Outcomes and Statistics FY10

Introduction 1

Awards and Honors 2

BHCS Circle of Care 4

Admissions and Registrations 6

Admissions by Service Lines 6

Non-Invasive Procedures 7

Pamela Graham - Patient Story 8

Patient Satisfaction Survey 10

Patient Satisfaction Initiatives 11

Nurse Satisfaction Survey 12

Nurse Certification 13

Shared Governance 14

Interdisciplinary Quality and 17Safety Committee

CMS Quality Indicators 18

Performance Report 19

In-Hospital Mortality 20

Readmissions to BHVH 21

Infection Report 21

Michael Oberman - Patient Story 22

Patient Falls 24

Pressure Ulcers 25

Center for Complex Arrythmias 26

Cardiac Rehab 26

Support Groups 28

Community Outreach 30

Continuing Education 32

Graduate Medical Education 33

Susan Herbert - Patient Story 34

Clinical Trials and Studies 36

2008 Physician Publications 41

David Thomasson - Patient Story 48

2009 Physician Publications 51

2009 Employee Research, 58Publications and Presentations

Accelerating Best Care 60at Baylor (ABC Baylor)

Becky Drake - Patient Story 62

Physicians Directory 64

Board Members 79

Patient Quotes 80

HOSPITAL LEADERSHIP TEAM CONTENTS

Nancy Vish, RN, PhD, NEA-BC

President and Chief Nursing Officer

Trey WickeVice-President of Finance

Kevin Wheelan, MDChief-of-StaffCo-Medical Director of Cardiology

Robert Stoler, MD, FACC, FSCAICo-Medical Director of CardiologyJanuary 2009 - June 2009

John Schumacher, MD, FACC, FSCAICo-Medical Director of CardiologyJuly 2008 - December 2008

Gregory Pearl, MD, FACS Medical Director of Vascular Surgery

Nancy Vish, RN, PhD, NEA-BC, FACHEPresident and Chief Nursing Officer

Kevin Wheelan, MDChief-of-Staff and Co-Medical Director of Cardiology

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Nancy Vish, RN, PhD, NEA-BC, FACHEPresident and Chief Nursing Officer

Trey WickeVice-President of Finance

Kevin Wheelan, MDChief-of-StaffCo-Medical Director of Cardiology

Robert Stoler, MD, FACC, FSCAICo-Medical Director of Cardiology

Gregory Pearl, MD, FACSMedical Director of Vascular Surgery

HOSPITAL LEADERSHIP TEAM

Awards and Honors 4BHCS Circle of Care 6Admissions and Registrations 8Admissions and Registrations by Major Service Lines 8Inpatient Average Length of Stay 8Non Invasive Procedure 9Hospital Service Area 10BaylorHeartHospital.com 11Employee Satisfactions Survey 12Policies, Services and Benefits Tailored to Employees 12 Segmented by NeedsOutpatient Patient Satisfaction Survey 14Inpatient Patient Satisfaction Survey 14Ambulatory Patient Satisfaction Survey 14Nurse Satisfaction Survey 16Employee Retention 17Nurse Certification 17BHVH Certified RN’s 17Performance Report 23In-Hospital Mortality 24Readmissions to Baylor Heart and Vascular Hospital 25Patient Falls 29Hospital Acquired Pressure Ulcers (HAPU) 30Center For Complex Arrhythmias 31Support Groups 34Community Outreach 36Continuing Education 38Graduate Medical Education 39Clinical Trials and Studies 42Physician Publications 2009 48Physician Publications 2010 54Employee Research and Publications 57Accelerating Best Care at Baylor (ABC Baylor) 58Physician Directory 64

CONTENTS

Baylor Jack and Jane Hamilton Heart and Vascular Hospital is the first hospital in North Texas dedicated solely to the needs of patients with cardiovascular disease. The entire focus of our facility is to create an optimal patient experience.

Whether a patient is coming for an initial consultation or returning for follow-up care, access is streamlined with all inpatient and outpatient services located in a single, easily identifiable location.

Our approach is to maintain excellence along the entire continuum of cardiovascular care. We offer advanced technologies and protocols to treat a patient’s particular condition. But we also focus on subsequent long-term follow-up care, which includes education, lifestyle modification and prevention.

We begin the discharge planning process during the patient’s hospitalization to help ensure the transition of care occurs smoothly and efficiently. The educational process also begins early so as not to overwhelm a patient or his or her family with too much information the day of discharge. We know that patients tend to absorb information better when it is repeated.

Since its inception, Baylor Heart and Vascular Hospital has served as a model both regionally and nationally. Many other institutions have opened as focused centers of excellence with hospital, research institute, outpatient and inpatients physicians all in one location.

Baylor Heart and Vascular Hospital is the leading center in North Texas for clinical research trials in electrophysiology, interventional cardiology and vascular surgical techniques, as well as new medications to treat heart disease. We are proud to be on the leading edge of investigational concepts that have become mainstays of treatment.

For two years in a row, Baylor Heart and Vascular Hospital ranked number one in the nation for the lowest readmission rates for heart failure patients.

The hospital continues to provide a stream of highly trained physicians, including general cardiologists, interventional cardiologists and electrophysiologists, who are serving patients regionally and nationally.

We offer major educational, community-based programs on prevention and risk factor identification. An annual continuing education program for physicians, nurses and allied health professionals regularly attracts more than 600 people.

As we look ahead to the next decade, we want Baylor Heart and Vascular Hospital to be recognized as the premiere facility for safe, compassionate, quality and effective cardiovascular care. We will continue to deliver care that is evidence-based with proven outcomes, emphasizing wellness and prevention at the outpatient level.

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AWARDS AND NATIONAL ACCREDITATIONS

Magnet Award for “Excellence in Nursing Services” The Magnet Recognition Program® was developed by the American Nurses Credentialing Center (ANCC) to recognize health care organizations that provide nursing excellence. The program also provides a vehicle for disseminating successful nursing practices and strategies. Of the nearly 6,000 hospitals in the United States, less than five percent have achieved Magnet recognition.

Centers for Medicare and Medicaid Services (CMS) – Lowest Heart Failure Readmission Rate of any Hospital in

the Country The Baylor Jack and Jane Hamilton Heart and Vascular Hospital (BHVH) had the lowest readmission rate for heart failure patients in the United States, according to the Centers for Medicare and Medicaid Services (CMS). Rates are based on the readmission of congestive heart failure patients within 30 days of discharge. BHVH is among 4,000 hospitals that were scored. The national average is 24.5 percent, and the readmission rate at BHVH is only 15.9 percent, which, according to CMS, is a national example of superior quality for other hospitals to follow.

The Joint Commission Accreditation Joint Commission standards address the organization’s level of performance in key functional areas, such as patient rights, patient treatment, and infection control. The standards focus not simply on an organization’s ability to provide safe, high quality care, but on its actual performance as well. Standards set forth performance expectations for activities that affect the safety and quality of patient care.

HealthGrades – 5 Star rated for PCI, AMI and CHF; Only 5 Star Rated PCI Program

in Region; Best in Region – PCI Program; 5 Star Rated – Carotid Endarterectomy;

Best in Region Overall Vascular Program HealthGrades’ hospital ratings and awards reflect the track record of patient outcomes at hospitals in the form of mortality and complication rates. HealthGrades rates hospitals independently based on data that hospitals submit to the federal government.

AHA – Get With the GuidelinesSM – Gold Level Get With The Guidelines (GWTG) is the premier hospital-based quality improvement program for the American Heart Association and the American Stroke Association. It empowers healthcare provider teams to consistently treat heart and stroke patients according to the most up-to-date guidelines.

Texas Health Care Quality Improvement Awards – Award of Excellence Winners of this non-competitive award are measured in the frequency of best care practices utilized on patients with specific conditions including acute myocardial infarction, heart failure, and pneumonia as well as surgical infection prevention.

Innovation Award from the American Association of Cardiovascular and Pulmonary Rehabilitation

(AACVPR) The award acknowledges programs that have enhanced their delivery of care for a patient population in a unique and creative way, beyond the traditional model of cardiac and pulmonary rehabilitation. AACVPR is dedicated to reducing morbidity, mortality and disability from cardiovascular and pulmonary disease through education, prevention, rehabilitation, research and disease management.

VHA Leadership Award in Clinical Excellence The award honors health care organizations that have differentiated themselves around national performance standards by achieving performance at the 90 percent level or above on clinical core measures. Baylor Hamilton Heart and Vascular Hospital won the award for acute myocardial infarction treatment, heart failure and surgical infection prevention.

Intersocieatal Commission for the Accreditation of Vascular Laboratories (ICAVL) The purpose of the Intersocietal Commission for the Accreditation of Vascular Laboratories (ICAVL) is to provide a mechanism for accreditation of facilities which perform comprehensive testing for vascular disease with noninvasive testing modalities. Laboratories assess every aspect of daily operation and its impact on the quality of health care provided to patients.

Intersocietal Commission for the Accreditation of Echo Laboratories (ICAEL) ICAEL accreditation is a means by which echocardiography laboratories can evaluate and demonstrate the level of patient care they provide. After a laboratory submits the application to the ICAEL, the application undergoes a confidential peer-review by the ICAEL’s trained reviewers, including both physicians and sonographers.

American College of Radiology – Accreditation for Computed Tomography (CT)

The American College of Radiology awards accreditation to facilities for the achievement of high practice standards after a peer-review evaluation of the practice.

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Clinical ExcellencePatient & Family Satisfaction

Health Care Team SatisfactionFiscal Responsibility

results inresults in

Honesty + Respect fu lness + In tegr i t y + Compass ion + Commun ica t ion + Pos i t i ve A t t i tudeFounding Principles

Satisfaction,Excellence & Trust

People’s ExpectationsExceededQuality Care

To redefine the relationship between physicians and the hospital with an integrated heart and vascular delivery system focused on high quality, cost effective care.

To operate an integrated heart and vascular health care delivery system, founded as a Christian Ministry of healing, that exists to serve people by offering a continuum of quality service committed to quality care and patient safety, medical education, research and community service.

Baylor Heart and Vascular Hospital values guide our actions as we remain faithful to our mission and work toward our vision.Integrity: Conducting ourselves in an ethical and respectful manner.Servanthood: Serving with an attitude of unselfish concern.Quality: Meeting the needs and striving to exceed the expectations of those we serve through continuous improvement.Innovation: Consistently exploring, studying and researching new concepts and opportunities.Stewardship: Managing resources entrusted to us in a responsible manner.

BHCS CIRCLE OF CARE

“Through our Circle of Care, we strive to deliver clinical excellence (Quality) every day. Our goal is to assure that patients and families receive excellent service (Service) and that they are satisfied with this service. In addition, we want to create an environment that attracts a superior health care team that feels satisfaction in their work (People). With these pieces in place, we believe our team can maintain fiscal responsibility (Finance) through a collaborative decision-making process.” – Nancy Vish, President/CNO

At Baylor Jack and Jane Hamilton Heart and Vascular Hospital, we put our patients front and center. Our mission, vision and priorities all support this patient-centered approach.In our “Circle of Care,” we focus on four key areas of excellence to help ensure that patients are our number-one priority: people, quality, service and fiscal stewardship.

Baylor Health Care System supports and cares for patients as individuals. We promote a healing environment in which the members of the health care team work together for the benefit of the patient.

Baylor adopts best practices and industry standards that support a culture dedicated to delivering effective care. These practices and standards not only enhance patient safety and quality of care, but also increases our level of performance as a health care system.

The leadership of Baylor Heart and Vascular Hospital employs the Circle of Care as a foundation for its strategic planning process. Ongoing attention is paid to the principal factors that determine success over our competition and sustainability for key stakeholders.

Baylor is committed to being a special place to work, attracting and retaining the best and the brightest. As we strive to provide high quality care, we advance our outcomes measures. Our ultimate goal is not only to provide quality patient care, but to define it.

Our Vision

Our Mission

Our Values

Our Care Model

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NON-INVASIVE PROCEDURES (FY2010)INPATIENT AVERAGE LENGTH OF STAYADMISSIONS AND REGISTRATIONS

ADMISSIONS AND REGISTRATIONS BY MAJOR SERVICE LINES

0

5,000

10,000

15,000

20,000

25,000

TOTALOUTPATIENTINPATIENT

FY2010FY2009FY2008FY2007FY2006

1,9971,9522,1292,680

3,104

19,36518,929

19,83020,959

20,892

22,46921,609

21,95922,91122,889

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

OPERATING ROOM

ELECTROPHYSIOLOGY/PACEMAKER

CATHETERIZATIONLAB

FY2010FY2009FY2008FY2007FY2006

1,522 1,454

1,8442,137 2,055

2,455 2,4572,357 2,353 2,319

6,4696,331

5,843 5,830 5,866

OPERATING ROOM

ELECTROPHYSIOLOGY/PACEMAKER

CATHETERIZATION LAB57%23%

20%

0.0

0.5

1.0

1.5

2.0

2.5

3.0

INPATIENT AVERAGE LENGTH OF STAY

FY2010*

2.7

FY2009

2.4

FY2008

2.3

FY2007

1.9

FY2006

1.6

*addition of ICU

PROCEDURE COUNT

Transthoracic Echocardiogram 8,298

Stress Echocardiogram 295

Dobutamine Stress Echocardiogram 139

Signal Average ECG 3

Metabolic Stress Test 84

Holter Monitors 72

Exercise Arterial Test 4

Transesophageal Echocardiogram 1,396

Cerebrovascular Studies 393

Arterial Studies 759

Venous Studies 1,149

Visceral Studies 73

Dialysis Access Scan 76

TOTAL PROCEDURES 12,741

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Baylor Heart and Vascular Hospital continues to move forward in the utilization of the website and associated tools for patient engagement, marketing, and administrative efficiency. Traffic is rising steadily quarter to quarter.

WEBSITE FY2010 BaylorHeartHospital.com

JUL-09 JUN-10INCREASE

%

Visitors 96 179 86.46%

Visits 103 185 79.61%

Page Visits 581 903 55.42%

FY2010 Accomplishments include:

• Request a “Know Your Numbers Card”

• Synergy between various media, television and web, to encourage 94 requests for “Know Your Numbers” card

• Completed website security enhancements

• Discharge section with “Take the Journey” brochure

• Special urls for easier patient access to specific website pages

• Integrated online registration onto site

• Revised home page rotating images

• Monthly eNewletters

• Women’s screening cards

• Video – Living Healthy, Know Your Numbers, Good Morning Texas

BaylorHeartHospital.com WEBSITE (FY2010)HOSPITAL SERVICE AREA* (FY2010)

PRIMARY SERVICE AREAS (PSA)50% Inpatient Volume

SECONDARY SERVICE AREAS (SSA)Additional 30% Inpatient Volume

TOTAL SERVICE AREAS (TSA)80% Inpatient Volume

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EMPLOYEE SATISFACTIONS SURVEY (Survey is conducted every two years)

Satisfaction and engagement factors are standardized across Baylor Health Care System (BHCS) permitting comparative analysis within and between units. The Towers Watson tool solicits staff responses and produces an eight-factor Employee Satisfaction Index (ESI) a six-factor Employee Engagement Index (EEI) and a four-factor Integrity Index. The process allows the organization to benchmark against:

• 2008 Baylor Heart and Vascular Hospital All Employee Survey results

* Baylor Health Care System All Employee Survey results

• Health Care normative data from Towers Watson Work USA national database of health care providers working in hundreds of hospitals and hospitals systems across the country.

• Normative data of Towers Watson USA’s national database of world-class, high-performing companies from industries other than health care.

EMPLOYEE SATISFACTION STATISTICS

2010COMPARED TO BAYLOR

HEALTH CARE SYSTEM

All Employee Survey Response Rate 93%

Employee Engagement Index 91% 86%

Integrity Index 88% 84%

Employee Satisfaction Index 84% 81%

LEADERSHIP EFFECTIVENESS BY BAYLOR HEALTH CARE SYSTEM PILLAR 2010

DIFFERENCE FROM HEALTH CARE NORM

*data collected from Towers Watson Work

USA national database

PEOPLE

I am offered training and opportunities that help me develop for future advancement / greater responsibility

85% +33

I believe we will achieve our vision of becoming the best place to give and receive safe, quality, compassionate health care

92% n/a

My entity seeks the opinions and suggestions of employees 80% +32

I have trust and confidence in the job being done by senior leadership 82% +27

Senior leadership at my entity explains the reasons behind major decision 80% +38

If I encountered an ethical question or problem, I would know what procedure to follow 91% +9

QUALITY

Leadership demonstrates a willingness to invest in continuously improving our processes

88% +28

Based on everything you observe, hear and experience in your job, how would you rate the quality of health care at Baylor Health Care System

95% n/a

SERVICE

I have a clear understanding of how my job contributes to my entity achieving its business objectives

94% +11

It is clear to me how the work I do on a day-to-day basis impacts our customers 99% +16

FINANCE

My entity provides information on how well we are performing against our financial goals 96% +31

SEGMENT NEEDS POLICIES, SERVICES, BENEFITS

SafetySafe Choice, Violence, Prevention, Def. Driving

Health Health screenings, THRIVE Wellness Program, Health Club Discounts

Career OrientedCareer Development, Clinical Coaches, Tuition Reimbursement, Leadership Development Programs, Internships, ASPIRE

Family Oriented2-Day Alternate Work Schedule (TDA); Adoption Assistance, Discounted Childcare Programs

Personal EmergenciesPaid Time Off (PTO), Emp. Assistance, Emp. Trust Fund, Personal/Funeral Leave, FMLA

Civic Minded Jury Duty, Mil. Leave, PTO

Security Insurance, ST/LT Disability; 4 medical plan options, 3 dental plans, life insurance

LT Financial Goals Credit Union, 401K plan, Retirement Plan

POLICIES, SERVICES AND BENEFITS TAILORED TO EMPLOYEES SEGMENTED BY NEEDS

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INPATIENT SATISFACTION SURVEY RESULTSFY2008 - FY2010

FY2008 MEAN SCORE

FY2009 MEAN SCORE

FY2010 MEAN SCORE

Likelihood recommending hospital

96 95.7 96.7

Skill of physician 95.9 95.4 96.5

Overall rating of care given 95.8 95.3 96.2

Friendliness/courtesy of the nurses

94.1 94.9 96

Std Overall Assessment 95.1 95 95.8

Overall Assessment 95.1 95 95.8

Extent to which nurses checked ID*

94.5 94.6 95.5

Courtesy of person admitting 94 93.9 95

Nurses' attitude toward requests

92.6 93.5 94.7

Staff worked together care for you

94.1 94.1 94.7

Skill of the nurses 93.1 93.7 94.6

Staff attitude toward visitors 93.8 93.5 94.1

Std Nurses 92 92.8 93.8

Friendliness/courtesy of physician

92.7 92.4 93.8

Attention to special/personal needs

91.2 91.9 93.4

Std Admission 91.6 91.8 93.2

Admission 91.6 91.8 93.2

Courtesy of person served food

92.7 92 93.1

Promptness response to call 91 92.1 93.1

Courtesy of person took blood

92.8 91.7 92.8

PATIENT SATISFACTION SURVEY

Baylor Heart and Vascular Hospital uses Press Ganey Associates to survey their patient population. Press Ganey uses patient discharge information to select a sample of recipients who receive a sample of mailed satisfaction surveys.

OUTPATIENT SATISFACTIONSURVEY RESULTSFY2008 – FY2010

FY2008 MEAN SCORE

FY2009 MEAN SCORE

FY2010 MEAN SCORE

Friendliness of staff 96 96.1 96.9

Likelihood of recommending 95.7 96.4 96.8

Overall rating of care 95 95.6 96.6

Std Overall Assessment 95 95.7 96.4

Skill of techs/therapists/nurses 95.5 95.6 96.3

Std Test or Treatment 94.5 94.9 96

Staff worked together provide care 94.7 95 96

Staff concern for comfort 94.5 95 95.9

Staff's concern/questions worries 93.8 94.3 95.6

Cleanliness of facility 94.6 94.8 95.1

Explanations given by staff 93.6 93.9 95.1

Our sensitivity to your needs 92.9 93.4 94.5

Helpfulness of registration person 93.1 93.9 94.4

Std Overall 92.8 93.7 94.2

Std Personal Issues 92.7 93.2 94.2

Our concern for privacy 93.2 93.6 94.2

Response to concerns/complaints 92.3 92.8 94.1

Ease of the registration process 92.7 93.6 93.7

Std Facility 90.9 91.8 91.8

Comfort of waiting area 90.4 91.4 91.8

AMBULATORY SATISFACTION SURVEY RESULTS FY2010*

FY2010 MEAN SCORE

Confidence in skill of physician 95.5

Likelihood of recommending center 94.9

Friendliness of nurses 94.8

Friendliness of physician 94.5

Std Overall Assessment 94.4

Overall Assessment 94.4

Degree staff worked together 94.3

Overall rating of care 94.2

Cleanliness of center 94.1

Friendliness of anesthesiologist* 93.6

Comfort of your room/resting area 93.4

Helpfulness of registration person 93.1

Nurses courtesy toward family 92.5

Confidence in skill of nurses 92.5

Std Physician 92.5

Physician 92.5

Information day of surgery 92.2

Nurses concern for comfort 92.1

Anesthesia/Anesthesiologist 92.1

Rate overall anesthesia experience* 92

*Note: This is a new survey for BHVH as of January 2010.

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Retention is a focus for our team. Retention metrics are also hardwired into the performance appraisals of the leadership team. Special classes are required for the leadership team on Retention.

BAYLOR HEART AND VASCULAR NURSING RETENTION, NEW HIRE RETENTION AND VACANCYDIRECT PATIENT CARE, ROLLING 12 – MONTH

FY2010BAYLOR HEALTH CARE SYSTEM

BAYLOR HEART AND VASCULAR

HOSPITAL

All Employees 89.50% 94.80%

Direct Patient Care RNs 86.60% 92.60%

Allied Health 91.00% 93.80%

Direct Patient Care UAPs 85.10% 98.00%

NURSE CERTIFICATION

Baylor Heart and Vascular Hospital has a program in place for certification reimbursement. A nurse may request up to $500 in reimbursement for the certification exam, a review course, and review course materials.

• Eligible direct care nurses: 30%

• Eligible nurse leaders certified: 58%

NURSE SATISFACTION SURVEY EMPLOYEE RETENTION We Would Like to Recognize Our Nationally Certified RN’s:

In August 2010, Baylor Heart and Vascular Hospital participated in the Nursing satisfaction Survey facilitated by national Database of Nursing Quality Indicators (NDNQI).

PRACTICE ENVIRONMENT SCALE MEAN SCORES*

AVERAGE OF ALL COMPARISON UNITS IN ALL COMPARISON HOSPITALS

NURSING PARTICIPATION

IN HOSPITAL AFFAIRS

NURSING FOUNDATIONS FOR QUALITY

CARE

NURSE MANAGER ABILITY,

LEADERSHIP AND

SUPPORT OF NURSES

STAFFING AND

RESOURCE ADEQUACY

COLLEGIAL NURSE-

PHYSICIAN RELATIONS

MEAN PES SCORE

Average of All Units In Your Hospital

3.22 3.31 3.17 2.91 3.29 3.18

Mean 2.85 3.08 2.96 2.79 3.06 2.95

*Rating of the extent to which characteristic is present. The higher the score, the more positive the rating on a scale of 1-4.

In addition to the satisfaction survey, Baylor Heart and Vascular Hospital continues to administer a Q12 survey of all staff. This survey questions staff about teamwork, respect, staffing levels, equipment, and general work environment. The surveys are separated by units and address issues such as communication (physician/peer), recognition/praise, equipment/tools, leadership and education. The survey uses a 1-5 scale. The survey results are presented to the leadership team and action plans are implemented based on average scores of 4.0 or less. These actions plans are presented at department meetings and all employee meetings.

During fiscal year 2010, Baylor Heart and Vascular Hospital continued and implemented a variety of programs and initiatives in response to the needs of the entire team, including the nursing staff such as:

• Focuses on the wellness portion of the Baylor Health Plan called THRIVE.

• A 30 day and 90 day follow-up on new hires, a 60 day new hire breakfast, and a new hire pin after 90 days of service.

• Baylor Heart and Vascular Hospital uses their staff in all collateral material to the community, as well as the website.

Beverly Allen, ADN, CPHQ, CPHRM

Charla Amos, BSN, RN-BC

Rose Andrews, BSN, RN-BC

Mary Atkins, BSN, RN-BC

Laurie Barta, ADN, CEPS, CCDS

Tammy Berbarie, ADN, RN-BC

Sharon Carroll, BSN, CEPS

Millie Church, BSN, CCRN

Holly Coleman, BSN, CCRN

Valerie Darst, BSN, RN-BC

Lisa Dodd, ADN, RN-BC

Diana Ekkis, BSN, TNCC

Stacy Fowler, BSN, CCRN

Jackie Geddie, ADN, RN-BC

Julie Gonzalez, ADN, CRN

Gabriell Grayson, BSN, RN-BC

Michael Harris, ADN, RCIS

Mini Iype, MSN, RN-BC

Sherry Keithly, ADN, RN-BC

Anne Lawrence, RN-BC

Laurie Linker, ADN, CNOR

Kristine Maguigad, BSN, RN-BC

Jennifer Maninang, ADN, CNOR

Ronald Maninang, ADN, TNCC

Paz McDonald, BSN, CCRN

Sandra McLeroy DeJong, BSN, RN-BC

Alphane McKinney, CNOR

Amy Merritt, BSN, CCRN

Mary Muldoon, RN-BC, CEPS

Aster Naffe, BSN, CCRN

Kelly Pinaga, BSN, RN-BC

Romeo Resurreccion, ADN, RN-BC

Cheryl Rowan, ADN, TNCC

Erica Salas, ADN, CNOR

Cindy Simmons, AND, RN-BC

Mindy Smart, BSN, RN-BC

Dee Ann Smith, AND, RN-BC

Tonja Solomon, AND, RN-BC

Paul St. Laurent, RN, ANP, CCRN, ACNP-BC, MSN

Rod Sta-Maria, BSN, RN, CCRN

Danielle Strauss, BSN, RN-BC

Araceli Ticzon, BSN, CMSRN

Henry Viejo, BSN, RN-BC

Denise York, AND, PCCN

Annabelle Zakarian, RN-CVN, MSN

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SHARED GOVERNANCE

The STARRS Committee

The STARRS Committee continues to play a very important role in satisfaction. STARRS stands for Service, Training, Accountability, Recruitment, Retention and Satisfaction.

Chair – Leigh Ann Ward, RT(R), ARRTCo-Chair – Daphne Smith, RN

As a standing agenda item the STARRS Committee has an open discussion period where representatives may bring up issues that require clarification, problem solving, process improvement or administrative support. Issues brought to this council over the past twelve months have led to higher levels of employee satisfaction. Their focus has moved from environmental improvements to staff teamwork. Initiatives include meet and greet breakfasts for new employees, employment anniversary cards and a focus on improving team work and recognition.

FY2010 Accomplishments include:

• Team Building activities within the multidisciplinary group– “Mission Recognition” pizza parties: Activities performed

at the monthly meeting provide an opportunity for staff to win a party for their department to promote Recognition and Team Building

• Monthly Anniversary Cards for staff members to celebrate their hire date

• Thank You Cards for staff members

• Volunteering at Austin Street Shelter, a local shelter

• Empty Bowls fundraiser for the North Texas Food Bank

• Diversity Holiday Party

• Adopt-a-Family during the Holiday Season

• Habitat for Humanity

• Special Olympics

The Standards and Measure Committee

The Standards and Measure Committee focuses on Patient and Family Satisfaction.When it comes to service, Baylor employees often go above and beyond what’s expected – on the patient floor, in administrative offices, in clinics and elsewhere. We want to make sure those efforts are recognized and rewarded. The Standards and Measures Committee helps identify those staff members who should be recognized for their efforts.

Chair – Scotty Pate, RT(R), ARRTCo-Chair – Priscilla Rubio

FY2010 Accomplishments include:

• Physician AIDET Press Ganey training

• Acquiring patient cell phone numbers via Access Services to assist with discharge phone calls

• 5 P’s signs (Potty, Pain, Position, Possession, Place) placed on SCU floors

• Revised Cardiac Rehab discharge surveys

• Cardiac Rehab phone scripting for patients

• Team Leader Press Ganey training

• eTeams training

• Access Services Non Invasive protocol for patient transfer between areas

• Shhh! signs placed on SCU floors to remind staff to watch noise levels during their shifts

• EP/PM Wired for Life education classes and ICD cards

• Continue to focus on an improve patient satisfaction through Press Ganey comments

• Staff members eligible for Service Excellence Awards. Staff chosen through comments posted on the Press Ganey survey and 5 Stars Service nomination forms.

• Staff who receive Service Excellence Awards are then eligible for the CEO Award presented by Baylor CEO Joel Allison

“Collaboration is at the heart of everything we do.” – Nancy Vish, President and CNO

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SHARED GOVERNANCE (Continued) Pain Management Committee

Chair – Paz MacDonald, BSN, RN, CCRN, ChairCo-Chair – Julie Gonzalez, RN, CRN, Co Chair

FY10 Accomplishments include:

• Patient and family education tools– Patient’s Guide to Pain Management Brochure in

English and Spanish

• Staff Education tools– “Pain Scripting” as guide for communication– Guide in providing pain relief, combining meds– Non-pharmacological strategies

• Pain Assessment Quiz for Nurses

• Involved in BHCS system wide standardization of PCA (Patient Controlled Analgesia) order sets

• Chair person attended ASPMN National conference

• Chair person attends the BHCS Pain Task Force meetings

Research

Chair – Jenny Adams, PhDCo-Chair – Mary Muldoon, RN, RN-BC, CEPS

FY10 Accomplishments include:

• Assessment of Functional Capacity Requirements during simulated automotive mechanic tasks for the purpose of developing an occupation-specific assessment for safe and expeditious return to work for cardiac patients

• Appropriate of sling immobilization to prevent lead displacement after pacemaker/implantable cardioverter defibrillator implantation

• Cardiac rehabilitation of a 77 year old male runner: consideration of the athlete, not the age

• Challenging Traditional Activity limits after coronary artery bypass graft surgery

• Measuring of functional capacity of requirements of police officers to aid in development of an occupation-specific cardiac rehabilitation training program

• Measuring of functional capacity requirement to aid in development of occupation-specific rehabilitation training program to help firefighters with cardiac disease safely to return to work

• Six month coaching via internet for patient’s post PCI

• Assessment of the value of a brief intervention and referral to a mental health professional for brief-stay cardiac hospital patients who report feelings of hopelessness and worthlessness

• Nursing and Clinical Observation: Femoral Access Risk Factors During Left Heart Catheterizations Leading to Additional Hospitalization and Vascular Surgical Intervention

• Family Care Card

• Pink Packet

• Insulin Sliding Scale study

• Patient satisfaction study

• Sneeze study

• Fire fighter brief report

• Myocardial work

• Standardization of a surgical site pre-cleansing technique for vascular patients

The CEO Awards of Excellence

The CEO Awards of Excellence is presented quarterly to outstanding employees, chosen from among the top monthly award recipients. Each quarterly honoree receives a $2,500 cash payment and a small keepsake, presented by Baylor CEO Joel Allison at Leadership Development Institute meetings.

The FY2010 CEO Award of Excellence winners were:

– Maria Gomez – Gabriell Grayson

Clinical Practice Council

Chair – Amy Merritt, BSN, RN, CCRN Co-Chair – Mindy Smart, BSN, RN, RN-BC

FY2010 Accomplishments include:

Focus on key projects such as: • Hypoglycemia protocol tracking form

• Hopelessness and Worthlessness project focusing on depression and our patients

• Diabetes Detectives is a project which stemmed from the need for further staff education on hyperglycemia and treatment

• Improved discharge teaching instructions which stemmed from needs identified during follow up phone calls

• New AMI protocol for utilizing lytics at outlying facilities

Professional Development Council

Chair – Laura Linker, BSN, RN, CNORCo-Chair – Tonja Solomon, RN, RN-BC

FY2010 Accomplishments include:

• Multiple unit based and hospital wide in-services throughout the year

• Review and updating of NOW Cards which are quick reference cards for new hires

• 3 annual seminars organized and led by staff members: – Cardiovascular Symposium– Vascular Seminar– Electrophysiology and Pacing Seminar

Epidemiology Council

Chair – Deborah White, MHA, BSCLACo-Chair - Jerry Amundsen, RN

FY2010 Accomplishments include:

• Cleaning of patient care equipment in individual areas addressed and staff educated.

• Cleaning by EVS of patient rooms, OR, EP Cath lab.

• Education on C. difficile with education to departments.

• Education on Hospital Acquired infections with education to departments

• H1N1 Education and response to possible pandemic.

• Education on hand hygiene with education to departments.

22 23

CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) FY2010 PERFORMANCE REPORT FY2010

HEART ATTACK QUALITY INDICATOR

HEART FAILURE QUALITY INDICATOR

SURGICAL INFECTION QUALITY INDICATOR

HEART ATTACK (ACUTE MYOCARDIAL INFARCTION) BHVH NATIONAL TEXAS

AMI Bundle 100% NA NA

Aspirin at arrival 100% 94% 92%

Aspirin at discharge 100% 92% 91%

ACEI or ARB for LVSD 100% 95% 95%

Adult smoking cessation advice/counseling 100% 82% 79%

Beta blocker at discharge 100% 96% 98%

HEART FAILURE BHVH NATIONAL TEXAS

CHF Bundle 100% NA NA

All discharge instructions 100% 90% 90%

Evaluation of LVS function 100% 90% 89%

ACEI or ARB for LVSD 100% 79% 78%

Adult smoking cessation advice/counseling 100% 93% 93%

SURGICAL INFECTION IMPROVEMENT PROJECT BHVH NATIONAL TEXAS

SCIP All or None Bundle 99.3% NA NA

Antibiotic received within one hour of incision 99% 91% 88%

Antibiotic selection 100% 98% 97%

Antibiotic discontinued within 24 hours 100% 87% 83%

Appropriate hair removal 100% 90% 89%

Beta blocker use preoperatively 100% 88% 85%

ATRIAL FIBRILLATION PERCENTAGE

Coumadin at discharge 100%

Patient follow-up 100%

Teaching smoking cessation 100%

PERCUTANEOUS CORONARY INTERVENTION PERCENTAGE

Lipid lowering medications at discharge 99.2%

Plavix at discharge 99.9%

ASA at discharge 99%

Teaching smoking cessation at discharge 100%

BETA BLOCKERS IN VASCULAR SURGERY PERCENTAGE

Prior to surgery 98.6%

Recovery room 98.6%

Specialty care room 99.5%

At discharge 98.1%

AHA GET WITH THE GUIDELINES PERCENTAGE

HbA1C>7 outpatient diabetic referral 100%

HbA1C>7 letter to PCP 93.7%

ADA diet orders for diabetic patients 98.1%

At discharge 98.1%

VACCINATIONS PERCENTAGE

Pneumococcal vaccination 99.4%

Influenza vaccination 99.7%

24 25

IN-HOSPITAL MORTALITY FY2010 READMISSIONS TO BAYLOR HEART AND VASCULAR HOSPITAL FY2010

EP/PACEMAKER/ICDCASE

COUNTIN-LAB PERCENT

POST PROCEDURE

PERCENT

Pacemaker Only 441 0 0.00% 2 0.45%

Event Recorder 36 0 0.00% 0 0.00%

ICD Only 486 0 0.00% 4 0.82%

EP Cases 894 0 0.00% 0 0.00%

TOTAL 1857 0 0.00% 6 0.32%

EP/PACEMAKER/ICDCASE

COUNTIN-LAB PERCENT

POST PROCEDURE

PERCENT

Diagnostic Cath Only 2294 0 0.00% 30 1.31%

Diagnostic Peripheral Only 464 0 0.00% 1 0.22%

Cardiac Intervention 1498 4 0.27% 12 0.80%

Peripheral Intervention 829 0 0.00% 5 0.60%

Peripheral Diagnostic w/ Cardiac Procedures 787 0 0.00% 9 1.14%

TOTAL 5872 0 0.07% 57 0.97%

CAUSE/PROCEDURE NO. CASES PERCENT

Pacemaker Lead Dislodgement 0 0.00%

Infection 2 0.45%

Another related procedure

7 1.59%

Other 3 0.68%

EP Ablation Re-Ablation 33 5.10%

Same site 23 3.55%

Different site 10 1.55%

ICD Only Lead Dislodgement 1 0.21%

Infection 5 1.03%

Another ICD relate procedure

13 2.67%

Other 3 0.62%

Coronary Interventions Same Vessel 44 2.42%

Coronary Angiogram Return for Intervention 198 4.89%

26 27

On the Rebound

With his whole life ahead of him, Jaden Isler’s heart just stopped one day. A senior in high school, Isler had accepted a basketball scholarship at a university in South Carolina the day before. “I was watching a high school softball game and was right in the middle of a conversation when it happened, and in an instant I was unconscious,” Isler says. At just 18 years old, he was experiencing sudden cardiac arrest.

That could have been the end of the story, but there happened to be a doctor watching the game who immediately started CPR. Someone called 911, and a police officer with a defibrillator restarted Isler’s heart. This quick action was critical to his survival.

The hospital Isler was first taken to couldn’t find anything wrong with his heart on initial testing. After all, sudden cardiac arrest, also known as sudden cardiac death, is more common in older adults with coronary heart disease and heart failure. Isler’s family decided to seek more advanced expertise at Baylor Hamilton Heart and Vascular Hospital.

After a thorough evaluation, Isler was diagnosed with idiopathic ventricular fibrillation, an abnormal heart rhythm that can lead to sudden cardiac arrest even in young patients with normal heart anatomy. An implantable cardioverter-defibrillator (ICD) was inserted to restart Isler’s heart in the event of another emergency.

“An ICD provides protection, especially for someone like Jaden who wants to continue to play competitive sports,” says Manish D. Assar, M.D., a cardiac electrophysiologist on the medical staff at Baylor Hamilton Heart and Vascular Hospital and Baylor University Medical Center at Dallas. Now, two years later, Isler is a junior at McMurry University in Abilene, Texas, where he plays point guard—a challenging position—on the basketball team. His ICD has only gone off twice, although never during athletic activity.

“I was alone in my dorm room the first time it happened, so it saved my life for sure,” Isler says. “And having the ICD as a precaution lets me pursue my goals as an athlete.”

O N E Y O U N G A T H L E T E R E T U R N S T O T H E G A M E A F T E R S U D D E N C A R D I A C A R R E S T

“...having the ICD as a precaution lets me pursue my goals as an athlete.”

– Jaden Isler

28 29

Baylor Heart and Vascular Hospital has selected multiple quality indicators, including nurse sensitive indicators that are monitored and reported monthly on a performance report card. This report card is reviewed in multiple forums including our shared governance councils, Medical Leadership, and Board of Manager meetings. This report is also reviewed in all employee meetings on a quarterly basis. Actions are taken for areas with improvement opportunities.

INTERDISCIPLINARY QUALITY AND SAFETY COMMITTEE PATIENT FALLS

Statistical process control charts are utilized to analyze the variance in fall incidence. The data subset has consistently trended below the NDNQI National Comparative Information mean for Bedside <100. The fall rate from 3Q08 to 2Q10 is consistently below the NDNQI benchmark. In addition, the injury rate for the Med-Surg group has remained below the NDNQI benchmark.

The clinical practice team of the Specialty Care unit designed the “Call, Don’t Fall” Program approximately two years ago to focus on falls. Nurse leaders and supervisors continue to educate nurses and patient care techs ongoing about the importance of fall precautions.

INFECTION REPORT

ADULT MED-SURG COMBINED 3Q08 4Q08 1Q09 2Q09 3Q09 4Q09 1Q10 2Q10 AVG

Specialty Care Unit 0.62 2.33 1.02 1.22 1.29 1.82 0.41 1.51 1.28

Hospital Adult Med-Surg Combined Median 0.62 2.33 1.02 1.22 1.29 1.82 0.41 1.51 1.28

ADULT MED-SURG COMBINED 3Q08 4Q08 1Q09 2Q09 3Q09 4Q09 1Q10 2Q10 AVG

Specialty Care Unit 0.18 0.54 0.24 1.22 0.52 0 0 0.33 0.38

Hospital Adult Med-Surg Combined Median 0.18 0.54 0.24 1.22 0.52 0 0 0.33 0.38

NATIONAL COMPARATIVE INFORMATION – BEDSIZE<100

3Q08 4Q08 1Q09 2Q09 3Q09 4Q09 1Q10 2Q10 AVG

25th percentile 1.96 2.17 2.11 1.87 1.88 1.83 1.79 1.81 1.93

50th percentile (median) 3.38 3.46 2.89 2.99 3.14 3 3.24 3.03 3.14

NATIONAL COMPARATIVE INFORMATION – BEDSIZE<100

3Q08 4Q08 1Q09 2Q09 3Q09 4Q09 1Q10 2Q10 AVG

25th percentile 0.25 0 0 0 0 0 0 0 0.03

50th percentile (median) 0.85 0.76 0.68 0.75 0.75 0.66 0.75 0.7 0.74

FALLS PER 1,000 PATIENT DAYS:

INJURY FALLS PER 1,000 PATIENT DAYSNATIONAL HEALTHCARE SAFETY NETWORK (NHSN) NO. PROCEDURES BHVH BENCHMARK

Abdominal aorta aneurysm 0 0 5.21

Carotid endartectomy 171 0.585 0.00

Peripheral bypass 148 4.054 4.69

Pacemaker/ICD 2 0.00

30 31

HOSPITAL ACQUIRED PRESSURE ULCERS (HAPU)

Baylor Heart and Vascular Hospital had no reported Hospital Acquired Pressure Ulcers for the FY 2009 and has consistently trended below the NDNQI National Comparative Information mean for Bedside <100. Current methods of investigating skin breakdown are effective. A specially trained group of “skin integrity” nurses do monthly skin integrity audits and standing delegated medical orders allow faster utilization of

ET nurse consults. Data indicating a unit to be at or below the NDNQI means are used as a measurement of success. Problem identification and appropriate education is provided if there is an identification of an acquired pressure related skin ulcer. All data regarding HAPU is reported at the month Health Care Improvement Committee and House wide Clinical Practice Committee.

Taking our commitment to advanced patient care a step further

By bringing together our cardiovascular expertise with advanced medical technology, Baylor Hamilton Heart and Vascular Hospital offers innovative procedures that treat abnormal cardiac rhythms including atrial fibrillation.Baylor’s Center for Complex Arrhythmias was created to help explain the causes, treatment options, and advanced procedures available at Baylor Hamilton Heart and Vascular Hospital.

Baylor Hamilton Heart and Vascular Hospital upgraded our electrophysiology labs with a Stereotaxis system. The Stereotaxis Treatment System allows our doctors to heal hearts more precisely and safely than before. By using computer-controlled magnets—which are positioned outside the body—to programmatically steer catheters and guidewires throughout the delicate cardiovascular system. With the computer to assist in precise navigation, the doctor is then able to focus on the patient and the outcome rather than the mechanics of the procedure.

CENTER FOR COMPLEX ARRHYTHMIAS

Adult Med-Surg Combined 3Q08 4Q08 1Q09 2Q09 3Q09 4Q09 1Q10 2Q10 AVG

Specialty Care Unit 7.14 0 0 0 0 0 4.76 0 1.49

Hospital Adult Med-Surg Combined Median 7.14 0 0 0 0 0 4.76 0 1.49

Adult Med-Surg Combined 3Q08 4Q08 1Q09 2Q09 3Q09 4Q09 1Q10 2Q10 AVG

Specialty Care Unit 0 0 0 0 0 0 0 0 0

Hospital Adult Med-Surg Combined Median 0 0 0 0 0 0 0 0 0

National Comparative Information – Bedsize<100 3Q08 4Q08 1Q09 2Q09 3Q09 4Q09 1Q10 2Q10 AVG

25th percentile 0 0 0 0 0 0 0 0 0

50th percentile (median) 6.25 7.14 7.14 5.88 5 5.88 5.92 4.35 5.95

National Comparative Information – Bedsize<100 3Q08 4Q08 1Q09 2Q09 3Q09 4Q09 1Q10 2Q10 AVG

25th percentile 0 0 0 0 0 0 0 0 0

50th percentile (median) 0 0 0 0 0 0 0 0 0

PERCENT OF SURVEYED PATIENTS WITH PRESSURE ULCERS

PERCENT OF SURVEYED PATIENTS WITH HOSPITAL ACQUIRED PRESSURE ULCERS STAGE II AND ABOVE

September 2009 AFIB Community Talk – Dr. Assar 49 Seminar

March 2010 AFIB Community Talk – Dr. Kowal 78 Seminar

April 2010 AFIB Talk – Dr. Franklin Hunt Regional Hospital Presentation

April 2010 AFIB Talk – Dr. Assar – Forney Presentation

May 2010 AFIB Talk – Dr. Franklin – Baylor University Medical Center’s ER MDs Presentation

June 2010 AFIB Community Talk – Dr. Franklin 41 Seminar

32 33

CARDIAC REHAB

Our program draws on a multidisciplinary team that includes internal medicine physicians, registered nurses, exercise specialists, registered dietitians, and social workers in a carefully designed program that is tailored to your specific needs.

Offered in three phases, our program features monitored physical activity in which you gradually increase the efficiency of your heart and lungs, strengthening your body’s muscles while gaining the confidence you need to return to daily life.

The only one of its kind in North Texas, the Return to Work Lab™ follows industrial athletes and those with jobs that require higher intensity levels after heart procedures to evaluate when their heart is physically ready to return to work. The goal of the Return to Work Lab is to train patients to achieve the fitness level necessary for them to safely perform required job duties upon return to work and/or activities of daily living.

Typical cardiac rehabilitation programs advise participants to perform lower levels of activity by using equipment such as the treadmill, bike, and light hand weights. Our program uses real-life tools and equipment that our participants might use--fire hoses, industrial tools, simulated red guns--that weigh the same as their real life counterparts. We also use training materials taken from these professions; stairway; stairmill; slideboard; agility equipment; simulated lawn equipment; and a weighted workstation.

After successfully completing this program, you will be confident that you’re ready for the demands of your job--and so will your family members, your physician, and your employer and coworkers.

RETURN TO WORK LAB – LIVE YOUR ACTION POTENTIAL

TOTAL ATTENDEES

FY 2006

FY 2007

FY 2008

FY 2009

FY 2010

Phase II* 5,317 5,419 4,583 4,253 4,874

Phase III** 2,656 2,830 2,930 3,326 3,308

*Phase II is a supervised outpatient program of individually prescribed exercise with continuous or intermittent ECG monitoring. **Phase II is a long term program generally including both clinical supervision by an exercise professional or nurse and intermittent ECG monitoring.

34 35

SUPPORT GROUPS

Support groups are one of the best resources for persons who have experienced heart and vascular disease. Share your experience and learn from others in one of Baylor’s ongoing support groups.

Leap For Life

Take the first leap toward a healthier lifestyle with Baylor Health Care System’s Leap (Lifestyle Education Awareness Program) for Life® program. Designed to meet the needs of patients and their families with heart disease, Leap for Life® teaches what you can do now to manage your disease and possibly improve your health. It’s a wellness and disease prevention program available to heart patients, their family members, and the community that empowers individuals with physical, dietary, and stress education to achieve better health.

LEAP FOR LIFEFY

2006FY

2007FY

2008FY

2009FY

2010

Cardiac rehab participants

122 120 79 69 86

Community participants

36 18 21 138 63

Guests 89 72 61 60 61

Total 247 210 161 267 210

Wired For Life

Baylor has teamed up with past implantable cardioverter defibrillator (ICD) recipients to provide future ICD recipients with support, comfort and answers to their questions. Volunteers meet with the future recipients and their families before and after the ICD procedure.

DATE OF EVENTNUMBER OF ATTENDEES:

September-09 5

November-09 12

March-10 25

May-10 21

Caring Hearts

Emotional support is an important part of recovery, and we think that it’s important for patients in cardiac rehabilitation to learn from the experiences of those who have already completed the program. In the Caring Hearts® program, people who are a year past their own cardiac event volunteer to visit a patient and their family before or after a procedure, offering empathy and support. Caring Hearts® volunteers also support waiting room staffs. Caring Hearts® volunteers are cardiac patients or family members of cardiac patients.

Heart Well Forum

Our Heart Well Forum helps you and your family members connect to other people who are experiencing the same things you are. Heart Well Forum is a monthly meeting and support group for cardiovascular patients and their families. The meeting features lunch, an educational presentation, and time for social interaction and support.

DATE OF EVENT

NUMBER OF ATTENDEES

NAME OF EVENT

July-'09 41 "The Western Diseases" by Dr. William Roberts

August-'09 51 "Stem Cell Therapy for Cardiovascular Disease" by Dr. Harold Urschel

September-'09 44 "How To Find The Up-Side of Any Down-Sided Mountain" by Mike Davis

October-'09 39 "The Heart of Connection: The Art and Science of Human Relationships" by Danielle Strauss

November-'09 46 "Special Training for Special People: The Importance of Specificity of Training for You" by Jenny Adams

December-'09 81 Holiday Party

January-'10 63 "Fit, Fun, and Fabulous for 2010" by Katy Kennedy, M.S. and Tiffany Shock, B.S.

February-'10 72 "Hypertension: Your Questions Answered" by Dr. William Roberts

March-'10 77 "Heart, Body, and Mind: Diabetes, Heart Disease, and Stroke" by Misty Jones, RD, LD

April-'10 62 “Peripheral Vascular Disease: What You Need to Know” by Dr. Jason Woolard

May-'10 73 "Preventing Heart Disease" by Dr. Clyde Yancy

June-'10 59 "Metabolic Syndrome: What Is It and What Can I Do About It?" by Paul St. Laurent

36 37

COMMUNITY OUTREACH

DATE OF EVENTNUMBER OF ATTENDEES

NAME OF EVENT

July-'09 14 UTA STARS Program

July-'09 31American Heart Association’sTop Walker - Dr. Choi presented a case

August-'08 354 ViVa Dallas - Hispanic Health Fair

August-'08 35 Dallas Police Academy - Leap For Life presentation

September-'09 225 American Heart Association’s Heart Walk

October-'09 108 Step Out: Diabetes 5K

November-'09 DRC Half Marathon & 5K

January-'10 228For Women For Life - Women’s Health Fair- Dr. Carlos Velasco

February-'10 1,938 North TX Food Bank Empty Bowls - People’s Choice Award

February-'10 American Lung Association

February-'10 64 Girl Scouts Job Shadowing

April-'10 19 AAA Screening

May-'10 25 With Knowledge Comes Power Seminar - Dr. Shyla High

June-'10 250 It’s A Guy Thing - Men’s Health Fair - Dr. Jerrold Grodin

June-'10 40 Stress and Blood Pressure Management - Paul St. Laurent

DATE OF EVENTNUMBER OF ATTENDEES

NAME OF EVENT

September-'09 54 PVD Screening

February-'10 58 PVD Screening

June-'10 62 PVD Screening

AUSTIN STREET SHELTER

Austin Street Shelter was chosen by the Clinical Advisory committee as Baylor Hamilton Hospital’s community project. Austin Street Shelter exists to provide emergency shelter and related services to the homeless in a compassionate community, and to provide “whole person” therapeutic programs. Baylor volunteers have assisted with clothing drives, food drives, and providing lunch/dinner for the shelter.

AMERICAN HEART ASSOCIATION: HEART WALK

Each year Baylor Hamilton Hospital supports the American Heart Association’s Mission to “Build healthier

lives, free of cardiovascular diseases and stroke” by raising donations through a series of activities and events. Baylor Hamilton Hospital’s employees, their families and pets participate in a fun-filled, non-competitive three-mile walk through downtown Dallas. Over 200 Baylor employees attend this annual event.

PERIPHERAL VASCULAR DISEASE SCREENINGS

Baylor Hamilton Heart and Vascular Hospital is committed to providing opportunities to be actively involved in the community. Community involvement suggestions have been received from our team members in our Advisory Council and Leadership Council.

38 39

CONTINUING EDUCATION

Baylor Hamilton Heart and Vascular Hospital hosts and sponsors four all-day events throughout the calendar year. These programs are created and managed by the Baylor Hamilton Hospital clinical team and are made available to the staff and community. Each year attendees travel as far as other states to attend our seminars.

In addition to the seminars and symposiums, Baylor Hamilton Heart and Vascular Hospital offers preceptor and charge nurse classes in addition to other on site continuing education opportunities.

CY 2006

CY 2007

CY 2008

CY 2009

CY 2010

Cardiovascular Symposium

640 420 460 550 411

Vascular Seminar 85 117 126 74

EP/Non Invasive Seminar

124 170 185 191 137

Cardiovascular Summit

126 118 100 75 86

Baylor’s graduate medical education program promotes diversity, quality and a combination of real-world applications and academic excellence. The dedicated physician leaders on the medical staff work to prepare fellows and interns for the challenging and rewarding field of medicine. Medical education has been a successful collaborative effort between Baylor University Medical Center at Dallas and Baylor Hamilton Heart and Vascular Hospital, both located on the downtown campus. All programs are accredited by the ACGME (Accreditation Council for Graduate Medical Education).

Cardiac Electrophysiology Fellowship

Fellows complete a twelve-month comprehensive training program. The curriculum includes diagnostic and procedure skills, outpatient management and clinical research. One fellow is accredited per year.

Cardiovascular Disease Fellowship

Fellows complete a three-year comprehensive training program which includes all aspects of cardiology. Clinical rotations at Baylor Hamilton Heart and Vascular Hospital include interventional cardiology, cardiac electrophysiology, cardiac rehabilitation, lipids, noninvasive cardiology, nuclear cardiology, and vascular medicine. Two fellows are accepted into the program annually.

Vascular Surgery Residency

The program annually offers two residency positions through the NRMP (National Residency Matching Program). The two-year residency is devoted exclusively to general vascular surgery with research participation.

Cardiovascular Interventional Fellowship

Fellows complete an 18-month comprehensive training program. The curriculum provides for an interventional clinical and procedural focus during the first year, followed by a focus on clinical research during the subsequent six months. One fellow is accepted into the program annually.

Baylor Heart and Vascular Hospital FY2010 Fellows were:

Ramy Ayad, MD

Paul Bhella, MD

Rahul Bose, MD

John Garner, MD

Yusuf Hassan, MD

Steven Lilly, MD

Brian Schwartz, MD

Leo Simpson, MD

Margaret Sullivan, MD

GRADUATE MEDICAL EDUCATION

40 41

Chance of a Lifetime

Chad Wheeler was diagnosed with congestive heart failure at the young age of 36, less than three years ago. He was at work and started getting winded. “I would walk across the yard and have to sit down,” he says. Before he could even schedule the appointment with a cardiologist that his doctor recommended, his shortness of breath began to worry his wife. She took him to the emergency room at Baylor University Medical Center at Dallas.

There, he was diagnosed with dilated cardiomyopathy, a condition that weakens and enlarges the heart. Dilated cardiomyopathy prevents the heart from efficiently pumping blood and can increase the risk of congestive heart failure. And Wheeler’s condition was progressing, says Shelley A. Hall, M.D., heart transplant medical director at Baylor Dallas and a physician on the medical staff at Baylor Hamilton Heart and Vascular Hospital.

The best treatment option for Wheeler was a heart transplant. But while he waited for a new heart to be available, keeping his heart in good condition was essential. As is the case with many patients, the first forms of treatment his doctors tried — oral medication and intravenous medication — didn’t remain effective for as long as Wheeler needed them. “As time wore on my heart got weaker,” he says. “That’s when Dr. Hall transitioned me to an LVAD.”

A left ventricle assist device (LVAD) is a mechanical pumptype device that takes over for a failing left ventricle of the heart. For Wheeler and many others, it keeps their heart pumping until a transplant can be performed. The U.S. Food and Drug Administration also has approved an LVAD device for what’s known as destination therapy. This means it can be used as a permanent solution for patients who aren’t candidates for a transplant.

Wheeler had the LVAD for 10 months before receiving a new heart. He felt better and even took a vacation during that time. Since his transplant in the fall of 2009, Wheeler is working hard to keep his heart in good shape and his recovery is progressing nicely. “He has no limitations,” Dr. Hall says. For Wheeler, the third time was definitely the charm.

P A T I E N T S W I T H C O N G E S T I V E H E A R T F A I L U R E H A V E M O R E O P T I O N S T H A N E V E R

“As time wore on my heart got weaker,” he says. “That’s when Dr. Hall transitioned me to an LVAD.”

– Chad Wheeler

42 43

CARDIOVASCULAR CLINICAL TRIALS AND STUDIESVIRGO—a National Institutes of Health study to assess the psychosocial and genetic risk factors for acute MI in young women and men. Primary investigator: Cara East MD

VISTA—a study of the second anti-plaque medicine varespladib, which will be used for 16 weeks after an episode of acute coronary syndrome. Primary investigator: Cara East MD

Congestive Heart Failure:

Atmosphere—a study comparing the renin inhibitor aliskerin versus an ACE inhibitor versus the combination for cardiac events in patients with congestive heart failure. Primary investigator: Cara East MD

Defibrillators:

Adaptive CRT—a study comparing the ACRT algorithm with echo-guided optimization of bi-ventricular CRT. Primary investigator: Peter Wells MD

Vest Predicts—a study to see if an external automatic defibrillator vest will reduce overall mortality 60 days following an MI in patients with EF < 35%. Primary investigator: Jay Franklin MD

Gene Trials:

CHF genomic study—a pilot study to evaluate genes in acute decompensated congestive heart failure in patients with chronic heart failure and EF < 35%. Primary investigator: Paul Grayburn MD

Fabry’s—a study to screen for Fabry disease by looking at the Fabry gene GLA, the enzyme a-galactosidase A, and urinary globotriaosylceramide in patients with different types of heart

disease and compared to control patients. Primary investigator: Raphael Schiffmann MD MHSc

Hypertrophic cardiomyopathy—a study to develop a comprehensive screening tool for genes causing hypertrophic cardiomyopathy within affected families. Primary investigator: Paul Grayburn MD

Heart Surgery:

ATS valves—two studies evaluating the implantation of the ATS valve in special high-risk populations. Primary investigator: Robert Hebeler MD

CoreValve transcatheter valve—a study comparing surgical or transcatheter valve replacement in severe or critical aortic stenosis. Primary investigator: Robert Stoler MD, Robert Hebeler MD, Paul Grayburn MD

CT Pain—a study comparing continuous marcaine versus intermittent marcaine versus placebo infusions into chest tubes after heart surgery. Primary investigator: Robert Hebeler MD

Cardiothoracic Surgical Trial Network Moderate MR—a trial which randomizes patients with ischemic CM to CABG only versus CABG with mitral annuloplasty. Primary investigators: Michael Mack MD, Paul Grayburn MD, Robert Hebeler MD

Cardiothoracic Surgical Trial Network Severe MR—a trial which randomizes patients with severe MR to mitral valve replacement plus chordal sparing versus mitral valve annuloplasty. Primary investigators: Michael Mack MD, Paul Grayburn MD, Robert Hebeler MD

Recent Research Successes:

Cryoablation for atrial fibrillation—the Baylor research team enrolled the largest number of patients in the United States. The cryoablation balloon system will likely be released by the FDA soon, which could shorten atrial fibrillation ablation times and increase procedure success.

Dabigatran for atrial fibrillation—dabigatran, the first direct thrombin inhibitor for anticoagulation of patients with atrial fibrillation, was released to the US market on 1November2010.

Harvest Pilot trial—the stem cells used in this study resulted in a significant decrease in amputations in patients with critical limb ischemia, leading to the upcoming Harvest Pivotal trial.

CoreValve—the Baylor team competed to be one of 40 sites selected in the US for this study of implanting an aortic valve percutaneously versus standard surgery versus medical therapy for high risk or inoperable patients.

Actively Enrolling Studies:

Atrial fibrillation:

Cabana—a National Institutes of Health study comparing atrial fibrillation ablation and medical therapy for paroxysmal atrial fibrillation. Primary investigator: Robert Kowal MD

Crystal AF—a study of an arrhythmia monitoring device in patients who have had a cryptogenic stroke. Primary investigator: Manish Assar MD

Prevail—a study of a left atrial appendage occluder device in patients with atrial fibrillation versus warfarin therapy. Primary investigator: Kevin Wheelan MD

Coronary Artery Disease:

Aquarius—a study of the safety and efficacy of the renin inhibitor aliskerin added to standard medical therapy in patients with coronary artery disease. Primary investigator: Ravi Vallabhan MD

Educate—a study of clopidogrel plus ASA comparing 12 months versus 30 months post PCI for a drug-releasing stent. Primary investigator: Robert Stoler MD

Excel—a study of patients with left main or three vessel coronary artery disease comparing PCI versus CABG. Primary investigator: Robert Stoler MD

Liberte DAPT—a study of prasugrel plus ASA comparing 12 months versus 30 months post PCI for a drug-releasing stent. Primary investigator: Robert Stoler MD

Solid—a study of a novel anti-plaque medicine called darapladib which may promote reabsorption of plaque in acute coronary syndrome. Primary investigator: Cara East MD

US Pella—a registry to assess outcomes using a catheter-mounted, LVAD-like device for PCI. Primary investigator: Robert Stoler MD

44 45

CARDIOVASCULAR CLINICAL TRIALS AND STUDIES (Continued)Definitive LE—a study to determine the long-term effectiveness of a specific device for the treatment of peripheral plaque. Primary investigator: Jay Vasquez MD

Dissection Trial—a study following deployment issues and long-term effects of a graft implanted for acute, complicated type B aortic dissections. Primary investigator: William T Brinkman MD

Harvest Pivotal trial—a study implanting bone-marrow derived stem cells along lower extremity blood vessels in patients with critical limb ischemia. Primary investigator: Greg Pearl MD

Thrive—a study for follow up of endovascular repair of descending thoracic aortic aneurysms. Primary investigator: Dennis Gable MD

Viper—a study of an endoprosthesis with a heparin-bioactive surface for the treatment of peripheral arterial disease. Primary investigator: Dennis Gable MD

Pulmonary Hypertension:

PF study—a study of a long-acting phosphodiesterase inhibitor as monotherapy or in combination with other treatments for pulmonary hypertension. Primary investigator: Johannes Kuiper MD

Miscellaneous:

Precision—a study of the effects of ibuprofen, naproxen, or Celebrex on cardiac events in patients who take daily arthritis medicines. Primary investigator: Cara East MD

Stride—a cardiac evaluation of patients entering a drug rehabilitation program, randomized to an exercise program versus the usual intensive educational program. Primary investigator: Nexus Recovery Center.

Synergene—a cardiac evaluation of patients about to undergo chemotherapy with a p53 gene-treated liposome. Primary investigator: John Nemunaitis MD

Dabigatran for mechanical valves—a study comparing the direct thrombin inhibitor dabigatran versus warfarin for anticoagulation after mechanical valve implantation. Primary investigators: Robert Hebeler MD, Cara East MD

Harvest CABG—a study using bone-marrow derived stem cells to be implanted at the time of CABG surgery in areas of the heart to which adequate vascular grafting cannot be applied at the time of surgery. Primary investigator: Baron Hamman MD

NAPA-2—a study comparing nesiritide versus placebo for brain and kidney protection during CABG surgery. Primary investigator: Robert Hebeler MD

Proact/On-X valve—a study to investigate the lowest dose of anticoagulation needed for the carbon-based mechanical valve for severe aortic stenosis. Primary investigator: Baron Hamman MD

Realism—a continuing access registry of percutaneous mitral valve repair with a clip device in patients with severe mitral regurgitation. Primary investigator: Paul Grayburn MD

Victoria Registry—a study collecting clinical and imaging information on CABG grafts, to improve the quality of CABG surgery. Primary investigator: Baron Hammon MD

Kidney Disease and the Heart:

BOSS—a study comparing high dose bicarbonate versus

placebo in patients with chronic kidney disease undergoing catheterization or other procedures using contrast. Primary investigator: Robert Stoler MD

SAMe and renal insufficiency—a National Institutes of Health study to assess the effects of the over-the-counter antidepressant SAMe on homocysteine and related metabolic factors. Primary investigators: Teodoro Bottiglieri PhD, Andrew Fenves MD, Cara East MD

Pacing:

No Pain—a study comparing lidocaine versus marcaine versus the combination for reduction of postoperative pain and pain medications after new device implantation. Primary investigators: Udaya Padakandla MD, Giovanni Filardo PhD

Reset—a study to determine if rate-adaptive pacing can improve heart failure symptoms and chronotropic incompetence due to diastolic dysfunction. Primary investigator: Jay Franklin MD

SLS—a study to evaluate the long-term reliability and performance of market-released cardiac therapy products by analyzing survival probabilities. Primary investigator: Kevin Wheelan MD

Peripheral Vascular Disease:

Choice—a study comparing two different carotid stents in patients who are considered too high risk for carotid endarectomy. Primary investigator: Bruce Bowers MD

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B A Y L O R H E L P S A N A C T I V E P A T I E N T R E T U R N T O A F U L L L I F E A F T E R A H E A R T A T T A C K

“I’m so lucky there were trained people there to administer CPR and jump-start my heart with the AED. It’s because of them that I’m alive today.”

— Matt Kieffer

Running Like a Champion

Matt Kieffer was close to the end of a half marathon he and his wife, Jessica, had spent months training for. He was short of breath, but figured everyone was after running nearly 13.1 miles. That’s pretty much the last thing he remembers. Bystanders confirmed that he finished the race and then collapsed. Kieffer, 37, had experienced sudden cardiac arrest. Fortunately, there was a nurse behind him in the race and emergency responders on site with automated external defibrillators (AEDs).

After being discharged from the hospital where he was taken initially, Kieffer decided to seek a second opinion at Baylor. He met with a cardiac electrophysiologist on the medical staffs at the Baylor Hamilton Heart and Vascular Hospital and Baylor University Medical Center at Dallas. Although they looked into every possible cause for Kieffer’s cardiac event, the team at Baylor didn’t find anything conclusive, which is typical in between 40 to 60 percent of cases of sudden cardiac arrest.

“We don’t necessarily know what happened,” says Robert C. Kowal, M.D., Ph.D., a cardiac electrophysiologist on the medical staffs at the Baylor Hamilton Heart and Vascular Hospital and Baylor Dallas, “but there’s technology to try to keep him from dying if it happens again.”

An implantable cardioverter defibrillator (ICD) was surgically placed between the skin and the muscle on Kieffer’s upper chest. The device monitors every heartbeat and, if it detects an abnormal heart rhythm it delivers a shock to restore normal rhythm in less than 30 seconds. “For any type of cardiac arrest, the survival rate without an ICD is between 2 and 15 percent depending on the time it takes emergency responders to arrive,” Dr. Kowal says. “With an ICD, the survival rate is typically between 95 and 98 percent.”

Kieffer is back to his active lifestyle and barely notices the ICD — except for the peace of mind it gives him.“Without this device,” he says, “I’d probably spend the rest of my life worrying about what might happen to me and my wife and kids.”

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PHYSICIAN PUBLICATIONS 2009

Journal Articles

Adams J, Julian P, Hubbard M, Hartman J, Baugh S, Segrest W, Russell J, McDonnell J, Wheelan K. A randomized controlled trial of a controlled breathing protocol on heart rate variability following myocardial infarction or coronary artery bypass graft surgery. Clinical Rehabilitation 2009;23:782-9.

Albert NM, Fonarow GC, Abraham WT, Gheorghiade M, Greenberg BH, Nunez E, O’Connor CM, Stough WG, Yancy CW, Young JB. Depression and Clinical Outcomes in Heart Failure: An OPTIMIZE-HF Analysis. American Journal of Medicine 2009;122:366-373.

Albert NM, Yancy CW, Liang L, Zhao X, Hernandez AF, Peterson ED, Cannon CP, Fonarow GC. Use of Aldosterone Antagonists in Heart Failure. Jama-Journal of the American Medical Association 2009;302:1658-1665.

Ambardekar AV, Fonarow GC, Hernandez AF, Pan W, Yancy CW, Krantz MJ. Characteristics and in-hospital outcomes for nonadherent patients with heart failure: Findings from Get With The Guidelines-Heart Failure (GWTG-HF). American Heart Journal 2009;158:644-652.

Araj F, Markham DW, Fernandez L, Thompson BS, Ayers CR, Patel PC, Mammen PPA, Drazner MH, Yancy CW. Long-Term Adherence to Evidence-Based Care and Outcomes of Black and Whites With Heart Failure: A Review of the UT Southwestern Heart Failure Database, 1996-2005. Journal of the American College of Cardiology 2009;53:A153 Supplement 1.

Bayram M, Yancy CW. Transthoracic Impedance Cardiography: A Noninvasive Method of Hemodynamic Assessment. Heart Failure Clinics 2009;5:161-168.

Ben Johnson W, Abraham WT, Young JB, Wheelan K, Smith AL, Chang YP, Brinkman P, InSync Registry I. Long-Term Performance of the Attain Model 4193 Left Ventricular Lead. Pace-Pacing and Clinical Electrophysiology 2009;32:1111-1116.

Brunson JM, Fine RL, Schussler JM. Acute Ascending Aortic Dissection Diagnosed with Transthoracic Echocardiography. Journal of the American Society of Echocardiography 2009;22:1086.e5-1086.e7.

Chai R, Chen S, Ding J, Grayburn PA. Efficient, glucose responsive and islet-specific transgene expression by a modified rat insulin promoter. Gene Therapy 2009;16:1202-1209.

Curtis AB, Yancy CW, Albert NM, Stough WG, Gheorghiade M, Heywood JT, McBride ML, Mehra MR, Oconnor CM, Reynolds D, Walsh MN, Fonarow GC. Cardiac resynchronization therapy utilization for heart failure: Findings from IMPROVE HF. American Heart Journal 2009;158:956-964.

Ezekowitz JA, Hernandez AF, Starling RC, Yancy CW, Massie B, Hill JA, Krum H, Diaz R, Ponikowski P, Metra M, Howlett JG, Gennevois D, O’Connor CM, Califf RM, Fonarow GC. Standardizing care for acute decompensated heart failure in a large megatrial: The approach for the Acute Studies of Clinical Effectiveness of Nesiritide in Subjects with Decompensated Heart Failure (ASCEND-HF). American Heart Journal 2009;157:219-228.

Falcone AM, Schussler JM. Sudden atrial fibrillation associated with acutealcohol ingestion and cor triatriatum. Proceedings (Baylor Univ Med Cent). 2009 Oct;22(4):335-6. PubMed PMID: 19865505; PubMed Central PMCID: PMC2760166.

Fazel P, Peterman MA, Schussler JM. Three-Year Outcomes and Cost Analysis in Patients Receiving 64-Slice Computed Tomographic Coronary Angiography for Chest Pain. American Journal of Cardiology 2009;104:498-500.

Fazel P, Roberts BJ, Brooks J, Grayburn PA. Echocardiographic findings in professional hockey players. Baylor University Medical Center Proceedings 2009;22:218-220.

Feldman T, Kar S, Rinaldi M, Fail P, Hermiller J, Smalling R, Whitlow PL, Gray W, Low R, Herrmann HC, Lim S, Foster E, Glower D, EVEREST Investigators (Grayburn, PA). Percutaneous mitral repair with the MitraClip system: safety and midterm durability in the initial EVEREST (Endovascular Valve Edge-to-Edge REpair Study) cohort. Journal of the American College of Cardiology 2009;54:686-94.

Filardo G, Hamilton C, Hamman B, Hebeler Jr RF, Grayburn PA. Relation of Obesity to Atrial Fibrillation After Isolated Coronary Artery Bypass Grafting. American Journal of Cardiology 2009;103:663-666.

Filardo G, Hamilton C, Hamman B, Hebeler RF, Grayburn P. Association between new onset postcoronary artery bypass graft atrial fibrillation and body habitus measures and gender. Journal of the American College of Cardiology 2009;53:A351 Supplement 1.

Filardo G, Hamilton C, Hebeler Jr RF, Hamman B, Grayburn P. New-onset post-operative atrial fibrillation following isolated coronary artery bypass graft surgery and long-term survival. Circulation: Cardiovascular Quality Outcomes 2009;2:164-169.

Filardo G, Hamilton C, Hamman B, Hebeler R, Grayburn P. New-onset Post-operative Atrial Fibrillation Following Aortic Valve Replacement Surgery and Long-term Survival. Circulation 2009;120:S767-S767.

Flaherty JD, Rossi JS, Fonarow GC, Nunez E, Stough WG, Abraham WT, Albert NM, Greenberg BH, O’Connor CM, Yancy CW, Young JB, Davidson CJ, Gheorghiade M. Influence of coronary angiography on the utilization of therapies in patients with acute heart failure syndromes: Findings from Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF). American Heart Journal 2009;157:1018-1025.

Fonarow GC, Abraham WT, Albert NM, Stough WG, Gheorghiade M, Greenberg BH, O’Connor CM, Sun JL, Yancy CW, Young JB. Age- and Gender-Related Differences in Quality of Care and Outcomes of Patients Hospitalized With Heart Failure (from OPTIMIZE-HF). American Journal of Cardiology 2009;104:107-115.

Forman DE, Cannon CP, Hernandez AF, Liang L, Yancy CW, Fonarow GC. Influence of age on the management of heart failure: Findings from Get With the Guidelines-Heart Failure (GWTG-HF). American Heart Journal 2009;157:1010-1017.

Gheorghiade M, Adams KF, Cleland JG, Cotter G, Felker GM, Filippatos GS, Fonarow GC, Greenberg BH, Hernandez AF, Khan S, Komajda M, Konstam MA, Liu PP, Maggioni AP, Massie BM, McMurray JJ, Mehra M, Metra M, O’Connell J, O’Connor CM, Pang PS, Pià IL, Sabbah HN, Teerlink JR, Udelson JE, Yancy CW, Zannad F, Stockbridge N. Phase III clinical trial end points in acute heart failure syndromes: a virtual roundtable with the Acute Heart Failure Syndromes International Working Group. American Heart Journal 2009;157:957-970.

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PHYSICIAN PUBLICATIONS 2009 (Continued)

Gibbons RJ, Gardner TJ, Anderson JL, Goldstein LB, Meltzer N, Weintraub WS, Yancy CW. The american heart association’s principles for comparative effectiveness research: A policy statement from the american heart association. Circulation 2009;119:2955-2962.

Golarz SR, Chu T-HB, Vasquez J. Endovascular placement of the venous limb of a dialysis access graft using a Gore TAG introducer sheath in a patient with a difficult access. Baylor University Medical Center Proceedings 2009;22:221-222.

Golarz SR, Hohmann S. Obstruction of the celiac axis resulting in a pancreaticoduodenal artery aneurysm. Baylor University Medical Center Proceedings 2009;22:330-331.

Hamman BL, Theologes TT. Surgical treatment of atrial fibrillation with diode-pumped laser. Baylor University Medical Center Proceedings 2009;22:230-233.

Hammill BG, Curtis LH, Fonarow GC, Heidenreich PA, Yancy CW, Peterson ED, Hernandez AF. Incremental Value of Clinical Data Beyond Claims to Predict 30-Day Outcomes Following Heart Failure Admission: Results From the AHA’s Get With the Guidelines-Heart Failure Registry. Circulation 2009;120:S394-S395.

Horwich TB, Hernandez AF, Liang L, Albert NM, LaBresh KA, Yancy CW, Fonarow GC. Weekend hospital admission and discharge for heart failure: Association with quality of care and clinical outcomes. American Heart Journal 2009;158:451-458.

Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, Jessup M, Konstam MA, Mancini DM, Michl K, Oates JA, Rahko PS, Silver MA, Stevenson LW, Yancy CW. 2009 Focused Update Incorporated Into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults. A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines Developed in Collaboration With the International Society for Heart and Lung Transplantation. Journal of the American College of Cardiology 2009;53:e1-e90.

Jacobi JA, Schussler JM, Johnson KB. Routine femoral head flouroscopy to reduce complications in coronary catheterization. Baylor University Medical Center Proceedings 2009;22:7-8.

Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG, Konstam MA, Mancini DM, Rahko PS, Silver MA, Stevenson LW, Yancy CW. 2009 Focused Update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults. A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines Developed in Collaboration With the International Society for Heart and Lung Transplantation. Journal of the American College of Cardiology 2009;53:1343-1382.

Johnson WB, Abraham WT, Young JB, Wheelan K, Smith AL, Chang Y, Brinkman P. Long-term performance of the attain model 4193 left ventricular lead. PACE - Pacing and Clinical Electrophysiology 2009;32:1111-1116.

Jones RH, Velazquez EJ, Michler RE, Sopko G, Oh JK, O’Connor CM, Hill JA, Menicanti L, Sadowski Z, Desvigne-Nickens P, Rouleau JL, Lee KL, STICH Hypothesis 2 Investigators (Grayburn, PA). Coronary bypass surgery with or without surgical ventricular reconstruction. New England Journal of Medicine 2009;360:1705-17.

Kamath SA, Drazner MH, Tasissa G, Rogers JG, Stevenson LW, Yancy CW. Correlation of impedance cardiography with invasive hemodynamic measurements in patients with advanced heart failure: The BioImpedance CardioGraphy (BIG) substudy of the Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness (ESCAPE) Trial. The American Heart Journal 2009;158:217-223.

Kedora J, Grimsley B, Pearl G. Endovascular treatment of an aberrant right subclavian artery aneurysm with use of the Zenith iliac plug. Baylor University Medical Center Proceedings 2009;22:144-145.

Kowal RC. Predicting Outcome from AF Ablation: Size of the Chamber, or Is Tissue the Issue? Journal of Cardiovascular Electrophysiology 2009;20:1011-1013.

Main ML, Goldman JH, Grayburn PA. Ultrasound contrast agents: balancing safety versus efficacy. Expert Opinion on Drug Safety 2009;8:49-56.

Mantas AM, Carry MM. Sinus of Valsalva aneurysm. Baylor University Medical Center Proceedings 2009;22:338.

Markham, D. W., L. T. Fernandez, C. H. Debes, B. S. Thompson, C. R. Ayers, P. P. A. Mammen, P. C. Patel, Yancy CW, and M. H. Drazner. “Initial Bnp Level at Time of Referral Predicts Long-Term Mortality: A Retrospective Review of the UT Southwestern Heart Failure Database.” Journal of Cardiac Failure 15, no. 6 (2009): 353.

McNamara DM, Tam SW, Sabolinski ML, Tobelmann P, Janosko K, Venkitachalam L, Ofili E, Yancy CW, Feldman AM, Ghali JK, Taylor AL, Cohn JN, Worcel M. Endothelial Nitric Oxide Synthase (NOS3) Polymorphisms in African Americans With Heart Failure: Results From the A-HeFT Trial. Journal of Cardiac Failure 2009;15:191-198

McQuade K, Gable D, Hohmann S, Pearl G, Theune B. Randomized comparison of ePTFE/nitinol self-expanding stent graft vs prosthetic femoral-popliteal bypass in the treatment of superficial femoral artery occlusive disease. Journal of Vascular Surgery 2009;49:109-15, 116 e1-9; discussion 116.

Mehra MR, Yancy CW, Albert NM, Curtis AB, Stough WG, Gheorghiade M, Heywood JT, McBride ML, O’Connor CM, Reynolds D, Walsh MN, Fonarow GC. Evidence of clinical practice heterogeneity in the use of implantable cardioverter-defibrillators in heart failure and post-myocardial infarction left ventricular dysfunction: Findings from IMPROVE HF. Heart Rhythm 2009;6:1727-1734.

Naffe A, Iype M, Easo M, McLeroy SD, Pinaga K, Vish N, Wheelan K, Franklin J, Adams J. Appropriateness of sling immobilization to prevent lead displacement after pacemaker/implantable cardioverter-defibrillator implantation. Baylor University Medical Center Proceedings 2009;22:3-6.

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PHYSICIAN PUBLICATIONS 2009 (Continued)

Nemunaitis MC, Schussler JM, Shiller SM, Sloan LM, Mennel RG. Primaryeffusion lymphoma diagnosed by pericardiocentesis. Proceedings (Baylor Univ Med Cent). 2009 Jan;22(1):77-80. PubMed PMID: 19169406; PubMed Central PMCID: PMC2626366.

Noguchi H, Matsumoto S, Onaca N, Naziruddin B, Jackson A, Ikemoto T, Shimoda M, Fujita Y, Chujo D, Iwanaga Y, Nagata H, Okitsu T, Kobayashi N, Ueno H, Chaussabel D, Grayburn P, Banchereau J, Levy MF. Ductal injection of JNK inhibitors before pancreas preservation prevents islet apoptosis and improves islet graft function. Human Gene Therapy 2009;20:73-85.

Patel PC, Singh KP, Seglem EJ, Ayers CR, Fitzsimmons CI, Kaiser PA, DiMaio JM, Ring WS, Yancy CW, Mammen PPA, Drazner MH, Meyer DM, Markham DW. Desensitization therapy is associated with improved survival to transplant in sensitized patients bridged with a left ventricular assist device. Journal of Heart and Lung Transplantation 2009:28:S83.

Patel S, Grayburn PA, High ST, Rosnes J, Choi JW. Usefulness of serial brain natriuretic peptide measurements for managing aortic valve stenosis in pregnancy. Baylor University Medical Center Proceedings 2009;22:226-229.

Peacock WF, Fonarow GC, Ander DS, Collins SP, Gheorghiade M, Kirk JD, Filippatos G, Diercks DB, Trupp RJ, Hiestand B, Amsterdam EA, Abraham WT, Dodge G, Gaieski DF, Gurney D, Hayes CO, Hollander JE, Holmes K, Januzzi Jr JL, Levy P, Maisel A, Miller CD, Pang PS, Selby E, Storrow AB, Weintraub NL, Yancy CW, Bahr RD, Blomkalns AL, McCord J, Nowak RM, Stomel RJ. Society of Chest Pain Centers recommendations for the evaluation and management of the observation stay acute heart failure patient-parts 1-6. Acute Cardiac Care 2009;11:3-42.

Peterson E, Yancy CW. Eliminating Racial and Ethnic Disparities in Cardiac Care. New England Journal of Medicine 2009;360:1172-1174.

Reese EA, Grayburn PA, Hebeler RF, Rothstein JM, Schussler JM. Preoperative visualization of an atrial septal defect by 64-slice cardiac computed tomography. Baylor University Medical Center Proceedings 2009;22:234-235.

Roberts WC, Bose R, Ko JM, Henry AC, Hamman BL. Identifying Cardiovascular Syphilis at Operation. American Journal of Cardiology 2009;104:1588-1594.

Roberts WC, Lensing FD, Kourlis H, Ko JM, Newberry JW, Smerud MJ, Burton EC, Hebeler RF. Full Blown Cardiovascular Syphilis with Aneurysm of the Innominate Artery. American Journal of Cardiology 2009;104:1595-1600.

Roberts WC, Velasco CE, Ko JM, Matter GJ. Comparison of the quantity of calcific deposits in bovine pericardial bioprostheses in the mitral and aortic valve positions in the same patient late after double-valve replacement. Journal of Thoracic and Cardiovascular Surgery 2009;138:1448-1450.

Roberts WC, Vowels TJ, Ko JM, Capehart JE, Hall SA. Cardiac transplantation for cardiac sarcoidosis with initial diagnosis by examination of the left ventricular apical “core” excised for insertion of a left ventricular assist device for severe chronic heart failure. American Journal of Cardiology 2009;103:110-4.

Schussler JM, White CH, Fontes MA, Master SA, Hamman BL. Spyder Proximal Coronary Vein Graft Patency over Time: The SPPOT Study. Heart Surgery Forum 2009;12:E49-53.

Shah B, Hernandez AF, Liang L, Al-Khatib SM, Yancy CW, Fonarow GC, Peterson ED. Hospital Variation and Characteristics of Implantable Cardioverter-Defibrillator Use in Patients With Heart Failure. Data From the GWTG-HF (Get With The Guidelines-Heart Failure) Registry. Journal of the American College of Cardiology 2009;53:416-422.

Sharma PS, Lubahn JG, Donsky AS, Yoon ADH, Carry MM, Grayburn PA, Wood PB, Ko JM, Burton EC, Roberts WC. Diagnosing cardiac sarcoidosis clinically without tissue confirmation. Baylor University Medical Center Proceedings 2009;22:236-238.

Shimoda M, Chen SY, Noguchi H, Matsumoto S, Grayburn PA. In vivo non-viral gene delivery of human vascular endothelial growth factor improves human islet survival and function after transplantation. Xenotransplantation 2009;16:315-315.

Shimoda M, Chen SY, Noguchi H, Matsumoto S, Grayburn PA. NeuroD1 directs differentiation of cytokeratin 19-positive human pancreatic non-endocrine cells into insulin producing cells. Xenotransplantation 2009;16:324-325.

Shimoda M, Noguchi H, Naziruddin B, Fujita Y, Chujo D, Takita M, Peng H, Tamura Y, Olsen G, Sugimoto K, Itoh T, Onaca N, Levy MF, Grayburn PA, Matsumoto S. Assessment of human islet isolation with four different collagenases. Xenotransplantation 2009;16:322-322.

Shimoda M, Noguchi H, Naziruddin B, Fujita Y, Chujo D, Takita M, Peng H, Tamura Y, Olsen G, Sugimoto K, Itoh T, Onaca N, Levy MF, Grayburn PA, Matsumoto S. Improved method of human islet isolation for young donors. Xenotransplantation 2009;16:323-323.

Wong SC, Bachinsky W, Cambier P, Stoler R, Janah A, Rogers J, Hermiller J, Nair R, Hutman H, Wang H, et al. A Randomized Comparison of a Novel Bioabsorbable Vascular Closure Device Versus Manual Compression in the Achievement of Hemostasis After Percutaneous Femoral Procedures. J Am Coll Cardiol Intv, 2009; 2:785-793.

Yancy CW, Feldman A. Isosorbide Dinitrate and Hydralazine as Therapy for African Americans with Heart Failure; a Failed Paradigm? CTS-Clinical and Translational Science 2009;2:309-311.

Yancy CW, Fonarow GC, Albert NM, Curtis AB, Stough WG, Gheorghiade M, Heywood JT, McBride ML, Mehra MR, O’Connor CM, Reynolds D, Walsh MN. Influence of patient age and sex on delivery of guideline-recommended heart failure care in the outpatient cardiology practice setting: Findings from IMPROVE HF. American Heart Journal 2009;157:754-762.e2.

Zoghbi WA, Chambers JB, Dumesnil JG, Foster E, Gottdiener JS, Grayburn PA, Khandheria BK, Levine RA, Marx GR, Miller Jr FA, Nakatani S, Quiñones MA, Rakowski H, Rodriguez LL, Swaminathan M, Waggoner AD, Weissman NJ, Zabalgoitia M. Recommendations for Evaluation of Prosthetic Valves With Echocardiography and Doppler Ultrasound. A Report From the American Society of Echocardiography’s Guidelines and Standards Committee and the Task Force on Prosthetic Valves, Developed in Conjunction With the American College of Cardiology Cardiovascular Imaging Committee, Cardiac Imaging Committee of the American Heart Association. Journal of the American Society of Echocardiography 2009;22:975-1014.

Book ChaptersEchols M, Yancy CW. Heart Failure in Racial/Ethnic Groups. In: Ferdinand K, Armani A, eds. Cardiovascular Disease in Racial and Ethnic Minorities: Humana Press, 2009.

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PHYSICIAN PUBLICATIONS 2010

Journal Articles

Albert NM, Fonarow GC, Yancy CW, Curtis AB, Stough WG, Gheorghiade M, Heywood JT, McBride M, Mehra MR, O’Connor CM, Reynolds D, Walsh MN. Influence of dedicated heart failure clinics on delivery of recommended therapies in outpatient cardiology practices: Findings from the Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting (IMPROVE HF). American Heart Journal 2010;159.

Albert NM, Fonarow GC, Yancy CW, Curtis AB, Stough WG, Gheorghiade M, Heywood JT, McBride M, Mehra MR, O’Connor CM, Reynolds D, Walsh MN. Outpatient Cardiology Practices With Advanced Practice Nurses and Physician Assistants Provide Similar Delivery of Recommended Therapies (Findings from IMPROVE HF). American Journal of Cardiology 2010;105:1773-1779.

Ayad RF, Assar MD, Simpson L, Garner JB, Schussler JM. Causes and management of drug-induced long QT syndrome. Baylor University Medical Center Proceedings 2010;23:250-255.

Bhella PS, Hassan Y, Schussler JM. Usefulness of 64-slice coronary computed tomographic angiography in the planning of percutaneous coronary intervention. Baylor University Medical Center Proceedings 2010;23:27-28.

Bose R, Choi JW. Successful Percutaneous Retrieval of Methyl Methacrylate Orthopedic Cement Embolism From the Pulmonary Artery. Catheterization and Cardiovascular Interventions 2010;76:198-201.

Bruckner BA, Bull D, Hammond B, Ali G, Elmar B, Matthias L, Michael RJ, Perryman L, Smedira N, Lattouf O, Bunge RR, Patel A. Impact-DCM: A Randomized, Controlled, Multi-Center Phase II Trial Utilizing Expanded Autologous Bone Marrow As Sole Therapy for Dilated Cardiomyopathy. Journal of Heart and Lung Transplantation 2010;29:233.

Cannon LA, Kereiakes DJ, Ghali M, Stoler R, Caputo R, Yakubov S, Hood K, Underwood P, Dawkins KD. The TAXUS Element Paclitaxel-Eluting Stent in Patients with and without Diabetes: Twelve-Month Outcomes of the PERSEUS Clinical Studies. JACC Vol 56/13/Suppl B 2010; B52; TCT-223

East C, Willis BL, Barlow CE, Grannemann BD, Fitzgerald SJ, Defina LF, Trivedi MH. Depressive Symptoms and Metabolic Syndrome in Preventive Healthcare: The Cooper Center Longitudinal Study. Metabolic Syndrome and Related Disorders 2010. [Epub ahead of print]

Evangelista LS, Rasmusson KD, Laramee AS, Barr J, Ammon SE, Dunbar S, Ziesche S, Patterson JH, Yancy CW. Health Literacy and the Patient With Heart Failure-Implications for Patient Care and Research: A Consensus Statement of the Heart Failure Society of America. Journal of Cardiac Failure 2010;16:9-16.

Exuzides A, Main ML, Colby C, Grayburn PA, Feinstein SB, Goldman JH. A Retrospective Comparison of Mortality in Critically Ill Hospitalized Patients Undergoing Echocardiography With and Without an Ultrasound Contrast Agent. JACC-Cardiovascular Imaging 2010;3:578-585.

Filardo G, Hamilton C, Hamman B, Hebeler Jr RF, Adams J, Grayburn P. New-onset postoperative atrial fibrillation and long-term survival after aortic valve replacement surgery. Annals of Thoracic Surgery 2010;90:474-479.

Fonarow GC, Albert NM, Curtis AB, Stough WG, Gheorghiade M, Heywood JT, McBride ML, Inge PJ, Mehra MR, O’Connor CM, Reynolds D, Walsh MN, Yancy CW. Improving Evidence-Based Care for Heart Failure in Outpatient Cardiology Practices Primary Results of the Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting (IMPROVE HF). Circulation 2010;122:585-596.

Friedewald VE, Cohn LH, Kelly JP, Roberts R, Wesson DE, Willerson JT, Yancy CW, Roberts WC. The Editor’s Roundtable: Health Reform and Its Implications for Cardiovascular Medicine. American Journal of Cardiology 2010;105:557-565.

Golarz SR, Grimsley B. Use of Wall Stent to Exclude a Thrombosed Inferior Vena Cava Filter. Annals of Vascular Surgery 2010;24.

Grayburn PA, Bhella P. Grading Severity of Mitral Regurgitation by Echocardiography: Science or Art? JACC: Cardiovascular Imaging 2010;3:244-246.

Hernandez AF, Fonarow GC, Hammill BG, Al-Khatib SM, Yancy CW, O’Connor CM, Schulman KA, Peterson ED, Curtis LH. Clinical Effectiveness of Implantable Cardioverter-Defibrillators Among Medicare Beneficiaries With Heart Failure. Circulation-Heart Failure 2010;3:7-13.

Heywood JT, Fonarow GC, Yancy CW, Albert NM, Curtis AB, Stough WG, Gheorghiade M, McBride ML, Mehra MR, O’Connor CM, Reynolds D, Walsh MN. Influence of Renal Function on the Use of Guideline-Recommended Therapies for Patients With Heart Failure. American Journal of Cardiology 2010;105:1140-1146.

Heywood JT, Fonarow GC, Yancy CW, Albert NM, Curtis AB, Gheorghiade M, Inge PJ, McBride ML, Mehra MR, O’Connor CM, Reynolds D, Walsh MN. Comparison of Medical Therapy Dosing in Outpatients Cared for in Cardiology Practices With Heart Failure and Reduced Ejection Fraction With and Without Device Therapy Report From IMPROVE HF. Circulation-Heart Failure 2010;3:596-605.

Ishizawar D, Yancy CW. Racial Differences in Heart Failure Therapeutics. Heart Failure Clinics 2010;6:65-74.

Lin BA, Forouhar AS, Pahlevan NM, Anastassiou CA, Grayburn PA, Thomas JD, Gharib M. Color Doppler jet area overestimates regurgitant volume when multiple jets are present. Journal of the American Society of Echocardiography 2010;23:993-1000.

McQuade K, Gable D, Pearl G, Theune B, Black S. Four-year randomized prospective comparison of percutaneous ePTFE/nitinol self-expanding stent graft versus prosthetic femoral-popliteal bypass in the treatment of superficial femoral artery occlusive disease. Journal of Vascular Surgery 2010;52:584-591.

Patel PC, Reimold SC, Araj FG, Ayers CR, Kaiser PA, Peshock RM, Yancy CW, Ring WS, Gupta S, Mishkin JD, Mammen PPA, Markham DW, Drazner MH. Concentric left ventricular hypertrophy as assessed by cardiac magnetic resonance imaging and risk of death in cardiac transplant recipients. Journal of Heart and Lung Transplantation. IN PRESS

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PHYSICIAN PUBLICATIONS 2010 (Continued)

Patel PC, Reimold SC, Araj FG, Kaiser PA, Peshock RM, Yancy CW, Ring WS, Gupta S, Mishkin JD, Mammen PPA, Markham DW, Drazner MH. Increased LV Mass and Concentricity as Assessed by Cardiac MRI Are Associated with Increased Mortality in Cardiac Transplant Recipients. Journal of Heart and Lung Transplantation 2010;29:328.

Roberts WC, Ko JM, Kuiper JJ, Hall SA, Meyer DM. Some Previously Neglected Examples of Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy and Frequency of Its Various Reported Manifestations. American Journal of Cardiology 2010;106:268-274.

Roberts WC, Ko JM, Schumacher JR, Henry Iii AC. Combined mitral and aortic stenosis of rheumatic origin with double-valve replacement in an octogenarian. International Journal of Cardiology 2010;140.

Rosenthal RL, Grimsley BR. Kinked Carotids. The New England Journal of Medicine 2010;362:44

Schussler JM, Grayburn PA. Contrast Guided Two-Dimensional Echocardiography for Needle Localization During Pericardiocentesis: A Case Report. Journal of the American Society of Echocardiography 2010;23:683e.1-683e.2.

Shimoda M, Chen S, Noguchi H, Matsumoto S, Grayburn PA. In vivo non-viral gene delivery of human vascular endothelial growth factor improves revascularisation and restoration of euglycaemia after human islet transplantation into mouse liver. Diabetologia 2010;53:1669-1679.

Shimoda M, Chen S, Noguchi H, Matsumoto S, Grayburn PA. Neurogenic Differentiation 1 Directs Differentiation of Cytokeratin 19-Positive Human Pancreatic Nonendocrine Cells into Insulin-Producing Cells. Transplantation Proceedings 2010;42:2071-2074.

Simpson L, Bhella P, Schussler JM, Grayburn PA, Assar MD. Pacemaker laser lead extraction and reimplantation of dual-chamber implantable cardioverter defibrillator via Mustard baffle in complete transposition of great arteries. Baylor University Medical Center Proceedings 2010;23:256-258.

Walsh MN, Yancy CW, Albert NM, Curtis AB, Gheorghiade M, Heywood JT, Inge PJ, McBride ML, Mehra MR, O’Connor CM, Reynolds D, Fonarow GC. Equitable Improvement for Women and Men in the Use of Guideline-Recommended Therapies for Heart Failure: Findings From IMPROVE HF.Journal of Cardiac Failure. IN PRESS

Walsh MN, Yancy CW, Albert NM, Curtis AB, Stough WG, Gheorghiade M, Heywood JT, McBride ML, Mehra MR, O’Connor CM, Reynolds D, Fonarow GC. Electronic health records and quality of care for heart failure. American Heart Journal 2010;159:635-642.e1.

Wu RS, Gupta S, Brown RN, Yancy CW, Wald JW, Kaiser P, Kirklin NM, Patel PC, Markham DW, Drazner MH, Garry DJ, Mammen PPA. Clinical outcomes after cardiac transplantation in muscular dystrophy patients. Journal of Heart and Lung Transplantation 2010;29:432-438.

Yancy CW. Transformation of Cardiovascular Health Presidential Address at the American Heart Association 2009 Scientific Sessions. Circulation 2010;121:2773-U121.

Yancy CW, Fonarow GC, Albert NM, Curtis AB, Stough WG, Gheorghiade M, Heywood JT, McBride ML, Mehra MR, O’Connor CM, Reynolds D, Walsh MN. Adherence to Guideline-Recommended Adjunctive Heart Failure Therapies Among Outpatient Cardiology Practices (Findings from IMPROVE HF).American Journal of Cardiology 2010;105:255-260.

Book Chapters

Yancy CW. Device Therapy for Left Ventricular Dysfunction. In: Maisel WH, ed. Device Therapy in Heart Failure. New York: Humana Press, 2010.

Schussler JM. An Interventionalist’s Perspective: Diagnosis of Cardiovascular Disease. In: Budoff MJ, Shinbane JS, eds. Cardiac CT Imaging. London: Springer, 2010:309-320.

EMPLOYEE RESEARCH AND PUBLICATIONS

J. Adams, K. Spencer, S. Jordan, J. Schneider, D. Cheng, K. Kennedy, T. Shock. Cardiac Rehabilitation of a 77 Year old male runner: Consideration of the athlete, not the age. JCRP - Journal. Vol 30, No.4. July/Aug 10

J. Adams, J. Schneider, M. Hubbard, T. McCullough-Shock, D. Cheng, K. Simms, J. Hartman, P. Hinton, D. Strauss. Baylor University Medical Center Proceedings. Vol 23, No.1 January 2010. Measurement of Functional capacity requirements of police officers to aid in development of an occupation-specific cardiac rehabilitation training program. Research Study - Published.

J. Adams, J. Roberts, K. Simms, D. Cheng, J. Hartman, C. Bartlett. The American Journal of Cardiology. Measurement of Functional capacity Requirements to Aid in development of occupation-specific rehabilitation training program to help firefighters with cardiac disease safely to return to work. March 15, 2009. RESEARCH STUDY - Published

J. Adams, M. Hubbard, J. Hartman, S. Baugh, W. Segrest, J. McDonald, J. Russell, K. Wheelan. A randomized controlled trial of a controlled breathing protocol on heart rate variability following myocardial infarction or coronary artery bypass graft surgery. Clinical Rehabilitation, 2009 Vol 23, No.9A

58 59

ACCELERATING BEST CARE AT BAYLOR (ABC BAYLOR)

Baylor Health Care System is committed to ensuring that health care providers have the tools needed to deliver health care in a safe, timely, effective, efficient, equitable, and patient-centered (STEEEP) manner. Accelerating Best Care is an innovative educational program focused on health care quality improvement, outcomes management, and staff development. It facilitates the enhancement of skills that lead to quality improvement efforts. ABC courses train participants in rapid cycle improvement processes, which is based on the Plan-Do-Check-Act model.

ABC Baylor course objectives are to teach the core principles of clinical quality improvement and include Rapid Cycle Improvement, design of data systems, data management, tools to improve outcomes, clinical practice guidelines and customer service.

At Baylor Heart and Vascular Hospital, it is a requirement for all nurse leaders/supervisors to complete the ABC Baylor course. We also included council chairs to further enhance their knowledge to assist others to implement rapid cycle improvement projects. The following is a list of completed ABC Baylor projects for the FY2010:

Plate Presentation and Standardization

Nancy Vish, RN, PhD, NEA-BC, FACHE

Project Leader: Carrie Johnson, MS, RD, LD

Cecilia Lijauco, MSN, RN

Edwin Fairhurst

Maria Rosales

George McGibboney

Lea Ann England, BSN, RN

Pharmacist – Patient Education

Nancy Vish, RN, PhD, NEA-BC, FACHE

Project Leader: Tammy Cohen, PharmD, MS

Thanh Lao

Tuyet Ngo

Evelyn Nwosu

Binu Ninan

Lea Ann England, BSN, RN

John Brower

Cecilia Lijauco, MSN, RN

Improving Outpatient Registration

Nancy Vish, RN, PhD, NEA-BC, FACHE

Project Leader: Carmen D. Jones

Trey Wicke

Gwen Galloway

Naytasha Beasley

Yvonne Jackson

Linda Lathrop-Dickerson

Antoinette Mills

Guinnis West

Becky Mann

Brenda Poil

Susan Mueller

ABC PROJECT TITLE TEAM MEMBERS

ABC PROJECT TITLE TEAM MEMBERS ABC PROJECT TITLE TEAM MEMBERS

Radiology Exam Dictation Leigh Ann Dibble R.T. (R), CIRCC

Project Leader: Andres Sisneros, R.T. (R)

Sara Keidel

Mike Gonzales, BSN, RN

George DeRogatis, R.T. (R) (CT)

Maria Gomez

D. Dockery, MD

M. Smerud, MD

JR Ayala, RT(R)

Daye Clayton, RT(R), (CV)

Bill Fenton, RT(R)

Scotty Pate, RT(R)

David Siren, RT(R),(CT)

Lisa Tadlock, RT(R),BS

Luz Vasquez, RT (R),(CV)

Colleen Wells, RT(R)

Monitoring Intake/Outputs and Daily Weights

Nancy Vish, RN, PhD, NEA-BC, FACHE

Project Leader: Dianne Newman, MSN, RN, CCRN

Mini Iype, MSN, RN, RN-BC

Paul St. Laurent, MSN, RN, ACNP, CCRN

LeaAnn England

Kristina Hahn RN

Stacy Yohanan RN

Mellody Rose RN

Ron Winston

Charles Jefferson

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ACCELERATING BEST CARE AT BAYLOR (ABC BAYLOR) Continued

Universal Medication List Nancy Vish, RN, PhD, NEA-BC, FACHE

Project Leader: Lea Ann England, BSN, RN Tammy Cohen, PharmD, MS

Tuyet Ngo

Holly Neatherlin

Doris Hutchinson, RN

Sherry Keithly, RN, RN-BC

Mike Davis

History and Physical Documentation Lea Ann England, BSN, RN

Project Leader: Sara Keidel, RHIA Trey Wicke

Stephen Johnston, MD

Cathy Knoff

Carole Salamah, BSN, RN

Improvement in Prevention of Hypoglycemic Episodes Cecilia Lijauco, RN, MSN

Project Leader: Jeff Wilcox, RN Dianne Newman, MHA, BSN, RN, CCRN

Beverly Allen RN, BS, CPHQ, CPHRM

Julie Gonzales, RN, CRN

Binu Ninan

Laura Linker, RN, CNOR

Allison Tidmore, BSN, RN

ABC PROJECT TITLE TEAM MEMBERS

ABC PROJECT TITLE TEAM MEMBERS

“Know Your Numbers” An AHA “Get With The Guidelines” Patient Education Initiative Cecilia Lijauco, MSN, RN

Project Leader: Annabelle Zakarian, MSN, RN Nancy Vish, RN, PhD

Lorna Enoy, RN

Gabriell Grayson, BSN, RN, RN-BC

Anavel Rivera, RN

Henry Viejo, BSN, RN, RN-BC

Aster Naffe, BSN, RN,CCRN

Theresa Ware

Quality Improvement: Cardiac Rehabilitation Nancy Vish, RN, PhD, NEA-BC, FACHE

Project Leader: Danielle Strauss, BSN, RN, RN-BC Jenny Adams, PhD

Julie Wylie, MS, RN, ANP

Baron Hamman, MD

Deloris Douglas, BSN, RN

Jennifer Jackson, RN

Tim Taylor

Tiffany Shock, BS

From WEAK to WEEKLY The Guiding STARR Program Amanda Gonzales

On-Boarding Process: Maintaining Weekly Contact Between A Guiding STARR and Their Assigned New Employee

Nancy Vish, RN, PhD, NEA-BC, FACHE

Project Leader: Kim Krause: PHR Annabelle Zakarian, MSN,RN, CVN,

Becky Mann

Linda O’Kelley

Teri Brooks, CCS

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No More Living Under Pressure

Odette Beason is a mother of four, so she knows what it feels like to have a baby pressing against her insides at the end of nine months. Beason felt this pressure on a daily basis, especially after she ate. Except she wasn’t pregnant. Beason, a 48-year-old resident of Mansfield, was frequently tired and her stomach hurt constantly. In fact, the pain got so bad she could no longer run two miles like she usually did nearly every day. She would also feel full after eating very little, so she was losing weight from her already slender frame.

A CT scan of Beason’s abdomen, led to a diagnosis of celiac artery compression syndrome, a relatively rare, anatomical form of PVD. “PVD is a blockage in any blood vessel other than the heart,” explains Jay Vasquez, M.D., a vascular and endovascular surgeon on the medical staffs at Baylor University Medical Center at Dallas and the Baylor Hamilton Heart and Vascular Hospital. “One of the ligaments in Odette’s abdomen was essentially strangulating her celiac artery, which supplies blood to the liver, stomach and spleen, so it’s a pretty important vessel.”

Surgery was performed to relieve the pressure on the celiac artery and a bypass was required to normalize the blood flow. The moment she woke up after surgery, Beason could tell the pressure had been relieved, Dr. Vasquez says.

Just one month after her surgery in July 2010, Beason was feeling great and even went on a business trip. She was told she could start easing back into running after another month and hopes to participate in a group run this fall, even if she has to walk part of the way.

Even though she didn’t have typical risk factors or any other blockages, Beason’s case of PVD was accuratelydiagnosed thanks to Baylor’s expertise. “Women are often under-diagnosed for PVD, even if they have risk factors,” Dr. Vasquez says. “If you’re told you have a blockage in one part of your body, make sure your doctor checks for other blockages, too.”

B A Y L O R H E L P S O N E P A T I E N T U N C O V E R A N U N C O M M O N F O R M O F P V D

“They understood my lifestyle and what’s important to me. I think that individual attention is what’s made my recovery go so smoothly.”

– Odette Beason

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PHYSICIAN DIRECTORY

General Cardiology

Paul Aggarwal, MD, FACC, FACP, FCCP Medical School: Memorial University, Canada; Internship: Tufts University; Residency: Tufts University; Fellowship: Tufts University, University of California San Francisco, University of Ottawa Heart Institute, Canada; Board Certification: Cardiovascular Disease, Internal Medicine;

Clinical Expertise: Heart Failure, Prevention of Heart Disease, Heart Disease in Women

Rafic Berbarie, MD Medical School: UT Medical Branch at Galveston; Internship: Baylor University Medical Center at Dallas; Residency: Baylor University Medical Center at Dallas; Fellowship: Baylor University Medical Center at Dallas; Board Certification: Internal Medicine, Cardiovascular Disease; Clinical Expertise: Cardiology

Andrew Berggren, MD Medical School: UT Southwestern Medical School; Internship: UT Southwestern Medical School; Residency: UT Southwestern Medical School; Fellowship: UT Health Sciences Center in San Antonio; Board Certification: Internal Medicine, Cardiovascular Disease, Nuclear

Cardiology; Clinical Expertise: Nuclear Cardiology, Cardiac Echocardiography, Cardiac Wellness

Melissa M. Carry, MD, FACC Medical School: University of Arkansas for Medical Sciences; Internship: University of Arkansas for Medical Sciences; Residency: University of Arkansas for Medical Sciences; Fellowship: UT Southwestern Medical School; Board Certification: Internal Medicine, Cardiovascular Disease;

Clinical Expertise: Non Invasive Cardiology, Echocardiography, Women Heart Disease

Cara A. East, MD, FACP Medical School: UT Southwestern Medical School; Internship: Parkland Hospital, UT Southwestern Medical School; Residency: Parkland Hospital, UT Southwestern Medical School; Fellowship: UT Southwestern-Center for Nutrition, Baylor University Medical Center at Dallas; Board Certification: Internal Medicine, Cardiovascular Disease, Endocrinology, Echocardiography; Clinical Expertise: Cholesterol Disorders, Cardiology Clinical Research, Echocardiography

Charles M. Gottlich, MD Medical School: UT Southwestern Medical School; Internship: University of California at San Francisco Medical School; Residency: University of California at San Francisco Medical School, UT Southwestern Medical School; Fellowship: UT Southwestern Medical School; Board

Certification: Internal Medicine, Cardiovascular Disease; Clinical Expertise: Cardiology

Paul A. Grayburn, MD, FACC Medical School: UT Medical Branch at Galveston; Internship: St. Paul University Hospital; Residency: St. Paul University Hospital; Fellowship: University of Kentucky Medical Center; Board Certification: Internal Medicine, Cardiovascular Disease; Clinical Expertise: Valvular Heart Disease,

Echocardiography

Jerrold M. Grodin, MD, FACC Medical School: Mount Sinai School of Medicine; Internship: Mount Sinai School of Medicine; Residency: Mount Sinai School of Medicine; Fellowship: Baylor University Medical Center at Dallas; Board Certification: Internal Medicine, Cardiovascular Disease; Clinical Expertise: Interventional Cardiology

Shelley A. Hall, MD, FACC Medical School: UT Southwestern Medical School; Internship: UT Southwestern Medical School; Residency: UT Southwestern Medical School; Fellowship: UT Southwestern Medical School; Board Certification: Cardiovascular Disease; Clinical Expertise:

Congestive Heart Failure, Transplantation

Brian W. Hardaway, MD Medical School: University of Tennessee-Memphis; Internship: University of Michigan; Residency: University of Michigan; Fellowship: The Cleveland

Clinic Foundation; Board Certification: Internal Medicine, Cardiovascular Disease; Clinical Expertise: General Cardiology, Congestive Heart Failure, Transplant

Shyla T. High, MD, FACC Medical School: Texas Tech University; Internship: Baylor University Medical Center at Dallas; Residency: Baylor University Medical Center at Dallas; Fellowship: Baylor University Medical Center at Dallas; Board Certification: Cardiovascular Disease; Clinical Expertise: Non Invasive

Cardiology, Echocardiography, Women Heart Disease

John W. Hyland, MD, FACC Medical School: Washington University Medical School; Internship: Barnes-Jewish Hospital, Washington University Medical School; Residency: Barnes Hospital, Washington University Medical School; Fellowship: Peter Bent Brigham Hospital, Harvard Medical School; Board Certification: Internal Medicine, Cardiovascular Disease; Clinical Expertise: General Cardiology, Nuclear Cardiology

Alfredo H. Jimenez MD, FACC Medical School: Universidad Nacional de Colombia Medical School; Internship: University of Missouri-Columbia; Residency: University of Missouri-Columbia; Fellowship: Washington University School of Medicine, Barnes-Jewish Hospital; Board Certification:

Internal Medicine, Cardiovascular Disease; Clinical Expertise: Cardiovascular Diseases

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James S. Sharp, MD Medical School: UT Medical Branch at Galveston; Internship: Louisiana State University Medical Center; Residency: Louisiana State University Medi-cal Center; Fellowship: Louisiana State Uni-versity Medical Center; Board Certification: Internal Medicine, Cardiovascular Disease; Clinical Expertise: Cardiac Wellness

James H. Shelton, MD, FACC Medical School: Harvard University; Internship: University of California at San Diego; Residency: University of California at San Diego; Fellowship: University of California at San Diego; Board Certification: Internal Medicine, Cardiovascular Disease; Clinical Expertise: Cardiovascular Diseases, Inter-

ventional Cardiology, Nuclear Cardiology

Michael N. Sills, MD, FACC Medical School: George Washington University; Internship: George Washington University Hospital; Residency: Strong Memorial Hospital; Fel-lowship: UT Southwestern Medical School; Board Certification: Internal Medicine, Cardiovascular Disease; Clinical Expertise: Non Invasive Cardiology, Echocardiography

Scott K. Stephenson, MD Medical School: UT Southwestern Medical School; Intern-ship: Baylor University Medical Center at Dallas; Residency: Baylor University Medical Center at Dallas; Fellowship: Baylor Univer-sity Medical Center at Dallas; Board Certi-fication: Internal Medicine, Cardiovascular Disease; Clinical Expertise: Cardiac Wellness

Clyde W. Yancy, Jr., MD Medical School: Tulane University School of Medicine; Internship: Parkland Memorial Hospital; Residency: Parkland Memorial Hospital; Fellowship: University of Texas South-western Medical Center at Dallas Affliated Hospitals; Board Certification: Internal Medicine, Cardiovascular Disease; Clinical Expertise: Heart Failure, Hypertension, Preventative Cardiology, Cardiomyopathy, Heart Transplantation

Cardiovascular & Thoracic Surgery

Baron L. Hamman, MD Medical School: UT Southwestern Medical School; In-ternship: University of Louisville Medical School; Residency: University of Louisville Medical School, University of Alabama; Fellowship: University of Alabama, Harvard Medical School; Board Certification: Cardiothoracic Surgery; Clinical Expertise:

Surgery of the Aortic Root, Mitral Valve Repair, Minimally Inva-sive Cardiac Surgery, Complex (and off pump) Coronary Artery Bypass Surgery

Robert E. Hebeler, Jr., MD Medical School: Tulane University School of Medicine; In-ternship: University of Texas Health Science Center at Houston; Residency: University of Texas Health Science Center at Houston; Fellowship: Emory University Hospital; Board Certification: Cardiothoracic Surgery; Clinical Expertise: Reconstructive Valve Surgery, Atrial Fibrillation, Left Ventricular Remodeling

PHYSICIAN DIRECTORY (Continued)

General Cardiology (Continued)

Stephen B. Johnston, MD, FACC Medical School: UT Health Science Center at San Antonio; Internship: Baylor University Medical Center at Dallas; Residency: Baylor University Medical Center at Dallas; Fellowship: Baylor University Medical Center at Dallas; Board Certification: Internal Medicine, Cardiovascular Disease,

Nuclear Cardiology, Echocardiography; Clinical Expertise: General Cardiology, Non-Invasive Cardiology

Mohammad N. Khan, MD Medical School: Punjab Medical College; Internship: UT Medical Branch at Galveston; Residency: UT Medical Branch at Galveston; Fellow-ship: UT Medical Branch at Galveston; Board Certification: Internal Medicine, Cardiovascular Disease; Clinical Expertise: Non-General Cardiology, Non Invasive Cardio, Cardiac Echo, Cardiac Wellness, Cadiovascular Disease

Karen K. Klatte, MD, FACC Medical School: UT Southwestern Medical School; Internship: Baylor University Medical Center at Dallas; Residency: Baylor University Medical Center at Dallas; Fellowship: St. Louis University Hospitals; Board Certification: Internal Medicine, Cardiovascular Disease, Echocardiography;

Clinical Expertise: Non Invasive Cardiology, Echocardiography, Nuclear Cardiology, Women Heart Disease

Johannes J. Kuiper, MD, FACC Medical School: New York University School of Medicine; Internship: New York University School of Medicine; Residency: Presbyterian Medical Center; Fellowship: Presbyterian Medical Center, University of California; Board Certification: Cardiovascular Disease, Echocardiography;

Clinical Expertise: Heart Failure, Transplantation, Pulmonary Hypertension

Rohit Parmar, MD, FACC Medical School: University of Bristol; Internship: UT Southwestern Medical School; Residency: UT Southwestern Medical School, University of Bristol; Fellowship: UT Medical Branch at Galveston; Board Certification: Internal Medicine, Cardiovascular Disease, Nuclear Cardiology, Echocardiography; Clinical Expertise: General Cardiology, Non Invasive Cardiology, Nuclear Cardiology, Cardiac Echocardiography

Robert L. Rosenthal, MD Medical School: Columbia University School of Medicine; Internship: UT Southwestern Medical School; Residency: UT Southwestern Medical School; Fellowship: UT Southwestern Medical School; Board Certification: Internal Medicine, Cardiovascular Disease; Clinical

Expertise: Preventive Cardiology, CT Coronary Angiography, Non Invasive Cardiology

68 69

Medicine, Endovascular Medicine; Clinical Expertise: Medical and Endovascular Management of Arterial and Venous Disorders

John R. Schumacher, MD, FACC, FSCAI Medical School: Indiana University; Intern-ship: Baylor University Medical Center at Dallas; Residency: Baylor University Medical Center at Dallas; Fellowship: Baylor University Medical Center at Dallas; Board Certification: Internal Medicine, Interven-tional Cardiology, Cardiovascular Disease; Clinical Expertise: Interventional Cardiology

Jeffrey M. Schussler, MD, FACC, FSCAI Medical School: UT Medical Branch at Galveston; Internship: Baylor University Medical Center at Dallas; Residency: Baylor University Medical Center at Dallas; Fel-lowship: Baylor University Medical Center at Dallas; Board Certification: Interventional Cardiology, Cardiovascular Disease, Cardiac

Computed Tomography (CT); Clinical Expertise: General Car-diology, Preventative Cardiology, Treadmill Testing/Stress Testing, Echocardiography/Stress Echocardiography, Nuclear Stress Testing, Cardiac Catheterization, Interventional Cardiology-Cardiac stents, Calcium Scoring, CT Coronary Angiography /Non-invasive Coronary Angiography, Takotsubo Cardiomyopathy/Broken Heart Syndrome

Rolando M. Solis, MD Medical School: Far Eastern University; Internship: Albert Einstein Healthcare Foundation; Residency: Baylor University Medical Center at Dallas; Fellowship: Baylor University Medical Center at Dallas; Board Certification: Cardiovascu-lar Disease; Clinical Expertise: Diagnostic

and Interventional Cardiology, Transvenous Permanent Pacemaker Implantation

Robert C. Stoler, MD, FACC, FSCAI Medical School: Duke University; Internship: UT Southwestern Medical School; Residency: UT Southwestern Medical School; Fellow-ship: Beth Israel Hospital, Harvard Medical School; Board Certification: Internal Medi-cine, Interventional Cardiology, Cardiovas-cular Disease; Clinical Expertise: Complex Coronary Interventions including Left Main Coronary Artery PCI and Chronic Total Occlusion PCI;  Valvular Heart Disease

Ravi Vallabhan, MD, FACC Medical School: UT Health Sciences Center in San Antonio; Internship: UT Health Sciences Center in San Antonio; Residency: UT Health Sciences Center in San Antonio; Fellow-ship: Baylor University Medical Center at Dallas; Board Certification: Interventional Cardiology, Cardiovascular Disease; Clinical

Expertise: Percutaneous Mitral Valve Repair, Alcohol septal ablation for HOCM, Medical Device Development,Management of Atrial Septal Defect (ASD) and Patent Foramen Ovale (PFO)

Carlos E. Velasco, MD, FACC, FACP Medical School: Universidad de Guayaquil School of Medicine; Internship: Baylor College of Medicine; Residency: Baylor College of Medicine; Fellowship: Vanderbilt Univer-sity Hospital, Baylor College of Medicine; Board Certification: Internal Medicine, Interventional Cardiology, Cardiovascular Disease; Clinical Expertise: Cardiovascular Diseases, Interventional Cardiology

PHYSICIAN DIRECTORY (Continued)

Cardiovascular & Thoracic Surgery (Continued)

Albert C. Henry III, MD Medical School: University of Texas Medical School at Hosuton; Internship: Memorial Hermann Hospital; Residency: Texas Heart Institute, UT Health Science Center at Houston; Fellowship: Texas Heart Institute; Board Certification: Cardiothoracic Surgery, General Surgery; Clinical Expertise: Thoracic Aneurysms

Greg Matter, MD Medical School: Baylor College of Medicine; Internship: University of Alabama; Residency: University of Ala-bama; Fellowship: University of Alabama; Board Certification: Cardiothoracic Surgery; Clinical Expertise: Cardiothoracic Surgery, Multiple Bypass, Reoperations, Treatment of Aorta and Heart Valves

Interventional Cardiology

Azam Anwar, MD, FACC Medical School: University of Missouri; Internship: Baylor University Medical Center at Dallas; Resi-dency: Baylor University Medical Center at Dallas; Fellowship: UT at San Antonio, San Francisco Heart Institute; Board Certifica-tion: Internal Medicine, Interventional Cardiology, Cardiovascular Disease; Clinical

Expertise: Complex Interventional Cardiology, Percutaneous Mitral

Valve Repair, ASD/PFO closure, Alcohol Septal Ablation for HOCM, Valvuloplasty, Medical Device Development

James W. Choi, MD, FACC, FSCAI Medical School: Northwestern University Medical School; Internship: Northwestern University Medical School; Residency: Northwestern University Medical School; Fellowship: Northwestern University Medical School; Board Certification: Internal Medicine, Car-diovascular Disease, Interventional Cardiol-ogy, Nuclear Cardiology; Clinical Expertise: Complex Coronary Interventions: Chronic Total Occlusions, Unprotected Left Main Stenting, Peripheral Vascular Interventions, Percutaneous pfo/asd Closures, Mitral and Aortic Valve Balloon Valvuloplasty

Michael S. Donsky, MD, FACC Medical School: UT Medical Branch at Galveston; Internship: D.C. General Hospital - George-town University; Residency: Parkland Me-morial Hospital; Fellowship: UT Southwest-ern Medical School; Board Certification: Internal Medicine, Cardiovascular Disease; Clinical Expertise: Interventional Cardiology

Kenneth B. Johnson, MD Medical School: University of New Mexico; Internship: Baylor University Medical Center at Dallas; Residency: Baylor University Medical Center at Dallas; Fellowship: Baylor University Medical Center at Dallas; Board Certifica-tion: Internal Medicine, Interventional Cardiology, Cardiovascular Disease, Vascular

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PHYSICIAN DIRECTORY (Continued)

Clinical Cardiac Electrophysiology

Manish Assar, MD, FACC Medical School: University of California at San Francisco Medical School; Internship: UT Southwestern Medical School; Residency: UT Southwestern Medical School; Fellowship: Duke University Medical Center, University of Western Ontario; Board Certification: Cardiac

Electrophysiology, Cardiovascular Disease; Clinical Expertise: Clinical Cardiac Electrophysiology, Catheter Ablation for Complex Arrhythmias (supraventricular/ventricular tachycardias), Pacemaker and defibrillator therapy including bi-ventricular resynchronization therapy for the treatment of heart failure, diagnosis and treatment of syncope, laser leas extraction

Alan S. Donsky, MD, FACC Medical School: UT Medical Branch at Galveston; Internship: Barnes-Jewish Hospital, Washington University Medical School; Residency: Washington University in St. Louis; Fellowship: St. Luke’s Episcopal Hospital, Baylor University Medical Center at Dallas; Board Certification: Internal Medicine, Cardiac Electrophysiology; Clinical Expertise: Clinical Cardiac Electrophysiology, Catheter Ablation for Complex Arrhythmias (supraventricular/ventricular tachycardias), Pacemaker and defibrillator therapy including bi-ventricular resynchronization therapy for the treatment of heart failure, diagnosis and treatment of syncope, catheter ablation for the treatment of atrial fibrillation

Jay O. Franklin, MD, FACC Medical School: Texas A&M University College of Medicine; Internship: Texas A&M University College of Medicine; Residency: University of Louisville; Fellowship: University of California at San Francisco Medical School, University of Missouri; Board Certification: Internal

Medicine, Clinical Cardiac Electrophysiology, Cardiovascular Disease; Clinical Expertise: Clinical Cardiac Electrophysiology, Catheter Ablation for Complex Arrhythmias (supraventricular/ventricular tachycardias), Pacemaker and defibrillator therapy including bi-ventricular resynchronization therapy for the treatment of heart failure, diagnosis

Robert C. Kowal, MD, PhD Medical School: UT Southwestern Medical School; Internship: Brigham and Women’s Hospital, Harvard Medical School; Residency: Brigham and Women’s Hospital, Harvard Medical School; Fellowship: Brigham and Women’s Hospital, Harvard Medical School, UT Southwestern Medical School; Board Certification: Cardiovascular Disease, Clinical Cardiac Electrophysiology; Clinical Expertise: Clinical Cardiac Electrophysiology, Catheter Ablation for Complex Arrhythmias (atrial fibrillation, supraventricular, and ventricular tachycardias), Pacemaker and defibrillator therapy including bi-ventricular resynchronization therapy for the treatment of heart failure, diagnosis and treatment of syncope, atrial fibrillation and genetic arrhythmia syndromes

Peter J. Wells, MD Medical School: Indiana University School of Medicine; Internship: Vanderbilt University; Residency: Vanderbilt University; Fellowship: UT Southwestern Medical School; Board Certification: Internal Medicine, Clinical Cardiac Electrophysiology, Cardiovascular

Disease; Clinical Expertise: Arrhythmia management including pacemaker and defibrillator implantation as well as curative ablation therapy

Kevin R. Wheelan, MD Medical School: Washington University School of Medicine; Internship: Baylor University Medical Center at Dallas; Residency: Baylor University Medical Center at Dallas; Fellowship: UT Southwestern Medical School; Board Certification: Internal Medicine, Clinical Cardiac Electrophysiology, Cardiovascular Disease; Clinical Expertise: Clinical Cardiac Electrophysiology, Catheter Ablation for Complex Arrhythmias (supraventricular/ventricular tachycardias), Pacemaker and defibrillator therapy including bi-ventricular resynchronization therapy for the treatment of heart failure, diagnosis

Vascular Surgery

Hassan I. Bukhari, MD, FACS Medical School: King Edward Medical College; Internship: Saint Charles Hospital; Residency: Tucson General Hospital; Fellowship: Baylor University Medical Center at Dallas, Wadley Institute of Molecular Medicine; Board Certification: General Surgery; Clinical Expertise: General Vascular Surgery, General Surgery

Tuan-Hung B. Chu, MD, RVT Medical School: UT Southwestern Medical School; Internship: University of Medicine & Dentistry of New Jersey; Residency: University of Medicine & Dentistry of New Jersey; Fellowship: Loyola University Medical Center; Board Certification: General Surgery, Vascular Surgery; Clinical Expertise: Abdominal Aneurysm, Peripheral Vascular Disease, Carotid Surgery, Varicose Vein Treatment, Lymphadema, Angiography, Non-Invasive & Surgical Management of Vascular Leisions, AV access

Toby J. Dunn, MD Medical School: Duke University School of Medicine; Internship: Washington University School of Medicine; Residency: Washington University School of Medicine; Fellowship: Washington University School of Medicine; Board Certification: General Surgery; Clinical Expertise: Vascular and Endovascular Surgery

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PHYSICIAN DIRECTORY (Continued)

Vascular Surgery (Continued)

Dennis R. Gable, MD, RVT, FACS Medical School: Baylor College of Medicine; Internship: University of Louisville; Residency: University of Louisville; Fellowship: Baylor University Medical Center at Dallas; Board Certification: Vascular Surgery, General Surgery; Clinical Expertise: Endovascular, Medical

and Surgical Treatment of Vascular Disorders - including Aneurysms, Carotid Stenosis, Peripheral Vascular Disease, Venous Disease, Varicose Veins, including Laser Treatment and Dialysis Access

Brad R. Grimsley, MD, FACS Medical School: Emory University School of Medicine; Internship: Wake Forest University School of Medicine; Residency: Wake Forest University School of Medicine; Fellowship: Baylor University Medical Center at Dallas; Board Certification: Vascular Surgery, General Surgery; Clinical Expertise: Endovascular, Medical and Surgical Treatment of Vascular Disorders - including

Aneurysms, Carotid Stenosis, Peripheral Vascular Disease, Venous Disease, Varicose Veins, including Laser Treatment and Dialysis Access

Stephen E. Hohmann, MD, FACS Medical School: University of California at San Diego; Internship: Baylor University

Medical Center at Dallas; Residency: Baylor University Medical Center at Dallas; Fellowship: Baylor University Medical Center at Dallas; Board Certification: Vascular Surgery, General Surgery; Clinical Expertise: Endovascular, Medical and Surgical Treatment of Vascular Disorders - including Aneurysms, Carotid Stenosis, Peripheral Vascular Disease, Venous Disease, Varicose Veins, including Laser Treatment and Dialysis Access

John C. Kedora, MD Medical School: Saint Louis University Medical School; Internship: Baylor University Medical Center at Dallas; Residency: Baylor University Medical Center at Dallas; Fellowship: Baylor University Medical Center at Dallas; Board Certification: Vascular Surgery, General Surgery;

Clinical Expertise: Endovascular, Medical and Surgical Treatment of Vascular Disorders - including Aneurysms, Carotid Stenosis, Peripheral Vascular Disease, Venous Disease, Varicose Veins, including Laser Treatment and Dialysis Access

Gregory J. Pearl, MD, FACS Medical School: Tulane University Medical School; Internship: Northwestern University Memorial Hospital; Residency: Northwestern University Memorial Hospital; Fellowship: Baylor University Medical Center at Dallas, Northwestern University Medical School; Board Certification: Vascular Surgery, General Surgery; Clinical Expertise: Endovascular, Medical and Surgical Treatment of Vascular Disorders - including Aneurysms, Carotid Stenosis,

Peripheral Vascular Disease, Venous Disease, Varicose Veins, including Laser Treatment and Dialysis Access

William P. Shutze, MD, FACS Medical School: Baylor College of Medicine; Internship: Baylor College of Medicine; Residency: University of Alabama; Fellowship: Baylor University Medical Center at Dallas; Board Certification: Vascular Surgery, General Surgery, Surgical Critical Care; Clinical Expertise:

Endovascular Mangaement of Thoracic and Abdominal Aortic Aneurysms

Bertram L. Smith, MD, FACS Medical School: UT Southwestern Medical School; Internship: UT Health Sciences Center in San Antonio; Residency: UT Health Sciences Center in San Antonio; Fellowship: Saint Thomas Hospital; Board Certification: Vascular Surgery, General Surgery; Clinical Expertise: Endovascular, Medical and Surgical Treatment of Vascular Disorders - including Aneurysms, Carotid Stenosis, Peripheral Vascular Disease, Venous Disease, Varicose Veins, including Laser Treatment and Dialysis Access

Javier Vasquez, Jr., MD, RVT Medical School: UT Southwestern Medical School; Internship: Baylor College of Medicine; Residency: Baylor College of Medicine; Fellowship: University of Connecticut; Board Certification: General Surgery, Vascular Surgery; Clinical Expertise: Abdominal Aneurysms, Carotid Disease,

Peripheral Vascular Disease, Endovascular Management of all Vascular Lesions, Dialysis Access, Lymphedemc and Cosmetic Varicose Vein Procedures, Carotid Stents, Leg Artery Stents, Thoracic Aneurysm Stent Graft Repair and Limb Salvage

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From Bad News to a Good Outlook

At first, it didn’t even occur to Suzanne Torio that she might be having a heart attack. It had been a typical day — until she began vomiting uncontrollably, which she didn’t know can be a sign of a heart attack in women. But when she began experiencing severe, crushing chest pain, that’s when she knew she needed help. Her husband, Cris, rushed her to the nearest hospital, where they performed an emergency angioplasty and triple bypass. The doctors did their best, but ultimately decided she needed the more sophisticated care available at Baylor University Medical Center at Dallas, where she was transferred.

“She’d had a massive heart attack,” explains Johannes Kuiper, M.D., a cardiologist on the medical staffs at Baylor Dallas and Baylor Hamilton Heart and Vascular Hospital. “That, combined with the surgeries, left her heart very vulnerable.”

The team at Baylor tried treating Torio’s heart failure with medication and started her on physical therapy. “I would get out of breath really quickly, though,” she admits.

After three diligent weeks of trying more conventional heart failure therapies, physicians on the medical staff at Baylor Dallas realized there was no other way to keep Torio alive long term without the use of a mechanical heart pump or LVAD. A left ventricle assist device (LVAD) is a device that takes over for a failing left ventricle of the heart. For Suzanne Torio and many others, it keeps their heart pumping until a transplant can be performed. The U.S. Food and Drug Administration also has approved an LVAD device for use as a permanent solution for patients who aren’t candidates for a transplant. After more physical therapy, Torio returned home, where she has continued to gain strength and confidence since her LVAD implantation in March.

“Even with risk factors like a family history, having a massive heart attack at her age was just a big dose of bad luck,” says Dr. Kuiper. “But the LVAD can make a huge difference for people like Suzanne, and I believe she will go back to her normal life.”

A D V A N C E D E X P E R T I S E H E L P S O N E W O M A N S U R V I V E H E A R T F A I L U R E

“I’m definitely feeling well and making good progress, and am hoping to go back to work sometime this summer.”

– Suzanne Torio

Physicians are members of the medical staff at one of Baylor Health Care System’s subsidiary, community or affiliated medical centers and are neither employees nor agents of those medical centers, Baylor Jack and Jane Hamilton Heart and Vascular Hospital, or Baylor Health Care System. ©2010 Baylor Health Care System. BHVH_358_2010 BHVH Outcomes Brochure. MOD-10184. 1/11

621 North Hall Street, Dallas, Texas 75226

BaylorHeartHospital.com 1.800.4BAYLOR