MHVI-Heart-and-Vascular-Heart-Valve

Structural (Heart Valve) Disease and Treatments

Structural heart disease is a defect of the heart that does not affect the blood vessels. Some of these heart conditions are congenital (present at birth) while other conditions develop over time due to aging and other disease processes. Congenital heart abnormalities include valve problems, defects in the walls between the heart chambers, and heart muscle deformities. It is estimated that 1 in 100 children are born with heart defects.

Valvular heart disease is a degenerative disease that affects the function of heart valves - flaps of tissues that control the flow of blood in and out of the heart and lungs. Aortic stenosis is the build-up of calcium deposits on the valve which causes it to narrow and reduce the flow to the rest of the body. About 12% of the U.S. population over the age of 75 develops aortic stenosis.

What are the symptoms of structural and valvular heart disease?
Symptoms vary depending on the type and severity of the structural heart defect. People may experience any of the following symptoms:

Shortness of breath

Fatigue

High-blood pressure

Chest tightening or pain

Kidney problems

Heart attack

Stroke

It is important to contact a medical professional for advice and treatment. Symptoms of a heart attack or stroke are a medical emergency. Don’t wait, call 911.
How is structural and valvular heart disease diagnosed and treated?
Congenital heart defects are often first discovered during a pregnancy by echocardiography (ultrasound) or immediately after birth. Heart murmurs can be detected by physical examination. Diagnostic tests used to confirm heart valve disease include echocardiography, EKG, chest x-ray, cardiac catheterization, stress testing, and cardiac MRI. Treatment options for structural and heart valve conditions include:

Medication - Medications do not cure structural heart disease but are used to treat symptoms and delay the onset of complications. Medications are used to control irregular heartbeats, prevent blood clots, increase the heart’s pumping ability, and to prevent patient discomfort.

Heart valve surgery - Cardiac surgeons repair or replace heart valves using the latest surgical techniques.

Transcatheter Aortic Valve Repair (TAVR) - A minimal invasive surgical technique that involves inserting a catheter (tube) in the groin or between the ribs into the heart. The artificial valve is compressed and guided through the catheter to the aortic valve. The balloon inside the device is expanded and the catheter then removed. The successful outcome is the new valve increases the blood flow to the body.

Transcatheter Mitral Valve Repair (TMVR) - A minimal invasive surgical technique for patients with mitral regurgitation (leaky valves) where a mechanical clasp (Mitral Clip) is used to clamp the mitral valve leaflets together restoring proper blood flow through the heart.

Closure procedures - A “plug” is fed through a catheter into the heart to block leaks or to close holes for patients with atrial septal defects, ventricular septal defects, and patent foramen ovales.

Left arterial appendage closure - Atrial fibrillation patients are at increased risk of stroke caused by blood clots that can be collected in this small pouch in the muscle wall of the left atrium. A device is inserted to close off this area, thus preventing blood from gathering in the appendage.

Coronary Artery Disease and Treatments

What is Coronary Artery Disease (CAD)?

Coronary artery disease is the most common type of heart disease in the United States. The disease is often caused by atherosclerosis, a condition in which the arteries become narrow because of the buildup of plaque. A complete blockage can result in a heart attack or stroke.

What are the symptoms of CAD?
As the coronary arteries narrows, less blood reaches the rest of your body. You may experience:

Chest pain (Agina)

Coronary artery spasm

Pain in your neck or left arm

Shortness of breath
What are the symptoms of a heart attack and how is it treated?
A heart attack is a medical emergency. A heart attack usually occurs when a blood clot blocks blood flow to the heart. Without blood, tissue loses oxygen and dies. Symptoms may come on suddenly, or you may have them for days or weeks before a heart attack. If you experience any of these possible heart attack symptoms, call 911 immediately:

Chest pain, also known as angina, which can feel like a tightness or heaviness in the chest

Lightheadedness, dizziness, or anxiety

Nausea, vomiting, or severe indigestion or heartburn

Pain that spreads from the chest to the arms, neck, jaw, belly, or back

Excessive sweating, including a cold sweat

Trouble breathing

Heart attack symptoms in women may be different than those in men. Though both men and women are likely to experience chest pain, women are slightly more likely than men to experience:

Fatigue

Heart palpitations, or fluttering, rapid heartbeats

Pain in the upper back or shoulder

Emergency Heart Attack treatment - Primary percutaneous coronary intervention (PCI) is the protocol for taking a patient who presents with ST elevated myocardial infarction (STEMI) directly to the cardiac catheterization laboratory to undergo mechanical revascularization using balloon angioplasty, coronary stents, aspiration thrombectomy, and other measures.
How is CAD diagnosed?
Physicians take a detailed patient history, blood work, and perform a physical examination. They may also order one of more of the following tests:

Chest X-rays use a small dose of radiation to create pictures of the structures inside the chest, including the lungs, heart, and chest wall.

Cardiac computed tomography scan (Cardiac CT) uses X-rays to create three-dimensional images of your heart and blood vessels.

An echocardiogram uses high-frequency sound waves to create images of your heart.

An electrocardiogram, also known as an ECG, measures the heart’s electrical activity.

Fractional flow reserve, also known as FFR, is a measurement of how well blood can flow through the coronary arteries. Narrowing or blockages in these arteries can lead to a heart attack without treatment.

Magnetic resonance imaging, better known as cardiac MRI, is a combination of radio waves, magnets, and computer technology to create images of your heart and blood vessels.

Stress tests are used to assess how your heart works during physical activity. There are several types of stress tests, including treadmill or bike stress tests, nuclear stress tests, stress echocardiograms, and chemically induced stress tests.
How is CAD treated?
Treatments for this disease can increase blood flow to your heart and slow the progression of the disease but are not a cure. Treating the disease involves reducing your risk factors, which may involve lifestyle changes. Your disease also may be treated with medication or surgical procedures, such as:

Balloon Angioplasty – A catheter is inserted in the wrist or groin then the interventional cardiologists will use X-ray images to guide the catheter through the artery to the blockage. A contrast dye will be injected to allow the narrowed area to be more clearly seen on an X-ray. A tiny balloon at the end of the catheter will be inflated, causing the plaque to mold against the artery wall. The physicians may insert stents which are small mesh tubes placed within the artery to prevent blockages and allow better blood flow.

Coronary Artery Bypass Surgery - restores normal blood flow through narrowed or blocked arteries by using a healthy blood vessel taken from your leg, arm, or chest to create a detour around the problem area.
Unexplained Chest Pain (Coronary Microvascular Dysfunction)
Unexplained chest pain, clinically known as Coronary Microvascular Dysfunction, has historically been difficult to diagnose because these tiny arteries around the heart are not visible on an angiogram. In fact, an estimated 50 percent of all angina cases are now attributed to CMD, with women accounting for most incidences.

MedStar Heart & Vascular Institute became one of only a few programs in the nation to use the Coroventis CoroFlow Cardiovascular System to detect CMD. It is an advanced software-based platform that, along with a special guidewire, can effectively measure the workings of the heart’s tiniest arteries, allowing physicians to confirm the cause of their patient’s unexplained chest pain.

The assessment begins with an angiogram, followed by threading the guidewire through the left anterior descending artery. Once in place, the wire measures true blood flow and microvascular resistance, which the CoroFlow software then determines whether the heart’s smallest arteries are functioning properly.

L-R: Drs. Itsik Ben-Dor, Brian Case, and Hayder Hashim

After a diagnosis, CMD patients are returned to their referring physician for treatment and management. CMD is often treated with medications and/or lifestyle changes to control risk factors and reduce symptoms.

Doctors Hayder Hashim, Brian Case, and Itsik Ben-Dor are the only specialists in the area to offer this approach to diagnosing CMD. Combined, they have performed 150+ of these procedures since its debut last year. They are also creating a CMD registry to follow patients long-term and further advance understanding of the disease.

For more information, please call 202-877-5975

Click here to learn more about our innovative tool to diagnose Coronary Microvascular Dysfunction
Diagnosing Coronary Microvascular Dysfunction: Melanie McCauley’s story

Sometimes called small artery disease or small vessel disease, coronary microvascular dysfunction is a condition that affects the walls and inner lining of tiny coronary artery blood vessels that branch off from the larger coronary arteries. MedStar Heart & Vascular Institute is one of only a few programs in the nation to offer a new technology that can effectively measure the workings of the heart’s tiniest blood vessels. Physicians now can correctly diagnose and treat coronary microvascular dysfunction. To learn more, please call:

MedStar Washington Hospital Center: 301-892-3302

MedStar Southern Maryland Hospital Center: 301-683-7004

Nationally recognized patient care team

Baltimore Region

Interventional Cardiology

Fady H. Iskander, MD

Fady H. Iskander, MD

Fady Iskander, MD,is a fellowship-trained, full-time interventional cardiologist practicing at MedStar Union Memorial Hospital. He is board-certified in internal medicine, echocardiography, nuclear cardiology, and cardiovascular disease.

Dr. Iskander’s clinical interests include complex coronary interventions, atherectomy, and coronary imaging. He is experienced in structural heart procedures—including transcatheter aortic valve replacement (TAVR), patent foramen ovale (PFO) closure, and valvuloplasty.

He also has expertise in the transradial cardiac catheterization procedure—the gold standard for cardiac catheterization. At MedStar Union Memorial Hospital, over 90% of cardiac catheterizations are performed transradially.

Dr. Iskander earned a master’s degree in clinical research from Rush University in Chicago. He has published multiple scientific papers and his passion for clinical research helps improve the lives of patients.

Dr. Iskander finds listening to patients is the key for quality care. He takes time to listen to his patients and understand their goals for each visit. He also prioritizes patient education and explains conditions and medical procedures in simple language. This increased understanding enables his patients to weigh in on their treatment plan. He encourages shared decision making to provide personalized care to achieve the best outcomes.

Antony Kaliyadan, MD

Antony Kaliyadan, MD

Antony Kaliyadan, MD, is a fellowship-trained interventional cardiologist who holds certifications in cardiovascular disease, echocardiography, nuclear cardiology and vascular imaging.

Dr. Kaliyadan's interests and expertise centers around complex coronary interventions, atherectomy, coronary imaging, and circulatory support devices. He also has a special interest in peripheral interventions and structural heart procedures including TAVR (transcatheter aortic valve replacement), PFO (patent foramen ovale) closure, ASD (atrial septal defect) closure, mitral valvuloplasty, etc.

He completed his fellowships in interventional cardiology, and structural and peripheral interventions at Thomas Jefferson University Hospital, his residency at Reading Hospital and Medical Center, and attended medical school at Jefferson Medical College. As a former chief medical resident, he took an interest in resident education and was elected teacher of the year. As part of his fellowship, Dr. Kaliyadan championed the transradial cardiac catheterization procedure. This procedure has become the gold standard for cardiac catheterization and MedStar Union Memorial Hospital performs more than 80% of catheterizations transradially.

Dr. Kaliyadan considers his ability to treat patients with complex cardiovascular disease a privilege. His philosophy of patient care centers on evaluating each patient individually and offering them the most minimally invasive approach possible for their condition. He is energized by the newer novel techniques and technologies that offer opportunities for treatment where no treatment was available before.

David B. Peichert, MD

David B. Peichert, MD

Education:
Fellowship: University of Maryland Medical Center
Residency Program: Leigh Valley Hospital Cedar Crest
Internship Program: St. Luke's Hospital - Allentown Campus
Medical School: Temple University School Medicine

Board Certification:
American Board of Internal Medicine, Cardiovascular Disease
American Board of Internal Medicine, Internal Medicine

David Peichert, MD is an interventional cardiologist who practices at MedStar Franklin Square Medical Center and MedStar Union Memorial Hospital.

Nauman Siddiqi, MD

Nauman Siddiqi, MD

Nauman Siddiqi, MD, FSCAI, FACC, is an interventional cardiologist who holds two board certifications in cardiovascular disease and interventional cardiology. He is fellowship trained in interventional cardiology and cardiology and holds a masters in epidemiology.

Dr. Siddiqi is committed to using the most advanced technology and procedures while partnering with fellow physicians to provide exceptional cardiac care and treatment for every patient. His professional interests include aortic and mitral valvuloplasty; transcatheter aortic valve replacement; the Watchman device, transradial cardiac catheterization; percutaneous coronary intervention, inclusive of pericardiocentesis; atrial septal defect; and patent foramen ovale closure, myocardial biopsy, and rotational atherectomy.

Most recently, Dr. Siddiqi was a member of the clinical team at Baylor Health Care System in Dallas, Texas. He is a fellow of the Society for Cardiovascular Angiography and Interventions and the American College of Cardiology.

John C. Wang, MD

John C. Wang, MD

John C. Wang, MD, is chief of the Cardiac Catheterization Laboratory at MedStar Union Memorial and scientific director for Baltimore Cardiovascular Research. Dr. Wang is board certified in Interventional Cardiology, Cardiovascular Disease and Internal Medicine. He specializes in minimally invasive procedures that increase blood flow to the heart, diminish chest pain and decrease the risk of heart attack.

Dr. Wang and his team perform more than 5,000 procedures a year. He finds great satisfaction in how quickly a patient's quality of life improves with the latest techniques in angioplasty, stenting and catheterization. Using an advanced procedure known as transradial cardiac catheterization, performed through the patient's wrist, Dr. Wang is able to offer patients a less-invasive, safer option than traditional catheterization, as well as a quicker recovery time and shorter hospital stay. Dr. Wang also performs transcatheter aortic valve replacements (also known as TAVR). He replaces a patient's aortic valve via a small catheter placed through the femoral artery without traditional open-heart surgery. MedStar Union Memorial is one of the few hospitals in the region to offer these procedures.

Dr. Wang's passion for clinical research helps improve the lives of patients. Widely published, Dr. Wang has been the principal investigator or sub-investigator on more than 40 studies relating to the safety and efficacy of new devices and technology in interventional cardiology. Currently, he is the national principal investigator of the OMEGA trial studying the latest generation of bare metal stents.

Before his medical training, Dr. Wang received his undergraduate degree from the University of Chicago. He also earned a Master's of Science in Epidemiology from the Harvard School of Public Health.

John Wang, MD, named 2020 "Top Docs" by Baltimore magazine for interventional cardiology.
Cardiac Surgery

Brian Bethea, MD

Brian Bethea, MD

Brian Bethea, MD, is the Chief of Cardiac Surgery at MedStar Union Memorial Hospital and the regional chief of outreach for the Baltimore region. He is board certified in thoracic surgery.

Dr. Bethea’s clinical interests involve minimally invasive approaches to valvular and structural heart disease. This includes procedures such as TAVR, transcatheter mitral valve repair and replacement, transcatheter tricuspid valve repair and replacement, and multi-arterial coronary revascularization.

Dr. Bethea is a member of the Society of Thoracic Surgeons.

After earning his medical degree from the University of Oklahoma, Dr. Bethea completed his residency in general surgery, followed by a fellowship in cardiac surgery, at The Johns Hopkins Hospital.

Dr. Bethea has participated in nearly all major U.S. clinical trials for TAVR and has been involved in early feasibility trials for transcatheter mitral valve repair and replacement. Due to his reputation, excellent outcomes, and high surgical volumes, he was selected to participate in past trials for the mitral and tricuspid valves, including Tendyne™, MitraClip™, ENCIRCLE, and TRILUMINATE. He is the only surgeon in Maryland to offer patient the latter two options.

He is a physician educator and proctor, traveling throughout the world to teach valve repair and replacement techniques to other surgeons. He serves as selection chair for the Tendyne trial, overseeing all patient selection for the entire trial.

Dr. Bethea has presented his work internationally and is widely published in all the major cardiothoracic medical journals. He was among the first authors to be published on the topic of transcatheter mitral valve replacement–a rapidly evolving and expanding field.

Philosophy of Care

“I aim to provide personalized, tailored care to each of my patients. Whether it’s a minimally invasive procedure, an open procedure, or a hybrid approach, I find the method that will best fit the person, rather than the other way around. Since I have been involved in the development of so many new technologies, I can provide patients with all their options, so we can make an informed decision together. I wholeheartedly believe in a team approach to providing care, and view patients, their families, and their referring physicians as integral members of the care team.”

Rachel Harrison, MD

Rachel Harrison, MD

Rachel Harrison, MD, is a cardiac surgeon at MedStar Union Memorial Hospital. She is board certified in general and thoracic surgery.

Dr. Harrison treats ischemic cardiac disease, structural heart conditions, valvular disease, and rhythm disorders, often through minimally invasive approaches. She is uniquely skilled in complex lead extraction and management, related to pacemakers and defibrillators, which may be necessary due to infections, device recalls, and other complications.

As a result of Dr. Harrison’s advanced surgical training, she offers her patients high levels of confidence in her technical expertise. She’s also had significant experience caring for very sick patients––prior to joining MedStar Health, she managed advanced heart failure, providing mechanical support, such as LVADs, and heart transplantation. She has served as an educator in the fields of lead management and heart failure, sharing her knowledge with other clinicians.

Dr. Harrison’s current research interests focus on structural heart and valvular protocols, including minimally invasive methods for replacing and repairing the tricuspid and mitral valves.

Philosophy of Care

“Every patient of mine is number one––in the clinic and in the operating room. I ensure the whole care team is united in our goals for surgery, always prioritizing what’s best for the patient. I treat each person as if they were a member of my own family and help guide them through decisions with a measured approach. I am conservative when recommending surgery and will only do so if it is truly in the best interest of the patient.”

Ricardo O. Quarrie, MD

Ricardo O. Quarrie, MD

Ricardo O. Quarrie, MD, is a board-certified cardiothoracic surgeon at MedStar Union Memorial Hospital.

Dr. Quarrie has specialty training in aortic disease and can manage advanced and complex aortic pathology. He sees patients with a wide range of conditions, including aortic aneurysm, connective tissue disorder, aortic valve disorder, chronic aortic dissections, and aortic root and arch abnormalities. Dr. Quarrie uses a variety of techniques, including minimally invasive (endovascular), as well as open surgical procedures. He performs coronary artery bypass surgery, thoracic endovascular aortic repair (TEVAR), and redo aortic surgery.

The cardiac surgery team at MedStar Union Memorial has earned a 3-star rating for coronary artery bypass grafting (CABG) and combined aortic valve replacement plus CABG procedures from The Society of Thoracic Surgeons–the highest achievable metric in the United States for these procedures. This puts the team in the top seven percent of high-performing hospitals nationwide.

Dr. Quarrie is a member of the Association of Academic Surgeons, the American Medical Association, The Society of Thoracic Surgeons, and Maryland Cardiac Services Quality Initiative (MCSQI).

After earning his medical degree from the Ohio State University College of Medicine, Dr. Quarrie completed a general surgery residency at the Ohio State University Wexner Medical Center. He then went on to advance his training with a fellowship in cardiothoracic surgery at Yale New Haven Hospital, and a fellowship in aortic disease at Cleveland Clinic Educational Foundation.

Dr. Quarrie’s research interests include cardiac ischemia-reperfusion injury, TEVAR, and new aortic stent devices. Throughout his career, he has written numerous articles for publications such as the Journal of Cardiac Surgery and the American Journal of Physiology-Heart and Circulatory Physiology. He has presented research at the regional and national levels, including conferences of the American College of Surgeons, International Society for Heart and Lung Transplantation, and the Academic Surgical Congress.

Philosophy of Care

“From a very early age, I was interested in medicine and healthcare, and was particularly fascinated by the physiology of the heart. At five years old, I was diagnosed with a hearing disorder, and underwent a total of four surgeries. The care and compassion my surgeon showed to my family and I left an impression on me. That was my first indication of the type of doctor I someday wanted to be. Therefore, I now take the time to learn about each of my patients so I can tailor the right treatment to their particular needs. I believe it’s important to really understand not only the patient’s disease process, but the person themselves–their background, disposition, desires, and expectations for their treatment.”

Washington Region

Interventional Cardiology

Nelson L. Bernardo, MD

Nelson L. Bernardo, MD

Nelson L. Bernardo, MD, specializes in Interventional Cardiology. Dr. Bernardo is the medical director of the Peripheral Vascular Laboratory at MedStar Heart Institute. He is also the director for Peripheral Intervention at the Cardiovascular Research Institute at MedStar Research Institute. He is also the co-chair for cardiac peripheral vascular diseases.

In addition, Dr. Bernardo serves as an assistant professor in the Division of Cardiology at the Medical College of Virginia campus of Virginia Commonwealth University School of Medicine.

Dr. Bernardo publishes extensively in his field. He lectures frequently at meetings and conferences, both nationally and internationally.

Dr. Bernardo was the clinical investigator or co-investigator in dozens of trials in the field of cardiology and cardiovascular disease. He is currently involved in a number of ongoing trials and clinical studies.

Dr. Bernardo is involved in peer review for numerous publications, including Angiology and Journal of Invasive Cardiology.

Brian Case, MD

Brian Case, MD

Brian Case, MD, FACC, joined the cardiology team at MedStar Southern Maryland Hospital Center in August 2021 as an Interventional Cardiologist and member of the MedStar Heart & Vascular Institute. He is board certified in interventional cardiology, cardiovascular disease and internal medicine with extensive fellowship training.

Dr. Case specializes in treating patients with coronary artery disease through modern technological interventions such as optical coherence tomography, which produces high-definition images of the artery to help guide stent selection, placement and deployment. His fellowship training includes performing fractional flow reserves (FFR), instantaneous wave-free ratios (iFR) and evaluating for physiological cardiac ischemia.

Philosophy of Care

“My hope and goal is to incorporate a lot of my fellowship training into the clinical practice and daily decision making for our patients here at MedStar Southern Maryland. In the world of physiology, using fractional flow reserves and instantaneous wave-free ratios on a daily basis will help guide treatment plans and allow us to provide more individualized, high-quality heart care. It’s about having transparency and innovation that leads to the best possible outcomes for our patients.”

Itshac Itsik Ben-Dor, MD

Itshac Itsik Ben-Dor, MD

Itshac Itsik Ben-Dor, MD, is Program Director Interventional Cardiology Fellowship MedStar Washington Hospital Center ,Associate Director Medstar Washington Hospital Center Cardiac Cath Labs, Associate professor Georgetown University Washington, DC.

A member, and a fellow of the American College of Cardiology and Board Certified in Internal Medicine, Cardiology, and Interventional Cardiology. Dr. Ben-Dor is part of a unique team that is performing high volumes of treatments for coronary and structural heart disease in addition to complex coronary interventions.

As an interventional cardiologist, Dr. Ben-Dor specializes in the treatment of coronary and structural heart disease through the use of percutaneous coronary intervention, balloon aortic and mitral valvuloplasty, alcohol septal ablation, transcatheter aortic valve implantation, mitral valve clip and transcatheter mitral valve replacement.

His clinical interests include treating patients with valvular heart disease and coronary physiology as well as acute coronary syndrome. His current research interests include exploring the efficacy and clinical outcomes of transcatheter aortic valve replacement and intravascular ultrasound and coronary physiology.

Dr. Ben-Dor received his medical degree from the Technion-Israel Institute of Technology in Israel before joining MedStar for fellowship training in interventional cardiology and structural heart disease in addition to residency training in internal medicine. Dr. Ben-Dor has completed more than 12 years of training, both in the United States and in Israel, which provide him with a depth of experience unparalleled in the region. He is certified by the American Board of Internal Medicine in Cardiovascular Diseases and Interventional Cardiology.

Dr. Ben-Dor was recently named Cardiovascular Disease Fellowship Faculty Educator of the Year by the MedStar Heart & Vascular Institute at Georgetown University. He is also widely published and has produced more than 280 manuscripts in peer-reviewed journals and serves on the editorial boards of Cardiovascular Revascularization Medicine Journal.

Philosophy of Care

“My role as a healthcare provider is to do what’s in the patient’s best interest. I believe it is important to educate and advise my patients as to the options they have regarding their care. There is always more than one treatment option available. For this reason, I believe patient-centered care is a big part of any medical decision.

Hayder Hashim, MD

Hayder Hashim, MD

Hayder Hashim, MD, is a cardiologist at Medstar Washington Hospital Center. As an interventional cardiology specialist, Dr. Hashim works with patients who have a wide variety of cardiovascular diseases including heart attacks, coronary artery disease, peripheral artery disease, advanced heart failure, and other conditions that require vascular intervention. Throughout his extensive clinical career, he has treated these conditions using some of the advanced procedures available: complex percutaneous coronary interventions, left ventricular assist devices, coronary artery atherectomies, and peripheral vascular intervention. Dr. Hashim is also board certified in nuclear cardiology, echocardiography, and vascular medicine.

Dr. Hashim has published his research in several peer reviewed journals and often gives presentations about his work at national and international meetings. He is dedicated to contributing to new and ongoing research efforts at Medstar Washington Hospital Center. He is particularly interested in plaque modification, including coronary artery plaque modification and alternative vascular access techniques.

After receiving his medical degree from the Baghdad University College of Medicine, Dr. Hashim completed a residency program in internal medicine at Rutgers University-New Jersey Medical School. He then completed two fellowships, the first in cardiovascular diseases at Rutgers University-New Jersey Medical School and the second in coronary and peripheral artery interventions at Albert Einstein College of Medicine/Montefiore Medical Center. During his fellowship training, Dr. Hashim also served as the Vice President and President of the American Heart Association (AHA) Fellows’ Society of Greater New York where he enjoyed working in the community to increase awareness about heart disease and sudden cardiac death.

In addition to being an attending cardiologist and active researcher, Dr. Hashim believes in engaging with the surrounding community by volunteering regularly and participating in public discussions with the AHA. Previously, he served as an executive speaker for the “Life is Why” campaign and as a member of the New York State advocacy committee for the AHA. Through these activities, he became an active advocate for the Hands-Only CPR bill in New York State, and played a major role in getting it passed in November of 2015.

Throughout his training and career, Dr. Hashim has received several great honors for his contributions to education, including the Golden Apple Excellence In Teaching Award for three consecutive years while at New Jersey Medical School and the prestigious Arnold F. Gold Award For Humanism and Excellence in Teaching.

Philosophy of Care

“When I practice, I always try to care for each of my patients as if they were members of my family. This is something I feel very strongly about. I feel it is incumbent upon me, the physician, to ensure that the patient understands their condition and the treatments available to them, so that they can make the best possible decisions for their circumstances. My patients come to me in times of great vulnerability and educating them is the cornerstone of my philosophy of care. I always put myself in their shoes and provide what I would like to have provided to me.”

Toby Rogers, MD

Toby Rogers, MD

Dr. Rogers in an interventional cardiologist and scientific lead for the MedStar Heart & Vascular Institute Structural Heart Disease program. He has a special interest in all aspects of minimally invasive treatment of structural heart disease, including Transcatheter Aortic Valve Replacement (TAVR), Transcaval access, Transcatheter Electrosurgery (LAMPOON and BASILICA techniques), para-valvular leak closure, percutaneous treatment of mitral valve regurgitation including Mitraclip and Transcatheter Mitral Valve Replacement (TMVR), LAA occluder, percutaneous pulmonary and tricuspid valve interventions, and cerebral protection devices for TAVR.

Philosophy of Care

MedStar Heart & Vascular Institute is a recognized leader in structural heart innovation so our patients can benefit from early access to the latest devices, treatments and techniques in this rapidly evolving sub-specialty. Our highly experienced team uses cutting edge multimodality imaging to plan each procedure to ensure we provide the best and most sustainable results for every patient.” —Toby Rogers, MD

Lowell Satler, MD

Lowell Satler, MD

Lowell Satler, MD,is Medical Director of the Cardiovascular Training and Educational Center and Director of Coronary Interventions at MedStar Washington Hospital Center in Washington, DC. Dr. Satler was one of the key physicians in the launch of the Structural Heart Disease Program, which advocates the use of percutaneous techniques to treat valvular disorders when standard surgery is not recommended.

In collaboration with Children's National Medical Center, he developed the Adult Congenital Heart Disease Program -- the only program in the region designed to follow patients with congenital heart defects from birth to adulthood. This program is fully staffed by congenital heart cardiologists to meet stringent requirements for multidisciplinary care.

In addition to his clinical work, Dr. Satler is an active investigator and serves as principal investigator for 21 interventional cardiology research protocols to improve patient outcomes in the treatment of coronary artery disease, congenital heart disease, carotid artery diseases, and other conditions.

In collaboration with AT&T, Dr. Satler developed CodeHeart, a wireless application that allows physicians to view ECGs and participate in real-time videoconferencing over a secure network. This technology was designed to improve heart attack diagnoses in the field, but can be used in all aspects of medical care to facilitate communication between experts and remote locations, thus enhancing treatment provided by first responders and shortening patient waiting time for treatment.

Dr. Satler writes and publishes extensively on the topic of invasive cardiology. His repertoire includes more than 300 scholarly publications in peer-reviewed journals and nearly 400 abstracts. In addition, he serves on the editorial boards of several cardiology journals, including the Journal of the American College of Cardiology,Catheterization and Cardiovascular Intervention, and the Journal of Invasive Cardiology. He is certified by the American Board of Internal Medicine in Cardiovascular Diseases and Interventional Cardiology. He is a member of Alpha Omega Alpha, the American College of Cardiology, the American Medical Association, the American Heart Association, and the American College of Physicians.

Dr. Satler earned his medical degree from Albany Medical College in New York. He completed a residency in Medicine at Albany Medical Center and a Cardiology Fellowship at the University of Alabama in Birmingham, AL.

Ron Waksman, MD

Ron Waksman, MD

Ron Waksman, MD, specializes in Interventional Cardiology. Dr. Waksman is the associate director of the Division of Cardiology at MedStar Heart Institute. He is also the director of Cardiovascular Research and Advanced Education at the Heart Institute. In addition, Dr. Waksman serves as clinical professor of Medicine (Cardiology) at Georgetown University.

He is editor-in-chief of Cardiovascular Revascularization Medicine and on the editorial boards of a number of other publications, including European Heart Journal and Journal of Interventional Cardiology.

Dr. Waksman publishes extensively and has authored or co-authored more than 600 articles. He has been the principal investigator for more than 100 research trials. Dr. Waksman serves on the Cardiac Cath Laboratory Peer Review Committee at MedStar Washington Hospital Center and is a MedStar Heart Institute board member.
Cardiac Imaging

Gaby Weissman, MD
Cardiac Surgery
Ammar S. Bafi, MD

Ammar S. Bafi, MD

Ammar S. Bafi, MD,is a cardiothoracic surgeon at MedStar Washington Hospital Center. He is board certified in thoracic surgery.

As a cardiothoracic surgeon, Dr. Bafi treats all adult cardiac disease, such as valvular and coronary artery disease, through the use of advanced surgical techniques. He specializes in mitral valve repair, as well as off-pump coronary artery bypass grafting.

With more than 25 years of experience, he has performed more than 10,000 heart operations with superb results, exceeding the national average in patient satisfaction, as well as achieving lower-than-average mortality outcomes. In his high-volume clinical practice, he performs approximately 400 heart surgeries each year.

Dr. Bafi serves on the Cardiovascular Surgery Program Quality Improvement Committee at MedStar Heart & Vascular Institute. He is also a member of the American College of Surgeons and the Society of Thoracic Surgeons.

Dr. Bafi received his medical degree from the George Washington University School of Medicine before completing a general surgery internship at Cornell University Medical Center/North Shore University Hospital. He then returned to the George Washington University Hospital to complete a six-year general surgery residency, which included one year of research. Finally, he completed a two-year specialty residency in cardiothoracic surgery at GWU, and one year as a clinical associate in the Department of Cardiac Surgery at the Cleveland Clinic Foundation.

Dr. Bafi’s clinical research includes serving as principal or co-investigator in multiple transcatheter aortic and mitral valve studies, including the CoreValve®, PARTNER, COAPT, and NeoChord™ trials. He continues to participate in many cardiac surgery and cardiology clinical trials, particularly as they relate to percutaneous valvular therapies. He works with a team of skilled interventional cardiologists to continue bringing novel treatments to his patients. Dr. Bafi’s research is widely published in medical journals.

Philosophy of Care

“Growing up as a child of diplomats, I lived in different countries. As a part of this experience, I learned to develop and appreciate a wide perspective on many people, religions, and cultures. I believe this contributes to my ability to connect and empathize with my patients and colleagues. I am driven by the knowledge that every day I’m working to improve the quality of life for my patients. I feel it is my privilege and honor to have a positive impact on my patients’ health and their lives.”

Jeffrey E. Cohen, MD

Jeffrey E. Cohen, MD

Jeffrey E. Cohen, MD,is a cardiovascular surgeon at MedStar Washington Hospital Center and the surgical director of the Structural Heart program for Washington region. He also serves as assistant professor of surgery at Georgetown University School of Medicine.

Dr. Cohen treats the complete range of adult cardiac diseases, including aortic stenosis and regurgitation, mitral regurgitation, mitral stenosis, tricuspid valve disease, endocarditis, coronary artery disease, and aortic aneurysm and dissection. He specializes in complex aortic surgery and structural heart therapies, implementing open, endovascular, and transcatheter techniques including transcatheter aortic valve replacement (TAVR), thoracic endovascular aortic repair (TEVAR), and transcatheter mitral valve replacement (TMVR).

He is a member of The Society of Thoracic Surgeons and serves as associate editor for the international, peer-reviewed journal Cardiovascular Revascularization Medicine (CRM).

Dr. Cohen earned his medical degree from the University of Pennsylvania School of Medicine. He then completed a residency in general surgery at the Hospital of the University of Pennsylvania, followed by a fellowship in cardiothoracic surgery at Stanford University Medical Center.

Dr. Cohen’s research has focused on developing novel therapies to correct the lack of blood flow to the heart to prevent tragic events such as a myocardial infarction, or a heart attack. His groundbreaking research investigating photosynthetic therapy for ischemic disease was published in Science Advances. His upcoming work will include studying gene therapy to address coronary artery disease. He has presented his research at a variety of national and international symposia and was a faculty speaker at the recent CRT meeting–one of the world’s leading interventional cardiology conferences.

Philosophy of Care

“I consider it a privilege to be granted the trust to operate on my patients. I believe in spending as much time with them as needed in order to inform them about their treatment, including pre-operative preparation, surgery, and post-operative care. I strive to offer patients the newest and most up-to-date therapies that will give them the best long-term results, most successful surgical outcomes, and shortest hospital stays. I offer them my recommendations for the best plan of care, recognizing that all key decisions must be made between myself, the patient, and the patient’s loved ones.”
Yuji Kawano, MD

Yuji Kawano, MD

Yuji Kawano, MD, is a cardiac surgeon at MedStar Washington Hospital Center with a unique specialization in minimally invasive and robotic heart surgery.

Dr. Kawano comes to MedStar Health from his advanced fellowship program at Emory University, where he received the full spectrum of training in robotic cardiac surgery under some of the first, and most experienced, robotic cardiac surgeons, worldwide.

A highly specialized approach, robotic heart surgery can provide patients with enhanced recovery, shorter hospital stays, and fewer complications compared to conventional methods. Robotics may be applied to treat mitral and tricuspid valve conditions, atrial fibrillation, and cardiac tumors, for low-risk surgical patients as well as high-risk patients with complex comorbidities.

Philosophy of Care

“Robotic surgery is an excellent option for a patient seeking better cosmesis, quicker recovery, and less post-surgical pain, without compromising the clinical result of surgery itself. I work closely with my colleagues to fully evaluate the benefits and potential risks for each case. My patients can always count on me to be honest with them –– to explain their situation and to help them understand their treatment options. My first priority is always the patient’s safety.”

Fellowships

Advanced Robotic Cardiac Surgery, Emory University Hospital, Atlanta, Georgia

Advanced Adult Cardiac Surgery, Brigham and Women’s Hospital, Boston, Massachusetts

Minimally Invasive Cardiac Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, Japan

Residencies

Cardiovascular Surgery, Ichinomiya Nishi Hospital, Aichi, Japan

General Surgery, Musashino Red Cross Hospital, Tokyo, Japan

Medical School

Osaka University Graduate School of Medicine, Osaka, Japan
Thomas MacGillivray, MD

Thomas MacGillivray, MD

Thomas MacGillivray, MD, is Physician Executive Director of Cardiac Surgery at MedStar Health and Chairman of Cardiac Surgery at MedStar Washington Hospital Center. Prior to joining MedStar Health, Dr. MacGillivray served as the Jimmy F. Howell, MD, Endowed Chair in Cardiovascular Surgery, Chief of the Division of Cardiac Surgery and Thoracic Transplant Surgery, and Associate Medical Director of the Cardiovascular Intensive Care Unit at Houston Methodist Hospital.

As a board-certified surgeon and thoracic surgeon with more than 30 years of experience in the field, Dr. MacGillivray is highly-skilled in both traditional open and minimally-invasive methods. While he performs conventional coronary artery bypass operations, valve repairs, and valve replacements, Dr. MacGillivray’s expertise stretches into more specialized procedures, including thoracic aortic repair and replacement, maze procedures, septal myectomies, and cardiac tumor procedures. He also has extensive experience in treating adult congenital heart disease.

Dr. MacGillivray is passionate about performing surgery — his dedication to clinical outcomes and seeing his patients through the entire care journey is evident in his love of caring for patients in the ICU and in the nursing units.

Dr. MacGillivray’s clinical interests include diseases of the aorta, including the aortic root, aortic arch, and thoracoabdominal aorta. He is a nationally recognized leader in the surgical treatment of patients with adult congenital heart disease, heart failure, and pulmonary embolism.

In addition to direct patient care, he also has a specific interest in quality improvement processes in cardiac disease, which involves database and outcome research. Dr. MacGillivray has published numerous peer-reviewed articles on aortic diseases, adult congenital heart disease, mechanical circulatory support, and cardiac tumors.

Dr. MacGillivray earned his medical degree at Tufts University School of Medicine before completing a general surgery internship and residency at Massachusetts General Hospital. He completed a two-year research fellowship at the University of California, San Francisco before returning to Massachusetts General Hospital for a specialty fellowship in cardiothoracic surgery, where he served as Chief Resident. Dr. MacGillivray did additional training in congenital heart surgery as the Chief Resident at Boston Children’s Hospital.

Before joining MedStar Heart and Vascular Institute, Dr. MacGillivray spent 19 years as a practicing cardiothoracic surgeon at Massachusetts General Hospital and Associate Professor of Surgery at Harvard Medical School, followed by five and a half years at Houston Methodist Hospital as the Jimmy F. Howell, M.D. Endowed Chair in Cardiovascular Surgery.

Dedicated to the advancement of the field of cardiothoracic surgery, Dr. MacGillivray is the First Vice President of the Society of Thoracic Surgeons. He is former President of the Northeast Cardiothoracic Surgery Society, is currently a member of the Thoracic Surgery Foundation Board of Directors, and holds a seat on the Editorial Board of the Annals of Thoracic Surgery. He has been involved in writing a number of clinical practice guidelines. He was the Writing Committee Chairman for the STS/AATS Clinical Practice Guidelines on Type B Aortic Dissection, and served on the writing group for the American Heart Association guidelines for the surgical treatment for pulmonary embolism. Some of his many acknowledgments have included multiple Partners in Excellence Team Awards by Massachusetts General Hospital and recognitions by Marquis Who’s Who In America and Best Doctors.

Dr. MacGillivray is excited to offer his expertise in various cardiac surgical subspecialties (complex aortic surgery) to the adept team at MedStar Heart and Vascular Institute and is honored to get to work in this nationally recognized heart program.

Philosophy of Care
“I consider it a privilege to take care of my patients–a privilege that, to me, implies a sacred trust. I care for every patient as if they were a member of my own family, and I try to do for them what I would want someone to do for my wife, my daughter, my brother, or my sister. There is no problem too big and no problem too small for my attention and my care.

“The practice of medicine now is a team sport. The beauty of MedStar Heart and Vascular Institute is that there is an incredible team of talented physicians and caregivers working together providing exceptional care. As with any team, one of the most important responsibilities is communication. When I work with referring physicians, my communication with them is vital for the patient’s success, since patients will return to their referring physicians after their heart surgery.

“While you can't always cure every disease or make every diagnosis, you can always be kind to every patient. Oftentimes, that is the medicine that helps the most; listening to them, understanding them, and being willing to help them. Throughout all my years of practice, I have found this to be absolutely true.”

Christian Shults, MD

Christian Shults, MD

Christian Shults, MD, is a cardiac surgeon at MedStar Washington Hospital Center. He is the regional director of cardiac aortic surgery, surgical ablation, and innovation, as well as the fellowship director for the complex aortic structural heart program. He is also an assistant professor of surgery at Georgetown University School of Medicine. Dr. Shults is board certified in general and thoracic surgery.

Dr. Shults specializes in the treatment of complex aortic disease, structural heart disease, valvular disease and redo valves, coronary artery disease, and atrial fibrillation through the use of open, endovascular, minimally invasive, and transcatheter treatment therapies. In particular, he treats patients with aneurysms of the aortic root, ascending aorta, aortic arch, descending thoracic aorta, and thoracoabdominal aorta, in addition to anomalous coronaries, hypertrophic cardiomyopathy, endocarditis.

As a national proctor for the Convergent Procedure for minimally invasive treatment of atrial fibrillation, Dr. Shults has performed one of the highest volumes in the country and gives lectures nationwide to other physicians about the procedure.

Dr. Shults is a member of the Society of Thoracic Surgeons, the American Medical Association, the Southern Thoracic Surgical Association, the International Society for Minimally Invasive Cardiothoracic Surgery, and a fellow of the American College of Surgeons. Dr. Shults recently served as interim chair of Cardiac Surgery between 2019 and 2021.

After receiving his medical degree from Georgetown University School of Medicine, Dr. Shults completed a residency in general surgery at MedStar Georgetown University Hospital-Washington Hospital Center. During this time, he spent a year at Harvard Medical School for a research fellowship at Massachusetts General Hospital, where he focused on developing novel strategies to treat patients in hemorrhagic shock. He then returned to MedStar Washington Hospital Center as chief resident of general surgery. After this, Dr. Shults continued his specialty training in Cardiothoracic Surgery at Emory University, where he completed a three-year specialized fellowship focusing on revascularization, complex aortic disease, valvular and transcatheter valvular therapies, as well as all other aspects of cardiac surgery. Next, he traveled to Leipzig, Germany for a visiting fellowship in minimally invasive/transcatheter aortic valve repair at the University of Leipzig Heart Hospital. He returned to the U.S. for an aortic surgery mini-fellowship at the University of Texas-Houston Memorial Hermann Hospital and an endovascular mini-fellowship at the Arizona Heart Hospital Department of Heart & Vascular Surgery.

Dr. Shults takes interest in healthcare reform, healthcare economics, and innovations for minimally invasive or transcatheter therapies. His research efforts include treatment outcomes for complex aortic disease, valvular heart disease, atrial fibrillation, and coronary artery disease. Dr. Shults is currently enrolling patients in several unique clinical trials, including the use of GORE® TAG® TBE, thoracic endoprosthesis in the treatment of lesions of the aortic arch and descending thoracic aorta; GORE® TAMBE, thoracoabdominal branch endoprosthesis for the treatment of thoracoabdominal and pararenal aortic aneurysms; NeoChord artificial chordae delivery system, a mitral valve repair technique for patients with severe mitral regurgitation; a new stent for the endovascular treatment of arch aneurysms; Allergan/Botox® study to evaluate the efficacy and safety of Botox for the treatment of atrial fibrillation; as well as several trials involving the latest in transcatheter valve technology. Additionally, he is principal investigator for the Bolton Medical acute complicated type B thoracic aortic dissection clinical trial.

Philosophy of Care

“My goal is to deliver the best solution possible to my patients, incorporating all of the innovation and technology available, while minimizing the impact on the body, such as recovery time and time away from work and daily activities. I take my role in the health of my patients very seriously. I’ve seen firsthand the impact that heart disease can have on a family: the downside of untreated heart disease and the downside of heart disease treatment complications. I’m intent on addressing and preventing complications from happening while also providing solutions. Each patient and their family are the center of a world that gets my full attention. An important aspect of treatment is explaining the disease process and providing an educational foundation to my patients so that they fully understand the significance of the disease and why it’s important to treat.”