HEALERS OF THE HEART

MonashHeart Annual Review 2016 – 2017

Benny Cooper 16–year old student School captain, church youth leader, volunteer life guard Cardiac arrest, echocardiography, cardiac CT CONTENTS 4 WHO WE ARE 6 2016 AT A GLANCE 8 DIRECTOR’S MESSAGE 10 ACTIVITY REPORT 12 BENNY’S STORY 14 CLINICAL SERVICE SUB-SPECIALTIES REPORTS 16 ACUTE CARDIAC SERVICES 17 CARDIAC CT SERVICES 18 CARDIAC RHYTHM MANAGEMENT SERVICES 19 INTERVENTIONAL SERVICES 20 NON-INVASIVE IMAGING SERVICES 21 PAEDIATRIC CARDIOLOGY & ADULT CONGENITAL HEART DISEASE SERVICES 22 LUCY’S STORY 24 FUNDRAISING REPORT 25 OUR FINANCES 26 CATHERINE’S STORY 28 MONASH CARDIOVASCULAR RESEARCH CENTRE REPORT 36 MANAGEMENT TEAM 38 KEVIN’S STORY 40 OUR PEOPLE 44 2016 MEDIA HIGHLIGHTS 46 THE VICTORIAN HEART HOSPITAL

2016 was overshadowed by the resignation of the inaugural Director of MonashHeart Professor Ian Meredith AM. Ian’s vision has been the driving force behind the concept of the Victorian Heart Hospital, a specialist cardiac hospital scheduled to open on the Monash University Campus. His leadership and vision will be sorely missed but he leaves behind a unified and well-functioning team strongly committed to high quality patient care, education and research into the future.

2 3 MonashHeart is Victoria’s largest cardiology service WHO WE ARE provider with more than 400 committed multidisciplinary team members operating across three sites, providing over 86,000 episodes of cardiological care to the community each year. We thrive on providing a diversified, leading cardiology healthcare service to patients of all ages, from in-utero and newborns right through to our mature citizens, which seeks to ensure patient and family satisfaction and best experience.

We are a part of Monash Health, the largest public health service provider in Victoria, Australia.

OUR MISSION OUR VISION

To improve community wellbeing through To be the leading cardiovascular healthcare outstanding cardiovascular healthcare provider in Australasia. services and provision of exceptional quality education, training and research We put our vision into action through our: opportunities for healthcare professionals. • Commitment to provide the best possible experience, atmosphere and environment for our patients.

• Drive to innovate and continually improve through research and technology development.

• Emphasis on real teamwork and authentic relationships.

4 5 2016 AT A GLANCE

PATIENT CARE PROCEDURES & TESTS RESEARCH EDUCATION LEADERSHIP ONLINE PRESENCE

More than 86,000 episodes of 21,594 ambulatory cardiac rhythm Numerous presentations made at national 11 subspecialty fellowships provided to Dr Arthur Nasis appointed Co-Chair of the Launch of new and refreshed MonashHeart website – a modern, contemporary design cardiological care in 2016 across our three management (CRM) tests performed or international meetings. cardiologists from Australia and overseas. Department of Health and Human Services that is smartphone friendly. service sites. including 12-lead ECGs, exercise stress Victorian Cardiac Clinical Network. 66 publications. PhD candidates. tests, ambulatory blood pressure 6 19,576 private consulting room Professor Richard Harper appointed the 44,464 unique visitors, 58,542 monitoring, Holter and loop monitoring and consultations provided, an increase of 7 per 31 national and international clinical trials Drs Dennis Wong and Yuvaraj Malaiapan Chair of the Australian Government MBS sessions and 143,196 total page views six-minute walk tests. cent in 12 months. hosted. complete their Doctor of Medicine (MD). Review Taskforce, Cardiac Services Clinical to the MonashHeart website. echocardiograms performed for Committee. 7,246 people admitted to inpatient 16,790 3 Robertson Family Research Scholarship Drs Robert Gooley and Om Narayan are Visitors to the website from 141 countries. children and adults, 241 more than 2016. positions created from another very cardiac care beds based at Dandenong awarded their PhD. Professor Ian Meredith is appointed the Hospital and Monash Medical Centre generous donation. Celebrated fifth twitterversary in December 5,979 cardiac catheterisation laboratory Executive Vice President and Global Chief (public and private patients). 3 Deakin University post graduate critical 2016 with 2,798 tweets to date and over Dr Sarah Zaman awarded a Monash Medical Officer for Boston Scientific, the procedures performed in the three cardiac 1,300 followers. University Early Career Practitioner care students and 2 master associates 1,487 children seen in the MonashHeart catheterisation laboratories. world’s second largest medical device Fellowship – a opportunity to continue her specialising in interventional cardiac nursing. paediatric clinics including the general company. Third year of MonashHeart Instagram with cardiac CTs performed, the largest research in the field of cardiology. cardiology clinic and adult and adolescent 3,277 5 advanced cardiology trainees (two third more than 1,660 followers by December congenital heart disease clinic; an increase dedicated cardiac service in Australia. Drs Arthur Nasis, Brian Ko and Dennis Dr Brian Ko won ‘Best Cardiac CT Poster’ year six month rotations) and 2 general 2016. of 7 per cent on 2015. Wong are appointed Associate Professors, at the Congress of European Society of medicine trainees (six month rotations). 2,680 attendances at the device Monash University. 1,413 Facebook followers (December An increase in consultations of 8.6 per Cardiology (ESC) in Italy. surveillance clinics across Clayton, 2016). cent over 12 months at the MonashHeart Dr Hashrul Rashid is awarded joint winner Dandenong and Casey, an increase of 16 Dr Emily Kotschet performs Victoria’s first quaternary specialist clinics, with 3,615 of the Monash Health Excellence in Medical per cent on the previous year. new generation subcutaneous implantable attendances. Education award. cardioverter defibrillator implantation and emergency heart attack (STEMI) is the first female Victorian cardiologist to 402 Live case transmission from the cardiac cases treated in the cardiac catheterisation implant the new Micra leadless pacemaker catheterisation laboratory to national and laboratory, the largest Victorian provider. (just the 2nd to be implanted in a Victorian). international conferences including TCTAP in Seoul, Korea, TAVI Summit in Korea and 300th percutaneous aortic heart valve World–first electrophysiology procedure AICT Conference in Taipei, Taiwan. implantation achieved in 2016 – for atrial fibrillation using the gold-tipped a significant milestone for the structural AI cath force catheter and first-in-human Host to CEPIA first ever live case heart disease program. implant of the MRI compatible heart failure education forum attended on-site by placement with a quadripolar LV pacing cardiac technologists, cardiac nurses and lead. cardiologists specialising in the complex area of cardiac rhythm management.

6 7 DIRECTOR’S MESSAGE

Much of our focus in 2017 and beyond will be on ensuring that the Victorian Heart Hospital will be developed as an entity of the highest quality and as an institution that MonashHeart, Monash Health, Monash University, the Victorian Government and the Victorian public can be justly proud.

I am honoured to present the MonashHeart As always, education and training remains a Annual Review 2016-17. pivotal activity of MonashHeart. Not only are we responsible for training the cardiologists of the The year 2016 was overshadowed by the future, but with the development of the fourth resignation in December of the inaugural Director cardiac catheterisation laboratory and the future of MonashHeart, Professor Ian Meredith AM, to move to the Victorian Heart Hospital, there is a take up a position as Executive Vice President and compelling need to train more cardiac technicians Global Chief Medical Officer of Boston Scientific and specialised cardiac nursing staff. I am pleased – the world’s second largest medical device to report that innovative training programs are company. Ian has been Professor / Director of being developed within MonashHeart that will MonashHeart since 2005 and during this time result in more cardiac technicians with expertise in has overseen the progression of MonashHeart echocardiography for whom there is a great and to its current position as a premier cardiology ever increasing demand, as well as more cardiac service and a major player on the international catheterisation nursing staff with expertise in scene. Ian’s vision has been the driving force interventional cardiac procedures. behind the concept and successful development of the Victorian Heart Hospital, a specialist cardiac Despite the high demand for cardiac services hospital scheduled to open on the Monash and our intensive in-house education programs University Campus in 2021. His leadership and I am happy to report that under the guidance of vision will be sorely missed but he leaves behind our research head, Professor Jim Cameron, our a unified and well-functioning team strongly research output remains high with a large number committed to high quality patient care, education of important publications in prestigious medical and research. A search is underway both in journals. In particular, as a result of our pioneering Australia and overseas for his replacement. research into improving the clinical utility of CT coronary angiography, we are now recognised as As in previous years our throughput of patient a world authority in this increasingly important cardiac services remains the highest in the state investigation. and is limited not by the demand for our services but rather by the physical limitations of the space Much of our focus in 2017 and beyond will be we occupy and the resources we have. Obviously on ensuring that the Victorian Heart Hospital the move to the Victorian Heart Hospital in 2021 will be developed as an entity of the highest will greatly help to alleviate the latter; in the quality and as an institution that MonashHeart, meantime we have received approval to develop Monash Health, Monash University, the Victorian a fourth cardiac catheterisation laboratory that Government and the Victorian public can be justly is expected to be opened in the latter half of proud. In this respect I am eternally grateful for 2017. This will help us meet the demand for the sterling efforts of Anne Mennen, Director of interventional cardiology procedures including Development, MonashHeart, whose hard work “I am constantly amazed and extremely the burgeoning demand for transluminal and perseverance continues to ensure that the percutaneous structural heart interventions. Victorian Heart Hospital project remains on track proud of the professional way without compromise of its ideals. I am constantly amazed and extremely proud of the professional way our staff (reception, our staff care for our patients.” administration, nursing, technical and medical Professor Richard Harper staff) care for our patients. Whether it be a Interim Director of MonashHeart cardiac crisis or a planned cardiac test, patients Monash Health are universally treated with dignity and respect Professor Richard Harper and receive the highest quality care. From the comments and letters I receive I know how much Interim Director of MonashHeart, Monash Health this is appreciated by both patients and their family.

8 9 ACTIVITY REPORT

Cardiac admissions to inpatient bed (public and private) 7,246 Echocardiograms 16,790 Cardiac Rhythm Management Services – Interventional Services – cardiac catheteriation laboratory services 1,097 cardiac catheterisation laboratory services 4,882

Private Consulting Room consultations 19,576 An echocardiogram is an ultrasound of the heart. Device implantation • • Coronary angiography 3,395 Echocardiography uses sound waves to capture images of the (pacemaker, implantable cardioverter defibrillator heart. We offer the full range of different types of echocardiograms Private Consultation Attendances and left atrial appendage occlusion device) 716 • Percutaneous cardiac interventions 1,487 including exercise stress echocardiogram and dobutamine stress 2016 19576 echocardiogram. • Electrophysiology study 381 Coronary Angiography 2015 18316

17661 Echocardiogram 2014 Electrophysiology study 2016 3395 2013 14723 2015 2016 16790 3182 2016 381 2012 12392 2014 2015 16549 3228 2015 374 2011 8630 2013 3176 2014 16812 2014 324 2010 6765 2012 3179 2013 15511 2013 283 2009 4254 2011 3227 2012 14301 2012 276 2008 1267 2010 3298 2011 13702 2011 209 0 5000 10000 15000 20000 2009 3172 2010 12658 2010 249 2008 3059 2009 11969 2009 200 Cardiac CT scans 3,277 2008 10608 0 3100 3200 3300 3400 2008 228 0 5000 10000 15000 20000 Percutaneous Cardiac Intervention A cardiac CT allows doctors to non-invasively, painlessly, quickly 0 100 200 300 400 and easily view the structure and function of the heart. It provides Cardiac Rhythm Management 2016 1487 Cardiac Rhythm Management – niche clinic attendances 786 a detailed three-dimensional view of cross sections of the heart ambulatory ECG services 21,594 2015 1431 including the coronary arteries, the heart muscle and heart valves. 2014 1280 Complex Atrial Fibrillation Clinic We diagnose, manage and treat cardiac arrhythmias including • 2013 1279 Cardiac CT bradyarrhythmias (slow heart rhythm) and tacharrhythmias (fast • Cardiac Inherited Disease Clinic 2012 1199 heart rhythm) in paediatric, adolescent and adult patients. 1165 2016 3277 • General Rhythm Assessment Clinic 2011 2010 1188 2015 3153 Complex Rhythm Assessment Clinic 12-lead electrocardiogram (ECG) • 2014 3068 • 16,216 2009 1216 2013 2995 • Ambulatory blood pressure monitoring 773 2008 1130 2012 2701 0 • Exercise stress testing 1,143 MonashHeart Paediatric Clinic attendances 1,487 1100 1200 1300 1400 1500 2011 1773 Hypertension Clinic attendances 2010 1415 • Holter and loop monitoring 3,221 • Paediatric Murmur Clinic 252 2009 1085 • 6-minute walk test 241 • General Cardiology Clinic 2008 274 • Adult and Adolescent Congenital Heart Disease Clinic 0 500 1000 1500 2000 2500 3000 3500 Structural Heart Disease Clinic attendances 359

10 11 “I’m thankful to God for the miracle of life, and blessed to have MonashHeart looking after me.”

Benny Cooper 16–year old student School captain, church youth leader, volunteer life guard Cardiac arrest, echocardiography, cardiac CT

Benny was an active 16-year old teenager Further investigations at MonashHeart enjoying playing sports and actively included an echocardiogram and cardiac CT involved in his local community and which revealed that Benny had a congenital church. He had decided to follow in his abnormality of the left coronary artery father’s footsteps to compete in triathlons supplying the heart muscle, requiring and was participating in a triathlon, when urgent open heart surgical correction. just one kilometre from the finish line, Benny had his surgery at the Royal with his father Paul running alongside Children’s Hospital and made a rapid him, he suddenly collapsed and became recovery, returning home to his relieved unresponsive. family just four days after his surgery.

Fortunately for Benny, his father, through Benny is grateful for his health and his role as life guard and chaplain at reflective on his experience. He credits the Frankston Life Saving Club, was his faith as a major factor in coming to trained in first aid and cardio-pulmonary terms with his near-death experience - “I’m resuscitation. After initially thinking he had thankful to God for the miracle of life, and simply fainted, he assessed him and sprang blessed to have MonashHeart looking after into action commencing resuscitation with me”. Benny has come out of the experience the assistance of a doctor, while bystanders embracing life even more, continuing called 000. alongside his father as a volunteer life guard, taking on a youth leadership role in On ambulance arrival, Benny was found his church and being elected as the Bayside to be in full cardiac arrest with the Christian College school captain while he monitor showing he was in a lethal cardiac completes his VCE studies. arrhythmia called ventricular fibrillation. Following two attempts at defibrillation by the paramedics, thankfully his arrhythmia was reverted and his heart returned to normal rhythm. Benny was subsequently placed in a medically induced coma and transferred to the paediatric intensive care unit at Monash Medical Centre under the care of MonashHeart.

12 13 CLINICAL SERVICE SUB-SPECIALTIES REPORTS

14 15 ACUTE CARDIAC SERVICES CARDIAC CT SERVICES

What we do • Five new consultants joined the • In June, we held our inaugural What we do Our cardiologists were invited to present • Ko BS, Wong DT, Norgaard BL, Leong ward service roster, Drs Tim Barton, MonashHeart Murmurs Day, a one-day at a number of national and international DP, Cameron JD et al. Diagnostic Acute Cardiac Services provide Rob Gooley, Stewart Healy, Liam event aimed at improving cardiology Cardiac CT services provide non-invasive meetings, including performance of transluminal coordinated healthcare to acute cardiac McCormick and Sarah Zaman. clinical skills for 30 medical registrars angiography to diagnose coronary attenuation gradient and non-invasive patients admitted to cardiac beds across across Monash Health and Eastern artery disease and assess structural and • Novel Non-Invasive CT-Derived fractional flow reserve derived from Monash Health hospitals. With 21 beds • We appointed Anna Geller to the Health in preparation for the RACP congenital heart disease. A CT scan is a Fractional Flow Reserve Based on 320-detector row CT angiography to in the Cardiac Care Unit (CCU) and beds position of Nurse Unit Manager, CCU Clinical Examination. painless, non-invasive test using an x-ray Structural and Fluid Analysis (CT-FFR) diagnose hemodynamically significant in the combined 24 bed Cardiology and Clayton. machine to take clear, detailed pictures for Detection of Functionally Significant coronary stenosis: An NXT Sub study. Cardiothoracic Unit at Monash Medical • The proportion of CCU Monash of the heart, which are then composed Stenosis, Toshiba symposium at the Radiology 2016 Apr;279(1):75-83. Associate Professor Arthur Nasis Centre Clayton (32 South), as well as • nursing staff with formal post- into a 3D picture. Congress of European Society of Impact factor 6.798 in 2016. 26 beds in the CCU at Jessie McPherson was appointed as Clinical Lead of the graduate critical care qualifications Cardiology, Rome, Italy, August 2016, Private Hospital (31 North), and 16 CCU Victorian Cardiac Clinical Network. increased to 79 per cent, with more Associate Professor Sujith Seneviratne. • Ko BS, Cameron JD, Munnur K, et beds at Dandenong Hospital. staff projected to complete their Group leader profile al. Novel non-invasive ct-derived We created the new position of • critical care training in 2017. • Application of CT-Derived Fractional fractional flow reserve based on MonashHeart Academic Registrar, Associate Professor Sujith Seneviratne Flow Reserve Based on Structural and structural and fluid analysis (CT- Group leader profiles a position designed to allow the Fluid Analysis (CT-FFR) for Detection of FFR) for detection of functionally successful trainee opportunities to Associate Professor Sujith Seneviratne is Functionally Significant Stenosis at the significant stenosis: a comparison with Associate Professor Arthur Nasis extend their clinical, research and Community Activity and Outreach the Co-Head of the luminary site 320-slice Toshiba symposium at RSNA Chicago, invasive fractional flow reserve.JACC teaching exposure in cardiology cardiac CT facility at MonashHeart. The Associate Professor Arthur Nasis is a USA, November 2016, Associate Cardiovascular Imaging 2016 Accepted under the supervision of the Head of During ‘Cardiac Blues Awareness Day’, service has developed into the largest in consultant cardiologist who has been Professor Sujith Seneviratne. for publication. Impact factor 7.815 in Acute Cardiac Services. In 2016, our MonashHeart Clayton CCU nursing staff in Australia and is well known around the the Head of Acute Cardiac Services at 2016. inaugural registrar was Dr Hashrul conjunction with staff from the Australian world for its cutting-edge research. It is • Recent Advances in Cardiac CT, Annual MonashHeart since 2015 and serves as the Rashid, whose high calibre work was Centre for Heart Health set up a stand for undoubtedly the most published cardiac CT Scientific Sessions, Cardiac Society, co-clinical lead of the Victorian Cardiac Clinical • Ko BS, Wong DT, Cameron JD et al. acknowledged by receiving the Best hospital visitors and wore ‘blue for cardiac service in Australia. Colombo, Sri Lanka, June 2016, Network, Department of Health and Human Diagnostic accuracy of the ASLA score: Oral Abstract Presenter at TCT Asia blues’ to promote the message that a heart Associate Professor Sujith Seneviratne. Services. He has a research interest in the a computed tomography angiographic Pacific in Seoul, Korea as well as the event is an emotional event, not just a evolving role of imaging in the assessment index to predict functionally significant Monash Health Excellence in Medical physical one. • Cardiac CT: Beyond Coronary Artery of coronary artery disease as well as clinical 2016 highlights coronary stenoses in lesions with Education Award. Stenosis, Cardiac Society of Australia outcomes and models of acute cardiac care. intermediate stenosis severity. • Our team performed 3,277 cardiac CT and New Zealand 65th Annual Radiology 2015 Jul; 276(1): 91-101, • The state government invested over scans. Scientific Meeting, Adelaide, August Mss Pauline Ryan, Anna Geller, Plans for 2017 epub 2015 Feb 24. Impact Factor 6.798 $700,000 to upgrade all MonashHeart 2016, Associate Professor Dennis Chris Rasmussen and Jane Purcell in 2015. Clayton and MonashHeart Dandenong • Participation in the ‘Deepening • Dr Kiran Munnur completed his PhD Wong. cardiac monitoring systems to state-of- on cardiac CT. Associate Professors Pauline, Anna, Chris and Jane lead the our Understanding of Quality the-art Dräger systems. Brian Ko and Dennis Wong were • CT perfusion and CT-FFR, Cardiac cardiac care nursing teams on the four Improvement in Australia’ study, awarded Doctor of Medicine (MD) for Society of Australia and New Zealand Community activity and outreach cardiac care inpatient units across Monash an Australia-wide, NHMRC funded • Expansion from 12 to 16 CCU beds their work on cardiac CT by Monash 65th Annual Scientific Meeting, Health, with units based at Monash Medical project that aims to identify how at Dandenong Hospital has reduced University. Adelaide, Australia, August 2016, In 2016 we continued to conduct talks to Centre and Dandenong Hospital, providing hospital quality management systems, waiting times, facilitating prompt Associate Professor Brian Ko. educate general practitioners and other acute cardiac services 24 hours per day, 7 leadership and culture in Australian transfer of patients for procedures and • Associate Professor Dennis Wong cardiologists in the appropriate use of days per week. These outstanding leaders hospitals are related to healthcare acute inpatient care. was appointed as Co-Director of the • NXT and sub studies, CT perfusion cardiac CT and calcium score. have responsibility for providing service delivery quality and patient outcomes Heart Health Theme Imaging Core Lab and CT-FFR. Society of Cardiovascular excellence in nursing care through highly in acute myocardial infarction. • We participated in the state-wide (South Australian Health & Medical Computed Tomography, Las Vegas, skilled nursing staff educated to the COPS (Colchicine in Acute Coronary USA, July 2016, Associate Professor • Upgrade of our Cardiac Information Research Institute). uppermost standards, with a focus on the Syndrome) trial, and CardiacMate Brian Ko Plans for 2017 System (CIS), which will enable very best patient and family experience. (smartphone-based cardiac We collaborated with Toshiba research complete data collection for the • We will maintain a strong focus on our rehabilitation) trial. in Japan in developing advances • Faculty member at the Society Acute Cardiac Services Database and research activities particularly in the area in cardiac CT technology including of Cardiovascular Computed more timely completion of discharge of assessing the functional significance of • We expanded our Heart Failure software to assess the functional Tomography, Las Vegas, USA, July 2016 highlights summaries for patients and GP’s. coronary stenosis detected by cardiac CT Program, where our weekly Early significance of coronary stenosis using 2016, Associate Professor Brian Ko. Intervention Systolic Heart Failure and non-invasive imaging of vulnerable • In 2016 we provided inpatient care • Expansion of our MonashHeart a desktop computer. (EISHF) clinic reviewed over 250 Over the last two years, our research efforts plaque and outcomes. to over 7,200 patients across our Murmurs Day to enable more medical patients. ‘Best Poster Award’ to Associate have resulted in publications in high impact inpatient units. registrars from across all of Victoria to • Professor Brian Ko at the European factor journals. Highlights include: attend. • We completed our first full year of • MonashHeart Dandenong CCU Society of Cardiology, Rome, Italy. the new two team ward consultant participated in Phase 2 of the • Gaur S et al. Coronary plaque cardiologist model at MonashHeart Acute Coronary Syndrome Nurse • Winner of ‘Best Poster Award in quantification and fractional flow reserve by coronary CT angiography Clayton. This has enriched patient Ambassador Program, led by Ms Sue Cardiovascular Section’ at Monash care and improved consult times, as Laughton, sponsored by the Victorian Health Research Week, Melbourne, identify ischemia causing lesions. well as provided more opportunity for Cardiac Clinical Network and overseen Australia 2016 for work led by European Heart Journal 2016 Apr meaningful on-round teaching of staff by the Heart Foundation. Associate Professor Brian Ko. 14;37(15):1220-7. Impact Factor 15.064 and students. in 2016.

16 17 CARDIAC RHYTHM MANAGEMENT SERVICES INTERVENTIONAL SERVICES

What we do 2016 highlights • MonashHeart has replaced and What we do 2016 highlights Our partnership with the postgraduate increased its suite of 24-hour Holter nursing team at Deakin University provided CRM services diagnose, manage and • We performed a total of 1,097 cardiac monitoring systems and blood Interventional cardiology is a We performed 4,882 interventional new academic opportunities for our nursing treat cardiac arrhythmias - essentially, laboratory procedures, increased pressure monitoring devices, and specialised branch of cardiology procedures including 402 emergency heart staff. Registered nurses Mariel Jacob, any form of abnormal heartbeat or device surveillance clinic attendances also acquired three new 12-lead ECG that deals specifically with catheter- attack cases. Ami Tan and Janine Castillo completed a conditions that may predispose to such by 16 per cent to 2,680 attendances, machines. based interventions for the diagnosis postgraduate graduate certificate in critical abnormalities. We provide a range and provided 21,594 cardiac rhythm and treatment of heart disease We continue to be involved in coronary and care (interventional nursing). of arrhythmia-specific consultation testing services. including coronary artery and structural clinical research which furthers clinics at all three MonashHeart sites. structural heart disease. We provide a our understanding of new technologies and Clinical Nurse Educator Kevin White and These include dedicated clinics for • In May 2016, CRM services hosted Community activity and outreach 24-hour emergency service for people brings world-class contemporary treatment Clinical Nurse Specialist Dianne D’Rosario management of complex forms of atrial Cardiac Electrophysiology Institute suffering a heart attack. Interventional to our patients including: undertook Masters of Nursing Practice We expanded our profile as a fibrillation (AF) and evaluation and of Australia (CEPIA) students for two • cardiologists assisted by the cardiac by research thesis, with clinical outcomes demonstration and training site Percutaneous approaches to the management of inherited or genetically- days of live-case demonstrations catheterisation laboratory team, • focused on the recognition and response to for visiting cardiologists both treatment of mitral valve disease determined arrhythmia conditions. of electrophysiology and ablation perform emergency angiography to clinical deterioration. nationally and internationally, for (REDUCE FMR and TWELVE Intrepid); procedures. This was the first time visually assess and if required, treat the procedures such as catheter balloon- live cases were included in the CEPIA coronary arteries. Our facilities located based ablation procedures for AF, • New generations of transcatheter Group leader profiles program and, due to overwhelmingly within MonashHeart Clayton, offer percutaneous left atrial appendage aortic valve replacement (Lotus EDGE, Community Activity and Outreach positive feedback, this will become an advanced, high-volume interventional Dr Jeff Alison (LAA) occlusion, subcutaneous ICD Evolut R FORWARD); annual event. cardiology services via two dedicated implantation and leadless pacemaker • Mr Kevin White was elected the cardiac catheterisation laboratories. Dr Jeff Alison has served as the Head of • In June 2016, with Dr Stewart implantation. • Being the first to implant the next Victorian President for the Australian the Electrophysiology program, Monash Healy as Principal Investigator and generation Lotus Edge transcatheter College of Critical Care Nursing. Medical Centre, Clayton since 1996 and MonashHeart as the lead site, the • MonashHeart CRM cardiologists aortic heart valve; Mr Kevin White was appointed the the Head of Cardiac Rhythm Management CRM team successfully completed also continue to provide proctoring Group leader profiles • • New generation dissolvable stent national training and education (CRM) services, MonashHeart since 2007. the ‘first-in-human’ procedure, part for these procedures to colleagues technology (FAST); and representative of the Interventional Under Jeff’s leadership, MonashHeart’s of a multicentre trial of a highly throughout Australia and South East Professor Ian Meredith Nurses Council. CRM service continues to grow both in the advanced, ablation catheter capable Asia. Professor Ian Meredith was the acting Head • World first, drug filled stent technology number and range of services provided. of measuring the amount of contact of MonashHeart’s Interventional Services (RevElution). • Our cardiologists continue to provide force applied at the catheter tip. Ms Lucy Rudolph Plans for 2017 up until his departure in December 2016. on-site intravascular ultrasound, We were privileged to transmit a number of optical coherence tomography (OCT) • In July 2016, Dr Emily Kotschet He continued to actively lead improvements Ms Lucy Rudolph is the Lead Cardiac • A number of multicentre research live cases to various esteemed cardiology and rotablation workshops for the introduced the technique of leadless in patient care, research, education and Technologist for MonashHeart’s CRM trials are in the development phase. meetings including: wider cardiology community. pacemaker implantation to Monash training, leaving a legacy of excellence services. Armed with a science degree, These include spin-offs from our first- and innovation in interventional cardiac with great success. • AICT 2016 in Taipei, Taiwan in April subspecialty training in cardiac technology in-man ablation catheter trial and new catheterisation technologies. • Dr James Sapontis facilitated on-site approaches to catheter ablation for AF, 2016; OCT workshops for the local cardiology both in Australia and the UK and advanced • In September 2016, Ms Melissa training in cardiac electrophysiology, particularly as first-line treatment. Ms Kara Zantuck community. Furthermore, in his role Harvey was appointed to the newly • 5th AP Valves in Seoul, South Korea in Lucy leads a team of 20 cardiac as chronic total occlusion specialist established MonashHeart position August 2016; • We are working through a process of Ms Kara Zantuck began her career in proctor, Dr Sapontis also travelled technologists who focus on cardiac rhythm of CRM Clinical Nurse Consultant. evaluation of 3-D electrophysiology cardiothoracic nursing 12 years ago both nationally and internationally to catheterisation laboratory procedures Melissa has established Australia’s first • TCTAP 2016 in Seoul, South Korea in mapping systems to replace the before joining the cardiac catheterisation continue to train the wider cardiology and electrocardiographic (ECG) service nurse-led AF evaluation and follow-up September 2016. existing (and ageing) system to ensure laboratory nursing team in 2006, where community in this highly-specialised provision. clinic, expanding the services provided patients continue to receive state-of- she found her niche. In 2014 Kara was area. in the complex AF clinic. Patients now Our team of cardiologists and trainees the-art care. appointed the Nurse Unit Manager and have faster access, detailed education, published over 30 articles in high impact leads the nursing team of 30 staff and closer monitoring and a consistent medical publications. three cath lab assistants. She manages Plans for 2017 point of contact for support. the immediate care centre, interventional Drs Yuvaraj Malaiapan, Brian Ko and To appoint a Head of Interventional cardiac catheterisation laboratories, cardiac Dennis Wong completed and submitted • • Under the guidance of Dr David Services following the departure of the rhythm management procedural laboratory their Doctor of Medicine thesis to Monash Adam, a complex ventricular acting Head. tachycardia ablation program has and the cardiac CT service. University. been introduced. This addresses a We will commence the build of Drs Robert Gooley and Om Narayan were • particularly difficult area of cardiac a fourth cardiac catheterisation awarded a Doctorate of Philosophy for their rhythm management and results to laboratory at MonashHeart Clayton research on structural heart disease and date have been very encouraging. which will also incorporate an coronary physiology respectively. important expansion of immediate • We are involved in several ongoing care centre day beds. multi-centre Australian trials including investigating the best management of AF with heart failure and how to manage the risk of sudden death after a heart attack.

18 19 NON-INVASIVE IMAGING SERVICES PAEDIATRIC CARDIOLOGY & ADULT CONGENITAL HEART DISEASE SERVICES

What we do • We welcomed three new trainees • Rashid H, Amiruddin A, Ramkumar S, What we do 2016 highlights Plans for 2017 commencing graduate diplomas in Haji K, Steele S, Nerlekar N, Meredith Echocardiography is a sonogram of echocardiography. I, Nasis A, Mottram P, Moir S. The MonashHeart Paediatric Cardiology • We are delighted to see continuing • The opening of the new Monash the moving heart, using ultrasound Utilisation of 320-slice multidetector CT and Adult Congenital Heart Disease development and increases in the Children’s Hospital in April 2017 sound waves to create images of the • Our non-invasive imaging fellowship in assessing the aortic root geometry Service offers a comprehensive services that we are able to offer to the will mean a change in location of heart, depicting the shape and size of program was again very successful in in bicuspid aortic valves and its cardiology service to patients from fetal children of south eastern Victoria, a our inpatient services and a small the heart, heart valves and cardiac 2016 with cardiologists Drs Danielle implications for transcatheter aortic life through to the age of 18 years, and population which continues to expand. proportion of our outpatient services. chambers. MonashHeart’s non- Harrop, Damon Jackson and Trent valve replacement. J Am Coll Cardiol. also to adults with congenital heart invasive imaging service performs the Hartshorne gaining skills in all aspects of 2016 Nov 1;68(18S):B204-B205. disease. Services include consultations, • In 2016 we provided more than • We hope to increase our senior complete range of echocardiography echocardiography and cardiac CT. echocardiography in children and also 7,300 occasions of service for our medical staff team to enable us to procedures including transthoracic, • Williamson J. Is geographical location in adults with complex congenital young patients, which represents continue to expand our services in transoesophageal and dobutamine • Ms Eileen Nah successfully completed a barrier for echo training? An heart disease, interventional rhythm a continuing year on year increase. response to ever growing demand. stress echocardiography. her graduate diploma in cardiac observational account of 10 student management (for patients weighing The greatest increases are in our We expect to continue to expand ultrasound with the Queensland cardiac sonographers’ pursuit to more than 30kg), interventional outpatient consultations and • our echocardiography services to University of Technology. achieve accreditation. Sonography 2016 cardiology services for adolescents echocardiography services. accommodate increasing demand, and Group leader profiles Dec; 3 142–145. and adults with congenital heart The non-invasive imaging team In 2016 we saw a 10 per cent increase to reduce patient waiting time for this • disease, cardiac CT services and fetal • Associate Professor Philip Mottram presented numerous abstracts at in outpatient consultations provided important service. echocardiography. Inpatient services are the 2016 Cardiac Society of Australia by the team, which is a 30 per cent Community activity and outreach provided primarily at Clayton through Associate Professor Philip Mottram is and New Zealand scientific meeting, increase on 2014. both Monash Newborn and Monash a clinical cardiologist and non-invasive including a poster presented by point-of- • Mr Stuart Cox continued his involvement Children’s Hospital. imaging specialist with expertise in all care echo educator Mr Anthony Wald. with the Solomon Islands and Tonga, • We also saw an 11 per cent increase forms of echocardiography along with providing pro-bono echo screening in our echocardiography occasions of cardiac CT. • Associate Professor Philip Mottram for the detection of rheumatic heart Group leader profiles service compared with 2015, a 21per delivered an invited lecture on the disease, along with senior sonographers cent increase on 2014. Mr Steve Farrell detection of left atrial thrombus at Ms Jacqueline Williamson and Ms Associate Professor Sarah Hope the Structural Heart Disease Australia Catherine Mylrea who were involved • We have introduced new consulting Mr Steve Farrell was a critical care nurse meeting. Dr Stuart Moir presented a in Australian indigenous screening Associate Professor Sarah Hope graduated and echocardiography clinics to with a post graduate diploma in critical number of lectures and participated programs. from the University of Edinburgh and accommodate increasing demand, care who went on to become a cardiac in teaching sessions at the 2016 Echo trained in paediatric cardiology in both with particular expansion of services at technologist and was the Chief Cardiac Australia meeting. • Dr Andre Monteiro from Timor-Leste the UK and Australia. She is also trained MonashHeart Dandenong. Technologist at Epworth Hospital until spent a three weeks’ sabbatical in and has trained many others in cardiac 2007. In 2008 he joined MonashHeart Manuscripts published in 2016 include: with MonashHeart, observing CT. Sarah is Head of Paediatric Cardiology • We welcomed the commencement of and was appointed the Chief Cardiac echocardiography and attending ward Services in MonashHeart and Monash training in paediatric and congenital Technologist in August 2015. • Xu B, Mottram P, Peverill R. rounds. Children’s Hospital. Sarah practices as heart disease for another of our Platypnoea-orthodeoxia syndrome: a paediatric cardiologist and also adult experienced cardiac sonographers this to assess breathlessness occurring Point-of-care echo educator Anthony year. 2016 highlights • congenital heart disease cardiologist. in the upright position, transthoracic Wald assisted in education sessions in • We performed 16,790 echocardiography should be performed the practical use of echocardiography in the upright position. Int J Cardiol. in emergency settings for Ambulance echocardiograms including for Community Activity and Outreach adult and paediatric patients. This 2016 Jan 1;202:636-638. Victoria and Adult Retrieval Victoria. represents a 4,000 increase in We continue to enjoy our ongoing • Peverill RE, Chou B, Donelan L, • procedures since 2010, reflecting relationship with HeartKids, who Mottram PM, Gelman JS. Possible Plans for 2017 the continued growth of our service, provide valuable support and mechanisms underlying aging-related and consolidates it as the busiest in encouragement for our patients and changes in early diastolic filling and • The coming year will see continued Victoria. their families during stressful and long axis motion - left ventricular length emphasis in preparing the team for less stressful periods of living with and blood pressure. PLOS ONE 2016 Jun the Victorian Heart Hospital and the • We participated in the MitraClip paediatric congenital and acquired 28;11(6):e0158302. projected opening of the fourth cardiac and Reduce FMR programs for the catheterisation laboratory. We will be heart disease. percutaneous treatment of mitral • Nerlekar N, Mulley W, Rehmani H, focussing on recruitment, training, regurgitation, and the first-in-man We continue to support the Ramkumar S, Cheng K, Vasanthakumar and expanding our services to meet • TWELVE trial of percutaneous mitral interventional cardiology treatment of SA, Rashid H, Barton T, Nasis A, demand. valve implantation. children from East Timor with severe Meredith IT, Moir S, Mottram complications of rheumatic heart PM. Feasibility of exercise stress • We will continue to progress the cross- • New senior echo educator Ms disease. echocardiography for cardiac risk site point-of-care echocardiography Jacqueline Williamson developed an program for the training of Monash innovative 10-week echo training assessment in chronic kidney disease patients prior to renal transplantation. Health emergency department and program which provides a fast track intensive care unit consultants and foundation in cardiac ultrasound for Clin Transplant. 2016 Oct;30(10):1209- 1215. registrars in rapid bedside transthoracic trainee sonographers. echocardiography.

20 21 “MonashHeart gave me the opportunity to follow my passion of electrophysiology and cardiac rhythm devices.”

Ms Lucy Rudolph Lead Cardiac Technologist Cardiac Rhythm Management Services

I have been working as a cardiac technologist It was both an honour and a privilege to for 15 years and joined MonashHeart in be appointed as the inaugural lead cardiac 2010 after working previously in the private technologist in cardiac rhythm management system and overseas, and prior to that in at MonashHeart in 2015. My key challenge another major Victorian hospital. is to lead the development of a team of advanced practice cardiac technologists MonashHeart gave me the opportunity to within a service that is continually growing, follow my passion of electrophysiology and while the whole time making sure the cardiac rhythm devices, and I have obtained patient remains the number one priority. post-graduate qualifications in both of these areas. It is certainly exciting to be part of a team that is focused on providing patients with Being able to do what I love across Victoria’s the latest innovations and treatments largest cardiology service and within a available, while also working towards department that is at the forefront of establishing the Victorian Heart Hospital. the latest technology is both exciting and challenging.

22 23 FUNDRAISING REPORT

OUR FINANCES

Our heartfelt thanks to each and every Unlocking the potential of our young, • Five new temporary pacing boxes MonashHeart services are principally Summary Outlook donor for your ongoing support of upcoming clinical researchers has been for cardiac theatre and cardiac funded by the Department of Health MonashHeart. Every donation, small and a key priority over recent years, with catheterisation laboratory services at and Human Services, private health MonashHeart finished the 2015/2016 MonashHeart will continue to explore large truly has an impact. This impact is the Robertson Fellowship donation in Clayton; and fund rebates, Monash Cardiovascular financial year positively with revenue at opportunities with emphasis on self- seen in the patient care improvements 2016 providing essential support for Research Centre research activities and $28.620M or 6 per cent above budget. funding models of care to meet the we have made; whether it is a new Drs Robert Gooley, Sarah Zaman and • A handheld blood flow doppler for the charitable donations. Funds received The revenue for the financial year included challenges in the continuing growth in piece of monitoring equipment, Liam McCormick. Rob and Liam have Cardiac Care Unit at Clayton. are used to deliver services to patients components of private, public and research demand for quality cardiology services. expanded clinical service or support of undertaken research into innovation in the through procedures conducted in the activity. Public revenue is funded by public This will ensure sustainable long term activity at 23 per cent of total weight inlier financial viability of the service into the our scholarship fund for bright clinical transluminal treatment of structural heart All of these purchases have had a cardiac catheterisation laboratories, equivalent separations (WIES). future. researchers. disease, and Sarah into preventing sudden significant impact on faster patient tests offered through our non-invasive cardiovascular death due to heart rhythm access to diagnostic cardiac tests, closer imaging and cardiac CT services as well In 2016, 593 of you made a donation problems. It was an unprecedented year for observation during cardiac procedures, as outpatient consultation services. to MonashHeart, raising over $253,990 donations to be used in clinical equipment and or better monitoring during transport for clinical developments, research and purchases including: across hospital floors. We are profoundly education. grateful to you all for your contributions. • 10 new ambulatory blood pressure TOTAL RAISED monitors for our cross-site service; As we seek to provide even more services for our community, along with our • Replacement of the cardiac stress significant Victorian Heart Hospital project, treadmill and case system at we will again be looking to our supporters, $253,990 MonashHeart Clayton; benefactors and donors to enhance our mission to be the leading provider of • Three new 12-lead ECG machines; exceptional cardiovascular care, training and research, through building Australia’s • An additional defibrillator transport first, state-of-the-art dedicated heart monitor for 32 South; hospital – one in which Victorians will receive excellence in cardiac care.

24 25 “I find it easy to understand why MonashHeart is regarded so highly.”

Catherine Tate Former registered nurse, interior designer, architectural historian PhD Melbourne University

My experience with Monash Medical Centre I find it easy to understand why began at 3am on Tuesday 29 November MonashHeart is regarded so highly as the 2016 after an ambulance delivered me to cardiologist I saw was an electrophysiologist, the emergency department. At home, I had a specialist in cardiac arrhythmias, who suffered an episode of atrial fibrillation with prescribed Sotalol and Xarelto as a stroke an erratic heart rate of 172 beats per minute. preventive. However, a week later, my However, by the time the ambulance arrived heart rate had slowed and I was feeling at the hospital, my heart rate had returned tired and dizzy. I contacted Melissa directly to normal. I was in emergency for four hours and she conferred with her colleagues to and, on discharge, was told that I would be discontinue the Sotalol. She quickly arranged referred to MonashHeart. an appointment for me to have an MIBI test in the Department of Nuclear Medicine at The problem was I did not receive an Monash Medical Centre and an appointment appointment and, after two weeks, I was for cardiologist review at the clinic. Melissa becoming anxious. I was afraid to go to bed understood my reaction to medication and at night for fear of having another episode suggested to the attending cardiologist that so I visited my GP who advised me to be I trial the ‘Pill in the Pocket’ should further patient. She said that MonashHeart was episodes occur. This means I can still live an highly regarded by the medical profession active life without being continually tired. It but that the hospital served a large area with also has given me reassurance to go to bed consequent stress on its services. Finally I at night. received an appointment for the general rhythm assessment clinic at MonashHeart I was pleased to hear that a Victorian Dandenong on 31 January. This was where Heart Hospital is in the planning stage I met Melissa Harvey, cardiac rhythm and will be constructed on the Monash management clinical nurse consultant. University Clayton campus. This new Melissa had commenced in October 2016 to hospital will centralise and expand cardiac manage the nurse led atrial fibrillation clinic. services reducing the lengthy wait time for As a former nurse myself, I was impressed investigations and provide more clinical care with Melissa. She was gentle yet thorough for patients. and with considerable knowledge of cardiac medicine.

26 27 MONASH CARDIOVASCULAR RESEARCH CENTRE REPORT

“As an academic clinician, my vision is to save lives at an individual patient level and globally through my research.”

Dr Sarah Zaman Interventional Cardiologist NHMRC Early Career Researcher

28 29 MONASH CARDIOVASCULAR RESEARCH CENTRE REPORT

Monash Cardiovascular Research 2016 highlights Centre (MCRC) is the service group of MonashHeart providing research • 34 specialist cardiologists and education in accordance with 6 (specialist cardiologist) PhD students the MonashHeart and Monash Health • strategic plans. • 6 cardiothoracic surgeons MCRC provides the academic and • 2 specialist radiologists research bridge between MonashHeart/ Monash Health and the Faculty of • 11 cardiology sub-specialty clinical/ Medicine, Nursing and Health Sciences, research fellows Monash University. • 2 cardiothoracic fellows/trainees The MCRC research goal is to support translational cardiovascular research, • 48 peer reviewed original manuscripts 2016 MCRC published papers per field of as high quality research produces high (66 total publications) study quality clinical practice and policy development. • 6 educators/nursing and cardiac The IF (Impact Factor) is the accepted way technologist researchers of assessing the status of research journals by measuring the number of citations per What we do • 10 clinical trial co-ordinators and article in the journal. research assistants MCRC provides international leadership in cardiovascular research through: • Hosted 31 national and international clinical trials – 71 per cent of these • Clinical and first-in-human studies were first-in-human or early stage and the evolution of new treatment device trials. strategies including structural heart disease (TAVI, TMVR) and coronary artery disease;

• Established presence in international clinical forums;

• Assessment of central haemodynamics, arterial mechanics and function and mechanisms of cardiovascular risk;

• Presence in cardiovascular innovation, “My research has cast new light on coronary especially in cardiac CT and the management of chest pain. artery blood flow and the role of arterial Clinical and translational research of international standard undertaken within elasticity in predicting cardiovascular events.” MCRC supports the continued uptake by MonashHeart of state-of-the-art cardiological treatments to improve the cardiovascular health and outcome of Dr Om Narayan the people of Melbourne, of Victoria and of individuals on a wider national and Cardiologist and PhD Fellow international level.

30 3331 MONASH CARDIOVASCULAR RESEARCH CENTRE REPORT

Highlights of the research groups Non-Invasive Imaging • Publication by Ko BS, Cameron JD, • Commenced Protect-ICD trial enrolment, Cardiac Nursing Snapshot of our sccesses Munnur RK, Wong DTL, Fujisawa investigating the best method of Interventional nurses Ms Amy Tan, Interventional Cardiology • Publication by Peverill RE, Chou B, Y, Sakaguchi T, Hirohata K, Hislop- detecting heart attack patients with • • Drs Om Narayan, Robert Gooley and Ms Janine Castillo and Ms Mariel Donelan L, Mottram PM and Gelman Jambrich J, Fujimoto S, Takamura K, the highest risk of sudden death, and Adam Hutchinson received their Professor Ian Meredith continued to Jacob completed their post-graduate • JS, 2016. Possible mechanisms Crossett M, Leung M, Kuganesan implanting ICDs early post infarct in PhD at a graduation ceremony in lead international pioneering work interventional nursing certificate. underlying aging-related changes in A, Malaiapan Y, Nasis A, Troupis J, these patients. Part of an international November 2016. in the transluminal catheter based early diastolic filling and long axis Meredith IT and Seneviratne SK, trial, originating in Adelaide. • Ms Jade Geer was appointed as a treatment of structural heart disease Drs Yuvaraj Malaiapan, Dennis Wong motion - Left ventricular length and 2016. Non-invasive CT-derived FFR casual interventional nursing lecturer • acting as the world-wide principal and Associate Professor John Troupis blood pressure. PLoS ONE, 11(6). based on structural and fluid analysis. • Continued recruitment for CAAN-AF, on the post-graduate critical care investigator in three international received their MD degrees at a A comparison with invasive FFR for to determine the best management of course at Deakin University. Mr Kevin multi-centre studies of the Lotus valve Provision of transoesophageal and ceremony in September 2016. • detection of functionally significant patients with AF and heart failure, an White continued to coordinate and system, a repositionable percutaneous transthoracic echocardiography stenosis. JACC: Cardiovascular area of cardiology lacking guidelines on lecture on that course also. • Dr Adam Brown received a School of replacement of stenotic aortic valves. in the assessment of and during Imaging, 2016. the role of cardiac desynchronisation Ian acted as international proctor intervention for research patients and AV node ablation. • Mr Kevin White and Ms Dianne Clinical Sciences at Monash Health Early Career Researcher Fellowship. for numerous sites implementing in the MonashHeart Mitral Valve • Publication by Ko BS, Wong DTL, D’Rosario submitted Masters theses this new modality of treatment, Intervention Program – LV RECOVER, Nørgaard BL, Leong DP, Cameron • Continued the Watchman and LAA in interventional cardiac nursing • Drs Brian Ko and Arthur Nasis training healthcare professionals TWELVE MVR, REDUCE FMR. JD et al. Diagnostic performance of occlusion device registry, with Victoria’s research. were appointed as Adjunct Clinical in the REPRISE III (repositionable transluminal attenuation gradient largest experience, and subsequently PhD candidates in MCRC 2016 Associate Professors in the percutaneous replacement of stenotic • Provision of transoesophageal and and non-invasive fractional flow proctoring other hospitals across Department of Medicine, School of aortic valve through implementation of transthoracic echocardiography reserve derived from 320-detector the state, and Australia. Research • Dr Om Narayan, MBBS, FRACP. Clinical Sciences at Monash Health. Lotus valve system) transfemoral valve in the assessment of and during row CT angiography to diagnose presentations at the CSANZ annual Entitled: “In vivo studies on ventriculo- implantation. (PMID: 25257635, PMID: intervention for research patients scientific meeting. hemodynamically significant vascular coupling and the role of • We created the new position of the 24169077, PMID: 22995115). in the MonashHeart Aortic Valve coronary stenosis: An NXT aortic pressure wave morphology on MonashHeart academic registrar, Intervention Program – REPRISE 1, 2 Cardiothoracic Surgery substudy. Radiology, 2016;279(1), pp. coronary blood flow”. Awarded 2016. a position designed to allow the • We performed early stage human and 3; and the EVOLUT R program. 75-83. trials in Transcatheter Mitral Valve • Completed recruitment (Monash • Dr Robert Gooley, MBBS, FRACP. successful trainee opportunities to extend their clinical, research and Repair and Replacement (TWELVE) • Commencement of a pilot study Strong industry partnership with Health are the third most successful Entitled: “The Influence of TAVI on • teaching exposure in cardiology and in ultrasonic athrectomy for heavy to assess the feasibility and clinical Toshiba Medical. recruitment site) for the Aspirin and myocardial and aortic structure and calcium deposition in coronary arteries impact of a cardiac sonographer- Tranexamic Acid in Coronary Artery function”. Awarded 2016. under the supervision of the Head of led training program for intensive Surgery (ATACAS) Trial. The aspirin arm Acute Cardiac Services. In 2016, our (Shockwave). Cardiac Rhythm Management Dr Kiran Munnur, MBBS, FRACP. care and emergency department showed that it did not matter whether or • inaugural registrar was Dr Hashrul Entitled: ”Longitudinal assessment • Publication by Serruys PW, Ormiston physicians in point-of-care • Commenced a subcutaneous ICD not aspirin was discontinued around the Rashid, whose high calibre work was of coronary plaque by computed J, Van Geuns R, De Bruyne B, Dudek echocardiography. program, following the first implant time of coronary artery bypass grafting. acknowledged by receiving the Best tomography coronary angiography, D, Christiansen E, Chevalier B, Smits in Australia by Dr Jeff Alison. Now Published in the New England Journal of Oral Abstract Presenter at TCT Asia intravascular ultrasound and optical P, Mcclean D, Koolen J, Windecker S, • Commencement of recruiting for MonashHeart have the most implant Medicine. Pacific in Seoul, Korea as well as the coherence tomography”. Ongoing. Whitbourn R, Meredith I, Wasungu the SUCCOUR study – a randomized experience in Victoria, proctoring at Monash Health Excellence in Medical L, Ediebah D, Veldhof S and Onuma controlled trial assessing the value numerous hospitals around the state. • Demonstrated the use of dynamic four- • Dr Nitesh Nerlekar, MBBS, FRACP. Education Award. Y, 2016. A Polylactide Bioresorbable of LV strain in the management of Clinical outcomes reported for CSANZ. dimensional computed tomography Entitled: “The Association of Epicardial Mr Kevin White was appointed the Scaffold Eluting Everolimus for chemotherapy patients at risk of imaging for re-entry risk assessment in Adipose Tissue, Clinical Adiposity and • national education and training Treatment of Coronary Stenosis: 5-Year cardiotoxicity. • Presentations at CSANZ sessions re-do sternotomy. Coronary Atherosclerosis Prevalence representative for the Interventional Follow-Up. Journal of the American demonstrating the clinical effectiveness and Progression: Insights using Provision of cardiac imaging for Completed a modelling study of Nurses Council of Australia, and College of Cardiology, 67(7), pp. 766-776. • of remote monitoring of pacemakers • Cardiac Computed Tomography”. five other multicentre trials utilising renal haemodynamics, function and Victorian President of the Australian and defibrillators. MonashHeart Ongoing. • Dr James Sapontis led MonashHeart echocardiography. was the first hospital in Victoria to oxygenation during cardiac surgery College of Critical Care Nurses participation in the FLAIR - functional commence remote monitoring of performed on cardiopulmonary bypass. • Dr Sam Mirzaee, MBBS, FRACP. (ACCCN), and National Board member. lesion assessment of intermediate • Ten research publications in devices, and our doctors currently have Entitled: “Assessment for Pre- stenosis to guide revascularisation – international journals. the largest service in Victoria. • Compared the chronobiology of Clinical Heart Failure at a Very Early • Ms Dianne D’Rosario presented study. MonashHeart, in collaboration Stanford type A aortic dissections Stage by Stress Echocardiography at both ANZET and at the ACCCN Cardiac CT with the Imperial College London, • Poster presentation of research between the northern and southern (ASPHALT-SEA) Study”. Ongoing. Cardiac Seminar on ‘Incidence of into the clinical outcomes of day hemispheres and showed that they are clinical deterioration in STEMI patients participated in the FLAIR trial, which • Over 20 publications, numerous MD candidates by research in MCRC 2016 case catheter ablation for AF, with more common in the cooler seasons. presenting for primary PCI’. has been investigating a new technique national and international called the instantaneous wave free radiofrequency and cryoablation • Dr Vimmaraj Bogawanshanmugam, presentations including a prize at • Mr Kevin White presented at ANZET ratio (iFR) which does not require the procedures, leading the country in safe MBBS, MD, DM. the Cardiac Society Australia and on ‘Interventional cardiac nurses’ administration of drugs for its accurate day case procedures. New Zealand (CSANZ) meeting and • Dr Yuvaraj Malaiapan, MBBS, FRACP recognition and response of clinical assessment. This trial involves multiple nominated for a young investigator • Published data on patient controlled (awarded 2016). deterioration’. centres across the world and continues award at the American College of a coalition between MonashHeart and sedation, which has now become • Dr Brian Ko, MBBS, PhD, FRACP Cardiology (ACC). Leader in new standard practice, in offering patients Imperial College London for further research and developments such as (awarded 2016). co-operation in future studies. undergoing catheter ablation suitable CT perfusion, TAG and CTFFR. pain relief and sedation throughout • Dr Dennis Wong, MBBS, PhD, FRACP. their procedure. (awarded 2016)

32 33 MONASH CARDIOVASCULAR RESEARCH CENTRE REPORT

Top 15 published output 2016 • Meredith IT, Tanguay J, Kereiakes DJ, • Peverill RE, Chou B, Donelan L, Cutlip DE, Yeh RW, Garratt KN, Lee Mottram PM and Gelman JS, 2016. • Akalanli C, Tay D and Cameron JD, DP, Steg PG, Weaver WD, Holmes Possible mechanisms underlying 2016. Optimization of a generalized DR, Brindis RG, Trebacz J, Massaro aging-related changes in early radial-aortic transfer function using JM, Hsieh W and Mauri L, 2016. diastolic filling and long axis motion parametric techniques. Computers in Diabetes mellitus and prevention - Left ventricular length and blood Biology and Medicine, 77, pp. 206-213. of late myocardial infarction pressure. PLoS ONE, 11(6). after coronary stenting in the • Boganashanmugam V, Psaltis PJ, randomized dual antiplatelet therapy • Schwalb W, Shirinzadeh B and Smith Wong DT, Seneviratne S, Cameron study. Circulation, 133(18), pp. 1772- J, 2016. A force-sensing surgical tool J, Meredith IT and Malaiapan Y, 1782. with a proximally located force/torque 2016. Chronic total occlusion – sensor. International Journal of Medical percutaneous coronary intervention • Meredith IT, Walters DL, Dumonteil Robotics and Computer Assisted Surgery. (CTO-PCI) experience in a single, multi- N, Worthley SG, Tchétché D, operator australian centre: need for Manoharan G, Blackman DJ, Rioufol • Tung MK, Ramkumar S, Cameron JD, dedicated CTO-PCI programs. Heart G, Hildick-smith D, Whitbourn RJ, Pang B, Nerlekar N, Kotschet E and Lung and Circulation, 25(7), pp. 676- Lefèvre T, Lange R, Müller R, Redwood Alison J, 2016. Retrospective cohort 682. S, Feldman TE, Allocco DJ and Dawkins study examining reduced intensity KD, 2016. 1-year outcomes with the and duration of anticoagulant and • Gaur S, Øvrehus KA, Dey D, Leipsic J, fully repositionable and retrievable antiplatelet therapy following left Bøtker HE, Jensen JM, Narula J, Ahmadi lotus transcatheter aortic replacement atrial appendage occlusion with the A, Achenbach S, Ko BS, Christiansen valve in 120 high-risk surgical Watchman device. Heart Lung and EH, Kaltoft AK, Berman DS, Bezerra patients with severe aortic stenosis: Circulation. H, Lassen, JF and Nørgaard BL, 2016. Results of the REPRISE II study. JACC: Coronary plaque quantification and Cardiovascular Interventions, 9(4), pp. • Zaman S, McCormick L, Gooley R, fractional flow reserve by coronary 376-384. Rashid H, Ramkumar S, Jackson computed tomography angiography D, Hui S and Meredith IT, 2016. identify ischaemia-causing • Myles PS, Smith JA, Forbes A, Silbert Incidence and predictors of lesions. European Heart Journal, 37(15), B, Jayarajah M, Painter T, Cooper permanent pacemaker implantation pp. 1220-1227. DJ, Marasco S, McNeil J, Bussières following treatment with the JS and Wallace S, 2016. Stopping vs. repositionable Lotus™ transcatheter • Ko BS, Cameron JD, Munnur RK, continuing aspirin before coronary aortic valve. Catheterization and Wong DTL, Fujisawa Y, Sakaguchi artery surgery. New England Journal of Cardiovascular Interventions, 2016 Nov T, Hirohata K, Hislop-Jambrich J, Medicine, 374(8), pp. 728-737. 12. doi: 10.1002/ccd.26857. [Epub Fujimoto S, Takamura K, Crossett M, ahead of print] Leung M, Kuganesan A, Malaiapan Y, • Nerlekar N, HA FJ, Verma Nasis A, Troupis J, Meredith IT and KP, Bennett MR, Cameron JD, “We are privileged to be involved in Seneviratne SK, 2016. Non-invasive Meredith IT and Brown AJ, 2016. CT-Derived FFR Based on structural Percutaneous coronary intervention and fluid analysis. A comparison using drug-eluting stents versus making a truly significant contribution with invasive FFR for detection of coronary artery bypass grafting for functionally significant stenosis. JACC: unprotected left main coronary artery Cardiovascular Imaging. stenosis. Circulation: Cardiovascular to translational research and the care of Interventions, 9(12). • Ko BS, Wong DTL, Nørgaard BL, our patients.” Leong DP, Cameron JD, Gaur S, • Penny-Dimri JC, Cochrane AD, Marwan M, Achenbach S, Kuribayashi Perry LA and Smith JA, 2016. S, Kimura T, Meredith IT and Characterising the role of Seneviratne SK, 2016. Diagnostic perioperative erythropoietin for Associate Professor Brian Ko performance of transluminal preventing acute kidney injury after attenuation gradient and non-invasive cardiac surgery: systematic review and fractional flow reserve derived from and meta-analysis. Heart Lung and 320-detector row CT angiography Circulation, 25(11), pp. 1067-1076. Associate Professor Arthur Nasis to diagnose hemodynamically significant coronary stenosis: An NXT substudy. Radiology, 279(1), pp. 75-83.

34 35 MANAGEMENT TEAM

Director of Development, Interim Director of Operations Manager, Operations Manager, Victorian Heart Hospital Business Manager Director of MonashHeart Monash Cardiovascular Research Centre Acute, Ambulatory & Cardiothoracic Surgery Procedural & Diagnostics

Ms Anne Mennen Mr Ying Chan Professor Richard (Rick) Harper Professor James Cameron Ms Kirsten Garner Mr John Koutsoubos Anne has over 20 years’ cardiac nursing Ying is a business manager with more than In late 2016 Rick was appointed the interim James is the Associate Director of Kirsten’s background in cardiothoracic On finishing school, John initially studied experience including cardiac care and 25 years’ financial management experience Director of MonashHeart. Rick is a renowned MonashHeart and the Director of the and intensive care nursing put her in engineering, but midway switched to cardiothoracic leadership roles. She within Monash Health and has been the cardiologist and highly respected advisor, Monash Cardiovascular Research Centre, a good position to instigate significant nursing, going on to become the Nurse undertook the role of Operations Manager, Business Manager for MonashHeart since lecturer and mentor. Rick established the encompassing MonashHeart clinical improvements in cardiac patient access Unit Manager of MonashHeart’s cardiac MonashHeart for 10 years, before becoming 2009. Aside from MonashHeart, his portfolio cardiology service at Monash Medical Centre, research, professional training and as the Cardiac Liaison Coordinator for catheterisation laboratories and cardiac the Director of Development for the Victorian also includes Monash Health Community, and, since 2005, has held the position of education. James completed undergraduate MonashHeart and cardiothoracics. Kirsten CT service. In this position, John led Heart Hospital project. Working closely with Allied Health and theatres. Ying’s knowledge Emeritus Director. Amongst the many and post-graduate study in engineering has also undertaken secondment as the significant change including the expansion Monash Health, Monash University and the of the operating environment within the responsibilities Rick has undertaken during and medicine and his background includes Deputy Director of Nursing at Monash of the cardiac catheterisation laboratories State Government, Anne is passionate about organisation has significantly contributed his career, recent highlights include Co-chair Professor of Electrical Engineering, Latrobe Medical Centre, the largest public hospital and establishment of Australia’s first ensuring the success of the Victorian Heart to the successful management of growth of of the Victorian Cardiac Clinical Network, and University and (adjunct) Professor of in Melbourne. In 2014, Kirsten was dedicated cardiac CT service, the largest Hospital; Australia’s first dedicated heart financial resources in MonashHeart and has Chair of the Cardiology Committee for the Medicine, Monash University. His work on appointed the Operations Manager for cardiac CT service in Australia. John took hospital. positively added to the financial outcomes Australian Government MBS Taskforce. arterial function and dysfunction in health acute, ambulatory and cardiothoracic up the challenge of Operations Manager year on year. and disease is internationally recognised, surgery services, a role where service for procedural and diagnostics in 2014, a with invitations to speak each year at improvements for patients with cardiac role where the very best, evidence-based hypertension and vascular medical sessions conditions is a key priority. patient services are an ongoing goal. at major conferences world-wide. 36 37 ”My goal was to work at the cutting-edge of technology and to be the best cath lab nurse I could be. ”

Mr Kevin White Nurse Educator Cardiac Catheterisation Laboratories

After growing up in the north of England, nurse educator in Australia. Kev has a an area with the highest incidence of heart passion for training the next generation of disease in the UK, Kev knows all about the interventional cardiac nurses and delivers importance of heart health and its impact a successful nurse training program with a on the community. specific focus on ensuring the highest levels of patient safety. Kev completed his nurse training in 2002 and, after a short time working in the Kev names his collaborative work with emergency department, discovered a Deakin University (where he now lectures) passion for caring for people with cardiac to bring their Masters in Nursing Practice conditions. “Transporting critically-ill to interventional cardiac nurses as one patients to the cardiac catheterisation of his greatest successes to date. His laboratory and watching the team open up achievements have been recognised a blocked coronary artery, and instantly nationally and he has been appointed improving the person’s symptoms was as the national education and training amazing to watch. Being able to help people representative for the Interventional Nurses in their most vulnerable moment was Council of Australia and New Zealand, and something I wanted to be a part of.” Victorian President of the Australian College of Critical Care Nurses. Kev came to Australia in 2004. “My goal was to work at the cutting-edge of technology It is his vision that “people with cardiac and to be the best cath lab nurse I could disease deserve access to healthcare be. To do that I knew I needed to work at professionals trained to the highest a truly world-class facility and a career at standard, and that’s why at MonashHeart MonashHeart was the obvious choice.” we are taking both a local and national approach to leading the way. We are Fast forward 13 years and, after working committed to world-class training, his way from novice cath lab nurse to education and research, ensuring our clinical nurse specialist and associate patients and families are in safe hands, nurse unit manager, Kev was appointed confident in the skill of nursing staff when as the first full-time interventional cardiac they need it most.”

38 39 The MonashHeart team is a wonderfully diverse team OUR PEOPLE and our people are at the heart of patient care. Our team members are bound by a shared passion to strive to make a Ms Thi Bui, real difference in the lives of our patients and to continually Dr Wally Ahmar improve our service. and Dr Caitlin Cheshire Administration

Business Manager Information Technology Bookings Officers Personal Assistants Reception Supervisor Ying Chan Manager Georgia Georgiou Jennielyn Capungcol Margaret Beddoe Val Koval Lauren Jones Kate Moroney Operations Managers Craig Pike Anna White Receptionists Kirsten Garner Billing Supervisor Be Wild Karen Chipperfield John Koutsoubos Lorraine Mitsikas Cardiac Catheterisation Jennie Corrie Laboratory Booking Private Consulting Director of Development Billing Clerks Shellie Hardman Officer Rooms Practice Anne Mennen Linda Farrugia Leigh Stewart Julie Lukacs Supervisor May Garcia Amanda Thomas Cardiac Liaison Maree Jones Kelly Grigg Clinical Applications Natalija Tsotsoros Coordinator Nina Harris Manager Private Consulting Kylie Vervark Katie Hogan Sheree Harris Pei Lee See Rooms Booking Officers Mezhgan Zekaria Jaana Kivi Kaye Chapman Pam Howell Booking Supervisor Narelle Rollings Brooke Wallace Sharnah Strode Cardiac Care Unit Clayton

Nurse Unit Manager Clinical Nurse Specialists Sheejamol Thomaskutty Melissa DiCasare Melissa Graham Anna Geller Deidre Ambrose Kim Tucker Kimberley Hansby Brendan Jackson Shannon Barrett Sammi Wang Xiang Hong Emily Leslie Interim Nurse Unit Clarissa Bermundo Kara Watt Judith Jachman Jin-Chiueh Morrison Managers Liezyl Bogaonon Lindy Whelan Leslie Jay Katie O’Brien Sara Coldicott Kay Cavanagh Elissa Jumeau Rachel Paul Sia Roussos Pre Admission Clinic Lani Cabellero Nisha Kumar Myky Serrano Coordinator Clinical Nurse Educator Helen Chilton Madhav Lee Manu Rhiannon Thomas Leslie Jay Yas Ivankovic Sybil Chong Silvi Matthew Tara Thomas Katie Hogan Cardiac Rehabilitation Anne McCurrach Maren Vong Associate Nurse Unit Jo Jeffs Coordinators Louise Mollet Marijana Vujcevic Managers Michelle Jones Sarah Bond Cindy Nhao Tegan Welsh Kelly Findlay Jane Mountfort Angela Erganay Rachel Nichol Karen Harrington Graduate Nurses Vasantha Munasinghe Meredith McMillan Bindu Ratnavally-Nair Crystal Hutton Candice Annells Emma Owen Carmen Scully Kirsten Salvas Samantha DiPaola Maryann Pang Registered Nurses Siny Simon Damian Atherton Michael Romero Shannon Tonkins Ward Clerks Irene Backo Leanne Rudd Jinci Antony Elizabeth McGrath Angelica Barreno Sally Shi Danny Carey Rory Neal Beata Csupor Stephanie Stevenson Kim Franklin Debra Dai

Cardiac Care Unit Dandenong

Nurse Unit Manager Clinical Nurse Specialists Registered Nurses Minimol Joseph Xue Mei Zhang Chris Rasmussen Claudette Brown Taisy Antony Athena Lai Sally Zhou Jason Chong Minimol Austine Suying Lui Associate Nurse Unit Graduate Nurses Michelle D’Lima Preethy Augustine Li Luo Managers Samantha Greenwood Chin Lee Trish Brindley Reena Moncy Rosario Arcamo Brooke Pattison Jo Panicker Skye Brokenshire Sheeba Paul Carol Cheng Ayesha Ponniah Liz Seyer Graeme Coad Anitha Philip Sue Laughton Courtney Wu Sangeeta Sharma Julie Dines Charlie Quach Shobhana Maharaj Sue Wall Lena Dobrodum Carlo Salvador Ward Clerk Kerry Morton Shusma Fernandes Kasia Shanawaz Suchitra Laxma Marius Tragarz Fedora Fernandez Teny Thomas Asha John Karin Walburgh Shainey Jose Rosemary Xia Yanging

40 41 OUR PEOPLE

Cardiac Catheterisation Laboratories, Immediate Care Centre & Cardiac CT Monash Cardiovascular Research Centre

Nurse Unit Manager Clinical Nurse Specialists Registered Nurses Joice Jose Cath Lab Assistants Director of Monash Research Manager Clinical Coordinators Data Manager Research Coordinators Kara Zantuck Meiling Balington Alexandra Amery Kelly Keir Marcus Hamilton Cardiovascular Maryanne Austin Caroline Bowman Kerrie-Lea Allen Mauro Baldi Lauren Bryce Rebecca Anderson Brigita Nogic Grant Short Research Centre Melissa Harvey Brianna Davidson Clinical Nurse Educator Medical Scientist Sojee Chand Cate Berriman Helen Smolka Rob Tyers James Cameron Maree Lawrence Jordan Laggoune Kevin White Michael Zhang Diane D’Rosario Skye Brokenshire Ami Tan Adele Manzoney Associate Nurse Unit Jade Geer Julia Cvetovac Judith Williams Wendy Wallace-Mitchell Managers Geraldine McBean Emily Fanner Rebecca Dean Cath Pemberton Marie Louise Fitzgerald Medical Staff Anna Petrakos Kathy Ruan Stella Floros Nadia Jhoomun Erin Vogt Elvenjoy Gopico Mariel Jacob Director of MonashHeart Emeritus Director Cardiologists Paediatric Cardiology General Medical/ Ian Meredith Richard Harper (Honorary/Locum) Services Fellows Cardiology Trainees Cardiac Technologists Andrew Davis Ibtihalat Mohamed Elizabeth Atkins Interim Director of Cardiologists Sue Ling Liew Ala Mustafa Kawa Haji MonashHeart David Adam Jonathon Lipshutz Lead Cardiac Rhythm Thi Bui Connor McCarthy Nikolas Jin Yang Richard Harper Wally Ahmar Advanced Cardiology Academic Research Chief Cardiac Andreas Pflaumer Technologist Management Cardiac Janice Chow Lauren Mills Jing Zhang Garry Barron Trainee (2nd year) Registrar Associate Director Stephen Farrell Technologist Angela Coumountouros Eileen Nah Robert Zirafi Tim Barton PhD Fellows/ Samuel Lovibond Hashrul Rashid of MonashHeart Lucy Rudolph Jessica Cseh Tara Ng Logan Bittinger Cardiologists Cardiac Technologist IBL Student James Cameron Advanced Cardiology Cardiac Clinical Gill Farrell Daniel Nicolici Ben Dundon Sam Mirzaee Educators Lead Echocardiogram Lucy Sargent Trainees (1st year) Psychologist (Honorary) Matthew Farrugia Katherine Ortiz Head of Acute Cardiac John Gelman Kiran Munnur Catherine Mylrea Cardiac Technologist Caitlin Cheshire Marlies Alvarenga James Harley Don Pathirana Secretaries Services Robert Gooley Nitesh Nerlekar Jacqui Williamson Stuart Cox Kunal Verma Rhonda Hassam Kate Sanford Sandra Howorth Arthur Nasis Stewart Healy Cardiac Rhythm Lead Cardiac Technologists Julie Hong Bernie Stouthamer Katherine Tompkins Betty Ho Advanced Cardiology Head of Cardiac CT Management Services Catheterisation Karen Anderson-Weller Chris Hunter Meena Sumathy Brian Ko Trainees (3rd year) Services Fellows Laboratory Cardiac Necia Azagra Angella Lao Karen Versteege Emily Kotschet Colin Machado Sujith Seneviratne Vivek Mutha Julie Banks Stephanie Layton Christie Whatley Jack Krafchek Jithin Sajeev Technologist Karthikeyan Rangasamy Amanda Way Duc Bui Qin Li Lynette Wilkinson Head of Cardiac Rhythm Michael Leung Management Services Siobhan Lockwood Interventional Services Jeff Alison Liam McCormick Fellows Cardiology and Cardiothoracic Unit, Monash Medical Centre Clayton (32 South) David McGaw Adam Brown Interim Head of Inter- Stuart Moir David Di Fiore ventional Services Roger Peverill Abdul Ihdayhid Ian Meredith Nurse Unit Manager Pre- Admission Clinic Clinical Nurse Specialists Registered Nurses Enrolled Nurses James Sapontis Om Narayan Pauline Ryan Coordinator Beth Callow Laura Barry Irene Dowling Head of Non-Invasive Bennett Sheridan Non-Invasive Imaging Joanne Lillie Lucy Fitzpatrick Crystal Bird Michelle Drane Imaging Services Suraj Varma Clinical Nurse Educator Services Fellows Sally Giordano Sophine Cafferty Philip Mottram Tony White Erin Gray Cardiac Rehabilitation Graduate Nurses Danielle Harrop Casey Halloran Emily Coote Dennis Wong Coordinator Glenda Calderon Trent Hartshorne Associate Nurse Unit Kimberley Hansby Colleen Coutts Head of Paediatric Sarah Zaman Claudia Street Bethany Henderson Damon Jackson Managers Katrina Hayes Jessie Distenfano Cardiology Services Jatinder Bhagart Emily Heke Jacqui Flanagan Ward Clerks Sarah Hope Alyce Bowtell Ann-Alyce Hill Ann-Alyce Hill Shirley Papalie Lisa Danher Anna Hillenga Maiyue Huang Anna Peraeu Susan Gussenhoven Rebecca Jedwab Megan Huybens Jacqui Van Heer Radhika John Danielle Kerwick Alice Jones Danniel Kitchen Frances Kenyon Annette Kennedy Melinda Norman Nikki Lee Emily Painter Sarah Smith Lilliana Padilla Emma Robinson Sarah Speakman Glenn Porter Nikita Rouse Maria Tsatsaris Tracey Richards Sarah Rowland Kristy Vos Leanne Rudd Annelise Stephenson Sarah Warwarek Lourdes Scurry Melanie Stewart Grace Simsir Lydia Team Jane Smith Amanda Wasely Clair Tonkin Lisa Tran

42 43 2016 MEDIA “MonashHeart saved my life.”

Michael Schroeder HIGHTLIGHTS 73-year old Fishing enthusiast 9 News, 7 News and Herald Sun

In 2016, some of the initiatives achieved and work performed by MonashHeart for the community was showcased in print and online publications, TV and radio and through an active social media presence.

JANUARY FEBRUARY MAY JUNE DECEMBER

Early in 2016 the ABC In February, there In May not only was In an Australian first, In a fitting end to an covered the heart- were both print and there very pleasing Professor Ian Meredith illustrious public health warming stories of two TV media of Mick, news of the State performed a combined career, The Weekend young East Timorese whose Fitbit alerted his Government’s percutaneous aortic Australian featured a receiving life-saving daughter Hollie to a commitment of $135 valve replacement tribute to Professor percutaneous heart serious heart issue, as million to the Victorian and percutaneous Ian Meredith as he left valve procedures with it was showing a heart Heart Hospital to transluminal septal MonashHeart to take up the MonashHeart rate of over 200 beats be built at Monash myocardial ablation the role of Executive Vice team. A simple mitral per minute. Further University (in addition for 87-year old Joan President and Global valvuloplasty procedure, monitoring in hospital by to the $15 million of who, the day after her Chief Medical Officer not available in East MonashHeart found that planning money already procedure reported she of Boston Scientific, a Timor but desperately Mick was experiencing committed), but also felt “fabulous”. Fortune 500 company needed by critically ill dangerous ventricular the Premier of Victoria that develops and MICHAEL’S STORY 21-year old Ana and tachycardia storms released the Victorian manufactures advanced 12-year old Jeca, is requiring implantation cardiac service plan “A medical technologies Michael had been experiencing dizzy spells for two weeks, but A heart attack had been ruled out very early in the emergency performed with life- of a cardioverter vision for world-class worldwide. He will miss it was the Fitbit which his daughter Hollie had bought him that department as there was no evidence on Michael’s 12-lead ECG or changing outcomes for defibrillator. cardiac care in Victoria”, his sons, he will miss alerted him to a heart problem. His Fitbit was telling him that his blood test results. However an echocardiogram (heart ultrasound) both. Both stories are with the Victorian Heart Australia and more than heart rate was climbing to over 215 beats per minute. Hollie was showed that Michael’s heart, as a result of a severe heart attack in a wonderful reflection Hospital the centrepiece anything he will miss the immediately concerned and insisted she take him to his GP. There 2010, was no longer pumping efficiently, and was now failing, with of the good work of cardiac care for the cardiac cath lab. his GP performed a 12-lead ECG which showed a potentially life- reduced heart function. A coronary angiogram performed a few that Victorian based south-east of Victoria. threatening cardiac arrhythmia called ventricular tachycardia. days later also reinforced the arrhythmia was not due to a recent medical aid charity East heart attack. Timor Hearts Fund is Michael’s quick-thinking GP called a MICA ambulance and Michael undertaking for young was transported to Monash Medical Centre where he was admitted Five days later Dr Healy inserted a preventative heart rhythm people from East Timor. under the care of MonashHeart, including heart rhythm specialist, device called an implantable cardioverter defibrillator into Michael’s cardiologist and electrophysiologist Dr Stewart Healy. At Monash chest – a special device that will revert any abnormal ventricular the treating team tried various treatments but still Michael was arrhythmias with a small, internal shock to restore normal heart experiencing episodes of conscious ventricular tachycardia. The rhythm when required. Only then was Michael safe to return home addition of a second drug infusion reverted Michael’s heart back to his daughter and grandchildren. into normal heart rhythm. But the next question was why was Michael experiencing such dangerous arrhythmias? Michael’s comment “MonashHeart saved my life” highlights his appreciation of the heart care he has and continues to receive.

44 45 THE VICTORIAN OUR VISION FOR THE FUTURE HEART HOSPITAL

A world-leading place for heart healing, translational research and the training of our future healthcare providers

Throughout 2016 there was steady Part of the $15 million planning funding Throughout 2016, the partnership of progress in our vision to build Australia’s announced in 2015 was put into extensive Monash Health and Monash University has first dedicated, purpose-built heart hospital project planning including completion of continued to be cemented throughout the – the Victorian Heart Hospital. the: project planning process. The Department of Health and Human Services, Victorian In April 2016, the Minister for Health the • Preliminary business case; Cardiac Clinical Network and Victorian State honourable Jill Hennessy, announced Government are immensely committed $135 million dollars towards Australia’s • Model of care document; to the project, and the important role the first heart hospital – bringing the State Victorian Heart Hospital will play as the Government’s commitment so far to a total • Functional brief; designated specialist cardiac centre for the of $150 million for this exciting project. south-east of Victoria. • Feasibility study; The Victorian State Government ‘Design, service and infrastructure plan for Victoria’s • Master planning document; cardiac system’ (May, 2016), describes the role the Victorian Heart Hospital will play • High value high risk business case. in the cardiac system of care for Victoria, with provision of cardiac care of the The level of input into the aforementioned highest complexity, with a strong clinical documents, particularly from the clinical leadership role for the state not only in teams, was outstanding; the quality of the care coordination but also clinical practice documentation and vision for the future is development, new technology, research, a testament to the passion and enthusiasm training and teaching. for this project from all members of the team. In 2017 we look forward to hearing how our submission to Government will progress, in the hope that the Victorian Heart Hospital will become a reality for our community, patients, supporters, philanthropists, staff, researchers, academics and students in the “A world-class heart hospital designed by very near future. patients for patients; today, tomorrow Anne Mennen and into the future.” Director of Development Victorian Heart Hospital

Mr Simon Jemmett, Ms Anne Mennen and Dr Neil Goldie

46 47 ”As the complexity of cardiovascular disease has increased, the role of the patient centric, multidisciplinary heart team of cardiology and cardiac surgery experts is the cornerstone of patient care.”

Professor Julian Smith, Ms Maree Lawrence, Ms Danielle Planner, Dr Robert Gooley and Mr Aubrey Almeida

48 49 MonashHeart Monash Medical Centre 246 Clayton Road, Clayton, VIC, 3168

MonashHeart Dandenong Hospital David Street, Dandenong, VIC, 3175

MonashHeart Casey Hospital 62-70 Kangan Drive, Berwick, VIC, 3806

Enquiries: 1300MHEART

www.monashheart.org.au