Meet Ellie Whelan, Heart Patient

In November 2013, young actress Ellie Whelan was performing in front of a packed auditorium at Appomattox Regional Governor’s School for the Arts and Technology when she collapsed onstage. Audience members thought it was part of the act; then she didn’t get up. At the age of 16, she had suffered a cardiac arrest.

The school nurse performed chest compressions while a teacher gave her mouth-to-mouth resuscitation. Despite their interventions, she still lost her pulse. Paramedics, then her father, arrived.

Story-3_Ellie_Whelan“I stepped through the door as they’re beginning to shock her,” recalls her father, Jim Whelan. “They shocked her three times in front of me.” Her mother, meanwhile, was unaware of the situation unfolding.

An ambulance took her to Southside Regional Medical Center, where, because of the direness of the situation, she was packed in ice as part of the ARCTIC protocol. The treatment involves cooling the body to prevent further cell death. Then she was airlifted to VCU Medical Center.

“I spent two days in an induced coma,” says Ellie Whelan. “I didn’t have any brain waves. My parents were pretty certain that it was the end for me, but my doctors really stayed calm and collected, and they were really comforting to my parents. I really don’t think that they would have been able to get through it without people like Dr. [Mary Ann] Peberdy,” the director of the ARCTIC program.

Once she emerged from her coma, she underwent extensive physical and genetic testing. The tests determined that her erratic heartbeat was caused by a gene mutation in the cells around her heart. VCU Director of Cardiology Dr. Kenneth Ellenbogen worked with a Mayo Clinic geneticist to determine the best pharmaceutical course for her condition. She also received an implantable cardiac defibrillator (ICD).

A year and a half after her traumatic experience, Whelan is now a junior at Appomattox, still involved in musical theater. She also teaches cotillion at the Richmond Women’s Club. “I was really worried that I wasn’t going to be able to do stuff like that again, and that’s really scary because that’s what I’ve been doing forever, that’s my passion,” she says.

Her brush with death “has really put a lot of things into perspective. I think that probably for the first time since I was really little, I’m comfortable in my own skin. I’m really happy with who I am. And when I’m not happy, I’m not scared to change it anymore,” she says, noting that she even has a new short haircut, something she has always wanted to try.

Encouraged by her friends, she now shares her story with others. She spoke at the American Heart Association’s “Bollywood Goes Red” gala at the Virginia Museum of Fine Arts in February and is also part of an ad campaign for VCU Medical Center.

Audiences connect with her “because she’s smart, she’s warm, she’s funny, she has a lot of insight into people and the human condition, and she says what she feels,” says Dr. Ellenbogen. “She’s just an amazing human being.”
Whelan, who had some warning signs before her arrest, says that a previous doctor didn’t take her concerns seriously enough because she is a teenager. “I think it’s really important to get the word out, that heart problems aren’t just for people who are older; they can happen to anybody,” she says.

Dancing with the Richmond Stars

Although he claims to have “two left feet and two left arms,” Dr. George Vetrovec and his partner, Rigby’s Jig dance instructor Nicole Libby, won the “People’s Choice Award” at Dancing with the Richmond Stars. Like the t.v. show, local “celebrities” are paired with dance instructors to prepare for the event, which has already raised $91,000 this year for the Children’s Hospital of Richmond at VCU.

DWTS_Dr_VetrovecDr. Vetrovec, the director of VCU Adult Cardiac Catheterization Laboratory, and his partner spent about 10 weeks practicing their dance-a rumba to the theme from “GoldenEye.”

“I danced as James Bond and Nicole danced as a Russian spy,” he says. “I came out like the Bond movies always start, pretending to shoot a gun.” Although dancing was outside of his comfort zone, he says he agreed to perform “because I thought it was a worthy cause. I had a good time.”

“We were so impressed with Dr. Vetrovec’s enthusiasm and desire to compete. He had his heart in this event to raise money for CHoR from day one. He spent many hours practicing in addition to helping with promotion, marketing and fund raising,” says Charlotte Roberts, who with Karen Shudtz has co-chaired the event since its beginning five years ago.

Letter from the Chairman

Friends and Supporters,

Saving a teenager with a rare genetic heart defect, welcoming new practitioners, celebrating 100 TAVRs, continuing leading-edge research and growing our practice have marked the prior six months. In this issue of The Beat, we share about these achievements.

You’ll read about our expansion and growth to new locations with new providers who bring extensive knowledge to our clinical and research programs. Access and outreach are core values for us, and because of that, this expansion to outlying clinics engages more people in Central Virginia and aids us in our ability to build relationships with community practitioners. These community relationships are central to our mission as an academic center.
Inside you will also read about our basic, clinical and translational 
science. Much of what we are doing is only happening in Virginia at VCU, and we are proud of that. From heart failure to valve disease, cardiac cath to electrophysiology and cardiac surgery, we are steadfast in our commitment to developing and delivering the latest science and interventions for our patients. Those of you who support us make this continued progress 
possible, and for that we are so grateful.
On behalf of Dr. Vig Kasirajan in Cardiac Surgery and our teams of cardiologists and cardiac surgeons, please enjoy this issue of The Beat, and thank you for your continued and steadfast support.

Warmest Regards,
Kenneth A. Ellenbogen, M.D.
Chairman, Division of Cardiology

Heart Rhythm Society Honors Dr. Ellenbogen

Congratulations to Dr. Kenneth Ellenbogen, chair of the Division of Cardiology, who has been selected for the Distinguished Teacher Award by the Heart Rhythm Society, a leading international professional organization for those who work in the cardiac arrhythmia field. The award recognizes an individual who has demonstrated outstanding skills as a teacher in electrophysiology and/or cardiac pacing.

“During his almost 30 years at MCV, dozens of fellows have benefited directly from his instruction, but his influence is much wider; he is an internationally recognized leader in fellow education, participating in and chairing dozens of fellow-training seminars. In addition, he is in the top echelon of highly sought speakers at national and international symposia for audiences of academic and practicing electrophysiologists,” says Dr. John M. Miller, professor of medicine at the Indiana University School of Medicine, in his nomination.

Dr. Ellenbogen, who also serves on the society’s Board Review Course, received the prestigious award in May at the organization’s annual meeting.

Welcome, New and Returning Faculty!

Children’s Hospital of Richmond at VCU (CHoR) has a new chief of Pediatric Cardiothoracic Surgery– Dr. Thomas Yeh, Jr.  Dr. Yeh has also been named director of the Children’s Hospital Foundation Heart Center at CHoR.

Story-9_Dr_Thomas_YehDr. Yeh, who joined the faculty on October 1, was previously affiliated with Pediatric Heart Center, Tulane University Hospital and Clinic. After receiving his M.D. from Johns Hopkins University, he completed his Ph.D. and general surgery and cardiothoracic surgery residencies at VCU Medical Center, then completed a pediatric cardiothoracic surgery fellowship at the Hospital for Sick Children, University of Toronto.

“Dr. Yeh is a nationally renowned congenital heart surgeon who has extensive experience in all aspects of surgery for children with heart conditions. His recruitment was an important milestone and due to close collaboration between Children’s Hospital Foundation and VCU Medical Center,” says Dr. Vigneshwar Kasirajan, chair of the VCU Department of Surgery. “He will raise the quality of care delivered to children in Virginia and make CHoR an important destination for complex cardiovascular care.”

In December, CHoR received a $28 million gift from Children’s Hospital Foundation, the single largest gift to pediatric health care in VCU’s history, to establish the Children’s Hospital Foundation Heart Center at CHoR. VCU Medical Center has supplemented the gift with a $14 million commitment toward equipment and operations.

“I was at VCU for 13 years during my medical training, and I’ve always wanted VCU to have a strong congenital heart program. So when the Children’s Hospital Foundation, VCU and CHoR came together to envision a world-class pediatric heart program, and offered me a chance to get back to my alma mater, I couldn’t resist,” says Dr. Yeh.
He is pleased to return to VCU. “It has always been a dynamic and exciting environment,” he says. “There is great nursing here, great doctors, eager beaver medical students and residents, and a fantastic infrastructure in terms of the labs, radiology, all the kinds of high-tech bells and whistles that you would like a great medical center to have.”

He adds that “I’m humbled by the incredible support of Children’s Hospital Foundation and VCU Medical Center. It is an honor to provide cardiac care to children and families in Central Virginia and to give back to one of the institutions that was so fundamental to my training.”

. . .

Story-9_Bagameri_GaborIn January, cardiothoracic surgeon Dr. Gabor Bagameri returned from a 3 ½–month deployment with the U.S. Army Green Berets in Afghanistan. “I went as a general surgeon with a forward surgical team in the Afghan mountains in a remote special forces camp,” he says.

Originally from Hungary, Dr. Bagameri joined the reserve in 2010 and made a six-year commitment in exchange for U.S. citizenship. He joined the VCU faculty last June and was deployed in September.

“I am happy to be back with my family and the work I really enjoy. After being deployed and in harm’s way, I appreciate the small gifts and pleasures life has to offer and not taking everything for granted,” he says. “I have the utmost respect for U.S. military members who are away from their families, fulfilling their missions at the highest standards and willing to sacrifice their lives without thinking about it twice.”

Now that Dr. Bagameri has returned, he is working in the structural heart program and Story-9_Gabor_Bagamerialso developing a new aortic disease program along with colleagues in vascular surgery, radiology, cardiology and genetics. “As a surgeon, he has unique skills in vascular and cardiac surgery, and is board-certified in both,” says Dr. Vigneshwar Kasirajan, chair of VCU Department of Surgery. As for his service, “We are very proud of his contributions to the armed forces and fully support him in this critical role.”


Leading the Way in Research

Dr. Keyur Shah is the principal investigator for two exciting studies, ATTR-ACT and Endeavor. “We are the only center in Virginia engaged in these trials,” says Dr. Shah, medical director of VCU’s Mechanical Circulatory Support Program. The stage III clinical trials involve the use of the drugs tafamidis and AALN-TTRSC for the treatment of hereditary cardiac amyloidosis.

Cardiac amyloidosis is caused by deposits of an abnormal protein in the heart tissue. Over time, the accumulation of these proteins can lead to heart failure. Dr. Shah’s studies will be targeted to identifying and treating those with a mutation of the transthyretin [TTR] gene, linked to the condition.

“It’s hereditary, and we think it’s one of the major causes for racial discrepancies in heart failure outcomes,” says Dr. Shah, noting that African-Americans are disproportionately affected by amyloid-related heart failure in the U.S. With the Endeavor and ATTR-ACT trials now beginning, “We can offer medical therapy for a disease that previously required heart and liver transplantation.”

He is also heading a third trial, Discovery, which will involve identifying those who may have the condition as a result of a TTR mutation. The study will provide free genetic testing to patients.

Dr. Zachary Gertz is VCU’s principal investigator for a national study on the Parachute Ventricular Partitioning Device, which may help in the treatment of heart failure. As the name implies, the device opens like a parachute and “excludes the non-functioning part of the heart, concentrating the blood in the areas of the heart where the muscle is still squeezing well,” says Dr. Gertz, director of the VCU Structural Heart Disease program.

The device is being tested on heart attack survivors who are suffering from heart failure. Placing the device does not require open heart surgery—it’s done under conscious sedation in the catheterization lab. To date, Dr. Gertz, one of the top implanters in the country, has inserted five of the devices in patients. “They appear to be working pretty well, but that is just my anecdotal experience. We will not really know if the device works until the trial is complete.” He hopes that the parachute will improve the overall function of the heart for those suffering from heart failure. Patients will be followed in the trial for up to five years.

Dr. Antonio Abbate and Dr. George Vetrovec are leading a stage III clinical trial at VCU on the Odyssey, an injectable drug created by Sanofi U.S. Services Inc. and Regeneron Pharmaceuticals. The drug is aimed at patients with high cholesterol that cannot be sufficiently controlled by a lipid-modifying or “statins” therapy.

“This is a new agent that has incredible power for lowering LDL cholesterol—the bad cholesterol. It has significant benefits, particularly for people who can’t take the stats, which are considered the gold standard for lowering cholesterol,” says Dr. Vetrovec, director of VCU Adult Cardiac Catheterization Laboratory. “Time will tell whether Odyssey will have better outcomes than the standard therapy. So far, it’s been very powerful and very effective.”


Discovery Series Event Focuses on Cardiology

Story-7_Dr_Ellenbogen_guestsAt a recent MCV Discovery Series event, guests learned more about heart disease and the latest advances in cardiovascular research. Dr. Jerome F. Strauss III, dean of VCU School of Medicine, led a panel of VCU Pauley Center cardiologists. The event was held November 6 at Two Rivers Country Club in Williamsburg.

“The MCV Foundation launched the Discovery Series in November 2013 in Williamsburg to help increase the visibility of VCU Medical Center and highlight our many areas of excellence. The response has been very positive. During the past year, the Foundation hosted four events and provided the guests with immediate access to the exciting work of our scholars, researchers and clinicians who are truly medical experts in their fields. In many cases, they wrote the books,” says Brian Thomas, interim president, MCV Foundation.

On the panel, Dr. Antonio Abbate spoke about the causes of heart attacks, the connection between inflammation and heart failure, and his clinical research on these subjects. Dr. George Vetrovec shared information about coronary artery disease and explained why people have heart attacks. Dr. Jordana Kron focused her talk on women and heart disease. Finally, Dr. Kenneth Ellenbogen spoke about advances in the electrical management of heart disease. After the event, guests had the opportunity for one-on-one discussions with the physicians at a strolling reception.

Dotty and Bill Healy of Williamsburg were among those attending the event. “The eveningStory-7_Dr_Kron_Dr_Vetrovec was extremely well-executed,” says Mr. Healy, who was impressed by the caliber of the speakers at the event. “The audience came away happy and informed. The doctors went the extra nine yards to provide a lot of needed bedside education.”

The Healys were inspired to make a significant gift to Pauley Heart Center to support cardiovascular research.

“I’m just absolutely delighted by their generosity and their support of Pauley Heart Center,” says Dr. Ellenbogen, chair of VCU Division of Cardiology. “Donations like this make a huge difference and really allow us to do groundbreaking research.”


In Memory

In recent months, the Pauley Heart Center has lost several special friends. These individuals have made great contributions to the life of our center, the impact of which will be felt for many years to come.

Businessman and devoted community philanthropist Charles Thalhimer died on September 2. His support to VCU included the Pauley Heart Center, the School of the Arts, the School of Medicine, the Massey Cancer Center and the School of Business. For the latter, he established the Thalhimer Family Endowment Fund, among the largest endowments in the VCU School of Business.

He served as co-chair of two large Pauley Heart Center campaigns. “He was very enthusiastic and worked tirelessly. Whenever you asked him to do something, he took it on with great vigor and always had ideas about people to involve. He was a very, very positive individual who was committed to doing good things,” says Dr. George Vetrovec, director of VCU Adult Catheterization Laboratory.

VCU lost another dear friend, John B. “Jack” Russell, who passed away on January 14. He was an attorney whose work focused on medical
malpractice defense.  In one of his most significant trials, he defended heart transplant pioneer Dr. Richard Lower and other MCV faculty after the university’s first heart transplant when they were sued by the brother of the donor.

“His seminal defense resulted in the acceptance of brain death as a legal concept and paved the way for the growth of solid organ transplantation worldwide,” says Dr. Vigneshwar Kasirajan, chair of the Department of Surgery for VCU Medical Center. “The modern practice of transplantation resulted from his successful defense.”

In addition to his influential work in the courtroom, “Jack Russell was a delightful person who was very supportive of the heart center and the cardiology consortium,” says Dr. Vetrovec.

Dr. Kenneth Ellenbogen, chair of VCU Division of Cardiology, fondly remembers James C. Roberts, who died on March 8. “Jim Roberts cast a gigantic shadow. He was a tall man, and he would walk into a room and command everyone’s attention. He was a brilliant lawyer and had a way of talking that made everyone come to an agreement in a happy and comfortable fashion. He had a mind like a steel trap but was the always affable friendly Southern gentleman. He played a role in a number of landmark legal cases.”

He was also a tireless community volunteer. With his wife, Charlotte, “Jim was a huge supporter of the Pauley Heart Center and was critical in helping us get it started,” says Dr. Ellenbogen. The James C. Roberts, Esq., Professor of Cardiology was named in his honor.

Two New Cath Labs Unveiled

In March, two more labs opened their doors as part of a $24 million renovation that VCU Pauley Heart Center began in 2013.

“They’re state-of-the-art labs aimed at providing the best quality imaging that’s available for both diagnosis and interventions,” says Dr. George Vetrovec, director of VCU’s Adult Cardiac Catheterization Laboratory. The improved imaging enhances the safety of routine procedures, while also allowing the heart center to treat more high-risk patients in a cath lab setting, he says.

In the large, uncluttered labs, stainless steel cabinets hide supplies, and much of the equipment is mounted on ceiling booms—meaning, no power cords to trip over. Large flat-screen monitors hover near operating tables. Physicians can view, on multiple split screens, patient vitals, past scans, images from other diagnostic equipment and real-time fluoroscopy—all supported by monitors in an adjoining control room. The equipment and the room design reduce patient and staff radiation exposure to the lowest levels possible while providing exceptional images.

Story-5_New_cath_labOn the floors, pathways in different colors show where the equipment will move during a procedure. The paths are helpful to team members. “It tells them right away where they can safely stand,” says Ruth Williams, RN, nurse manager, Invasive Cardiology, Electrophysiology and Cardiovascular Procedural Care Unit.

The new environment combines the amenities of a cardiac catheterization lab with the sterile environment of an operating room—allowing for more complex invasive interventions. Cath 1 is designed for the pediatric population with bright colors on the walls and other amenities. In the room, doctors can also perform diagnostic and interventional procedures in the peripheral veins and arteries of the body.

“Before, when we had patients with blockages in their legs, we really didn’t have optimal facilities in the cath lab to work with them. They had to have surgical interventions,” says Dr. Kenneth Ellenbogen, chair, VCU Division of Cardiology.

“Cath 2” includes an Innova IGS 520 system and Corindus Vascular Robotics, used for percutaneous cardiac interventions and the positioning of stents.

“Cath 3” and “Cath 4” are now undergoing renovations. Cath 4 will be a “hybrid” room featuring the Discovery IGS 630 system, which has a gantry with flexible positioning that is ideal for conducting procedures for structural heart disease. It also allows doctors to immediately convert from minimally invasive to open-heart procedures if necessary.

The heart center opened the first new lab in September 2013. When the entire project is completed, the Pauley Heart Center will have seven state-of-the-art GE labs to meet the increasing needs of its patients and enhance its ability to conduct new procedures in the long term.

As for research, “the labs will give us more tools to understand the physiology of the heart and will lead to more discoveries,” says Dr. Ellenbogen.


VCU Completes 100th TAVR!

Congratulations to cardiologist Dr. Zachary Gertz and cardiac surgeon Dr. Gabor Bagameri and their team for performing VCU’s 100th transcatheter aortic valve replacement in March. Only a few other sites in the region have achieved this landmark.

“We are very proud of our excellent results and ability to bring this and other new therapies for valvular heart disease that do not require open chest surgery. This has made a huge impact on our patients’ lives and we look forward to leading the medical community in this area,” says Dr. Kenneth Ellenbogen, chair of VCU Division of Cardiology.

According to Dr. Gertz, director of the VCU Structural Heart Disease program, “Every case has one cardiologist and one surgeon and we work together.” The team has also started doing the procedure with conscious sedation, instead of with general anesthesia or a breathing tube. “It leads to faster recovery times. We do more of this than any other program in the state.”