Cath Lab Digest

Several revolutionary advancements have occurred in the treatment of cardiovascular disease in the past few decades — notably, the use of a percutaneous route for more than just diagnostic evaluations. The percutaneous approach to the treatment of all forms of vascular disease is now so common that it is considered, though not always used, for virtually every case with which we are confronted. EVAR and TEVAR have allowed a minimally invasive approach to aortic pathology. In the U.S., we have completed the Edwards Sapien transcatheter aortic valve implantation trial and we are enrolling in the Medtronic CoreValve trial. Outside the U.S., the number of TAVI procedures is already in excess of 10,000. Like other minimally invasive procedures, it has initially been studied and performed in those patients with a high or extremely high surgical risk. The results have been outstanding in comparison to either surgery or medical therapy. Of course, we are now discovering new complications—access site, stroke, paravalvular leak, etc. Nonetheless, TAVI is an amazing procedure that will help continue the paradigm of minimally invasive, less morbid and safer cardiovascular interventions for our patients.

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ARAVINDA NANJUNDAPPA, MD, RVT Dr. Nanjundappa completed medical graduation in Adichunchanagiri Institute of Medical Sciences, India. He is specialist in Internal Medicine and Cardiology. He has certification in Cardiovascular Disease, Internal Medicine and Interventional Cardiology. He has been resident and fellow at Seton Hall University, Shands Hospital, Washington Hospital Center. He has also served as Director of Vascular Medicine and Peripheral Interventions at Pitt County Memorial Hospital, Greenville, North Carolina. At present, he is working as an Associate Professor of Medicine and General Surgery at West Virginia University School of Medicine, Charleston, West Virginia. He is a Board-Certified Cardiologist and Interventionalist.

Recipient of numerous teaching, research awards and grants, Dr. Nanjundappa is author of more than 60 peer-review journal articles and text book chapters. A frequent national and international guest lecturer, he serves on the editorial boards of eight journals including: Angiology; Interventional Cardiology (Associate Editor); and The Internet Journal of Endovascular Medicine (Chief Medical Editor). Dr. Nanjundappa has participated in several important Clinical Trials including: CLEVER, CORAL, CAPTURE, CREST, HERCULES, MOBILITY, and CHOICES.

ROBERT S. DIETER, MD, RVT Dr. Dieter is an interventional cardiologist and vascular medicine specialist. He has completed advanced fellowship in Vascular Medicine and Peripheral Vascular Interventions at Georgetown University/Washington Hospital Center in Washington, D.C.

With a patient care emphasis in Vascular Medicine, he specializes in the management of patients with complex vascular diseases. He manages patients with stroke, TIA, and those at risk for stroke, particularly those with carotid artery blockages requiring angioplasty/stenting or those with PFO. He also specializes in renal artery stenosis. In fact, Dr. Dieter has published on new and potentially safer methods to treat blockages in the renal arteries. Dr. Dieter performs minimally invasive abdominal aortic aneurysm repair (endograft). Dr. Dieter has extensive training in the management of patients with claudication, as well as those with critical limb ischemia and non-healing ulcers — particularly in patients with diabetes. Furthermore, Dr. Dieter is board-certified in interventional cardiology and specializes in angioplasty, stenting and myocardial infarction treatment. Although Dr. Dieter is a vascular medicine specialist and interventional cardiologist, his underlying philosophy is the prevention of disease. He completed an advanced fellowship with renowned experts in Preventive Cardiology. Dr. Dieter actively treats patients with complex dyslipidemias.

Dr. Dieter graduated Alpha Omega Alpha from medical school. He has written over 100 journal articles, eight book chapters, is on the editorial board of several medical journals, and lectures internationally on cardiovascular diseases. He is the editor of two textbooks on vascular disease.