Cardiology; Cardiovascular Disease; Interventional Cardiology
I am an interventional and clinical cardiologist at the Buffalo VA Medical Center (Buffalo VAMC). The focus of my practice is the cardiac catheterization laboratory, though I also see outpatients in the cardiology clinic and perform inpatient clinical consultations in the hospital. I care for individuals with a spectrum of cardiovascular disease, including patients with stable coronary disease, acute coronary syndromes, valvular diseases and cardiomyopathies. I participate as a site investigator in multicenter clinical research trials. My particular research interests are in studies of lipid management and preventive cardiology, intravascular ultrasound and plaque regression, critical care pathway development and application and outcomes research in the treatment of acute coronary syndromes. My current research involvement includes studies on lipid therapy using a PCSK9 inhibitor drug, HDL infusion therapy assessing for coronary artery atheroma regression by intravascular ultrasound, managing myocardial risk following non-cardiac surgery and assessing optimal treatment strategies for atrial fibrillation patients who have undergone coronary intervention and require a combination of antiplatelet and anticoagulation therapy. I am also involved in a supportive role with a study of novel antibiotic therapy. I enjoy teaching. I teach cardiology fellows in the cardiac catheterization laboratory and in the cardiology clinic during initial cardiology consultations and follow-up outpatient care. I also teach fellows, medical residents and medical students during consultative rounds in the hospital.
Cardiology; Interventional Cardiology
I am an interventional cardiologist specializing in structural heart interventions. My clinical practice includes general cardiology, interventional cardiology and complex valvular heart diseases. I see patients at the UBMD cardiology offices--and at Buffalo General Medical Center (BGMC), where I direct the complex valve clinic. I also direct structural heart interventions at the Gates Vascular Institute (GVI) and BGMC, and in that capacity I perform transcatheter aortic valve replacements, mitral clip procedures, left atrial appendage occlusion, atrial and ventricular septal defect closure and percutaneous paravalvular leak closures. I also care for patients by performing routine diagnostic coronary angiograms and percutaneous coronary interventions (PCI)/angioplasty. I believe that in this era of technologically advanced, modern medicine it is the physician’s responsibility to educate patients in a straightforward and open manner about the different treatment modalities. I spend time with my patients to ensure that they are comfortable with the treatment options they choose and that they have a clear understanding of the alternatives, benefits and risks. My research interests are in new devices for aortic and mitral valve replacement, novel therapeutics in the form of stem cells and newer therapies for acute coronary syndromes. I also collaborate with the Toshiba Stroke Research Center to develop advanced imaging modalities in the cardiac catheterization laboratory. I am investigating the use of robotic PCI to improve precision in stent placement and reduce radiation dosage in the catheterization laboratory, and I serve as the local principal investigator for a number of multicenter clinical trials in these areas. For example, I am: evaluating the LOTUS transcatheter valve to CoreValve in high-risk patients (Reprise III, Boston Scientific); investigating the safety and efficacy of transcatheter aortic valve implantation (TAVI) in patients with severe, symptomatic aortic stenosis (AS) at intermediate surgical risk by randomizing patients to either surgical aortic valve replacement (SAVR) or TAVI (SURTAVI, Medtronic); and determining the efficacy of cardiac stem cells in patients with recent myocardial infarction and ischemic cardiomyopathy (ALLSTAR, Capricor. I train residents and cardiology fellows through didactic and bedside teaching, and I mentor their research projects. I also oversee cardiology fellows in outpatient settings. Additionally, I collaborate with the departments of Anesthesiology and Pediatrics and the Division of Pulmonary, Critical Care and Sleep Medicine to train their residents and fellows.
Cardiology; Cardiovascular Disease; Interventional Cardiology
As an interventional cardiologist, I perform a variety of invasive diagnostic and interventional cardiac catheterization procedures. My primary interests are in the diagnosis and treatment of acute coronary syndromes and interventional treatment of complex coronary lesions such as unprotected left main coronary artery interventions, bifurcating lesions and chronic total occlusions. Although my focus and passion have been interventional cardiology, I maintain an active interest and involvement in general cardiology and internal medicine and treat a variety of cardiovascular diseases, including congestive heart failure, valvular heart disease, arrhythmias and dyslipidemias. I practice at the Buffalo VA Medical Center (Buffalo VAMC) where I have been the chief of the cardiac catheterization laboratory since 1999. In addition to my responsibilities in the laboratory, my duties include attending on the cardiology consult service, covering the inpatient acute medicine service and interpreting a variety of non-invasive studies (e.g., stress tests, Holter and event monitor studies and EKGs). I enjoy teaching and working with medical students, residents and fellows as they progress through their hospital rotations on cardiology consults and weekend medicine service coverage. I also mentor, supervise and teach fellows in the cardiac catheterization laboratory and outpatient cardiology clinic.
Cardiology; Cardiovascular Disease; Interventional Cardiology; Endovascular Medicine; Vascular Medicine
I am an interventional cardiologist with UBMD Cardiovascular Medicine, with specialized training in echocardiography, nuclear cardiology and noninvasive vascular interpretation (RPVI). I see outpatients through the UBMD ambulatory practice at the Amherst Clinic, and I care for patients admitted to the Buffalo General Medical Center (BGMC) consultative service and BGMC’s Cardiac Care Unit (CCU). My interventional practice involves evaluating and caring for patients with coronary and structural heart diseases. I perform diagnostic coronary angiography, percutaneous coronary intervention (PCI), coronary atherectomy, percutaneous mechanical hemodynamic support, cardiac biopsy, patent foramen ovale (PFO)/atrial spetal defect (ASD) closure and transaortic valve replacement (TAVR). I also have a specialized focus on evaluating and managing patients with peripheral vascular disease, including noninvasive vascular testing and endovascular interventions. I see patients at the Gates Vascular Institute (GVI) where I perform diagnostic peripheral and carotid angiography and interventions for peripheral arterial diseases. These procedures include lower extremity arterial atherectomy, angioplasty and stenting, renal and mesenteric artery revascularization and subclavian intervention. I am active in research at the GVI by participating in a number clinical trials. One aims at protecting patients from renal damage during PCI (CARIN, Ischemix). Another involves an alternative procedure to perform TAVR for intermediate-risk patients with symptomatic aortic stenosis (SURTAVI, Medtronic). A third clinical trial addresses using intracoronary delivery of stem cells in patients postanterior myocardial infarction with ischemic left ventricular dysfunction (ALLSTAR, Capricor). As a faculty member at the University at Buffalo, I teach and mentor residents and fellows during their hospital rotations.