CardiologyClinicalOutcomesReport BASED ON 2009 DATA

Cardiology ClinicalOutcomesReport
B A S E D O N 2 0 0 9 D AT A
Cardiology ClinicalOutcomes Report
Table of Contents
Cardiology Procedures Summary
2
Acute Myocardial Infarction
4
Cardiac Catheterization
8
Interventional Cardiology
10
Electrophysiology
14
Advanced Heart Failure
16
Pediatrics/Adult Congenital Heart Failure
18
Cardiac Rehabilitation
19
Research
20
Our Physicians
Inside Back
Cover
Inova Alexandria Hospital
Inova Fairfax Hospital
Inova Fair Oaks Hospital
Inova Loudoun Hospital
Inova Mount Vernon Hospital
Hybrid operating room – opened Fall 2010
B A S E D O N 2 0 0 9 D AT A
Award-Winning Care
• In 2009 Inova Heart and Vascular Institute
at Inova Fairfax Hospital was ranked
among the top 50 heart programs in the
nation by U.S. News & World Report
From left to right: Ted Friehling, MD – Medical Director, Electrophysiology Laboratories, Albert Del Negro, MD – Electrophysiologist,
Bryan Raybuck, MD – Medical Director, Catheterization Laboratories, Paul DiLorenzo , MD – Interventional Cardiologist, Harvey Sherber,
MD – Medical Director, Inova Heart and Vascular Institute, Joseph Kiernan, MD – Co-Medical Director CCU/PCCU, Patricia A. Knowles,
Administrator, Inova Heart and Vascular Institute, Hamid Taheri, MD – Interventional Cardiologist.
Located in the Washington, DC region, Inova Heart and Vascular Institute is a national leader in
providing world-class cardiac care. The physicians, nurses, and health professionals within our five
hospitals, our network of private practice physicians and our emergency care centers bring a special
commitment to each patient they treat.
The impact of their commitment is measurable – in the outcomes on the pages that follow as well as
in the faces of the families and patients we treat. Renowned expertise. Unparalleled patient satisfaction.
Breakthrough research. Innovative technology and equipment.
This is world-class cardiology at Inova Heart and Vascular Institute – thank you for the opportunity to
share our outcomes data and accomplishments with you and your team of healthcare professionals.
Sincerely,
• Of the more than 6,000 ICUs in the
nation, Inova Fairfax Hospital’s
cardiovascular ICU is one of only 315 units
(5%) awarded the Beacon Award for
excellence in critical care nursing from
the American Association of Critical Care
Nurses.
• Independent healthcare-ratings agency
HealthGrades, Inc. has awarded Inova
Heart and Vascular Institute numerous
awards:
> Inova Fairfax Hospital ranked #1 in
Virginia for cardiology services
> Inova Alexandria and Inova Fairfax
Hospitals rated 5-stars for heart
attack care
> Inova Alexandria and Inova Fairfax
Hospitals rated 5-stars for heart
failure care
Patricia A. Knowles, BSN, RN, MS, CNOR
Administrator, Inova Heart and Vascular Institute
inova.org/heart
1
Inova Heart and Vascular Institute Overview -Cardiology Procedures
At Inova Heart and Vascular Institute, our physicians and staff use research, education
and technological experience to enhance the care they provide, to ensure that
our innovative techniques, decades of experience and team of experts add up to a
different kind of cardiovascular care – one that saves, and changes, lives.
Inova Heart and Vascular Institute Overview – 2009
Inova Fairfax
Hospital
Inova Alexandria
Hospital
Inova Loudoun
Hospital
Interventional Cardiology
Diagnostic Cardiac Catheterizations
4,038
586
78
Percutaneous Coronary Interventions
2,413
328
29*
5
0
0
52
0
0
Electrophysiology Studies
886
104
35
Ablations
736
11
34
1,489
178
22
26
0
4
13,929
4,424
2,102
Cardiac Computed Tomography (CT) Scans
263
0
0
Cardiac Magnetic Resonance Imaging (MRI) Scans
197
26
0
1,468
1,268
0
366
118
0
Percutaneous Valvuloplasties
Percutaneous ASD and PFO Closures
Electrophysiology
Device Implants
Device Lead Extractions
Diagnostic and Cardiac Imaging
Echocardiograms (Echos)
Nuclear Cardiology Tests
Stress Tests
2
Inova Heart and Vascular Institute
*STEMI program started 2009
Data comparisons on the pages
that follow represent Inova Heart
and Vascular Institute outcomes
compared with patients at
hospitals included in the American
College of Cardiology National
Cardiovascular Data Registry
(ACC-NCDR) Cath PCI Registry for
hospitals that perform more than
500 PCI procedures per year. All
comparison data are based on
a one-year rolling average;
therefore, there may be differences
compared with totals reported
elsewhere in this report.
IAH: Inova Alexandria Hospital • IFH: Inova Fairfax Hospital • IFOH: Inova Fair Oaks Hospital • ILH: Inova Loudoun Hospital • IMVH: Inova Mount Vernon Hospital
About the Inova Heart and Vascular Institute
Anchored by the 204-bed facility in Falls Church,Virginia, the Inova Heart and Vascular Institute
has locations throughout Northern Virginia at Inova Alexandria Hospital, Inova Fairfax Hospital,
Inova Fair Oaks Hospital, Inova Loudoun Hospital and Inova Mount Vernon Hospital.
Facility highlights of Inova Heart and Vascular Institute – Falls Church location
• Five-story building with attached parking garage
• A three-level, light-filled circular atrium with water feature serves
as a focal welcome point
• 204 private patient rooms, over 90% with telemetry monitoring
• 48 intensive coronary-care beds
• Six cardiovascular operating rooms, including a hybrid
operating room
• 11-room catheterization and electrophysiology suite
• Heart and lung transplant clinic
• Healing Garden and Heart Healthy Café
inova.org/heart
3
Acute Myocardial Infarction – Experience in Numbers
As the largest heart attack care provider in Northern Virginia, our ST-Elevation Myocardial
Infarction (STEMI) teams care for the most acute cases including transfers from other
emergency departments.
Inova’s heart attack centers are at the heart of the community’s emergency
care system.The high volume transfer centers at both Inova Alexandria and
Inova Fairfax Hospital support other community hospitals in Virginia, the
4
Inova Heart and Vascular Institute
District of Columbia, and Maryland, with the AirCare helicopter service
transferring patients to Inova from a 200-mile radius.
IAH: Inova Alexandria Hospital • IFH: Inova Fairfax Hospital • IFOH: Inova Fair Oaks Hospital • ILH: Inova Loudoun Hospital • IMVH: Inova Mount Vernon Hospital
Seamless Integration
Our integrated network of free-standing emergency care centers and state-of-the-art
emergency departments collaborate with EMS and community hospitals throughout the
region to ensure that every heart attack patient receives world-class heart attack care.
Inova Fairfax Hospital, home to the region’s only Level 1 trauma center, was recognized
with a Silver Award as part of the ACTION Registry®, an outcomes-based national
quality improvement program designed to measure and improve care for high-risk
myocardial infarction (MI) patients. Inova Fairfax Hospital is the only hospital in Virginia
to earn a Silver Award. Silver status indicates core measure compliance at least
85 percent of the time for a full year.
PCI Angiographic Success Rate
of STEMI patients - 2009
STEMI Case Volumes - 2009
350
300
250
200
150
100
50
0
100%
75%
50%
25%
0%
Inova
Fairfax
Inova
Alexandria
Source: NCDR CathPCI Registry®
Adverse Events in STEMI
Patients with PCI - 2009
Inova
Fairfax
Inova
Alexandria
TRANSFER PATIENTS
ED PATIENTS
Source: NCDR ACTION Registry® -GWTG
7%
6%
5%
4%
3%
2%
1%
0%
Inova
Fairfax
NCDR
Inova
Alexandria Registry
Source: NCDR CathPCI Registry®
inova.org/heart
5
Acute Myocardial Infarction – Process of Care Indicators
AMI Process of Care Indicators - 2009
Inova Alexandria Hospital was the first hospital
in Northern Virginia to pilot the advanced
LifeNet Program
Instead of waiting for a heart attack patient to arrive
by ambulance, doctors at Inova Alexandria Hospital
can start a treatment plan in advance with LifeNet,
an electrocardiogram system that transmits the
patient’s electrocardiogram (ECG/EKG) tracing from
the ambulance to the hospital’s emergency
department.
Inova Alexandria was the first hospital in Northern
Virginia to pilot the system, which has now been
implemented at Inova Alexandria Hospital, Inova
Fairfax Hospital and Inova Loudoun Hospital. With
the transmission results, Inova physicians can
assess the situation to determine what level of
care will be needed upon the patient’s arrival. If
the interventional team is necessary, they can be
activated before the patient arrives. If the patient is
far from the hospital, EMS professionals can send
additional test results to the hospital while they’re
en route – saving time and improving outcomes.
IFH
IAH
IFOH
ILH
IMVH
N’tl Avg
Aspirin on Arrival
100%
96%
100%
100%
100%
94%
Aspirin on Discharge
99%
98%
100%
100%
100%
93%
Beta-Blockers on Discharge
100%
98%
100%
100%
100%
93%
ACEI/ARB for LVSD
100%
100%
100%
100%
N/A
90%
PCI within 90 minutes
100%
86%
N/A
100%
N/A
77%
Smoking Cessation
100%
94%
100%
100%
N/A
95%
Source: CMS Core Measure Performance Data
AMI All-Cause 30 Day Mortality
Inova Fairfax
National
0%
5%
10%
15%
20%
Source: CMS Hospital Heart Attack Mortality, Hospital Compare Website
6
Inova Heart and Vascular Institute
IAH: Inova Alexandria Hospital • IFH: Inova Fairfax Hospital • IFOH: Inova Fair Oaks Hospital • ILH: Inova Loudoun Hospital • IMVH: Inova Mount Vernon Hospital
Aggressive Goals
Door-to-balloon times nationally are typically benchmarked against a 90-minute goal.
At Inova, our ST-Elevation Myocardial Infarction (STEMI) teams consistently meet this goal
and are now pursuing a more aggressive goal of 60 minutes.
Initiatives like the ST-elevation myocardial infarction (STEMI) Nurse program are being
implemented and have demonstrated further reduction in door-to-balloon time.The STEMI
nurse facilitates seamless transition through the diagnosis and treatment continuum and
ensures timely, effective treatment for all heart attack patients.
STEMI Nurse Program – someone to count on
The STEMI Nurse Program goal ensures that families of heart attack patients have
personalized attention during their loved one’s assessment and hospitalization.The STEMI
Nurse is dedicated exclusively to guiding an individual and his or her family through their
hospitalization, is available to answer any questions during initial assessment and treatment.
Primary PCI Received within 90
minutes of hospital arrival - 2009
69
68
67
66
100%
98%
96%
94%
92%
90%
88%
Door to Balloon Median Time - 2009
Non-transfer-in patients
65
Inova
Fairfax
Inova
National
Alexandria Data
Source: NCDR ACTION Registry® -GWTG
Inova Heart and Vascular Institute is among an
elite group of hospitals in the nation to develop
hypothermia protocols for comatose survivors of
cardiac arrest. Arctic Sun® is an advanced,
non-invasive technique that circulates chilled
water in external cooling pads to lower a patient's
body temperature to between 32 and 34°C,
inducing mild hypothermia. Therapeutic
hypothermia helps reduce the risk of ischemic
injury to the brain following cardiac arrest by
blunting the body’s natural inflammatory response.
The sooner cooling initiates, the better the outcome.
Patients whose cardiac arrest was the result of
ventricular tachycardia or ventricular fibrillation
are the best candidates for this therapy. For those
who qualify, the survival rate is double the normal
rate. These patients also have fewer secondary
injuries, a faster recovery, shorter hospital stays
and a quicker return to a productive quality of life.
64
63
62
61
60
59
58
57
Therapeutic Hypothermia Protocols – Arctic Sun®
Inova
Fairfax
Inova
National
Alexandria Data
Source: NCDR ACTION Registry® -GWTG
inova.org/heart
7
Cardiac Catheterization
Inova’s cardiac catheterization programs bring the region’s most experienced cardiologists
and clinical staff together with state-of-the-art technology to provide unparalleled cardiac
diagnostic and interventional care.
Specialized expertise in outpatient catheterization
Inova’s cardiology medical leadership and staff have invested in building an
innovative outpatient cath program ensuring convenient and comfortable
care with the expertise offered only at comprehensive heart centers. Our
high ratio of outpatient procedures (in 2009 our outpatient ratio was 65%) is
made possible through early ambulation protocols and consistent use of
closure devices.
The state-of-the-art cath lab suite at Inova Fairfax Hospital – one of the
largest in the region – ensures pre-procedure preparation, cardiac
catheterization, and post procedure recovery areas are all located within the
same dedicated suite. Family members can stay with patients before their
procedure and during their recovery period.This coordinated approach to
care, along with a dedicated Interventional Cardiology Admission and
Recovery (ICAR) suite staff, have contributed to our consistently low
complication rates.
Diagnostic Cardiac Catherizations
5,000
4,500
4,000
3,500
3,000
2,500
2,000
1,500
1,000
500
0
2007
Inova Fairfax
8
Inova Heart and Vascular Institute
2008
Inova Loudoun
2009
Inova Alexandria
IAH: Inova Alexandria Hospital • IFH: Inova Fairfax Hospital • IFOH: Inova Fair Oaks Hospital • ILH: Inova Loudoun Hospital • IMVH: Inova Mount Vernon Hospital
Diagnostic Cardiac Catherizations Complications - 2009
1.6%
1.4%
1.2%
1.0%
0.8%
0.6%
0.4%
0.2%
0%
0%
Composite rate
(any adverse event)
Inova Fairfax
AMI
Stroke
Inova Alexandria
Death
Emergent CABG
surgery
NCDR Registry
inova.org/heart
9
Interventional Cardiology
Inova’s experienced interventional cardiology team – celebrating 26 years of excellence.
In 2009 our outpatient ratio of Percutaneous Coronary Interventions (PCI) was 54.7%, as compared to 22.7% nationwide.
Percutaneous Coronary Interventions- 2009
3,000
60%
2,500
50%
2,000
40%
1,500
30%
1,000
20%
500
10%
0
2007
Inova Fairfax
10
PCI Patient Characteristics - 2009
2008
2009
Inova Alexandria
Inova Heart and Vascular Institute
0%
Age > 75 yrs
Prior heart
attack
Inova Fairfax
Heart failure
Diabetes
Renal
insufficiency
Prior bypass
surgery
Severe LV
dysfunction
Multi-vessel
disease
IAH: Inova Alexandria Hospital • IFH: Inova Fairfax Hospital • IFOH: Inova Fair Oaks Hospital • ILH: Inova Loudoun Hospital • IMVH: Inova Mount Vernon Hospital
PCI Outcomes for Adjunctive Medications – Inova Fairfax
Inova Fairfax
ACC Comparison
100%
80%
60%
40%
20%
0%
As
pir
in
Be
tablo
cke
rs
Sta
ti
ns
As
pir
in
AC
E
Be
tablo
cke
rs
Th
Sta
ti
ns
ien
op
yri
din
es
AT DISCHARGE
BEFORE PROCEDURE
Source: NCDR CathPCI Registry®
PCI Outcomes for Adjunctive Medications – Inova Alexandria
Inova Alexandria
ACC Comparison
100%
80%
Inova Heart and Vascular Institute
offers comprehensive PCI programs
at Inova Alexandria Hospital, Inova
Fairfax Hospital and Inova
Loudoun Hospital.
60%
40%
20%
0%
As
pir
in
Be
tablo
cke
rs
BEFORE PROCEDURE
Sta
ti
ns
As
pir
in
AC
E
Be
tablo
cke
rs
Th
Sta
ti
AT DISCHARGE
ns
ien
op
yri
din
es
Source: NCDR CathPCI Registry®
inova.org/heart
11
Interventional Cardiology
Inova’s cardiac nursing programs are led by dedicated clinical practice
specialists who focus on clinical outcomes and measurement of a robust set
of indicators and quality measurement.The level of training maintained by
our cath lab staff is unmatched, with all cath lab technicians holding registered
cardiovascular invasive specialist (RCIS) credentials. Many of our supervisors
have over 25 years of experience.
PCI Complications – 2009
6%
5%
4%
3%
2%
1%
0%
Mortality
Major vessels
Blood
transfusions complications
ACC Comparison
Emergent CABG
Inova Fairfax
Any serious
adverse
outcome
Based on rolling four quarters 2009 NCDR/PCI Registry®
12
Inova Heart and Vascular Institute
IAH: Inova Alexandria Hospital • IFH: Inova Fairfax Hospital • IFOH: Inova Fair Oaks Hospital • ILH: Inova Loudoun Hospital • IMVH: Inova Mount Vernon Hospital
Complications of PCI Procedures Performed to Treat Acute MI
Acute renal failure protocols
% of Patients at
Inova Alexandria
Hospital
ACC Comparison
Group for Inova
Alexandria Hospital
% of Patients
at Inova Fairfax
Hospital
ACC Comparison
Group for Inova
Fairfax Hospital
Cardiac death
2.4%
*
2.7%
*
Non-cardiac death
2.0%
*
0.0%
*
Periprocedural MI
0.4%
0.7%
0.0%
0.7%
Renal Failure
1.5%
1.7%
1.5%
1.4%
Vascular Complications
0.7%
2.1%
0.0%
2.3%
*ACC data not released
Complications of PCI Procedures Performed to Treat Other Cardiac Conditions (Non-Acute MI)
% of Patients at
Inova Alexandria
Hospital
Inova’s cardiology teams have instituted
an aggressive protocol designed to mitigate
the incidence of acute renal failure
associated with the use of contrast media
in diagnostic and interventional cardiology
procedures. The new protocols, in effect at
all Inova facilities, address patient risk
profile, inpatient or outpatient status and
various clinical factors to evaluate risk of
potential adverse effects from contrast
administration. Clinical leadership in both
cardiology and interventional radiology
monitor compliance with the protocols and
are assessing effectiveness over the
long term.
ACC Comparison
Group for Inova
Alexandria Hospital
% of Patients
at Inova Fairfax
Hospital
ACC Comparison
Group for Inova
Fairfax Hospital
Cardiac death
1.1%
*
2.0%
*
Non-cardiac death
0.7%
*
0.0%
*
Periprocedural MI
0.9%
1.2%
0.8%
0.9%
Renal Failure
0.2%
0.4%
0.0%
0.4%
Vascular Complications
0.7%
1.3%
0.8%
1.3%
*ACC data not released
inova.org/heart
13
Electrophysiology
With specialized expertise in EP, our physicians and lab staff demonstrate consistently
outstanding outcomes and low complication rates.
Inova’s high volume electrophysiology (EP) program is the only
comprehensive program in the region, with pediatric electrophysiologists
from Inova Fairfax Hospital for Children working alongside specialists in
adult electrophysiology to provide the full spectrum of cadiac care.
Electrophysiology Lab Volume
Inova Fairfax
Hospital
Inova Alexandria
Hospital
Inova Loudoun
Hospital
Electrophysiology Studies
886
104
35
Ablation
736
11
34
Pacemakers
839
139
16
ICD
650
39
6
26
0
0
Device Lead Extraction Procedures
14
Inova Heart and Vascular Institute
IAH: Inova Alexandria Hospital • IFH: Inova Fairfax Hospital • IFOH: Inova Fair Oaks Hospital • ILH: Inova Loudoun Hospital • IMVH: Inova Mount Vernon Hospital
An International Destination for Atrial Fibrillation
Treatment –The Maze Procedure
Inova Heart and Vascular Institute is home to an internationally
renowned atrial fibrillation program.The program, which features one
of the largest minimally invasive Maze procedure programs in the nation,
is distinguished by close collaboration between electrophysiology and
cardiac surgery to offer the full spectrum of advanced atrial fibrillation
treatment alternatives.
Inova Heart and Vascular Institute’s Hybrid Operating
Room (opened Fall 2010) .
With specialized expertise in EP, our physicians and lab staff demonstrate
consistently outstanding outcomes and low complication rates. Inova is
the only healthcare provider in the country that currently offers an
electrophysiology training program designed for students pursuing a
master’s degree in cardiovascular sciences.
Hybrid procedures
Inova’s interventional cardiologists and cardiac surgeons often work
collaboratively to achieve optimal results for the patient. In 2010, Inova
will open the first hybrid Operating Room in the Washington, DC area.
A fully equipped surgical suite with a cath lab in the same room. Benefits will include increased safety for patients for whom having immediate
surgical back-up is preferable, as well as increased opportunities to
perform minimally invasive alternatives to traditionally open procedures.
In addition, patients will benefit from shorter recovery times and a
more convenient, less stressful patient experience avoiding the need for
multiple procedures over separate days.
inova.org/heart 15
Advanced Heart Failure
Inova’s heart failure program offers comprehensive, evidence-based care to treat
and manage every stage of heart failure, from minimal symptoms to advanced disease
and heart transplant.
Inova is the only heart failure program in Northern Virginia, and the only
heart transplant program certified by the Centers for Medicare & Medicaid
Services (CMS) in the metropolitan Washington region. For more than 20
years, our multidisciplinary team of cardiologists, surgeons, nurse practitioners,
transplant coordinators and social workers has provided individualized care
to patients of all ages and backgrounds.
Congestive Heart Failure Volumes
2007
2008
Inova Fairfax Hospital
938
849
1,055
Inova Alexandria Hospital
416
498
497
Inova Loudoun Hospital
232
226
232
Inova Fair Oaks Hospital
240
209
253
Inova Mount Vernon Hospital
285
245
270
2,111
2,027
2,307
Total Inova
2009
The Heart Transplant Program at Inova Heart and Vascular Institute – Fairfax is
the only heart transplant program certified by the Center for Medicare/Medicaid Services
(CMS) in Northern Virginia. For more information about our Advanced Heart Failure and
Transplant Program, call 703-776-7075.
16
Inova Heart and Vascular Institute
IAH: Inova Alexandria Hospital • IFH: Inova Fairfax Hospital • IFOH: Inova Fair Oaks Hospital • ILH: Inova Loudoun Hospital • IMVH: Inova Mount Vernon Hospital
Largest Regional Ventricular Assist Device (VAD) Program
Since 1990, we have participated in the research and development of Ventricular
Assisted Devices as a bridge-to-transplant or as destination therapy for patients ineligible
for heart transplant.
Our ventricular assist device (VAD) program is one of the largest and busiest
in the Mid-Atlantic. Inova was one of only two VAD programs in the DC
region awarded The Joint Commission’s “Gold Seal of Approval” certification,
recognizing exemplary care, medical providers and support services.
Ventricular Assistance Device (VAD) Implantation
35
30
Volume
25
20
15
10
5
0
2006
2007
2008
2009
Inova HeartLink Tel-Assurance® Program
Heart failure patients can now manage their care from home using
Inova HeartLink, a free, phone and web-based support program.
Participants check-in daily via an automated system and answer
questions about their health. Trained care management nurses use
the information to evaluate and adjust medications and treatment
plans. Patients avoid hospitalization, physicians care for their patients
more efficiently, and families are reassured by another set of eyes
watching out for their loved ones. Inova HeartLink is the only program
of its kind in Northern Virginia. To enroll a patient in the free Inova
HeartLink program, log on to inova.org/heartlink or call:
HeartLink Care Manager Phone Numbers:
Inova Alexandria Hospital: 703-504-7881
Inova Fairfax Hospital: 703-776-4444
Inova Fair Oaks Hospital: 703-776-4444
Inova Loudoun Hospital: 703-858-8080
Inova Mount Vernon Hospital: 703-664-7492
Inova Alexandria
Hospital
Inova Fair Oaks
Hospital
Inova Loudoun
Hospital
Inova Mount
Vernon Hospital
Inova Fairfax
Hospital
Total Enrollment
109
24
27
138
274
6 Month Retention Rate
64%
33%
48%
48%
41%
11.2 Months
9.7 Months
8.3 Months
15.2 Months
12.5 Months
Heart Link Program
Average Length of Time in Program
inova.org/heart
17
Pediatric Cardiology
Adult Congenital Heart Clinic
Inova Fairfax Hospital for Children is the region’s premier medical resource
for pediatric cardiac referrals. Located just outside of Washington, DC, our
mission is to provide world-class heart care to the region’s children, working
together with physicians, caregivers and families.
Electrophysiology Volume by Procedure
65
The Adult Congenital Heart Clinic was one of the
first programs in the country designed to care for this
special patient population. Sixteen years later, it remains
the only center of its kind in Northern Virginia.
60
The Adult Congenital Heart Clinic at Inova Heart and Vascular Institute is a
unique, full-service resource for patients living with congenital heart disease.
The clinic offers comprehensive evaluation and ongoing management for
both long-standing and newly diagnosed conditions. Our collaborative
physician team specializes in state-of-the-art medical treatment, including
surgical, non-surgical and minimally invasive options, for adult- and
pediatric-acquired heart, cardiovascular and pulmonary disease.
55
50
45
40
VOLUME
35
30
25
20
15
2007
2008
2009
Total Patients
81
49
78
New Patients
14
13
14
Follow-up Patients
67
36
64
10
5
0
Dilation of
Valves, Vessels
PDA Occlusions
2007
2008
ASD Device
Closures
Coil Occlusion
of Vessels
Atrial
Septostomies
2009
Interventional Catheterization Volume
by Procedure
80
For more information or to make a referral to the Adult Congenital
Heart Clinic, call 703-776-3599.
VOLUME
70
60
50
40
30
20
10
0
ICD Placements
2007
Electrophysiology
Studies
2008
18 Inova Heart and Vascular Institute
Pacemaker
Procedures
Ablations
2009
IAH: Inova Alexandria Hospital • IFH: Inova Fairfax Hospital • IFOH: Inova Fair Oaks Hospital • ILH: Inova Loudoun Hospital • IMVH: Inova Mount Vernon Hospital
Cardiac Rehabilitation
Inova Heart and Vascular Institute’s cardiac rehabilitation programs offer
medically supervised exercise and education for adults with heart disease.
Patients also receive education and guidance on prevention and wellness,
contributing to overall positive outcomes related to their total cardiac treatment
plan. Anyone diagnosed with heart problems or who has undergone cardiac
surgery, angioplasty, stenting, or other heart procedures can participate. Cardiac
rehabilitation services are provided at the following Inova hospitals:
Inova Alexandria Hospital: 703-504-3398
Inova Fairfax Hospital: 703-776-3635
Inova Loudoun Hospital: 703-858-6674
Inova Mount Vernon Hospital: 703-664-8034
Patient Visits
2007
2008
2009
Phase I
1,015
482
379
Phase II
10,109
10,791
10,144
Phase III
794
1,406
1,025
Cardiac Rehab Outcomes
Year
2009
Total
<45 Years
Enrollment of Age
335
2.3%
45-65 Years
of Age
66-80 Years
of Age
>80 Years
of Age
Compliance
39%
51.4%
7.2%
79.1%
inova.org/heart
19
2009 Research Participation
Advanced Heart Failure
Double-blinded Placebo-Controlled, Multicenter Acute Study of
Clinical Effectiveness of Nesiritide in Subjects with Decompensated
Heart Failure (ASCEND HF), Shashank Desai, MD, Pharmaceutical
Trial, Closed.
Evaluation of the HeartWare® Left Ventricular Assist Device (LVAD)
System for the Treatment of Advanced Heart Failure, Shashank Desai,
MD, Device Trial, CAP Enrolling
Interagency Registry of Mechanically Assisted Circulatory Support
(INTERMACS), Shashank Desai, MD, Patient Registry/Device,
Enrolling
Prospective Evaluation of Elastic Restraint to Lessen the Effects of
Heart Failure (PEERLESS HF) Trial, Shashank Desai, MD, Device
Trial, Follow-up.
Reducing Decompenssation Events Utilizing Intracardiac Pressures in
Patients with Chronic HF - Chronicle ICD Implantable Cardioverter
Defibrillator (REDUCE HF), Shashank Desai, MD, Device Trial,
Closed
Evaluation of the VentrAssist™ Left Ventricular Assist Device as a
Bridge to Cardiac Transplantation-Pivotal Trial (VentrAssist BTT),
Shashank Desai, MD, Device Trial, Closed.
Evaluation of the VentrAssist™ Left Ventricular Assist Device for the
Treatment of Advanced Heart Failure as Destination Therapy
(VentrAssist DT), Shashank Desai, MD, Device Trial, Closed.
Cardiac/CV Surgery
Continued Access Protocol for the Evaluation of Catheter Cryoablation
in the Treatment of Paroxysmal Atrial Fibrillation (CRYO CAP
AF), Marc Wish, MD, Device Trial, Follow-up.
Evaluation of the Safety and Efficacy of the OPTIMIZER™ II System with Active Fixation Leads in Subjects with Heart Failure
Resulting from Systolic Dysfunction (FIX-HF-5), Marc Wish, MD,
Device Trial, Follow-up
Optimum Lead Insulation Material Registry, Marc Wish, MD, Patient
Registry/Device, Follow-up.
Clinical Research Evaluation of the ASSURE Device Atrial and
Ventricular Tachyarrhythmia Therapies Registry (REASSURE AV
Registry), Marc Wish, MD, Patient Registry/Device, Follow-up.
Randomized Evaluation of Long-term anticoagulant Therapy
(RE-LY) Comparing the Efficacy and Safety of Two Blinded Doses of
Dabigatran Etexilate with Open Label Warfarin for the Prevention of
Stroke and Systemic Embolism in Patients with Non-valvular Atrial
Fibrillation, Albert DelNegro, MD, Pharmaceutical Trial, Closed.
Response of Cardiac Resynchronization Therapy Optimization with
V-V Timing in Heart Failure Patients (Response HF), Marc Wish,
MD, Device Trial, Closed.
SMARTDELAY determined AV Optimization: A comparison to
Other AV Delay Methods Used in Cardiac Resynchronization
Therapy (SMART-AV), Sarfraz Durrani, MD, Device Trial, Cosed.
Use of the Accumetrics VerifyNow P2Y12 Platelet Function Assay to
Determine Readiness for Cardiac Surgery after Receiving a P2Y12
ADP binding site inhibitor During Coronary Catheterization and/or
Percutaneous Coronary Intervention, Niv Ad, MD/Harvey Sherber,
MD,Test/Procedure Trial, Closed.
Interventional Cardiology
Electrophysiology
Randomized Controlled Trial of the Medtronic Endeavor Drug
(ABT-578) Eluting Coronary Stent System versus the Taxus
Express2 Paclitaxel-Eluting Coronary Stent System in De Novo
Native Coronary Artery Lesions (Endeavor IV), Bryan Raybuck, MD,
Device Trial, Follow-up.
A Randomized Controlled Trial of Radiofrequency Ablation for the
Treatment of Paroxysmal Atrial Fibrillation Using the Bard High
Density Mesh Ablation System (MAGELLAN), Ted Friehling, MD,
Device Trial, Closed
20
Biventricular versus Right Ventricular Pacing in Heart Failure Patients
with Atrioventricular Block (BLOCK HF), Margaret Bell, MD,
Device Trial, Follow-up
Inova Heart and Vascular Institute
Artic Front Trial: A Randomized Controlled Clinical Trial of Catheter
Cryoablation in the Treatment of Paroxysmal Atrial Fibrillation
(STOP AF), Marc Wish, MD, Device Trial, Follow-up.
A Prospecitve evaluation in a randomized trial of the safety and
efficacy of the use of the TAXUS Element Paclitaxel-Eluting
Coronary Stent System for the treatment of de novo coronary artery lesions (PERSEUS), Bryan Raybuck, MD, Device Trial, Followup.Patent Foramen Ovale closure with the AMPLATZER PFO
OCCLUDER in Patients with Recurrent Cryprogenic Stroke due to
presumed paradoxical embolism through a Patent Foramen Ovale who
have failed conventional drug therapy (PFO ACCESS Registry),
James Thompson, MD, Patient Registry/Device, Enrolling
Prospective Randomized Investigation to Evaluate Incidence of
Headache Reduction in Subjects with Migraine and PFO Using the
AMPLATZER PFO Occluder compared to Medical Management
(PREMIUM), James Thompson, MD, Device Trial, Enrolling
WATCHMAN Left Atrial Appendage System for Embolic
PROTECTion in Patients with Atrial Fibrillation (PROTECT
AF), Bryan Raybuck, MD, Device Trial, Follow-up.
A Clinical Evaluation of the Endeavor® Resolute Zotarolimus-Eluting Coronary Stent System in the Treatment of De Novo Lesions in
Native Coronary Arteries with a Reference Vessel Diameter of 2.25
mm to 4.2 mm, Hamid Taheri, MD, Device Trial, Closed.
A Clinical Evaluation of the XIENCE™ V Everolimus Eluting
Coronary Stent System in the Treatment of Subjects with de novo
Native Coronary Artery Lesions (SPIRIT IV), Bryan Raybuck, MD,
Device Trial, Follow-up.
A Randomized, Controlled Trial to Evaluate the Safety and Efficacy
of the ZoMaxx Drug Eluting Coronary Stent System as Compared
to the TAXUS Express2 Paclitaxel-Eluting Stent in De Novo Coronary Artery Lesions, Bryan Raybuck, MD, Pharmaceutical Trial, Follow-up.
JOMED JOSTENT Coronary Stent Graft HDE, Bryan Raybuck,
MD, Device Trial, Enrolling.
Cardiology
PHIII Randomized, Double-blind, Parallel group Efficacy and Safety
Study of AZD6140 Compared with Clopidogrel for Prevention of
Vascular Events in Patients with Non-ST Elevation Acute Coronary
Syndrome (ACS), Adrian Magee, MD, Pharmaceutical Trial, Closed.
Acute Cardiac Allograft Cellular Rejection and Cardiac Allograft
Vasculopathy: Identification of Diagnostic Biomarkers and Target
Pathways for Prevention Therapy, Adrew Keller, MD,Tissue Collection
Trial, Enrolling.
IAH: Inova Alexandria Hospital • IFH: Inova Fairfax Hospital • IFOH: Inova Fair Oaks Hospital • ILH: Inova Loudoun Hospital • IMVH: Inova Mount Vernon Hospital
Inova Heart and Vascular Institute Cardiology Specialists
CARDIOLOGY
Khalid A. Abousy, MD
Marjaneh Akbari, MD
Muhammad Ali, MD
Ather Anis, MD
Walter L. Atiga, MD
Subash B. Bazaz, MD
Kambeez Berenji, MD
Rachel L. Berger, MD
Steven F. Berman, MD
George A. Besch, MD
Elizabeth S. Biegelsen, MD
Carl Bon Tempo, MD
Kenneth M. Brooks, MD
Christine D. Bussey, MD
Dean Carpousis, MD
Felix Castro, MD
Anthony C. Chang, MD
Tania Chao, MD
Keith H. Chu, MD
Mariano D. Chutuape, MD
Nicholas A. Cossa, MD
Robert E. Cunnion, MD
Anna Teresa Czajka-Giermasz, MD
Stephen M. Day, MD
Albert A. Del Negro, MD
Shashank S. Desai, MD
Paul E. DiLorenzo, MD
Thien M. Do, MD
James Duc, MD
Sarfraz A.K. Durrani, MD
Michael G. Escano, MD
Aldo R. Esposito, MD
Timothy Farrell, MD
Cleveland Francis, MD
William G. Franklin, MD
Ted D. Friehling, MD
Rajat Garg, MD
Mohammad R. Ghafouri, DO
Brian N. Glick, MD
John S. Golden, MD
Michael H. Goldman, MD
Tariq M. Haddad, MD
Afsane Haddad-Mashad, MD
Abdul Haji, MD
Richard J. Hart, MD
Khaldoon I. Hilmi, MD
Jack D. Horton, MD
Edwin K. Huang, MD
Denise L. Hurst, MD
Jeffrey A. Jackman, MD
George O. Jones, MD
Noah Jones, MD
Laurance W. Kam, MD
Anne K. Kassira, MD
Robert Dana Kelberg, MD
Andrew J. Keller, MD
Sateesh Kesari, MD
Fareeha I. Khan, MD
Charanjit S. Khurana, MD
Joseph M. Kiernan, MD
Albert Kim, MD
Gulam-Mohmed M. Kolia, MD
Bhanu Krishnan, MD
Sara Kulangara, MD
Cynthia Lee, DO
Christopher J. Leet, MD
Warren S. Levy, MD
Yaning Liu, MD
Jeffrey S. Luy, MD
Shahryar Mafi, MD
P.F. Adrian Magee, MD
Alireza Maghsoudi, MD
Ara M. Maranian, MD
Carey Marder, MD
Christopher May, MD
Francis J. McGrath, MD
Robert L. McSwain, MD
Stuart A. Meyers, MD
Lawrence A. Miller, MD
Azita Moalemi, MD
Jason M. Morda, MD
Mehrdad Mostaan, MD
Alfred C. Myaing, MD
Sunil Nachnani, MD
Pradeep Nayak, MD
Minh Van Ngo, MD
Michael P. Notarianni, MD
John T. O'Brien, MD
Paul J. O'Brien, MD
Martin J. O'Hara, MD
Antonio R. Parente, MD
Young D. Park, MD
Richard P. Perrin, MD
Paula Pinell-Salles, MD
Pio F. Poblete, MD
Dean M. Pollock, MD
Todd C. Pulerwitz, MD
Jun Anthony Ventura Quion, MD
Narian P. Rajan, MD
Gautam Ramakrishna, MD
Devanhalli Ramaswamy, MD
Haroon Rashid, MD
Jason M. Rashkin, MD
Bryan D. Raybuck, MD
Kevin M. Rogan, MD
Arnold J. Rosenblatt, MD
Stephen P. Rosenfeld, MD
Lawrence R. Rubin, MD
Anne M. Safko, MD
Chirag M. Sandesara, MD
Richard A. Schwartz, MD
S.Tariq Shahab, MD
Khosro Shareghi, MD
Rishabh Sharma, MD
Stuart Sheifer, MD
Mazhar Sheikh, MD
Harvey S. Sherber, MD
Robert A. Shor, MD
Padma Shukla, MD
Balbir S. Sidhu, MD
James N. Sipes, MD
Tseday E. Sirak, MD
Prachak Siriprakorn, MD
Tina L. Slottow, MD
Michael A. Solomon, MD
George Sopko, MD
David A. Strouse, MD
Anne E. Summers, MD
John Y Sunew, MD
Hassan Tabandeh, MD
Raghu R.Tadikamalla, MD
Hamid Taheri, MD
Mark P.Tanenbaum, MD
Naghmeh Tebyanian, MD
Eric M.Thorn, MD
Bruce P.Tinker, MD
Ketan K.Trivedi, MD
Constantine J.Tziros, MD
Raymond Vergne, MD
Mark C.Vives, MD
Marc H.Wish, MD
Jerzy W.Wrobel, MD
Jonathan E. E.Yager, MD
Shahram Yazdani, MD
Kambiz Yazdani-Najafabadi, MD
M. Rafiq Zaheer, MD
ELECTROPHYSIOLOGY
Walter L. Atiga, MD
Margaret Bell Fischer, MD
Anthony C. Chang, MD
Albert A. Del Negro, MD
James Duc, MD
Sarfraz A.K. Durrani, MD
Ted D. Friehling, MD
Abdul Haji, MD
Denise L. Hurst, MD
Robert L. McSwain, MD
Haroon Rashid, MD
Chirag M. Sandesara, MD
David A. Strouse, MD
Marc H.Wish, MD
IINTERVENTIONAL
CARDIOLOGY
Khalid A. Abousy, MD
Marjaneh Akbari, MD
Ather Anis, MD
Kambeez Berenji, MD
George A. Besch, MD
Elizabeth S. Biegelsen, MD
Carl Bon Tempo, MD
Nicholas A. Cossa, MD
Stephen M. Day, MD
Aldo R. Esposito, MD
Rajat Garg, MD
John S. Golden, MD
Edwin K. Huang, MD
Noah Jones, MD
Charanjit S. Khurana, MD
Joseph M. Kiernan, MD
Albert Kim, MD
Lawrence A. Miller, MD
Dean M. Pollock, MD
Narian P. Rajan, MD
Bryan D. Raybuck, MD
Kevin M. Rogan, MD
S.Tariq Shahab, MD
Harvey S. Sherber, MD
Prachak Siriprakorn, MD
Tina L. Slottow, MD
John Y Sunew, MD
Hamid Taheri, MD
Shahram Yazdani, MD
PEDIATRIC CARDIOLOGY
Hasan I. Abdallah, MD
Annette K. Ansong, MD
Margaret Bell Fischer, MD
Alan E. Benheim, MD
Patrick F. Callahan, MD
Radha Reddy Cohen, MD
Robert B. Escalera, MD
Frank Galioto, MD
Wali Gauvin, MD
Kathleen Hamilton, MD
Rabih Hamzeh, MD
Seymour I. Hepner, MD
Thomas J. Hougen, MD
Sharon S. Karr, MD
Omar Khalid, MD
Rami Kharouf, MD
Adrienne Kilgore, MD
William C. Kirby, MD
Jennifer Lindsey, MD
Mohamed K. Mardini, MD
Jeffrey P. Moak, MD
Jin H. Park, MD
Joanna B. Rosenthal, MD
Harish S. Rudra, DO
Iran M. Sadr, MD
Mubadda A. Salim, MD
Stephen R. Shapiro, MD
Michael Charles Slack, MD
Sherif S.Tawfik, MD
James D.Telep, MD
James A.Thompson, MD
Potom
ac R.
Lovettsville
World-Class Care, Conveniently Located
With multiple locations throughout Northern Virginia, the Inova
Heart and Vascular Institute provides the full spectrum of diagnostic
and interventional cardiac services as well as electrophysiology,
cardiac and thoracic surgery including minimally invasive surgery,
heart and lung transplantation, and implantation of artificial heart
devices. The Institute also offers prevention and risk reduction
through classes and wellness programs, including cardiac and
pulmonary rehabilitation. Our locations include:
• Inova Alexandria Hospital
Waterford
15
Hillsboro
Purcellville
Poolesville
Leesburg
Hamilton
28
7
urn
Ashburn
50
Sterling
50
Washington D.C.
Arlington
Centreville
Fairfax
Fai
aii
Suitland
Haymarket
anda
andale
a
an
n
nd
d
dale
e
Annandale
Burke
Alexandria
Manassas Park
Franconia
nco
co
onia
on
o
a
Manassas
Newington
Nokesville
Lake Ridge
Brentsville
Dale City
Dumfries
Quantico
1 • Inova Alexandria Hospital
2 • Inova Mount Vernon Hospital
3 • Inova Fair Oaks Hospital
4 • Inova Fairfax Hospital
4 • Inova Fairfax Hospital for Children
4 • Inova Heart and Vascular Institute
5 • Inova Loudoun Hospital
www.inova.org/heart
Occoquan
Woodbridge
Calverton
Montclair
PHI AirCare transports patients by helicopter to the Inova Heart and
Vascular Institute from within a 200 mile radius. The helicopters,
equipped as flying emergency intensive care units, contain
monitoring equipment, ventilators and defibrillators, allowing
nurses and paramedics to begin treatment while in route to
the hospital.
College Park
McLean
Falls
Church
F
• Inova Mount Vernon Hospital
>> To refer a patient, or for more information,
call (703) 776-3856.
Silver Spring
Chillum
Chantilly
The Plains
• Inova Fairfax Hospital
• Inova Loudoun Hospital
Bethesda
Reston
Arcola
Kensington
Potomac
7
Middleburg
• Inova Fair Oaks Hospital
• Inova Fairfax Hospital for Children
Rockville
Indian Head
Mount
Moun
M
nt V
Vernon