Parallax by Ankur Kalra

The State of Ohio reported its first coronavirus cases on March 9. Prior to that, on February 28, the Cleveland Clinic announced that they are prepared to open 1,000 additional hospital beds if needed. Ohio was one of the states to follow recommendations and intervene quickly. Ankur Kalra asks Grant W Reed, Director of the Cleveland Clinic’s STEMI program, to reflect on the actions they took and the challenges of delaying cardiovascular procedures in the wake of the coronavirus pandemic. Dr Reed offers insight on the factors that influenced the Cleveland Clinic’s STEMI policy for COVID-19. Ankur and Grant discuss the triage considerations for patients with structural heart disease and the steps the clinic took to protect its healthcare workers. In this week’s Parallax Dr Kalra and Dr Reed are addressing questions in the wake of Cleveland Clinic’s decision to reopen services for essential procedures. Which cardiac operations should be performed? What is the impact of COVID-19 outbreak on cardiac surgery? How

This week Ankur Kalra talks with Lisa Rosenbaum, national correspondent for The New England Journal of Medicine and cardiologist at Brigham and Women’s Hospital. Lisa Rosenbaum has been writing extensively about the human face of medicine. Her articles have been widely circulated by publications like The New York Times, The New Yorker and The New England Journal of Medicine. In this edition of Parallax Dr Kalra asked Dr Rosenbaum about the influences that shaped her choices as a writer and as a healthcare professional. Dr Rosenbaum opens up about her childhood and how she connected to her grandfather through writing and medicine. We learn about Lisa’s first day at medical school and her latest writing project. Tune in to learn about a doctor’s path to medical journalism. Hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO. Connect and submit your questions to Ankur via: podcast@radciffe-group.com. Related sources: https://www.nejm.org/doi/full/10.1056/NEJMms2009984 https://books.google.co.uk/b

A week after Jag Singh had tested positive for COVID-19, he became a patient in his hospital’s intensive care unit. This week he joins Ankur Kalra, MD to tell us about his journey as a clinician-scientist. Jagmeet P Singh, a Professor of Medicine at Harvard Medical School, a renowned Clinical Trialist, and the past Clinical Chief of Cardiology at Massachusetts General Hospital joins Ankur Kalra for a deep conversation about his journey across three continents. Dr Singh talks about the importance of choosing fulfillment over success. We gain more insights on the recent late-breaking clinical trial, MADIT-CHIC focusing on cardiac resynchronization therapy. Ankur asks Jag about his experience of being on the other side of the healthcare system as a patient and his participation in an investigational drug study. What is Dr Singh’s advice for young cardiologists? How does he balance his responsibilities? How did his hospitalisation shape Dr Singh’s outlook on his role as a medical professional? Tune in to list

“It’s a tsunami not just a wave. The worst tsunami you can imagine” Prof Michele Senni is Director of Cardiology at Papa Giovanni XXIII Hospital, Bergamo Italy. He contracted COVID-19 himself and in this latest podcast he meets with Ankur Kalra, MD to discuss his personal experience in dealing with patients and COVID-19 in Europe’s outbreak epicentre. Hear them discuss the burden on healthcare, patient selection, the importance of testing and PPE and how COVID has resulted in a reduction of acute myocardial infarction and heart failure in patients. Submit your question to Ankur via: podcast@radciffe-group.com. Hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO. What to listen for: In this episode they discuss: • [03.00] Personal experience from the front line in Bergamo, Italy • [19.45] ACS and COVID-19 patients • [24.00] Myocarditis reduction in COVID-19 patients • [25.30] Acute onset heart failure and cardiomyopathy in COVID-19 patients • [29.40] Increased pulmonary pressure in COVID-19 patie

“We are at war with a pandemic and the enemy is not each other, it’s the virus.” In this latest episode, Ankur Kalra, MD meets with Andrew Sauer, MD, co-author of upcoming paper in US Cardiology Review on COVID-19 and Cardiovascular Disease that provides a concise and current summary of cardiovascular complications from COVID-19. Hear them discuss the latest issues surrounding the pandemic, the known cardiac implications and the rapidly emerging data. Submit your question to Ankur via: podcast@radciffe-group.com. Hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO. What to listen for: In this episode they discuss: [00.00] Introductions [05.55] The importance of lessons learned from other countries and the importance of social distancing [09.25] Troponin elevation in COVID-19 positive patients [13.15] Receptor mechanisms and treating COVID-19 patients with hypertension [19.19] Cardiac arrhythmia mechanisms in COVID-19 patients [23.00] Fulminant myocarditis, co

In these unprecedented times, we provide an early release episode to gain insight on dealing with the COVID-19 pandemic from Deputy Editor in Chief of US Cardiology Review, a BDG interventional cardiologist, Bill Gogas, MD, PhD practising in East Asia. Hear Bill’s take on how East Asia responded to and successfully managed the pandemic and how they are now seeing a significant reduction in cases outside the epicentre. Hear how the strategy resulted in only 93 patients in Bill’s city of Nanjing, testing positive for coronavirus with a city population of 8 million. Learn about effective responses, the importance of early control and how as a cardiovascular physician your life and practice may be impacted from the virus. Submit your question to Ankur via: podcast@radciffe-group.com. Hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO. What to listen for: In this episode they discuss: [02.45]: Opening thoughts [03.35]: What consequences should we expect? [04.43]: Contai

We can count on our fingertips how many “interventional intensivist” exist in the US. In this episode Ankur Kalra, MD meets with Dr Ann Gage, Cleveland Clinic’s first “interventional intensivist”. She discusses her unique skill set, what it means to be an interventionalist in the cath lab but also an expert in cardiovascular intensive care and advocates why such a unique skill set and critical care training are required in today’s modern medicine. Submit your question to Ankur via: podcast@radciffe-group.com. Hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO. What to listen for: In this episode they discuss: • [03.00] Becoming an interventional intensivist: a look back • [05.05] Roadblocks and pathways to becoming an ‘interventional intensivist’ • [13.30] Scholarly research on the pathway of the ‘interventional intensivist’ • [15.00] An interventional intensivist is not a critical care doctor • [17.30] Is a direct training pathway coming for the interventional intensivist? • [20.45] The cha

Dr Cavalcante meets with Ankur Kalra, MD to discuss his recent review published in US Cardiology Review 13.2; on a new aortic stenosis staging system that has important implications for clinical outcomes following aortic valve replacements to aid the treatment of aortic stenosis. Listen to this, as well as an overview on his interesting childhood and his views on the future of cardiac imaging to treat TAVR. Submit your question to Ankur via: podcast@radciffe-group.com. Hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO.

The first female cardiac surgeon qualified in the 1960’s. Today there are only 4.5% women in cardiology and only 4% in thoracic surgery. Ankur Kalra meets with Dr Kendra Grubb, the first women to be trained at the University of Virginia, US, on cardiothoracic surgery and the 250th board certified women in thoracic surgery. Her recent post on social media went viral. It was a photo of an all-women surgical team carrying out a complex structural heart procedure. It had over 100,000 views and was seen by people in over 75 different countries. It’s clear from this online reaction, that now is the time for women to be recognised for the work they are doing in medicine. Listen to this engaging discussion between them on the challenges of being a woman in cardiovascular medicine today. Submit your question to Ankur via: podcast@radciffe-group.com. Hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO.

In our final episode of the year, Ankur has an long conversation with Sukh Nijjer from Imperial College London about the most impactful, exciting and controversial clinical trials of 2019. Sukh and Ankur also discuss how these trials might change practice in the future, and how practice patterns and decisions differ between the US and the UK. In light of an emerging trend of shared decision making between physicians of different specialities and patients with a vast amount of information at their fingertips, Sukh and Ankur examine what tools they use to reconcile the growing data from clinical trials. Trials discussed in detail include those presented at the ACC in New Orleans: PARTNER 3 & Evolut Low Risk on TAVR/TAVI, and SAFARI & COAPT on radial vs femoral access; presented at the ESC in Paris: THEMIS and ISAR-REACT 5 on DAPT post-PCI, DAPA-HF on SGLT2i’s for heart failure, and COMPLETE on PCI of non-culprit lesions in STEMI; presented at TCT in San Francisco: TWILIGHT on DAPT post-PCI, and EXCEL at 5 yea

Recorded before the American Heart Association (AHA) Scientific Sessions 2019, Ankur is joined by Rasha K Al-Lamee, Interventional Cardiologist at Imperial College Healthcare NHS Trust in London and Study Director of the Objective Randomised Blinded Investigation with Optimal Medical Therapy of Angioplasty in Stable Angina (ORBITA) trial. Rasha talks about how she got into academia, the significance of her end-of-training PhD, and what led to the genesis of ORBITA. Ankur and Rasha also discuss the findings and unanswered questions of ORBITA, and how recent research in coronary revascularisation and stable ischemic heart disease has (or has not) changed their clinical practice. Finally, in anticipation of its presentation at AHA 2019, Rasha gives an overview of the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA). Submit your question to Ankur via: podcast@radciffe-group.com. Hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO.

This week, Ankur spoke with Ajay J Kirtane on why he became a cardiologist, how he fell into academic research, and why the cardiology specialty is heavy with people of Indian origin. Ajay also talks about how he has negotiated between competing priorities in clinical and academic work, and how he manages fatherhood with a busy career. Ahead of the American Heart Association Scientific Sessions 2019, Ajay also shared what he thinks we can expect from the highly anticipated ISCHEMIA trial. Submit your question to Ankur via: podcast@radciffe-group.com. Hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO.

How did Gregg from Cleveland, Ohio become Gregg W Stone MD, world-leading interventional cardiologist and clinical trialist? This week, Ankur had the pleasure of speaking to Gregg about his personal and professional journey through the ‘golden years’ of interventional cardiology. Gregg also shares his tips on how to progress from clinical practice into academic research, and what it takes to be a successful clinical investigator. Finally, Gregg shares with Ankur what personality traits he looks for in mentees and why presenting a finalized project in your application might not be enough. Submit your question to Ankur via: podcast@radciffe-group.com. Hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO.

Recorded on site at TCT, COAPT investigator Dr Neal S Kleiman and Ankur discuss the realities of establishing an academic career as an interventional cardiologist. Neal explains why it is important to wear multiple hats and balance academia with a clinical presence. Digging more into the practicalities of everyday work-life, Neal reflects on the challenges of reporting to multiple bosses who have different goals, and how geography enabled him to move between cathlab and academia. Neal also shares what he looks for in early career academic cardiologists. Submit your question to Ankur via: podcast@radciffe-group.com. Hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO.

13: 2/2 Srihari S Naidu on Work-Life Balance: How to get it right by Radcliffe Cardiology

Srihari S Naidu shares his career tips for young, ambitious cardiologists and what he has learnt about mentorship from his numerous leadership positions. Hari elaborates on the different types of mentorship, the importance of developing non-academic skills, why you should focus on your strengths rather than weaknesses, and the fickle art of managing one’s public/private personas as a young cardiologist in an era of social media. Having recently applied for the programme himself, Ankur also speaks with Hari about the history, purpose and future of the Society for Cardiovascular Angiography and Interventions (SCAI) Emerging Leader Mentorship (ELM) Fellowship Programme. Submit your question to: podcast@radciffe-group.com. Guest @SrihariNaiduMD. Hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO.

What are the key pillars of self-care and what do dirty windshields have to do with it? How can you take meditation “off the matt”? What has chronobiology and Ayurveda taught us about working with, rather than against, our circadian rhythm? In the final episode of our Burnout and Resilience Series, Kavitha and Ankur give you some practical tools of self-care to help you avoid burnout. Kavitah Chinnaiyan, MD, is an award-winning author and, Cardiologist and Director of Cardiac CT Research at Beaumont Health, MI. Send us your thoughts to this episode for Ankur to share in future episodes: podcast@radciffe-group.com. Guest @ChinnaiyanMD. Hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO.

What does mindfulness have to do with burnout? Is our definition of success driving our stress and anxiety? How can we channel our ego into something positive? In our second episode on burnout and resilience, Kavitah Chinnaiyan, MD, and Ankur take a deeper dive into mindfulness and training the brain to move from Default-Mode to Task-Positive Networks. Kavitha is an award-winning author and, Cardiologist and Director of Cardiac CT Research at Beaumont Health, MI. Send us your thoughts to this episode for Ankur to share in future episodes: podcast@radciffe-group.com. Guest @ChinnaiyanMD. Hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO.

How do you nurture resilience in the midst of competition, envy and individualism? What is moral injury? Is the current healthcare landscape driving physicians to burnout? Are we too focused on data and study results? These are some of the questions discussed by Kavitha Chinnaiyan, MD, award winning author, Cardiologist and Director of Cardiac CT Research at Beaumont Health, MI, and host Ankur, in the first episode of this three-part series on burnout and resilience. Send us your thoughts on this topic for Ankur to share in future episodes: pocast@radciffe-group.com. Guest @ChinnaiyanMD. Hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO.

Madhav Swaminathan joins Ankur Kalra for a dynamic conversation about diversity, inclusion and leadership. Madhav shares how, as President of large organisation like the American Society of Echocardiography, he works to create an inclusive platform with opportunities for individuals from diverse backgrounds. Ankur and Madhav also discuss positive traits of leadership, why we should embrace failure and the importance of mentorship throughout all stages of one’s medical career. Send us your comments to this episode for Ankur to share in future episodes: pocast@radciffe-group.com. Guest @mswami001. Hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO.