MAY 2019
GW Structural Heart Team Expanding  Treatment of Valvular Heart Disease

GW Structural Heart Team

Drs. Christian Nagy, Jonathan Reiner, Ramesh Mazhari and our cardiac surgeons Drs. Elizabeth Pocock, Farzad Najam, and Gregory Trachiotis, are leading GW in advancements in structural heart disease.  Valve and structural heart disease is a new term in cardiology that encompasses the full scope of conditions caused by abnormalities of the heart valves. Heart valve conditions are either congenital or can be acquired later in life.  When one or more of the heart's four valves is damaged or defective, the heart cannot function as efficiently and can lead to serious health conditions.
A breakthrough in valve therapy has been a major advancement in the field called transcatheter aortic valve replacement (TAVR), which is a minimally invasive percutaneous surgical procedure.  TAVR repairs the valve without the need for open heart surgery by wedging the new replacement valve into the aortic valve's place instead of removing the old, damaged valve.  What is special about our structural heart disease program at GW is not just the rapidly increasing number of cases performed, but the amazing fact that most patients including those in their 70s, 80s, and 90s, go home the next day with virtual no recovery period. Our average TAVR discharge time from the time the procedure is performed is 1 day.  Recently an individual who had their valve replaced at GW on a Tuesday, participated in a charity walk the next weekend.  
Initially, TAVR was targeted for the elderly and other individuals who were high risk for open heart surgery. But in recent years the benefits of this approach have been extended to much younger and more moderate-risk patients making it available to a broader population. The ultimate breakthrough of this procedure was recently reached, when studies showed that TAVR outperformed open heart surgery even in low-risk patients. Percutaneous valve replacement can be performed on old damaged bioprosthetic valves as well as native valves. Not only are valves placed in people who have natural valve deformity but we can also insert a new valve inside a worn out old artificial valve which was previously implanted surgically. This is a more complex procedure that can avoid a reoperation. At GW, we have been training our interventional cardiology fellows in valve replacement, preparing the next generation of cardiologists on this radical treatment. This fall, our team presented a unique case at the Transcatheter Cardiovascular Therapeutics (TCT) Meeting in San Diego on "Simultaneous Double Valve-in-Valve Transcatheter Aortic and Tricuspid Valve Replacement for Failed Bioprosthetic Aortic and Tricuspid Valve Stenosis," in which we inserted two new transcatheter valves in the aortic and tricuspid position over two failed artificial valves. This unique case is the first reported case in the literature worldwide. 
GW Heart Team Participates in Pulmonary Hypertension's First Annual Northern Virginia Walk

The GW Pulmonary Hypertension team led by Dr. Mardi Gomberg participated in the Pulmonary Hypertension Associations' Northern Virginia Walk on Saturday, May 4th in Lee District Park. There were more than 200 people in attendance.  The GW Hospital sponsored the team and provided snacks, a tent and giveaways to participants.  Our GW team participants included Drs. Mardi Gomberg and Jalil Ahari, Denise Lewis, Monica Jenkins, Lorri Marshal, and Maureen Townsend.

Dr. Gomberg Presents at International Society of Heart and Lung Transplant Annual Meeting

Dr. Mardi Gomberg presented at the 2019 International Society of Heart and Lung Transplant in Orlando, FL. Former Chair of International Society of Heart and Lung Transplantation Council she spoke at the largest pulmonary hypertension session about the clinical implications of the new World Symposium PH Consensus Statement entitled, "The drugs don't (or might not) work anymore! Implications for treatments in PAH with the new hemodynamic definition." Dr. Gomberg was co-author two poster presentations: "Two polymorphic gene loci associated with treprostinil dose in pulmonary arterial hypertension," a study that demonstrate d genetic links related to right ventricular function and prostacyclin dosing, and "Patients with severe pulmonary arterial hypertension treated with ABI-009, nab-Sirolimus, an mTOR inhibitor: Interim results from a phase 1 clinical trial," a study that was a presentation of the preliminary experience in a Phase I trial of oral nab-sirolimus.
Dr. Gomberg also recently published on updated risk stratification score for pulmonary arterial hypertension, "An update of the risk score calculator in pulmonary arterial hypertension patients from the registry to evaluate early and long-term PAH disease management (REVEAL)," in the national journal, Chest, earlier this year.

Drs. Tracy and Mercader Lead Sessions at the
Heart Rhythm Society's 40th Annual Scientific Sessions

Dr. Syed Quadri in the HRS Bowl 2019

GW Electrophysiologists, Drs. Cynthia Tracy and Marco Mercader participated in the Heart Rhythm Society (HRS) 40th Annual Scientific Sessions this May in San Francisco, CA. The HRS is the major US medical association for advances in treatment of heart rhythm disorders. Dr. Mercader chaired the main session on Syncope and presented "Syncope: After 40 years of HRS, still a lot of open questions." Dr. Cynthia Tracy was on the program committee for the annual meeting and chaired three sessions: "Global Disparities in Cardiac Pacemaker Therapy,"  "What Are Atypical Clinical Paths Really Like?" and " Ablation Should Be Performed in All Patients With Brugada Syndrome Session."
Our GW Eletrophysiology fellow Dr. Syed Quadri competed in the semifinal round of Heart Rhythm Bowl 2019, the annual HRS "game-show" quiz competition where EP fellows from around the world are selected based on a 50-question prequalifying exam.
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