WellStar Structural Heart and Valve Program · The WellStar Structural Heart and Valve Program is a...

WellStar Structural Heart and Valve Program

Structural Heartand Valve Clinic

3Structural Heart and Valve Program

Table of Contents

WellStar Structural Heart and Valve Program (SAVE) ......................................................... 4

WellStar Cardiovascular Surgery .......................................................................................... 5

Transcatheter Aortic Valve Replacement (TAVR)................................................................. 7

TAVR Case Study ................................................................................................................... 9

Transcatheter Mitral Valve Repair (TMVR) ......................................................................... 10

TMVR-MitraClip® Case Study ............................................................................................ 12

WATCHMAN™ Left Atrial Appendage Closure System ................................................. 13

WATCHMAN™ Case Study................................................................................................ 15

Referring Patients to the SAVE Program ........................................................................... 16

WellStar SAVE Team ............................................................................................................ 17

Contact Information ............................................................................................................ 19


4 WellStar Kennestone Hospital

Structural Heart And ValvE (SAVE) Program

The WellStar Structural Heart and Valve Program is a collaborative, comprehensive initiative focused on the evaluation and treatment of patients with advanced and complex structural heart problems including valvular heart disease, intracardiac shunt defects and left atrial appendage occlusion. Providing traditional valve surgery along with minimally invasive interventional options, WellStar’s clinical results are among the national leaders in terms of positive outcomes with fewer complications.

The core of the WellStar Structural Heart and Valve Program is a multidisciplinary team of valve specialists that includes cardiac surgeons, electrophysiologists, interventional cardiologists, a cardiac sonographer and a cardiac anesthesiologist. Offering one-stop collaboration between multiple specialists, the WellStar Structural Heart and Valve team provides timely work-ups and evaluations, close contact with the patient and families throughout their journey and ongoing communication with referring physicians.

Our patient-centered approach is facilitated by a Nurse Coordinator who guides the patient and family from the point of evaluation through treatment and recovery. The Nurse Coordinator serves as a link to the care team and provides patient education, support and information related to hospital services and community resources.

Structural Heart and Valve Team:

William Cooper, M.D., Cardiac Surgery

Matt Grabowski, M.D., Cardiac Anesthesiology

Sarita Kansal, M.D., Interventional Echocardiography

Narendra Kanuru, M.D., Cardiac Electrophysiology

Richard Myung, M.D., Cardiac Surgery

Amar Patel, M.D., Interventional Cardiology

Arthur Reitman, M.D., Interventional Cardiology

Allison Berard, PA-C

Hetal Patel, PA-C

Tiffany Amos, RN, BSN, Program Manager

Kevin Wall, RN, BSN, Outreach Coordinator


Cardiovascular Surgery at WellStar Kennestone Hospital

wellstar.org

Now also providing cardiac surgery services at WellStar Atlanta Medical Center.

• The WellStar Cardiovascular Surgery team includes Dr. William Cooper, Dr. Theresa Luu, Dr. Harrell Lightfoot and Dr. Richard Myung.

• Society of Thoracic Surgery (STS) rates the coronary artery bypass program with a “3 Star Quality Rating” out of 3 Stars

- Only the top 10 percent of hospitals in the nation are awarded this recognition by STS

• Recognized by BCBS for the Cardiac Distinction Recognition Award for Cardiac Excellence and by Aetna as an “Institute for Quality Cardiac Medical Intervention Hospitals” due to high achievement in cardiac surgery quality indicators as defined by the National Quality Forum

• Awarded Joint Commission certification for CAB and Valve Replacement and Repair programs

- WellStar Health System is the second in the nation to achieve dual certification in CAB and valve repair/ replacement

• The cardiovascular surgery team provides world-class cardiovascular surgical care and outcomes through state-of-the-art, high quality service delivery

The cardiovascular surgery team treats:

• Aortic valve disorders

• Aortic aneurysms

• Mitral valve disorders

• Triscupid valve disorders

• Coronary artery disease

• Atrial fibrillation

• Structural heart defects

WellStar Medical Group Cardiovascular Surgery 61 Whitcher Street | Suite 4100 Marietta, GA 30060 | 770-590-4180

New satellite offices:

WellStar Metro Atlanta Cardiovascular Medicine 999 Peachtree St. N.E. | Suite 850 Atlanta, GA 30309 | 404-874-1788

WellStar Cardiovascular Medicine North Fulton 4500 Hospital Boulevard | Suite 230 Roswell, GA 30076 | 770-410-4520

OFFICE LOCATIONS:


WELLSTAR CARDIOVASCULAR SURGERY PHYSICIANS

HARRELL LIGHTFOOT, M.D.

Dr. Harrell Lightfoot is a cardiothoracic surgeon. He operates at WellStar Kennestone Hospital in Marietta, Georgia

Dr. Lightfoot received his bachelor’s degree from Johns Hopkins University and his medical degree from the University of North Carolina at Chapel Hill. He completed his general surgery residency at Emory University, and his cardiothoracic fellowship at the University of Texas Southwestern Medical Center in 2016.

Dr. Lightfoot’s clinical interest include coronary artery bypass, endovascular and open aortic surgery, and minimally invasive thoracic surgery. During his fellowship at UT Southwestern, he gained significant experience in robotic thoracic surgery including the management of lung cancer, mediastinal masses, esophageal cancer and benign esophageal disease. Dr. Lightfoot plans include utilizing this expertise as a major part of his practice with WellStar Medical Group, Cardiovascular Surgery.

WILLIAM A. COOPER, M.D., MBA

Dr. William A. Cooper is a board certified cardiothoracic surgeon. He holds the position of medical director of cardiovascular surgery with WellStar Health System.

Dr. Cooper is a graduate of the University of Missouri-Kansas City, where he earned Bachelor of Arts in Biology and Doctor of Medicine degrees in the combined six year BA/MD program. Dr. Cooper received his post graduate training at Emory University, where he chose his specialty —cardiothoracic surgery.

His commitment to advancements in the medical field has led Dr. Cooper to become involved in many national and international organizations. Through publication, research, leadership and the national presentations he has given among his peers, Dr. Cooper has become a respected authority in the field of cardiovascular surgery.

Dr. Cooper retired as a Colonel from the United States Army Reserve Medical Corps. He is a veteran of Operation Iraqi Freedom where he served two tours of duty during 2004 and 2007.

Dr. Cooper’s special interests include valvular heart disease, aortic aneurysms, and healthcare quality and safety improvement.

Dr. Theresa D. Luu is a cardiothoracic surgeon, board certified in general and thoracic surgery. She operates at WellStar Kennestone Hospital in Marietta, Georgia.

Dr. Luu is a graduate of the University of Pennsylvania in Philadelphia, where she earned a Bachelor of Arts in Biological Basis of Behavior. She received a Medical Doctorate from Emory University School of Medicine in Atlanta, Georgia. Dr. Luu’s postgraduate training includes a one-year stent as chief resident in general surgery and a 4-year fellowship and residency in cardiothoracic surgery at Emory University. Following the completion of her training, she remained at Emory as an assistant professor of surgery until her current position with WellStar Health System.

Dr. Luu enjoys giving talks and lectures to the local community to educate people on various topics related to her specialties and areas of clinical interests which include endoscopic atraumatic coronary artery bypass, atrial fibrillation ablation, and minimally invasive thoracic surgery.

THERESA LUU, M.D.

RICHARD MYUNG, M.D.

Dr. Richard J. Myung is a cardiothoracic surgeon, board certified in both general and cardiothoracic surgery. He is co-director of the structural heart program for WellStar Health System and operates at WellStar Kennestone Hospital in Marietta, Georgia.

Dr. Myung earned a Bachelor of Science in Molecular, Cellular, and Developmental Biology from the University of California, Los Angeles. He received a Doctor of Medicine at New York Medical College. Dr. Myung received his postgraduate training in cardiothoracic surgery at Emory University School of Medicine. Following his completion of training, he remained at Emory as an assistant professor of surgery until his current position at WellStar Health System.

Dr. Myung’s special interests include minimally invasive valve repair and replacement, trans-catheter valve replacement, minimally invasive coronary revascularization, and aortic aneurysm repair.

For direct transfer from your hospital into WellStar Kennestone Hospital or WellStar

Atlanta Medical Center, please call 1-855-WELL888 (935-5888).


WellStar Cardiac NetworkTranscatheter Aortic Valve Replacement (TAVR)

With an ever-aging population, identification and

treatment of heart valve disease has become a primary

focus in the treatment of cardiovascular disease. Aortic

valve stenosis is of particular concern given the dismal

prognosis of this condition as the valve worsens. The

normal aortic valve allows blood to freely exit the left

ventricle, the main pumping chamber of the heart. In

aortic stenosis, the valve does not fully open, due to

heavy calcium build-up, which decreases blood flow

from the heart. Without treatment, approximately 50%

of severe aortic stenosis patients will not survive more

than two years from the onset of symptoms. Historically,

treatment was via open-heart surgery. A significant

portion of patients however are not candidates for

traditional aortic valve replacement surgery due to

overwhelming co-morbidities such as age, history of

heart disease, frailty or other health issues.

Using the Edwards SAPIEN 3 Transcatheter Heart

Valve, WellStar Kennestone Hospital offers a life saving

alternative in the form of Transcatheter Aortic Valve

Replacement (TAVR).

The Edwards SAPIEN 3 Transcatheter Heart Valve is

approved by the U.S. Food and Drug Administration

(FDA) as a therapy for patients with severe symptomatic

calcified native aortic valve stenosis who have been

determined to be intermediate, high or prohibitive

surgical risk to replace their diseased aortic heart valve.

Edwards SAPIEN 3 transcatheter heart valve

Edwards SAPIEN 3 transcatheter heart valve closed

Edwards SAPIEN 3 transcatheter heart valve open


This procedure enables the placement of a balloon-

expandable heart valve into the body via a catheter. The

valve is designed to replace a patient’s diseased native

aortic valve without traditional open-chest surgery and

while the heart continues to beat – avoiding the need to

stop the patient’s heart and connect them to a heart-

lung machine. The procedure can be performed with

minimal anesthesia and takes approximately one hour.

The average hospital stay is two days.

The valve is approved to be delivered through an artery

accessed through a small incision in the leg (transfemoral

procedure); or for those patients who do not have

appropriate access through their leg artery, the valve can

be delivered via an incision between the ribs and then

through the apex of the heart (transapical procedure).

The WellStar TAVR team includes cardiac surgeons

Dr. William Cooper and Dr. Richard Myung,

interventional cardiologists Dr. Arthur Reitman and

Dr. Amar Patel, cardiac sonographer Dr. Sarita Kansal

and cardiac anesthesiologist Dr. Matt Grabowski.

Offering one-stop collaboration between multiple

specialists, the WellStar TAVR team provides timely

work-up and evaluations, close contact with the patient

and families, ongoing communication with referral

sources and clinical outcomes comparable or exceeding

those of academic medical centers nationally.

For further information, call 770-590-4180.

While open-chest surgery to replace the aortic valve is the gold standard treatment for severe symptomatic aortic stenosis, there are some patients who are not eligible for surgery or considered at high risk for surgery. These patients may be candidates for Transcatheter Aortic Valve Replacement (TAVR), which allows Heart Teams to replace a diseased aortic heart valve without open-chest surgery.

AMAR PATEL, M.D.INTERVENTIONAL

CARDIOLOGIST

WILLIAM COOPER, M.D. CARDIAC SURGEON

RICHARD MYUNG, M.D. CARDIAC SURGEON

ARTHUR REITMAN, M.D. INTERVENTIONAL

CARDIOLOGIST

SARITA KANSAL, M.D. CARDIAC SONOGRAPHER

MATT GRABOWSKI, M.D.CARDIAC ANESTHESIOLOGIST


Transcatheter Aortic Valve Replacement (TAVR)Case Reported by Amar Patel, MD, Arthur Reitman, MD and Richard Myung, MDWellStar Kennestone Hospital, Marietta, GA

Patient presentation/overview: Eighty-nine year old female with severe aortic stenosis, presented to the hospital on multiple occasions with CHF exacerbations. PMH includes CAD s/p PCI to LAD and RCA with DES 10/2014, PAF, breast CA s/p L mastectomy with chemo/radiation, and malignant hyperthermia. Deemed high-risk for surgical AVR secondary to advanced age and frailty.

Procedural Overview: The patient underwent successful transfemoral TAVR via a percutaneous approach with a #23 Edwards Sapien XT prosthesis.

Case Conclusion/Outcome: One-year echo shows normal functioning TAVR prosthesis with no AS/AI. Patient has had no further hospitalizations for heart failure and reports “feeling great.”

Pre-TAVR Echo Deployed TAVR

Post-TAVR Gradients Post-TAVR Echo


WellStar Cardiac NetworkTranscatheter Mitral Valve Repair

The MitraClip® procedure is a minimally invasive

catheter based therapy. It is performed using venous

access and real-time imaging thereby avoiding

cardiopulmonary bypass. A catheter is inserted

through the femoral vein to the affected area of the

heart. The MitraClip® is then delivered to the heart

through a catheter and attached to the leaflets of

the mitral valve. Once the clip is properly placed and

securely attached, it is deployed and the catheters

removed.

Patients generally recover within the post-procedure

hospitalization and demonstrate improved functional

capacity and a reduction in hospital readmission for

heart failure.

Clip Delivery System and Steerable Guide Catheter

Transcatheter Mitral Valve Repair (TMVR) provides

an option for select patients with degenerative

Mitral Valve Regurgitation (MR).

Mitral Regurgitation is the most common type of

heart valve insufficiency in the United States. It results

from a lack of leaflet coaptation between the two

leaflets of the mitral valve. In a normally functioning

mitral valve, blood flows in a single direction between

the left atrium and left ventricle. MR is characterized

by systolic retrograde flow from the left ventricle

into the left atrium. Over time, MR may lead to heart

failure, atrial fibrillation or pulmonary hypertension.

The two most common types of MR are Functional

(where the left ventricle is enlarged and pulls the

mitral leaflets away from each other preventing

closing) and Degenerative (a problem with the valve

leaflets themselves that prevents proper closure).

Approximately 4 million people have significant

mitral valve insufficiency with an annual incidence

of 250,000 new patients. Approximately 50, 000

of these patients undergo surgery each year in the

United States. Reasons for denying surgery include

impaired left ventricle ejection fraction (LVEF),

multiple comorbidities, and advanced age, all of

which are determinants for high operative risk.

TMVR increases the options for patients with

significant, degenerative MR who are at prohibitive

risk for surgical intervention. Using the Abbott

MitraClip® System, WellStar Kennestone Hospital

began offering transcatheter mitral valve repair in

April 2015.


AMAR PATEL, M.D.INTERVENTIONAL

CARDIOLOGIST

WILLIAM COOPER, M.D. CARDIAC SURGEON

RICHARD MYUNG, M.D. CARDIAC SURGEON

ARTHUR REITMAN, M.D. INTERVENTIONAL

CARDIOLOGIST

SARITA KANSAL, M.D. CARDIAC SONOGRAPHER

MATT GRABOWSKI, M.D.CARDIAC ANESTHESIOLOGIST

According to the ACC/AHA guidelines for valvular heart

disease, patients should be considered for mitral valve

intervention even if medications have led to improvement

in symptoms. Efforts will be made at WellStar to

effectively identify and appropriately evaluate patients

with moderate to severe MR.

Patients considered for evaluation include:

Asymptomatic Severe MR with:

• Central jet MR ≥40% LA

• Vena Contracta ≥0.7 cm

• Regurgitant Volume ≥30 cc

• Regurgitant Fraction ≥ 50%

• ERO > 0.20cm2

• LVEF > 60% and LVESD < 40mm

• LVEF ≤ 60% and LVESD ≥ 40%

• Pulmonary hypertension

Moderate MR with:

• Atrial fibrillation

• Pulmonary hypertension

• Symptoms

The WellStar TMVR team includes cardiac surgeons

Dr. William Cooper and Dr. Richard Myung, interventional

cardiologists Dr. Arthur Reitman and Dr. Amar Patel,

cardiac sonographer Dr. Sarita Kansal and cardiac

anesthesiologist Dr. Matt Grabowski. Offering one-stop

collaboration between multiple specialists, the WellStar

TMVR team provides timely work-up and evaluations,

close contact with the patient and families and ongoing

communication with referral sources.

For further information, call 770-590-4180.

MR is a debilitating disease that over time may lead to heart failure, atrial fibrillation or pulmonary hypertension. Medical therapy can treat the symptoms of MR. To treat the disease itself, surgery is effective for eligible candidates, but this is not an option for many patients. For significant, symptomatic, degenerative MR patients who are at prohibitive risk for surgery, TMVR provides an option.


Transcatheter Mitral Valve Repair (MitraClip®) Case Reported by Amar Patel, MD, Arthur Reitman, MD and David Caras, MD WellStar Kennestone Hospital, Marietta, GA

Patient presentation/overview: Eighty-six year old female presents to the Structural Heart Clinic with complaints of worsening shortness of breath, dyspnea on exertion and fatigue. Stress echo confirmed severe mitral regurgitation. Patient with prior surgical aortic valve replacement. She was evaluated by cardiac surgery and deemed extreme risk for traditional MVR secondary to redo sternotomy and advanced age.

Procedural Overview: The patient underwent successful transcatheter mitral valve repair with the use of two MitraClip® devices.

Case Conclusion/Outcome: - Reduction in mitral regurgitation from severe to trivial. - Patient was discharged POD #1 to home with family and continues

to progress well and reports a resolution of her symptoms.

Pre-Op Echo Pre-Op Echo

Clip #1 Deployed Clip #2 Deployed


WellStar Cardiac NetworkWATCHMAN™: Left Atrial Appendage Closure Device

Patients living with non-valvular atrial fibrillation (AF) now have access to a new treatment option that significantly reduces the risk of stroke. WellStar Kennestone Hospital is the first non-academic hospital to offer the treatment in Georgia. The WATCHMAN™ Left Atrial Appendage Closure Device is a first-of-its kind, proven alternative to long-term Warfarin therapy for stroke risk reduction in patients with non-valvular AF.

The WATCHMAN™ device is intended for percutaneous, transcatheter closure of the left atrial appendage (LAA). Approximately 90% of strokes in individuals with AF originate from blood clots that have formed in the LAA. The WATCHMAN™ device permanently closes off the LAA thus preventing clot formation and migration of emboli to the brain. The WATCHMAN™ device is a highly effective treatment option as an alternative to long-term anticoagulation for people who are at risk for stroke due to AF and who are not good long-term candidates for blood thinning. This may be due to certain medical conditions, a history of bleeding while on anticoagulation or a risk of bleeding from work-related accidents or falls.

Non-valvular AF is an irregular heartbeat that can lead to blood clots, stroke, heart failure and other heart-related complications. AF is the most common cardiac arrhythmia, currently affecting more than five million Americans. Patients with AF have a five-fold increased risk of stroke due to blood stagnating from the improperly beating atrium and the resulting blood clot formation. Stroke is more severe for patients with AF, as they have a 70% chance of death or permanent disability.

The WellStar WATCHMAN™ Team

NARENDRA KANURU, M.D. CARDIAC ELECTROPHYSIOLOGIST

ARTHUR REITMAN, M.D. INTERVENTIONAL CARDIOLOGIST

AMAR PATEL, M.D. INTERVENTIONAL CARDIOLOGIST


The most common treatment for stroke risk reduction in patients with AF is Warfarin therapy. The WATCHMAN™ device offers comparable AF stroke risk reduction to Warfarin. Additionally, the WATCHMAN™ device has demonstrated statistically superior reductions in hemorrhagic stroke, disabling stroke and cardiovascular death compared to Warfarin over long-term follow-up.

Despite its proven efficacy, long term Warfarin therapy is not well tolerated by some patients and carries a significant risk for bleeding complications. Nearly half of patients eligible for Warfarin are currently untreated due to tolerance and adherence issues. More than 90% of patients who receive the WATCHMAN™ device are able to stop Warfarin after 45 days.

The 1-1 ½ hour procedure is minimally invasive and is performed by a multi-disciplinary physician team including interventional cardiologists, an electrophysiologist, an interventional echocardiographer and an anesthesiologist. Because the left atrial appendage is shaped and sized differently in different people, ultrasound helps the team take measurements and choose the appropriately sized device. While the patient is under general anesthesia, the WATCHMAN™ device is implanted through a femoral vein access via a trans-septal approach by using a catheter-based delivery system. Following the procedure, patients typically need to stay in the hospital for 24 hours.

For further information regarding WATCHMAN™, contact the WellStar Structural Heart and Valve Program at 770-590-4180.


Left Atrial Appendage Occlusion (WATCHMANTM device)Case Reported by Amar Patel, MD, Arthur Reitman, MD and Narendra Kanuru, MD WellStar Kennestone Hospital, Marietta, GA

Patient presentation/overview: Eighty-seven year old female was referred to the Structural Heart Clinic for consideration of LAA occlusion. Patient with chronic atrial fibrillation since her mid-twenties complicated by multiple GI bleeds requiring transfusions. She had been tried on warfarin, rivaroxaban, and aspirin in the past for CVA prophylaxis.

Procedural Overview: The patient underwent successful successful left atrial appendage occlusion with a 30mm WATCHMAN™ device.

Case Conclusion/Outcome: - Patient was started on warfarin for 45 days post-procedure and tolerated well.

- 45-day follow-up echo shows excellent device placement with no evidence of leak or flow into the appendage. Patient was able to stop warfarin at that time.

Angiography of Appendage

Post-Deployment Echo 45 Day Follow-up Echo

WATCHMANTM placement WATCHMANTM deployment


Referring Patients to the WellStar SAVE Program

Whom Should I Refer?• Patients with valvular heart disease that is moderate to severe in nature• Patients with a PFO, ASD, PDA, or VSD• Patients with atrial fibrillation who are not good candidates for anti-coagulation or are

considering alternatives to anti-coagulation

How Can You Contact SAVE?Within WellStar Health System

Inpatient• “Inpatient Consult to Structural Heart” in WellStar Connect under “Orders”• Contact Allison Berard, PA-C at 770-241-8467 or Hetal Patel, PA-C at 517-902-1789

Outpatient• “Ambulatory Referral to Structural Heart” in WellStar Connect under “Orders”• Contact the Structural Heart Clinic: 770-590-4180

Outside WellStar Health SystemYou may call anyone on our team directly and we will be happy to handle your referral. If you prefer, you can also fax patient information to our office at 770-590-4186.

Dr. Amar Patel, Interventional Cardiologist .................................................. 678-206-9564

Dr. Arthur Reitman, Interventional Cardiologist .......................................... 404-723-9019

Dr. William Cooper, Cardiothoracic Surgeon ............................................... 678-467-2597

Dr. Narendra Kanuru, Cardiac Electrophysiologist ...................................... 404-788-7698

Dr. Richard Myung, Cardiothoracic Surgeon ................................................ 404-520-6523

Tiffany Amos, RN, BSN, Program Manager ................................................. 678-925-4309

Allison Berard, PA-C, Physician Assistant ...................................................... 770-241-8467

Hetal Patel, PA-C, Physician Assistant ........................................................... 517-902-1789

Kevin Wall, RN, BSN, Outreach Coordinator ............................................... 678-736-1529


WellStar’s Structural Heart and Valve Team

Dr. Cooper earned his medical degree at the University of Missouri in Kansas City, Mo. He completed his general surgery and cardiothoracic surgery residencies at Emory University in Atlanta, Ga. He is a Lieutenant Colonel – Medical Corps in the United States Army Reserve.

He is board certified by the American Board of Surgery and the American Board of Thoracic Surgery. He is a member of the Atlanta Medical Association, Georgia State Medical Association, Association of Black Cardiologists, Southern Thoracic Surgery Association, Society of Thoracic Surgeons, Association of Black Cardiothoracic Surgeons and Cobb County Medical Society. Dr. Cooper is in practice with WellStar Medical Group, Cardiovascular Surgery.

Dr. Myung earned his bachelor’s degree at the University of California in Los Angeles, Calif. and his medical degree from New York Medical College in Valhalla, N.Y. He completed residencies at Georgetown University Medical Center in Washington, DC, University of Pennsylvania in Philadelphia, Pa. and Emory University Medical Center in Atlanta, Ga.

He is board certified by the American Board of Surgery and the American Board of Thoracic Surgery. He is a member of the American College of Surgeons and American Medical Association. Dr. Myung is in practice with WellStar Medical Group, Cardiovascular Surgery.

A native of New Orleans, Dr. Reitman is a board certified cardiologist who graduated with a bachelor’s degree in English literature from Washington University in St. Louis in 1991. He earned his medical degree from Louisiana State University, New Orleans, in 1995. After completing his internal medicine internship and residency at Tufts Affiliated Hospitals, he went on to a Cardiovascular Disease fellowship at Brown University, Providence, R.I.

Dr. Reitman completed an Interventional Fellowship at The Mount Sinai School of Medicine in New York City in 2002 and is board certified in Interventional cardiology.

Special interests include complex coronary atherosclerotic disease, including atherectomy devices, novel antiplatelet therapeutics, and nuclear cardiology. Dr. Reitman is currently on staff at WellStar Cobb, Douglas, Kennestone and Paulding hospitals. He currently serves as the medical director of the Catheterization Labs at WellStar Kennestone and Cobb Hospitals.


Dr. Patel received his medical degree from the Medical College of Georgia. He completed his internship and residency at the University of Alabama at Birmingham and went on to complete a fellowship in Cardiovascular Disease and interventional cardiology at Emory University. Dr. Patel is a professional member of the American College of Cardiology and the Society of Cardiac Angiography and Intervention. Dr. Patel is board certified in Cardiovascular Disease and interventional cardiology. He is a member of several medical and professional societies. He has advanced training in cardiac and peripheral vascular imaging and extensive experience in clinical research. Dr. Patel’s areas of interest include: percutaneous coronary intervention, structural heart disease/congenital heart defects, and valvular hear disease. Dr. Patel joined Cardiovascular Medicine in August 2007. He is currently on staff at WellStar Cobb, Douglas, Kennestone and Paulding hospitals. When not at work, Dr. Patel loves to spend time with his wife and children. He also enjoys traveling and reading.

Dr. Kansal is the Medical Director of Non-Invasive Imaging for WellStar Health System and a board certified cardiologist with additional board certified training in echocardiography and nuclear cardiology. She received her medical degree from the University of Delhi and completed her internship and residency at Southern Illinois University in 1997. She was on faculty as assistant professor until 2000. She subsequently did her cardiology fellowship at Vanderbilt University and a fellowship in echocardiography at Emory University. Dr. Kansal is a fellow of the American College of Cardiology(ACC), the American Heart Association(AHA), and the American Society of Echocardiography(ASE). She joined Cardiovascular Medicine in September 2004. She is also ex-clinical assistant professor of medicine at Emory University. She is medical director of echocardiography of WellStar Cardiac Diagnostics and is currently on staff at WellStar Cobb and Kennestone hospitals. Dr. Kansal’s areas of interest are echocardiography, nuclear cardiology, and women’s health. A native of India, Dr. Kansal is married and has two children.

Dr. Kanuru attended both college and medical school at the University of Miami and graduated from the six-year combined bachelor’s/medical degree program in 1994. During that period, he spent one year at the University of Tuebingen in Germany as a Foreign Studies Scholar. He completed his internship and residency in internal medicine at Emory University. Following a cardiology fellowship at the University of Tennessee, he returned to Atlanta and completed a two-year cardiac electrophysiology fellowship at Emory University in 2002. Dr. Kanuru is board certified in Cardiovascular Disease and clinical cardiac electrophysiology. He is a member of the North American Society of Pacing and


Contact Information

For more information about the WellStar Structural Heart and Valve Program, contact:

Tiffany AmosStructural Heart Program Manager

[email protected]

Amar Patel, M.D.Co-Medical Director

[email protected]

Richard Myung, M.D.Co-Medical Director

[email protected]

Electrophysiology (NASPE). He joined Cardiovascular Medicine in July 2002, and is fully trained in all aspects of invasive electrophysiology, including biventricular pacemakers/ICDs, complex arrhythmia management and ablation, transseptal catheterization, and transvenous lead extraction. He is currently on staff at WellStar Cobb, Douglas, Kennestone, and Paulding hospitals. A native of Sheffield, Ala., Dr. Kanuru is married with two children and now resides in Marietta. He is an automotive enthusiast, an avid reader and enjoys hiking and running.

Dr. Grabowski earned his medical degree from the Georgetown University School of Medicine. He completed an internship at the Georgetown Hospital, his residency at the George Washington University Medical Center and his fellowship in cardiothoracic anesthesia at Emory University School of Medicine. Dr. Grabowski is board certified by the American Board of Anesthesiology.


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