the use of MRIs Dr. Hundley Patterson.” in creating images of coronary arteries that Hundley felt drawn to cardiovascular supplied the heart muscle. “Dr. Hundley is a nationally and internationally medicine after working in the cardiovascular During this time, his innovative work recognized leader in his area of research ICU. “The patients were relatively sick, and caught the attention of Dr. George Vetrovec, on the cardiac complications of cancer there was a lot of satisfaction in the care that the former chair of cardiology who retired in therapy. His ability to collaborate with faculty could be delivered in that environment to 2015. “We sat next to each other at a dinner at VCU Massey Cancer Center is already make them well.” of the Society for Cardiac Angiography demonstrated through our participation in his From 1988 to 1996, he completed and Intervention. He had just won a prize cardiac toxicity prevention trials, which bodes his internship and residency in internal from the organization for imaging studies,” well for productive future collaborations medicine, as well as his fellowship in recalled Vetrovec, who later tried to recruit between our two centers. We are excited cardiovascular disease at Parkland Memorial Hundley—twice—but the timing wasn’t right. about him joining us at VCU Health.” Hospital and the University of Texas Vetrovec recalled his first impressions. “I — Dr. Gordon Ginder Southwestern (UTSW) Medical Center in thought he was very, very intelligent and Director, VCU Massey Cancer Center Dallas. There, while originally training to well-spoken and thoughtful. He had this be an interventional cardiologist, he grew innovative new technology and was at the “Dr. Hundley is a proud alumnus of fascinated by cardiac imaging. forefront of its development.” VCU School of Medicine, and we are His world changed the first time he saw While Hundley liked Dallas, he and his wife equally proud of him. With his outstanding an MRI. Parkland Hospital was one of few longed to get back to the East Coast, closer to reputation as a physician-scientist and facilities in the country to own the advanced family. When Dr. William Little at Wake Forest mentor, Hundley is a perfect fit as medical imaging system in 1993. “One morning Baptist Medical Center offered him a place on director. His research in the exciting I went over to pick up a patient from the the faculty in 1996, he accepted. program of cardio-oncology will build on magnetic resonance imaging scanners “They recruited me there because they our strengths. This is central to our strategy DR. GREG HUNDLEY POINTS OUT THE SUPERIOR IMAGING OF THE SIEMENS MAGNETOM VIDA 3T MRI SYSTEM. who was scheduled to undergo a heart had a lot of patients experiencing heart to attain comprehensive cancer center catheterization. On the screen of the MRI attacks and they wanted to use this new designation for Massey. Additionally, Dr. He wears a dark suit and a stylish at VCU Medical Center with the magnetic associate chair of research. “Hundley is an scanning console was an image of a beating MRI technology clinically,” he said. Hundley will elevate Pauley’s national tie. He is 56 years old but looks years resonance imaging (MRI) technology internationally renowned expert in cardiac heart as if it was being displayed on a high- Hundley and Little further developed prominence and federal research portfolio.” younger. necessary to do his high-caliber work. The imaging. He is not only a skilled clinician but definition TV,” he said. “Thirty years ago, that clinical MRI protocols to image coronary — Dr. Peter Buckley foundation raised an additional $5 million for also a talented researcher. He also brings an was an amazing accomplishment.” arteries and measure blood flow within Dean, VCU School of Medicine His glasses give him the appearance of Hundley’s recruitment and research. extensive experience in mentoring trainees them in patients a scholar—which, indeed, he is. Among “It was an amazingly generous gift of and junior faculty.” His world changed the first time he saw an MRI. presenting with chest his achievements, he has more than 200 Stan and Dorothy Pauley and their family, in “I was very impressed with Dr. Hundley Parkland Hospital was one of few facilities in pain suspected of peer-reviewed articles and $24 million in their tradition of commitment to excellence when I first met with him due to several the country to own the advanced imaging system experiencing a heart NIH grants, and 19 years of continuous NIH in health care delivery, that made this all factors, among which are his very humble in 1993. attack. At the time, Did you know... funding to his name. Despite this, Hundley is possible,” said Hundley. and pleasant personality, his excellent patients with blocked approachable. Sitting across from a visitor at The Pauleys’ gift enabled the foundation reputation as a physician-scientist, as well as Today, as during the 1990s, the cardiac arteries were treated with intravenous • Since 1999, Dr. Hundley has been a round table near his desk, he is friendly and to receive an additional $5 million in his vision for the heart center,” said Dr. Fadi catheterization lab used invasive procedures thrombolytic therapy, which involved using involved with more than $71 million in eager to talk about his new role with Pauley. matching funds from the Glasgow Salloum, Natalie N. and John R. Congdon Sr. incorporating angiograms—x-ray photos clot-busting drugs. With this therapy, “we awarded research funded grants. “There’s an enormous opportunity here Endowment. Endowed Chair. obtained by using contrast dye injected could never tell whether the infarct artery • He currently serves as associate editor with the talent at VCU Health. We have The suite will support his groundbreaking When asked about the impact of hiring through catheters placed in the arteries of was open or closed, and this MRI technique for Circulation and Cardiology Today and expertise in heart failure, cancer treatment, work in preventing and treating heart failure Pauley’s first director, Ellenbogen said, “It one’s arms or legs—to detect blockages in could do this.” serves on the editorial board of five other electrophysiology, image acquisition in cancer patients and mark a new era of is highly significant and very exciting. It will the coronary arteries. At Parkland and UTSW, After he’d been there less than three peer-reviewed journals. and analysis, bioinformatics, biomedical collaboration between Pauley and VCU’s be like taking us from the major leagues to investigators were working on noninvasive months, a superior new technology • He is married to his loving wife of 30 engineering and coronary heart disease,” he Massey Cancer Center. the World Series.” He added, “Dr. Hundley MRI methods that did not require an emerged that replaced thrombolytic therapy: years, Kim Hundley, a speech pathologist, said. “We have renowned physicians like Dr. “Massey has been one of the research is going to provide us with the depth in interventional heart catheterization balloon angioplasty. This meant MRI was “who has encouraged and tirelessly Kenneth Ellenbogen; a phenomenal CEO of sites with which we have collaborated in research and cutting-edge clinical research procedure to visualize and measure blood not needed to view the coronary arteries supported my career,” he said. The the hospital, Deborah Davis; and an exciting the past for my trials,” he said. “Now, with that will attract physicians from all over the flow in these same coronary arteries. because patients went straight to the heart Hundleys have three children: Anna, 22; new dean with a great vision, Dr. Peter the new lab, I’m going to work side by world to study, train and do research with us.” However, the process of viewing the heart catheterization lab to not only view the Jennifer, 18; and Will, 17. Buckley.” side with these same physicians as well Hundley grew up in Richmond, then and these arteries took a long time. “It arteries but directly open them. as VCU engineering attended the College of William and Mary, took probably an hour and a half to take 10 “So, I was stuck. Because I’d moved “I was very impressed with Dr. Hundley when I first and VCU Health where he met his wife, Kim, a native pictures of the heart, and then you stayed there to introduce this new technique, and met with him due to several factors, among which exercise physiologists, of Ashland. After graduating in 1984, he up all night typing binary commands so you Little came in said, `Well, we’re not going to are his very humble and pleasant personality, his behavioral scientists attended medical school at VCU School of could see them the next day,” he recalled. do that anymore.’ I said, `What am I going excellent reputation as a physician-scientist, as and cardiovascular Medicine. “Literally all night, until 4 to 6 a.m.” to do?’ And he said, `Well, you’ll think of well as his vision for the heart center,” said Dr. Fadi medicine specialists. “I was here when the transition occurred Today, instead of all-night sessions, something.’” Salloum. We are going to be to move the main clinical operation from “with MRI you can acquire and visualize a He soon discovered that being a using the very latest West Hospital to Main Hospital,” he said. complete 3D image data set of the whole physician deep in the heart of tobacco While winding down his practice at MRI and cardiopulmonary exercise test During his long hours as a medical student, heart in 15 seconds,” he said with a laugh, and barbecue country presented special Wake Forest Baptist Medical Center, where technologies, which are going to open up all he remembers taking a tunnel to the capitol still amazed. challenges. “A lot of people had coronary he served as program director for the kinds of possibilities. I’m looking forward to to eat at Chicken’s. Skull and Bones was Inspired, he became involved in research artery disease, but they were not very cardiovascular imaging program, he helped seeing what these collaborations will bring.” another favorite. with mentors Drs. David Hillis, Richard good candidates, because of their smoking the MCV Foundation secure funds to build a “We are all very excited to have him join “My class was large, with a lot of diversity Lange, Geoff Clarke and Ron Peshock to and obesity, to have pictures made of their new $4 million Cardiovascular Imaging Suite and lead Pauley,” said Dr. Antonio Abbate, and talent and phenomenal clinical and corroborate MRI findings by comparing heart noninvasively to determine if they

2 THE BEAT / AUTUMN 2018 VCU HEALTH PAULEY HEART CENTER 3 imaging suite, proved irresistible. Hundley will be able to continue and expand his work in the new Cardiovascular Imaging Suite. The new 7,200-square-foot imaging suite includes capabilities to assess tissue anatomy, perfusion, function and metabolism with high temporal resolution at rest and during exercise. VCU Medical Center will be one of the few sites in the world capable of these tests. Although his work focuses on cancer patients, “the techniques are applicable for all patients with cardiovascular disease,” he said. Because of cancer’s rapid metabolism rate, the disease provides a special window to understanding heart disease. “High blood pressure causes heart or vessel damage, but it takes 60 years for you to see that, so that’s not great for conducting a study. But in a cancer patient, because of how quickly the disease metabolizes, that 60 Coming Home continued blood vessels in the body. “Heart failure unidentified until it is significantly progressed. Hundley, along with Drs. Craig Hamilton and Kerry clinicians and years is shrunk into weeks,” he said. is a complex disease where not just the His interests took a turn one day, while Link, began using an MRI to image their , scientists in studying “The developments we’re finding in the needed a heart catheterization.” Noninvasive heart has problems contracting or relaxing, working with program manager Kim Lane “and that really took off, because it provided an mechanisms and cancer patient population will help us better echocardiography and radioisotope but also the blood vessels that carry the and acquiring a MRI of a patient who’d had answer for a population that didn’t have one.” A methods to prevent understand heart and vascular disease and techniques were often inadequate in these blood have problems,” he said. “With MRI, heart failure after being treated for cancer. story about their noninvasive MRI ran on NBC heart attacks, strokes, high blood pressure, diabetes, patients with patients. one could image the heart, blood vessels, “The type of imaging we were doing always Nightly News. heart failure and high cholesterol and all the other causes of Hundley, along with Drs. Craig Hamilton kidneys and other structures simultaneously. produced a picture that was black or white,” exercise intolerance in heart failure,” he said. and Kerry Link, began using an MRI to In so doing, one could determine why he said. “But this time we got gray.” the cancer,” he said. “The heart has a high those treated for cancer—later putting them “It’s enormously exciting for us to be able image their hearts, “and that really took tissues weren’t receiving the blood supply The physicians first blamed it on a glitch metabolism, so it makes sense that it would into clinical practice. to do this in central Virginia.” off, because it provided an answer for a they needed.” in the new software program. However, they be susceptible.” “Oncologists are so effective in treating To get a preview of the new Cardiovascular population that didn’t have one.” A story Hundley, in collaboration with Drs. David later realized that the gray areas indicated Working with his associates, Hundley cancer that now, for many cancers, heart Imaging Suite, please see “New Cardiovascular about their noninvasive MRI ran on NBC Herrington and Dalane Kitzman at Wake early heart damage from the cancer received more than $20 million in NIH problems are the primary cause of the death Imaging Suite Debuts” on page 14. Nightly News. Forest, studied the etiologies of heart failure treatments. Often this damage could be funding for a research trial to use MRIs for these patients,” he said. Next, he began to grow interested in when the heart ejection fraction is preserved, detected before permanent injury occurred. to identify patients who were developing With all these discoveries, Hundley DR. GREG HUNDLEY RUNS ALONG THE JAMES heart failure while doing stress tests. While or shows up as normal, on echocardiograms. “The chemotherapies and the radiation heart injury from their cancer treatment. was highly recruited by other facilities. The RIVER. HE IS A LONGTIME ADVOCATE FOR these tests are usually done on just the This latter syndrome, common in older therapies were actually damaging the heart Additionally, he has had the opportunity to opportunity to work at his alma mater as THE IMPORTANCE OF ADOPTING A HEALTHY heart, he and Little began testing all the individuals, often causes heart failure to go and blood vessels in addition to treating work with a number of emerging younger the first-ever director, with a state-of-the-art LIFESTYLE.

Abbate, Van Tassell Receive $2.7 Million Grant for Heart Failure Study

In June, the National Heart, Lung, The body produces inflammation— patients with a recent hospitalization, those quench the inflammatory response, improve and Blood Institute (NHLBI) awarded marked by redness, heat, swelling and who took anakinra achieved lower levels exercise capacity and possibly reduce a $2.7 million grant to a research pain—as a natural and protective response of inflammation and were able to exercise rehospitalization after a hospitalization for team led by Dr. Antonio Abbate, vice to injury. In the case of cardiac patients, longer than those who did not. Over a decompensated heart failure,” said Abbate. chair of the Division of Cardiology, inflammation often occurs following a heart six-month period, only one of the patients The latter—typically accompanied by labored and Dr. Benjamin Van Tassell, vice attack. But lingering, chronic inflammation receiving the treatment had to return to the breathing, swelling of the legs or feet and chair for clinical research in the VCU is also linked to many diseases, including hospital. By contrast, nearly one-third of the fatigue—is an acute condition that reflects School of Pharmacy’s Department heart failure, he said. patients who did not receive the treatment the sudden worsening of heart failure. of Pharmacotherapy and Outcomes In the past few years, Abbate and Van were hospitalized during the same time. “The treatment for heart failure has Sciences. The grant will allow them Tassell have used anakinra to target a Their upcoming REDHART2 phase dramatically improved over the past 50 to further their promising studies specific type of inflammation caused by II clinical trial will involve 102 patients, years. We mark the 50th anniversary of using the anti-inflammatory drug the IL-1 protein. Anakinra, an IL-1 blocker, followed for six months. The trial will be at Pauley this year, anakinra, an Interleukin-1 (IL-1) was originally developed as a drug for restricted to patients who have systolic which is an incredible milestone,” he said. blocker, in treating heart failure. rheumatoid arthritis. heart failure, have been admitted to the “Unfortunately, for every patient with heart DR. BENJAMIN VAN TASSELL DR. ANTONIO ABBATE Van Tassell and Abbate have narrowed hospital and discharged within the past disease that is saved and for every heart- “This very important award from the NHLBI their focus on anakinra in nine subsequent two weeks, and show blood markers failure patient who survives the global improvements are urgently needed.” decompensated heart failure. builds on 10 years of work done here at trials, mostly funded by the NHLBI and indicative of enhanced inflammatory burden of heart failure grows, and millions The trial will enable Abbate to zero in on “REDHART2 will be the largest single VCU Health,” said Abbate, the James C. other National Institutes of Health agencies. response, he said. of patients experience symptoms and a solution for the many patients he sees in trial to date for our team,” he said. “We are Roberts, Esq. Professorship of Cardiology. In their 2016 study of 60 heart failure “We will test the ability of anakinra to limitations related to it worldwide. Further the hospital, again and again, suffering from looking forward to starting.”

4 THE BEAT / AUTUMN 2018 VCU HEALTH PAULEY HEART CENTER 5 Cardiology Chair Recognized Cardiology Fellows Place Second in for Outstanding Scholarship By Erin Lucero National Fellows-in-Training Jeopardy Contest

The American College of Cardiology “Improving patient care depends upon heart failure and atrial fi brillation. He also is Each year, the Fellows-in-Training (ACC) has recognized Dr. Kenneth developing a better understanding of health involved in developing more effective ways (FIT) Jeopardy contest offers one Ellenbogen for his contributions and disease, and then applying those to perform ablation to treat atrial fi brillation. of the most exciting events at the to its fl agship journal. Ellenbogen fi ndings,” said Dr. Peter Buckley, dean of The editor or co-editor of fi ve textbooks American College of Cardiology’s was honored with the 2018 Simon VCU School of Medicine. “Dr. Ellenbogen of cardiac electrophysiology, he has Annual Scientifi c Session, which Dack Award for Outstanding has a remarkable track record in doing served as principal investigator on more brings together cardiologists and Scholarship at the Journal of the that, and he’s known internationally for than 100 funded grants and contracts cardiovascular specialists from around American College of Cardiology advancing the cardiology fi eld through his and has published more than 250 original the world. This year, the Virginia team (JACC) editorial board meeting, held research and teaching. I’m proud to see scientifi c reports and more than 140 book was made up of three cardiology in conjunction with the ACC’s 67th him recognized for his contributions.” chapters, editorials and review articles. fellows from Pauley, Drs. Guru Kowlgi, Annual Scientifi c Session in March in Ellenbogen serves on the editorial boards Mohammad Rajab and Cory Trankle. Orlando, Fla. The editor or co-editor of of seven specialty journals, including the The team placed second in the fi nal fi ve textbooks of cardiac JACC. An ACC fellow, he is co-editor of competition. The JACC ranks fi rst among cardiovascular electrophysiology, he has their Electrophysiology Self-Assessment journals in the world for its scientifi c served as principal investigator Program. “Their achievement is a huge deal,” said Dr. impact. The Simon Dack Award honors the on more than 100 funded grants Ellenbogen has served as chair of the Kenneth Ellenbogen. “This is a competition publication’s founding editor and recognizes and contracts and has published American Heart Association’s Committee between cardiology programs across the the contributions and accomplishments more than 250 original scientifi c on Electrocardiography and Arrhythmias, as nation, and VCU Health’s quality is refl ected of outstanding peer reviewers who assist reports and more than 140 book well as on the steering committee of two by how well the team has performed. I think the journal in its mission of publishing chapters, editorials and review National Institutes of Health trials, AFFIRM our cardiology fellows and faculty have much important new clinical information. articles. and MOST. Ellenbogen has been an invited to be proud of.” Ellenbogen was honored with four fellow lecturer and speaker all over the world and According to Rajab, the Pauley fellows had reviewers from University of California, Ellenbogen’s academic, clinical and has given more than 300 talks at major qualifi ed to be on the Virginia team by winning Irvine; Hospital Universitario Clinico San research efforts include developing new national meetings. both the state and Mid-Atlantic competitions, Carlos in Madrid, Spain; Johns Hopkins types of pacemakers and exploring the beating teams from the University of Medicine; and Mayo Clinic. role of pacemakers in treating congestive Virginia, Virginia Tech Carilion and others from Maryland, Delaware and D.C.

“Their achievement is a Even competitors from other programs huge deal,” said Dr. Kenneth were complimentary. A cardiology program Ellenbogen. “This is a director from another university told them, competition between “Watching you guys answer those questions cardiology programs across the in less than a second made me want to go “Guru really took the initiative to nation, and VCU Health’s quality back and read [my medical books],’” recalled push our team to study in advance of the is refl ected by how well the Kowlgi. “That for me was immensely competition. Some of the attendings, such team has performed.” humbling and something I will remember for VCU Health Pauley Heart Center Consortium as Dr. Jay Koneru, helped keep us motivated many years.” as well, prompting us with trivia questions all answers were required to be in the form Although they had wanted to take home The cardiology consortium started to provide support in the form of advice, possible the new Pauley Pilot Grants throughout the day,” said Trankle. The team of a question. fi rst place, said Kowlgi, “when it sunk in, we with an “exploratory” dinner community support and philanthropy. program, which funds early investigator-led focused on guidelines, landmark clinical trials Nine teams advanced to the semifi nals. realized that we had done quite well to make meeting in 1997 to assess the The program has been exceedingly pilot projects that test promising ideas. The and other areas important to know for their After further eliminations, the Virginia, it to that state and were thankful for the interest in community support for successful, including two major campaigns grants enable researchers to collect data so fi eld of medicine. “I would say studying for Minnesota and New York teams competed in fantastic training we have received at VCU a focused cardiology center at VCU culminating in the naming of VCU Health that they may apply for major grants from the competition ended up being another the fi nal round. The Minnesota team, made Health.” Health. Bolstered by early support, Pauley Heart Center with a donation from the National Institute of Health and the way for us to prepare to be independent up of fellows from the Mayo Clinic, took including the Eric Lipman Research Dorothy and Stan Pauley. Steered by American Heart Association. cardiologists.” fi rst place, and the New York team, made up FROM L TO R: PAULEY FELLOWS DRS. Professorship in Cardiology and the volunteer leaders James Roberts, James To join the Consortium online, please Thirty-fi ve regional winning teams took of members from the Montefi ore Medical MOHAMMAD RAJAB, GURU KOWLGI AND CORY Kimmerling Chair, the Consortium Sanderlin and Charles Thalhimer, hundreds visit vcuhealth.org/pauley and click on part in the FIT Jeopardy fi nals on March 10 Center and New York Medical College, TRANKLE RECEIVED PLAQUES FROM DR. B. represented a new opportunity of donors participated in these campaigns “Support Pauley Heart Center” to be and 11 in Orlando, Fla. Contestants from placed third. HADLEY WILSON, CHAIR OF THE AMERICAN to engage grateful patients and with philanthropic support to Pauley. Their directed to a page where you can fi ll out an the U.S. and Canada took turns selecting “What grabbed me was the amount of COLLEGE OF CARDIOLOGY’S BOARD OF community leaders focused on impact has been extraordinary to the online form. Or contact Carrie Mills, cmills@ from the four categories, which all featured energy and enthusiasm that the competition GOVERNORS. THEY ALSO RECEIVED A COPY supporting the cardiology program. research, education and clinical efforts of vcuhealth.org or (804) 828-0423. questions drawn from the American rounds generated. It was great to see other OF THE HEART SOUNDS 4, A COLLECTION OF the faculty and staff. Board of Internal Medicine Certifi cation VCU Health doctors show up to cheer us on,” AUDIO FILES OF DIFFERENT TYPES OF HEART With a rich history in transplant and early Pauley continues to provide new FROM L TO R: DR. TIMOTHY WOLFGANG, Examination Blueprint. Like the game show, said Trankle. MURMURS. pioneering work in and opportunities for recruitment of scientists, DR. GLENN BARNHART, HARRY THALHIMER; coronary angioplasty, the program sought to clinicians and teachers to expand the DR. PETER BUCKLEY, DAVID AND CHRISTINE COTTRELL, “What grabbed me was the amount of energy and enthusiasm that Read more online at vcuphc-thebeat.org use that recognition to expand opportunities. advancement of cardiac care regionally DEBORAH DAVIS; DR. KENNETH ELLENBOGEN, the competition rounds generated. It was great to see other VCU The Consortium focused on asking members and nationally. In 2017, member gifts made VINCE RADLEY, DR. VIGNESHWAR KASIRAJAN Health doctors show up to cheer us on,” said Trankle.

6 THE BEAT / AUTUMN 2018 VCU HEALTH PAULEY HEART CENTER 7 Pauley Offers Innovative Consortium Celebrates Interventions for Lower Extremity PAD Heart Transplantation

of the patient’s veins. The surgery requires Stroke general anesthesia and a hospital stay. Pauley’s teams take care of some of the Prevention via area’s most complex lower extremity PAD patients. the Carotid “We’ve been able to offer people limb- saving procedures in situations where other Artery institutions can only offer amputations,” said Levy. Additionally, “we’ve had patients with Pauley’s vascular surgeons have severe blockages that require both open extensive experience with the minimally surgical bypass and angioplasty on two invasive stenting of the carotid artery, different areas of their leg. Since we have which is found in the neck. The the region’s most modern hybrid suites, interventions are performed via catheter. we’re able to take advantage of our facilities “Most are not emergency for the patient’s benefi t, performing both the procedures but are performed promptly bypass and the angioplasty in one setting.” when patients are discovered to have a About 80% of the surgical procedures for severe blockage in the carotid artery to lower extremity PAD are scheduled, with the their brain,” said Dr. Mark Levy. “Some remaining 20% performed under emergency of those patients have had ministroke DR. MARK LEVY DR. LUIS GUZMAN circumstances. The interventions have led to or stroke symptoms; other patients signifi cantly improved mobility and quality of are occasionally identifi ed before Peripheral artery disease (PAD) is like magnetic resonance angiograms or life for patients. they develop these life-threatening often called a “silent killer.” Often, computed tomography, or CT, scans. The “Drs. Levy and Guzman are expert symptoms.” individuals are not aware they have exams are available at Pauley’s downtown clinicians with decades of experience in Signs and symptoms for a stroke the condition until it has signifi cantly Richmond, Stony Point, Prince George and treating patients with peripheral arterial may include face drooping, blurred progressed. Colonial Heights locations. disease. Combining a collaborative vision, diffi culty with speech or a sudden approach with state-of-the-art weakness, often on one side of the DR. MOHAMMED QUADER DISCUSSES INNOVATIONS IN HEART TRANSPLANTATION AT THE “People are walking around all the time with “There is a signifi cant interaction between technologies, they and their body. Always call 911 in the event of a CONSORTIUM DINNER. blockages in their legs,” said Dr. Mark Levy, the two processes. When a coronary artery colleagues offer some of the suspected stroke. chair of the Division of Vascular Surgery disease patient has both conditions, their most advanced interventions This year’s Pauley Consortium dinner liver transplant that evening. The combined and the H. M. Lee Professorship in Vascular risk of mortality increases sevenfold. That’s in the region,” said Dr. Kenneth highlighted the 50th anniversary heart-liver transplant is a rare, lifesaving Surgery. “When it’s symptomatic, it’s usually why the prevention and the treatment of Ellenbogen. of Virginia’s fi rst heart transplant, procedure that treats complex and often leg cramping or gripping when walking. If the this is very important.” The Pauley teams stay Did you know... performed at MCV by Dr. Richard fatal diseases including familial amyloidosis blockage is more severe, then it can cause current on research that can Lower on May 25, 1968. polyneuropathy. pain in the feet at rest, which is known as For more advanced cases of benefi t patients with PAD and have taken About 8.5 million people in the U.S. Other speakers included Dr. Kenneth ischemic rest pain. Sometimes the condition PAD, Pauley’s vascular surgeons and part in trials for new therapies aimed at suffer from peripheral artery disease, The dinner, held in May at the Dominion Ellenbogen, who gave opening remarks and can be asymptomatic until the patient interventional cardiologists offer various increasing lower extremity circulation. according to the American Heart Arts Center’s Dorothy Pauley Square, spoke about the new research pilot grants develops gangrene, due to lack of circulation.” procedures: Whatever the necessary treatment, “we Association. included many Pauley friends and funded by donations to the Consortium’s The blockages are caused by Minimally invasive, catheter-based are patient-centered and safety-focused,” supporters. The guests included three annual fund. Michael Rao, Ph.D., president atherosclerosis, or the buildup of plaque in treatment. Angioplasty and stent: A said Levy. heart transplant patients and several of VCU and VCU Health, introduced a arteries. Risk factors for developing PAD catheter is inserted into the patient’s femoral To set up a consultation, please contact retired cardiac surgeons who had worked video featuring transplant survivor and include smoking, diabetes, hypertension and artery in the groin. The doctor then directs the Pauley Heart Center at 1-800-762-6161. with Lower, including Dr. Joe Deignan, a VCU alumna Jeni Simonitis. Dr. Peter high cholesterol. the catheter through the body to the location member of the team that performed the Buckley, dean of VCU School of Medicine, In addition, “the vast majority of patients of the blockage. A small balloon is then fi rst transplant. and Deborah Davis, CEO of VCU Hospitals with PAD will have coronary artery disease,” infl ated to open the artery, which is followed The following Pauley physicians “As a cardiothoracic surgeon myself, and Clinics, announced the leadership gift said Dr. Luis Guzman, medical director of by the placement of a mesh stent. have expertise in treating lower I came to VCU Medical Center from the to establish the Christine B. and David E. Pauley’s Cardiac Catheterization Laboratory. During an atherectomy, the physician extremity PAD: Cleveland Clinic in 2000 because of the Cottrell Surgical Innovation Suite, a new “There is a signifi cant interaction between uses a catheter with a blade on one end incredible program Dr. Dick Lower built,” facility designed to foster cutting-edge the two processes. When a coronary artery to shave off plaque that is hardened to Dr. Francisco Albuquerque, Jr. said Dr. Vigneshwar Kasirajan, one of surgical research and education. disease patient has both conditions, their the artery walls. Like angioplasty, this • Vascular Surgery the evening’s speakers. Since the fi rst Ellenbogen recognized the importance risk of mortality increases sevenfold. That’s procedure is generally performed under local Dr. Jose Exaire transplant, “we have performed 590 heart of the donors and others gathered. “We why the prevention and the treatment of this anesthesia, with patients leaving the hospital • Interventional Cardiology transplants at VCU Medical Center as well appreciate your support and investment is very important.” the same day or the next morning. as more than 300 at the Hunter Holmes in the research, clinical and educational Dr. Luis Guzman Pauley’s vascular and cardiology teams Lower extremity bypass surgery is McGuire VA Medical Center.” mission place just blocks away from where • Interventional Cardiology often collaborate on the treatment of recommended when patients have large Kasirajan and Dr. Mohammed we are now,” he said. “We are able to be Dr. Robert Larson patients. Early treatments can include diet blockages or are not good candidates for Quader spoke about innovations in heart extraordinary thanks to your support.” • Vascular Surgery and other lifestyle changes or medications. the minimally invasive, catheter-based transplantation and advanced heart failure, To see a preview of the planned surgical The fi rst step is a 3D cardiovascular procedures. In the procedure, the surgeon Dr. Mark Levy and what to expect in the next decades. suite, please visit surgery.vcu.edu/aboutus/ evaluation using state-of-the-art ultrasound bypasses the blockage by creating a new • Vascular Surgery Dr. Daniel Tang was unable to join the cottrells imaging and noninvasive imaging tests path for blood fl ow by using a from one celebration as he was fi nishing a heart and

8 THE BEAT / AUTUMN 2018 VCU HEALTH PAULEY HEART CENTER 9 Heart of the Matter

Pauley Heart Center: Proud of Its Past. are over. I would argue it is not.” lasting three decades. When Simonitis began Stem cell therapy, now in the trial stage, experiencing chest pains three years ago, she is showing great promise in repairing tissue hoped it was heartburn. It turned out to be a Poised for the Future. By Janet Showalter damaged by heart attacks. If successful, this form of chronic rejection. would save patients who otherwise need a In August 2017, Simonitis was placed back heart transplant. on the transplant list. Four months later, she Jeni Simonitis was 8-years-old as Another national study underway is for got the call that a donor heart had been found. she lay in a hospital bed at MCV the Carmat heart, which has been called the She and her husband, Jason, grabbed her bag, Hospitals, now VCU Medical Center, in world’s first self-regulating, total artificial heart. already packed with clothes and Stripes, and December 1992. It uses embedded sensors to regulate the rate drove to VCU Medical Center. A few hours of blood flow to a patient based on his or her later, she was in surgery. This time around, her With her parents by her side, she anxiously individual needs. hospital stay was two weeks instead of three. awaited news that a donor heart had been Tang is also excited She missed nine weeks of work. found to save her life. “We were demystifying cardiac transplantation,” said about research that “It’s amazing how much more advanced Twice she went into cardiac arrest. Hess, who retired in 2011. “People back then thought could lead to an they are now,” Simonitis said. “Technology “It was scary,” she said. “We weren’t sure we were crazy as hell. Or they thought it was a piece increase in donor is better, the medications are better and the they would find a match in time. But they did. I of cake. Today, it is standard heart patient care.” hearts. Currently, about surgeons, I think, are more skilled. The team remember the doctor coming in and telling us 2,500 heart transplants is right there with you through it all. I trusted we had a heart. It was a Christmas miracle.” failure and transplantation cardiologists at VCU are performed in the U.S. each year. But about them every step of the way.” Twenty-five years later, in December 2017, Medical Center has grown from two to six while 4,000 people nationwide are waiting. As she did after her first surgery, Simonitis Simonitis underwent her second successful the number of surgeons has doubled to four. “The need is great,” Tang said. “We need will send a letter to the donor family, offering heart transplant at VCU Medical Center. Today, the medical center averages 25 to do all we can to meet it.” her gratitude. “It never crossed my mind to go anywhere transplants a year, including several multi- The prime window to successfully use a “Words can’t possibly express how else,” said Simonitis, 34. “The team there is just organ transplants. donor heart is four to six hours after death. That thankful I am,” she said. “I know my heart amazing. They are passionate about what they “This has been a second coming,” Shah time frame is not always plausible because of came at a cost. It means someone else’s do, and they are the best in the field.” said. “Our staff takes a lot of pride in that, and distance to the recipient, and sometimes the family suffered great tragedy. I never lose sight The world’s first successful human- our patients can see the passion we have in heart goes unused. But new ways to expand of that. Every year on the anniversary of my to-human heart transplant took place in serving our community.” protection times are being studied, including a surgery, I celebrate that family. They gave me December 1967 in South Africa. Five months Each year, thousands of patients turn pump system that would keep the heart viable the greatest gift possible. They gave me life.” later, the first heart transplant in Virginia — to the center for inpatient and outpatient until it arrives at its destination. Janet Showalter is a contributing writer for the alumni magazine. ninth in the country and 16th in the world — care, ranging from noninvasive cardiology Another area of study by Dr. Mohammed This article was originally published in the spring 2018 VCU Alumni took place at MCV Hospitals. procedures to heart transplantation. Pauley’s Quader, assistant professor of surgery, is magazine. Alumni can read the whole magazine online at vcualumni.org Since that historic moment 50 years ago, NOW ON HER SECOND HEART TRANSPLANT, JENI SIMONITIS STILL HAS THE SAME STUFFED transplant and heart failure experts speak at exploring ways to recover a heart from a person the team has completed more than 590 heart ANIMAL FROM HER FIRST TRANSPLANT AT AGE 8. national conferences, lead clinical trials, take who has suffered a cardiac death. Currently, transplants, including the first heart-lung trans- part in funded research and have published donor hearts are used only if the person suffers VCU Medical Center’s heart trans- plant in Virginia and the first total artificial heart 20th century, with the late MCV surgeon Dr. performed the world’s first human-to-human hundreds of abstracts and manuscripts. brain death because blood continues to flow plant program was established in 1968, making it the longest-running transplant on the East Coast. It is the second- Richard Lower leading the way. Lower, along heart transplant. Lower performed his first The center has become known worldwide to the heart. In a cardiac death, blood ceases transplant program on the East Coast oldest heart transplantation program in the U.S. with Dr. , began extensive in May 1968. In all, he took part in 393 heart for its groundbreaking work, and Pauley to flow and the heart sustains cellular damage. and the second oldest in the U.S. “It’s an amazing thing we do here,” said research in California in the late 1950s and transplants before he retired in 1989. leads the way in device-based treatments for But research is uncovering ways to protect the • MCV Hospitals celebrated the Dr. Daniel Tang, the Richard R. Lower, M.D. later successfully completed the first heart “Lower was cautious, as he should have advanced heart failure. In 2006, Kasirajan led donor heart from cellular damage, making it first long-distance heart transplant Professorship in Cardiovascular Surgery and transplant in an animal model. been,” said Dr. Michael Hess, who worked the team that completed the first total artificial viable for transplantation. in the world in 1977 when Dr. director of heart transplantation, heart-lung Their work grabbed media attention, as well with Lower for 10 years and started the heart heart implant on the East Coast. In addition, the ongoing study of modifying Szabolcs Szentpetery made the 600-mile flight from Richmond to transplantation and mechanical circulatory as the eye of renowned transplant surgeon Dr. failure program. “He did groundbreaking work Since then, VCU Medical Center has genetic signatures could one day open the Indianapolis to bring back a donor support. “It may not be uncommon anymore, David Hume, chief of surgery at MCV Hospitals that led to incredible growth in the field.” performed more than 100 artificial heart door to cross-species heart transplantation. heart. but it is hardly routine. The very notion that we at that time. In 1965, Lower accepted Hume’s Soon after Hess became medical transplants, and its program is the third “It’s very exciting to think what the future • In 1981, Dr. Michael Hess created are taking a heart that was someone else’s invitation to join him in Richmond to lead the director of cardiac transplantation in 1979, the largest in the country. Pauley also implants can bring,” Tang said. the International Society of Heart and giving it to a patient so that they may have cardiac surgery program. team was well on its way to performing more about 40 ventricular assist devices a year. Tang, who performed Jeni Simonitis’ and . life is truly amazing. It is very emotional and As the team inched closer to its ultimate than 50 heart transplants a year. A VAD is a mechanical pump that helps surgery in December, said that while the • The first heart-lung transplant never gets old.” goal, Dr. , a young South “We were demystifying cardiac the heart push blood to the body. Artificial procedure is becoming more common, he will in Virginia took place at MCV African surgeon, transplantation,” said Hess, who retired in 2017. hearts and VADs can allow a heart transplant never get used to the miracle it is. Hospitals in 1986. Since that historic moment 50 years ago, the team visited Richmond “People back then thought we were crazy as candidate to safely survive until a donor heart “When you call the patient and tell them we • In 1994, the first left ventricular has completed more than 590 heart transplants, for three months to hell. Or they thought it was a piece of cake. becomes available. have found a donor heart for them, they jump assist device was implanted at MCV Hospitals. including the first heart-lung transplant in Virginia observe the team’s Today, it is standard heart patient care.” “This work has become mainstream,” for joy,” he said. “Even though they know it is a and the first total artificial heart transplant on work. He became But when Lower retired, the program took Kasirajan said. “It’s incredible how far we’ve come.” daunting surgery, they look forward to it.” • The first total artificial heart on the East Coast, and the third in the obsessed with a hit. Several other surgeons and physicians For some, it might sound like science Simonitis can remember the fear she felt the East Coast. It is the second-oldest heart country, was implanted at VCU transplantation program in the U.S. becoming the first also left, and three other transplant programs fiction. For others, research in the areas of as a young girl, clutching her stuffed tiger, Medical Center in 2006. surgeon to perform opened in Virginia. The number of heart stem cell and gene therapy, genetic coding and Stripes, in her hospital bed. Born with a heart • VCU Heart Center was renamed The race to perform the first human-to- a human heart transplant. transplants completed at MCV Hospitals offers a promising future. defect, a transplant was her only option. VCU Pauley Heart Center in 2006 human heart transplant was a competitive one. A few weeks after Barnard returned plummeted to fewer than 10 annually. “People looked at what Lower was “As they were wheeling me to surgery, I to recognize a $5 million gift from “It was similar to the race to get a man on to South Africa, Lower and Hume nearly “When I interviewed for a job here in doing 50 years ago and thought those guys got scared and wanted to back out,” she said. the Pauley Family Foundation. the moon,” said Dr. Keyur Shah, section chief performed the first transplant but decided 1999, they had done only one transplant that were absolute cowboys because they were “But I knew I had to do it. A few months later, • The center has 14 endowed of heart failure. “Anytime you accomplished against it because the donor and recipient year,” said Dr. Vigneshwar Kasirajan, the Stuart doing something that was so unusual,” said I was back on the playground with my friends. professorships and chairs. anything to get you closer to your goal, you blood types did not match. McGuire Chair of Surgery. “But we were able Tang, who performs about half of the heart I got my life back.” • Since 1972, the American Heart were on the cover of Time magazine.” That opened the door for Barnard, who to rebuild it. I am most proud of the team we transplants at VCU Medical Center. “Their For more than 20 years, her donor heart Association has funded 138 VCU Health researchers with $12.8 The breakthrough was one of the most found a donor for a patient under his care. have assembled here.” work evolved into what we are doing today. served her well. The average life expectancy million. significant in the field of medicine in the On Dec. 3, 1967, Barnard successfully Over the past 15 years, the number of heart People may think that the days of the cowboy of a donor heart is 12 years, with some

10 THE BEAT / AUTUMN 2018 VCU HEALTH PAULEY HEART CENTER 11 Campaign Kicks Off for Surgical Innovation Suite Conference Focuses on Women’s Heart Health

Pauley recently unveiled plans for the smoking, diabetes, and obesity—there new Christine B. and David E. Cottrell are nontraditional risk factors that play an Surgical Innovation Suite, which will important role in women, she said. “These support innovation in cardiac surgery emerging, nontraditional risk factors include and other interventions. Through a hypertensive disorders of pregnancy, new $5 million fundraising campaign, gestational diabetes, autoimmune disease Pauley is now reaching out to its and breast cancer treatment.” supporters to make the state-of-the- Tangley, a cardiology nurse at Pauley art lab a reality. for more than 35 years, described the talks as “enlightening.” For instance, in Dr. John In fall 2017, the Cottrells generously donated Reavey-Cantwell’s talk on carotid artery $1 million to launch the initiative. VCU disease, “he promoted the simple act of hopes to raise an additional $4 million for listening for a bruit to help when screening.” the 6,000-square-foot lab. The lab will be A bruit is the sound heard over a blood built on the ninth fl oor in Sanger Hall in vessel refl ecting turbulent blood fl ow. the same lab space of Dr. Richard Lower. Dr. Huzaefah Syed spoke on cardiac risk He helped develop the techniques for in women with rheumatologic disease—an transplanting a human heart and performed important topic, said Kron, “because many the ninth transplant in the United States. infl ammatory diseases predominantly “The new Cottrell Surgical Innovation DR. VIGNESHWAR KASIRAJAN (LEFT) AND DAVID AND CHRISTINE COTTRELL DISCUSS PLANS FOR FROM L TO R: DR. ERIKA MASON, DR. STEPHANIE MAYER, DR. BARBARA LAWSON, DR. PHOEBE ASHLEY, affect women.” Suite will offer the space and advanced THE NEW COTTRELL SURGICAL INNOVATION SUITE, TO BE LOCATED IN SANGER HALL. DR. JOHN REAVEY-CANTWELL, DR. JORDANA KRON, DR. HUZAEFAH SHAH, AND ALLISON GOODWIN, M.S. Following breakfast, Dr. Kenneth technologies necessary to usher in Ellenbogen gave opening remarks. Other preeminent cardiovascular and other to improve the viability of hearts procured $10K – $75K: Donor recognition Electrophysiology nurse Eileen “The conference was fantastic,” said speakers included Dr. Stephanie Mayer surgical research at VCU Health,” said Dr. from donors after circulatory death. The lab $75K – $500K: Named research spaces Tangley never misses VCU Health’s Dr. Jordana Kron, who organized the event (diabetes), Dr. Barbara Lawson (valvular Vigneshwar Kasirajan. “One of the focus will be available to the faculty of all surgical $500K – $700K: Surgical space Women’s Heart Health Symposium. with fellow Pauley cardiologist Dr. Phoebe heart disease), Dr. Jose Exaire (peripheral areas for research will be to understand specialties and VCU’s schools of Pharmacy recognition “I have attended all of the Ashley. “As in previous years, the feedback vascular disease), genetic counselor Allison organ preservation further and to improve and Engineering for preclinical, translational “We are grateful to Christy and David symposiums so far and look forward was very positive. Attendees really enjoyed Goodwin (genetics) and Dr. Erica Mason the number of organs available for and other research studies. The site will Cottrell for providing the lead gift for this to it each February now,” she said. “It the day, both the lectures and catching up (obstructive sleep apnea). transplants. Also, this space will help us also provide additional space for students new venture and invite others to be a part of has really opened up my eyes to the with old friends, and had suggestions for “Throughout the conference, we train future generations of surgeons.” and continuing medical education. this exciting campaign,” said Kasirajan. subtle, yet sometimes signifi cant, topics to include next year.” highlighted that heart disease is the number One faculty member who will use All donations to the campaign are For more information, contact Carrie circumstances that are unique to Highlights of the day included a talk on one cause of death in U.S. women, killing the new lab is cardiothoracic surgeon Dr. appreciated, and naming opportunities are Mills at (804) 828-0423. women’s heart health.” hypertension in women, led by Dr. Benjamin more than all types of cancer combined,” Mohammed Quader, who is studying how available for extraordinary levels of support: Van Tassell. “It was very thought-provoking,” said Kron. “Women hear and worry a lot About 100 health care providers attended said Kron. “He challenged the audience about breast cancer, but they should be the annual conference in February at the to think about the ways research answers aware that cardiac disease is their number Virginia Historical Society. Participants and sometimes doesn’t answer the critical one threat.” Sharing a Piece of History arrived from all over the state and even questions of how diseases and treatments Save-the-date! The Fourth Annual Heart outside Virginia for the symposium, affect women differently than men.” Health in Women Symposium will be on On May 24, a group of current and sponsored by Pauley and VCU Health In addition to traditional risk factors for Saturday, February 2, 2019. Visit vcuhealth. retired physicians gave a historical Continuing Medical Education. cardiac disease—such as hypertension, org/pauley for more information. grand rounds presentation on the 50 years of heart transplantation at VCU Health. The program focused on the work of Dr. Richard Lower and how the heart transplant program began Save the Date: Heart Failure Symposium at the Medical College of Virginia, now VCU Medical Center. About 250 Pauley doctors will present “Heart director of heart transplantation who will P.A.; and “Genetic Heart Disease: MRI guests attended the event. Failure Symposium: Caring for present opening remarks. Imaging Potpourri” presented by Drs. Greg our Community” on Saturday, Other morning topics will include heart Hundley, John Grizzard and Krishnasree “It was standing room only in the Egyptian DRS. DANIEL TANG, SZABOLCS SZENTPETERY AND TIMOTHY WOLFGANG October 13. Targeted to health care failure, cardiac transplantation, mechanical Rao. Building auditorium,” said Dr. Michael Hess, professionals, the event provides an circulatory devices, pulmonary hypertension Attendees will receive continuing one of the guests, who also appeared in a Cooke, gave opening and closing remarks. generational event. The room was fi lled with in-depth look at current practices, and structural heart disease. Drs. Melissa medical education credit for the video interview with Dr. George Vetrovec. He observed how many of the clinical people who over many years had built and emerging technologies and medical Smallfi eld, Antonio Abbate, Ben Van Tassell, symposium, which will run from 8 a.m. to “The event was designed to inspire our discoveries made 50 years ago had led sustained the heart program at VCU Health,” advances in this rapidly growing and Zachary Gertz and Inna Tchoukina will be 2 p.m. and include breakfast and lunch. students and demonstrate the high quality of to further developments in the fi eld, and said Shah. “There was a real sense of pride evolving fi eld. some of the featured speakers. The event will be held at VCU McGlothlin our cardiac transplant program.” presented a chart showing that cardiac about our continuation of the program’s In the afternoon, guests will rotate to Medical Education Center, 1201 E. Marshall Drs. Szabolcs Szentpetery and Tim transplantation one year survival rates have advanced heart failure and transplant Dr. Keyur Shah, section chief of heart three rooms for short sessions on “LVADs” Street, Richmond, Virginia 23219. Call (804) Wolfgang also shared their memories of improved from 41% in the early era to 97% research.” failure, will speak in the morning on presented by Drs. Daniel Tang, Mohammad 628-0719 for more information or visit vcu. working with Dr. Lower in the program’s in recent years. To see the videotaped interview, please “Identifying Patients for Advanced Heart Quader and Vigneshwar Kasirajan; “Pacing cloud-cme.com early days. Dr. Keyur Shah, one of the hosts Guests included faculty, fellows, visit MCVFoundation.org Failure Therapies” and moderate the event Case Studies” presented by Drs. Gautham along with Drs. Daniel Tang and Richard residents and alumni. “It was a multi- along with Dr. Richard Cooke, medical Kalahasty, Jay Koneru and Kristyn Gentry,

12 THE BEAT / AUTUMN 2018 VCU HEALTH PAULEY HEART CENTER 13 New Stony Point Clinic Offers Heart and Vascular Care in One Location

out they need surgery, they can get a pre- operative appointment on the same day. All other pre-operative testing, including electrocardiograms, labs, and radiology, can be done in the same building.” The vascular clinic offers a full range of ultrasound and other arterial testing. “We offer pretty much the gamut, from checking the circulation in the legs to testing for deep vein thrombosis, blocked carotid arteries, and fi stulas,” said Gary Travis, a registered vascular technologist. “While the vascular lab at Stony Point has daily scheduled appointments, patients can be seen the same day for emergent needs.” DR. VIGNESHWAR KASIRAJAN, DR. KENNETH ELLENBOGEN, DR. PETER BUCKLEY, DR. GREG HUNDLEY, STAN PAULEY, KATHY PAULEY HICKOK, DR. MARSHA The clinic space underwent a complete RAPPLEY, DEBORAH DAVIS, AND DR. GORDON GINDER CELEBRATE THE RIBBON-CUTTING OF THE NEW CARDIOVASCULAR IMAGING SUITE. renovation before its opening. The 15 exam rooms are decorated in warm colors and designed with patient comfort in mind. New Cardiovascular Imaging Suite Debuts “We have equipment in every room, Joseph Chodkiewicz, the fi rst Kontos, M.D. Professorship of Cardiology. which makes it very convenient. We also “The new Cardiovascular waiting to changing rooms, then on to rooms (ECG) stress testing, stress echocardiography, echocardiogram patient at Pauley’s Services include Holter monitor have scales in each room, for patient Imaging Suite was designed with for procedures and recovery. A plexiglass wall exercise MRI, and MRI CPET testing for new Stony Point outpatient placements, lab work, echocardiograms, privacy,” said McRae. Examination tables multidisciplinary collaboration in with rows of 2-inch holes allows for improved patients. Normally, patients who undergo clinic, had the honor of cutting a vascular testing and pre-operative can accommodate patients up to 500 mind,” said Dr. Greg Hundley. communication between the patient recovery CPET have a catheter placed in their wrist, to ceremonial ribbon to a patient room assessment appointments, which are pounds, and a wheelchair scale provides and control rooms. draw blood samples during the test; breathe on January 9, 2018. required before surgeries. The clinic plans to easy access for patients with disabilities. Filled with numerous monitors and screens A sign indicates “Magnet Always On” at into a tube to measure ventilation, oxygen offer stress testing within the year. Patients often note the friendliness of displaying MRI and cardiopulmonary the doorway to the room that holds a new consumption and carbon dioxide production; “I was very much impressed with the staff, said Stewart. “Our nurses here exercise test (CPET) fi ndings, the suite’s Siemens Magnetom Vida 3T MRI system, and are hooked up to a blood pressure cuff, the professionalism of the clinic,” said “You can come for women’s are exceptional in managing patient calls, 435-square-foot control room provides which just received FDA approval last fall. pulse oximeter and ECG leads. The new testing Chodkiewicz, a health care worker for heart health, heart failure, for concerns and questions,” she added. space for Hundley to work with a wide array The term “3T” refers to a 3 Tesla magnet, will include all these measurements coupled numerous hospitals over the years and a electrophysiology and device, Ronda Boyd, a patient access of experts in cardiovascular medicine and indicating the strength of the magnetic fi eld. with magnetic resonance imaging. A bicycle heart patient since 2008. “The new location and consultation with thoracic representative, said the new Stony Point radiology as well as biomedical engineering, The new Siemens wide bore MRI is the attachment will allow patients to pedal to get is much more convenient—we live in surgery, vascular surgery, cardiac clinic has proven popular with the patients medical informatics, physical medicine and fi rst 3T system of its kind at VCU Health their heart rates up while lying inside the MRI. Bon Air—and you don’t have to fi ght the surgery and transaortic valve she sees at checkout. “They like it because rehabilitation, and behavioral medicine. The and generates a fi eld twice as strong as the “MRI CPET imaging is done by only a downtown traffi c.” replacement,” said Karen Stewart. it’s not the hustle and bustle of downtown,” group is exploring heart failure in cancer and existing 1.5T machines. The 3T runs faster, few centers in the world,” said Canada. “It The clinic is on the second fl oor of VCU she said. “It’s more relaxing because cardiac patients. is less vulnerable to background noise, and will refi ne our ability to detect early signs of Health’s Stony Point 9000 building, which “We’re very patient-centric,” said everything they need is in one central spot.” “The new suite is a cutting-edge produces higher resolution images as a result. cardiopulmonary disease and more accurately is conveniently located off the Chippenham clinical coordinator Ann McRae. “A patient To schedule an appointment at the diagnostic unit offering a combination of The new Biomatrix Sensors of the Siemens’ determine the causes of exercise intolerance Parkway, near the Stony Point Fashion Park, can come here for a vascular test prior to new Stony Point clinic, please call equipment, procedures and expertise only model help anticipate a patient’s breath- in symptomatic patients.” and offers free parking. About 25-30 Pauley seeing their vascular surgeon. If it turns (804) 628-4327. available at a few top-tier institutions,” said holding capability, to reduce the percentage of According to Dr. Ann Fulcher, chair of physicians and surgeons see patients at exercise physiologist Justin Canada, Ph.D. poor quality scans. the Department of Radiology, “the lab Stony Point each week. A $4 million donation by Stan and Dorothy will enhance collaboration between “We now have a strong footprint in Pauley and family made the suite and “MRI CPET imaging is done by only a radiologists and cardiologists as this community for all heart services and Hundley’s recruitment and research possible, few centers in the world,” said exercise exercise/stress testing followed by providers,” said nurse manager Karen and enabled Pauley to receive an additional $5 physiologist Justin Canada, Ph.D. magnetic resonance imaging will be Stewart. “You can come for women’s heart million gift for the project from the Glasgow performed in the same area.” She health, heart failure, for electrophysiology Endowment. Stan Pauley and his daughter, “It’s the Cadillac of the 3 Tesla systems,” added, “this will promote a close working and device, and consultation with thoracic Kathy Pauley Hickok, attended the offi cial said Brent Metts, MRI modality manager at relationship as these physicians strive to surgery, vascular surgery, cardiac surgery ribbon-cutting held July 17. VCU’s Massey Cancer Center. provide optimal diagnostic examinations for and transaortic valve replacement. We also “Our visit to the new suite was most Heart studies involve more than 1,000 their patients which can then be used to have a provider who does a special clinic for gratifying. We are very excited by Dr. images and can take 45 minutes to an hour guide therapy.” lipid management.” Hundley’s vision and are pleased to have been to complete at many facilities. “With the The suite provides technologies and Drawing so many specialists to one able to support this unique endeavor,” said new equipment, for some patients, we opportunities not available at any other location, the clinic creates a collaborative Stan Pauley. “We think the work that will be can complete the studies in as little as 15 academic institution in Virginia, North Carolina environment that benefi ts patients. conducted here will have a major impact on minutes,” said Hundley, who explored the or Maryland and will draw other VCU Health “When we are all in the same space, the lives of many heart and cancer patients.” effectiveness of these shorter MRI sessions experts and students as well as from VCU’s we can consult with each other in real time. Located on the ground fl oor of the as principal investigator of a multi-center, School of Engineering and other academic This is particularly helpful when treating North Hospital, the 7,200-square-foot suite NIH-funded study of patients undergoing the programs, said Hundley. patients with complex needs,” said Dr. is decorated in warm earth tones. Blue- imaging for the treatment of cancer. “This is going to be a training facility for Zachary Gertz, medical director of Pauley’s accented entrances guide patients from The new suite offers electrocardiogram the next generation,” he said. Stony Point clinic and the Hermes A. JOSEPH CHODKIEWICZ CUTTING A CEREMONIAL RIBBON AS ECHO TECHNICIAN KIM MURPHY LOOKS ON.

14 THE BEAT / AUTUMN 2018 VCU HEALTH PAULEY HEART CENTER 15 First Class Mail U.S. Postage First Class Mail 1200 EAST BROAD STREET PAID U.S. Postage P.O. BOX 980036 Permit No. 869 PAID RICHMOND, VIRGINIA 23298–0036 Richmond, VA Permit No. 869 Return Service Requested Box 980036 Richmond, VA Richmond, Virginia 23298-0036

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Friends and Supporters,

It’s an exciting time at Pauley. In this month’s issue, you will read about amazing research, new facilities, state-of-the-art A publication of technologies, grateful patients VCU Health Pauley Heart Center and our fi rst-ever director, Dr. Greg Hundley. Design Bergman Group Hundley is well-respected—not just Photography in Virginia or the U.S., but all over the VCU Creative Services world—for his groundbreaking research in cardiac imaging. Like many of our General Information faculty members, he is not satisfi ed with (804) 628-4327 the status quo but is continually thinking Cardiology about ways to improve patient outcomes and prevent heart disease. He’s a thoughtful, (804) 828-8885 brilliant and very warm human being. We are so delighted to have him here and hope Cardiothoracic Surgery you will enjoy reading about him in the cover story. (804) 828-2775 Our new Cardiovascular Imaging Suite will support Hundley’s research, including his Pediatric Cardiology collaborative work with VCU Massey Cancer Center. The venture was made possible (804) 828-9143 through the support of our great friends, Stan and Dorothy Pauley. Heart Failure and Transplant One of my favorite stories is about our bright cardiology fellows, who recently (804) 828-4571 placed second in the national Fellows-in-Training Jeopardy contest at the American Heart Valve College of Cardiology’s Annual Scientifi c Session. I could not be more pleased. It’s a (804) 628-4327 testament to the outstanding education they have received. Finally, in this issue, you’ll also read about the plans for a new Surgical Innovation Address Suite, unveiled at our Consortium dinner in May. In gratitude for the care he received at Box 980036 VCU Health, David Cottrell, along with his wife, Christine, provided a generous lead gift Richmond, Virginia 23298-0036 for the new suite. “When I arrived, I was your patient,” he wrote in an open letter to the Richmond Times-Dispatch. “Today, you are my family.” Copyright 2018. All rights reserved. We would not be where we are today without the support of people like the Cottrells, the Pauleys and other members of our family. Thank you! HOW TO MAKE A GIFT. Gifts to VCU Health Pauley Heart Center allow Sincerely, us to invest resources in Dr. Kenneth A. Ellenbogen transforming patient care, education and research. For more Chair, Division of Cardiology information on how to honor a loved Martha M. and Harold W. Kimmerling, M.D. Chair in Cardiology one or a caregiver, please contact Carrie Mills at (804) 828-0453 or [email protected]