Advanced Heart Failure and Transplant Cardiology Fellowship

The fellowship consists of basic curriculum (heart failure curriculum), as well as heart transplantation curriculum.

Diagnosis, Assessment and Prognosis

• Identify patients with advanced disease
• Interpret the results of laboratory testing; cardiac CT/MR and endomyocardial biopsies; cardiopulmonary stress testing; echocardiography; heart catheterizations; hemodynamics; nuclear stress-testing and risk stratify patients with HF
• Obtain complete medical histories, including review of patient medical records, and perform accurate examinations with an emphasis on cardiac findings

Management of HF

• Awareness of treatment options for the management of specific cardiomyopathies, including cardiac amyloidosis, Fabry disease, sarcoidosis, etc.
• Institute an effective plan for the diagnostic evaluation of patients with new onset HF
• Understand the concepts of disease management and healthcare delivery
• Understand the indications for device therapy including implantable cardiac defibrillators and biventricular pacing devices
• Understand the indications for heart transplant consideration
• Understand the multiple pharmacologic treatment options now available, and recognize the appropriate indications for each therapy
• Understand the role of non-pharmacologic interventions including diet and education
• Understand the treatment options for the management of arrhythmias in HF

Diagnosis, Assessment and Prognosis

• Interpret the results of laboratory testing; cardiac CT/MR and endomyocardial biopsies; cardiopulmonary stress testing; heart catheterizations; hemodynamics; echocardiography and nuclear stress-testing
• Obtain complete medical histories, including review of patient medical records, and perform accurate examinations with an emphasis on cardiac findings
• Risk stratify patients with HF and identify patients with advanced disease

Management of Decompensated Patients

• Contribute to discharge planning, longitudinal care and prevention of readmission
• Manage volume overload using standard therapies including diuretics, and the role of ultrafiltration and hemodialysis in appropriate patients
• Recognize the need for mechanical circulatory support in patients with advanced or refractory disease
• Recognize the role of hemodynamic monitoring including pulmonary arterial catheters
• Understand the role of inotropes, vasopressors and vasodilators
• Understand the various options now available, including percutaneous support devices, temporary and permanent implantable assist devices

End-Stage Heart Failure/Palliative Care

• Understand the role of palliative care in end-stage HF, and participate in discussions on end-of-life issues with patients, family members and other providers

The Heart Transplantation Curriculum makes sure that fellows are aware of the scope, trends and outcomes of heart transplantation in the U.S. and understand the role of the United Network for Organ Sharing and local organ procurement organizations.

Immunosuppression

• Understand strategies for induction therapy; drugs used for chronic immunosuppression and their side effects and therapies used for treatment of acute rejection

Indications for Intropes, Hemodynamic Monitoring and Mechanical Support

• Understand the indications for using inotropes and vasodilators, the place of hemodynamic monitoring using pulmonary arterial catheters and the indications for short and long-term mechanical circulatory support

Indications for Transplantation

• Understand transplant listing criteria and the prioritization of recipients for donor offers

Long-Term Post-Transplant Care

• Chronic kidney disease – Role of calcineurin inhibitors, induction therapy in preserving renal function
• Complications – Familiarity with early and late complications of transplantation
• Infections – Early vs. late infection, opportunistic infections and activation of latent infections, prophylaxis
• Malignancy – Leading cause of late death equaling vasculopathy, post-transplant lymphoproliferative disorders and skin cancers, role of viral factors (EBV, etc.)
• Transplant vasculopathy – Late graft failure, immune and non-immune causes/factors, histopathological and clinical difference compared to atherosclerosis, treatment

Rejection

• Awareness of typical clinical and pathological findings, the classification system for grading rejection and appropriate treatment strategies for each grade of rejection
• Understand and differentiate the pathophysiology of acute antibody mediated and cellular rejection as well as chronic rejection
• Familiarity with surveillance strategies, including endomyocardial biopsies; drug level monitoring; gene expression profiling and genomic markers of rejection, echocardiography and cardiac MR; immune function assays and antibody monitoring

Selection of Patients

• Evaluation of the transplant recipient and selection criteria
• Understand the pre-transplant work-up process; psychological and social considerations; exclusion criteria; listing procedure and status; individual issues; HLA sensitization and techniques for desensitization; the place of retransplantation; use of inotropes and assisted circulation as a bridge to transplant

Surgical Aspect of Heart Transplantation and Early Post-Operative Care

• Awareness of early and medium-term complications of heart transplantation
• Familiarity with donor and recipient surgical procedures including organ preservation and biatrial technique vs. bicaval
• Understand the management of donor candidates; evaluation of donor offers and the procurement of organs (‘donor runs’)

Simon C. Chakko, MD
Chief of Cardiology, Bruce W. Carter Department of Veterans Affairs Medical Center

Mauricio G. Cohen, MD
Director, UHealth Tower Cardiac Catheterization Laboratory

Eduardo J. De Marchena, MD
Director, Interventional Cardiology Fellowship Program

Chunming Dong, MD

Jeffrey Goldberger, MD
Chief, Cardiovascular Division

Joshua M. Hare, MD
Director, Interdisciplinary Stem Cell Institute
Louis Lemberg Professor of Medicine

Maureen H. Lowery, MD
Clerkship Director, Internal Medicine, University of Miami Leonard M. Miller School of Medicine
Course Director, Cardiovascular Module, University of Miami Leonard M. Miller School of Medicine
Medical Director, Non-invasive Diagnostic Laboratory, Sylvester Comprehensive Cancer Center

Raul Mitrani, MD
Director, Clinical Cardiac Electrophysiology Fellowship Program

Robert J. Myerburg, MD
Assistant Director, Cardiovascular Disease Fellowship Program

Rafael F. Sequeira, MD
Director, Coronary Care Unit

Carlos E. Alfonso, MD
Director, Cardiovascular Disease Fellowship Program

Joseph E. Bauerlein, MD
Director, Advanced Heart Failure and Transplant Cardiology Fellowship Program
Medical Director, Cardiac Transplant Program
Site Supervisor, Advanced Heart Failure and Transplant Cardiology Fellowship Program

Martin S. Bilsker, MD
Director, Jackson Memorial Hospital Echo/Doppler Laboratory

Claudia A. Martinez Bermudez, MD  

Carl E. Orringer, MD
Director, Preventive Cardiology and Advanced Lipid Management

Alan H. Schob, MD
Site Supervisor, Interventional Program, Bruce W. Carter Department of Veterans Affairs Medical Center

David M. Seo, MD
Director, Genomic Medicine Registry
Medical Director, Clinical Informatics

Lina Shehadeh, PhD

Sharon N. Andrade-Bucknor, MD
Director, UHealth Tower Cardiac Prevention and Rehabilitation Program
Medical Director, Exercise Lab

Antonio Barquet-Leon, MD

Michael D. Dyal, MD
Voluntary Faculty

Litsa K. Lambrakos, MD

George R. Marzouka, MD
Director, Echocardiography

Nina Thakkar Rivera, DO

Alex H. Velasquez, MD
Kian Qin, PhD

Robert B. Stang, MD
Chief, Coronary Care Unit, Bruce W. Carter Department of Veterans Affairs

Joao F. Braghiroli, MD
Interventional Cardiologist/Structural Heart Disease

Ivan A. Buitrago, MD
Associate Medical Director

Rosario Colombo, MD
Associate Medical Director, Cardiovascular Disease, Non-invasive Cardiology

Hany Elmahdy, MD
Associate Medical Director, Jackson Medical Group

Alexandre Ferreira,
Program Director, Interventional Cardiology Fellowship Program
Voluntary Faculty, Associate Professor, Medicine, University of Miami

Cesar Mendoza, MD
Medical Director, Interventional Cardiology, Jackson Medical Group

Ivan Mendoza, MD
Associate Medical Director, Cardiac Electrophysiology, Jackson Medical Group

Khalid Minhas, MD
Associate Medical Director, Jackson Medical Group

Bashar Obeidou
Associate Medical Director, Jackson Medical Group

Rhea Sancassani, MD
Medical Director, Cardiology Ambulatory Clinic, Jackson Health System

Assaf Tzur, MD
Medical Director, Cardiac Electrophysiology, Jackson Health System

Anila Veerani, MD
Medical Director, Cardiac Rehab, Jackson Health System
Medical Director, Heart Station, Jackson Health System

Juan Zambrano, MD
Medical Director, Interventional Cardiology, Jackson Health System