Interventional Cardiology

The Interventional Cardiology Training Program is a one year Fellowship certified by the American Board of Internal Medicine for subspecialty training in angioplasty. Interventional Cardiology training exists within the general Cardiology Fellowship Program at Yale University and Yale New Haven Hospital.

Clinical Training Environment

Clinical training in interventional cardiology takes place primarily in the catheterization laboratories at Yale-New Haven Hospital. Yale-New Haven has three new digital Philips cath labs (including one combined vascular/cardiac lab), and one GE lab. Yale-New Haven performs 6,000 diagnostic procedures and 1600 interventional procedures annually, with 85% of this volume from the University interventional practice. Yale Interventional Cardiology employs all modalities of state-of-the-art percutaneous intervention, including intravascular ultrasound, rotational atherectomy, thrombectomy, distal protection, and coronary brachytherapy. Yale-New Haven serves as a tertiary referral center for a number of diagnostic catheterization labs throughout the state of Connecticut, as well as hospitals without diagnostic catheterization facilities. Yale-New Haven Hospital is fully committed to primary angioplasty as the treatment of choice for acute myocardial infarction, with approximately 80 primary angioplasties performed from our own ER annually, and a larger number of “salvage” or “rescue” procedures on patients from outside hospitals.

Interventional trainees participate in all university interventional procedures at Yale-New Haven Hospital and have primary responsibility for inpatient evaluation and management of patients with acute MI, unstable angina and stable angina. Trainees are also encouraged to participate in the evaluation and management of patients with peripheral vascular disease, including participation of diagnostic and therapeutic procedures for iliac, femoral, renal, carotid, and subclavian disease.

In addition to procedures at Yale-New Haven Hospital, interventional trainees participate in all coronary interventional and peripheral diagnostic and interventional procedures at the West Haven VA Medical Center. The West Haven VA is a clinical training site for Yale University School of Medicine, for all Yale residency programs, and for Yale general cardiology fellow trainees. The West Haven VA is a tertiary care hospital with a full range of cardiac services, including over 200 coronary interventions annually.

Outpatient training occurs through the Branford offices of Yale Cardiology. All Interventional trainees see patients one half day a week for primary evaluation and for follow up after hospitalization or after elective interventions.

Research

Yale has a long tradition of being at the forefront of interventional innovation, being the first cath lab in the northeast to use rotational atherectomy and the first in New England to place an intracoronary stent. More recently, Yale was first in Connecticut to use brachytherapy, and the Yale Endovascular Brachytherapy Program has the highest volume of cases in the state. Yale Interventional Cardiology continues to participate in all important multicenter interventional trials, such as the recently completed US rapamycin stent trial (SIRIUS).

In addition to multicenter clinical trials, Yale Interventional Cardiology is active in a number of single center, cath lab based translational research protocols. Recent examples include studies of complement activation in acute coronary syndromes, platelet-leukocyte interaction in acute coronary syndromes, brachytherapy dosimetry, mental stress ischemia, and estrogen modulation of coronary inflammation. Interventional fellows may also actively pursue research interests in basic science, with recent trainees involved in angiogenesis, stem cell therapy, and cardiac gene therapy research. Fellow trainees are particularly encouraged to participate in these local protocols; nonclinical research time can be tailored to the individual trainees needs and toward completion of an independent research project. Collaborations with other members of the cardiology section and members of the medical school faculty are strongly encouraged.

Fellow Education

The core of interventional fellow training centers on the hands-on experience of performing coronary interventions on a broad range of patients, with a wide spectrum of techniques in a variety of clinical scenarios. However in addition to training in the cath lab, Yale Interventional Cardiology holds weekly meetings for case review, journal club, and a series of didactic lectures which center on core materials for the Interventional Cardiology Subspecialty Board Exam. Other educational venues include weekly Cardiac Catheterization Conference and Yale Cardiology Grand Rounds, which is held semi-monthly throughout the academic year.

Faculty

Joseph J. Brennan Jr., M.D.
Associate Professor of Medicine (Cardiology)
Director, Interventional Fellowship Program

Henry S. Cabin, M.D.
Professor of Medicine (Cardiology)
Associate Section Chief, Cardiology Section, Yale University School of Medicine
Associate Director, Cardiac Catheterization Laboratory, Yale New Haven Hospital

Michael Cleman, M.D., F.A.C.C.
Professor of Medicine (Cardiology)
Director, Cardiac Catheterization Laboratory, Yale-New Haven Hospital

Faisal Hasan, M.D.
Instructor of Medicine (Cardiology)

Christopher J. Howes, M.D.
Assistant Professor of Medicine (Cardiology)

Michael Remetz, M.D.
Associate Professor of Medicine (Cardiology)
Director, Goodyer Cardiology Teaching Firm

Steven Pfau, M.D.
Assistant Professor of Medicine (Cardiology)
Director, Cardiac Catheterization Laboratory, VA Connecticut

John F. Setaro, M.D., F.A.C.C.
Associate Professor of Medicine (Cardiology)
Director, Cardiovascular Disease Prevention Center