Clinical Rotations

Interventional Cardiology: Clinical Rotations

Direct Care

The Interventional Clinical fellowship provides an extensive clinical apprenticeship in the direct care of interventional patients. Fellows will be responsible for the assessment and care of all in-patients referred for percutaneous coronary intervention. The fellow will gain valuable experience in review of angiograms and in making important decisions regarding coronary revascularization and management. By following patients to discharge, fellows will learn post-procedural management, will learn to identify and treat complications from percutaneous intervention and catheterization and become familiar with the importance of continuum of care. The latter includes an important focus on aggressive risk factor modification with emphasis on lipid, blood pressure, and diabetes control and smoking cessation, diet and exercise, cardiac rehabilitation, and instruction in the warning symptoms of acute coronary syndrome and restenosis and the appropriate strategy to adopt. An Interventional attending will provide direct, one-on-one supervision of fellows in the care of these patients.

Procedural Experience

The fellows will acquire extensive experience in the performance of all interventional cardiovascular procedures including balloon angioplasty, coronary stenting, rotational atherectomy, intravascular ultrasound, physiologic assessment of coronary flow (Doppler techniques and fractional flow reserve), intra-coronary brachytherapy, distal protection devices, temporary pacemaker insertion, intra-aortic balloon pump insertion and aortic balloon valvuloplasty. In addition, the fellow with acquire experience in selected peripheral vascular procedures including selective renal arteriography and intervention, lower extremity angiography and intervention and subclavian angiography and intervention. Exposure to trans-septal procedures including percutaneous closure of atrial septal defects and patent foramen ovales is also available. Hands-on experience will be obtained in the performance of all these procedures under the direct, one-on-one supervision of an Interventional Cardiology attending.

Follow-up Care

The Interventional fellows will provide direct care for all outpatients admitted after a percutaneous intervention. In addition, the Interventional fellow will work with the nurse practitioners providing care to patients under their care who have undergone percutaneous coronary interventions. The fellow will coordinate their post-procedure and follow-up care.

Interventional Outpatient Clinic

The Interventional fellow will be scheduled to see outpatients in the Interventional Outpatient Clinic one morning each week (Friday) from 8:00 a.m. to 12:00 noon. These evaluations will include:

  • outpatient referrals for catheterization and PCI
  • urgent new patient referrals to Interventional Cardiology
  • urgent “drop in” referrals (existing patients with cardiac problems)
  • follow-up of patients who have undergone interventions, surgery, or medical therapy.