AM Case 2: Complex LM PCI with imaging and physiology

Director of Rescue the Heart Program, Director CTO, and Advanced Coronary Therapeutics, Morristown Medical Center Dimitrios Karmpaliotis, MD, PhD, FACC, FSCAI is Medical Director of the Cardiovascular Rescue and Recovery Program and the Advanced Coronary Therapeutics and Chronic Total Occlusions Program at Morristown Medical Center. Dr. Karmpaliotis was formerly at the Center for Interventional Vascular Therapy at Columbia University Medical Center, where he provided world-class care since 2014. He is a former associate professor of medicine at Columbia University Medical School and formerly served as director of the Chronic Total Occlusions, Complex and High-Risk Angioplasty Program at New York-Presbyterian/Columbia University Medical Center.

Dr. Pratik Sandesara is an interventional cardiologist at Emory University Hospital and an assistant professor of medicine at Emory University School of Medicine. His clinical focus is on complex and high-risk percutaneous coronary intervention including chronic total occlusion revascularization.

Dr Stéphane Rinfret is an academic interventional cardiologist and world-renown expert in chronic total occlusion (CTO) percutaneous coronary intervention (PCI). He was appointed chief of interventional cardiology at the McGill University Health Centre (MUHC) and associate professor of medicine at McGill University in 2016 where he built a very active chronic total occlusion (CTO) and Complex Higher-risk but Indicated Procedures (CHIP) program. He has now moved to the US to work with at Emory Healthcare and Emory University, as associate-director of complex PCI and full professor (acting) of Medicine, to pursue his academic career and busy clinical practice, mostly at Emory Saint Joseph's Hospital, the oldest hospital of Atlanta serving a very large population. Dr Rinfret has held several peer-reviewed grants, published over 150 peer-reviewed articles, several abstracts, and has been invited over 300 times to give lectures in the last 10 years. His epidemiological research focuses on health services and outcomes. He is also a high-volume and world-renown coronary operator, performing over 400 percutaneous coronary interventions (PCIs) per year, mostly from the transradial approach and most with complex anatomies. Dr Rinfret was one of the Canadian pioneers in CTO PCI and has contributed to expand access to the technique in Canada and all around the world through sharing his expertise. He is the lead editor of a textbook on CTO PCI published by Springer in 2015, currently being reviewed for a second edition. He has performed over 1200 CTO PCIs since January 2010, one of the largest volumes in the world, including a large number of retrograde procedures, and pursues a very active teaching program of transradial and CTO PCI techniques in Canada and Europe.

Dr. William Nicholson is acting Associate Professor of Medicine at Emory University School of Medicine and Director of Complex Coronary and Cardiac Intervention at Emory Healthcare. Dr. Nicholson also serves as the program director for the Advanced Complex High-Risk Interventional Procedures (CHIP) fellowship at Emory University Hospital. Dr. Nicholson came to Emory in 2020 after fourteen years in private interventional cardiology practice in York, Pennsylvania. While in private practice, Dr. Nicholson founded and developed that institution’s carotid stenting program, structural heart program, transcatheter aortic valve replacement program, and the complex coronary intervention program. He also has become nationally and internationally recognized for his expertise in treatment of Chronic Total Occlusions (CTO’s). He is a perennial live case operator for nationally televised conferences. Dr. Nicholson formerly trained at Emory University Hospital having completed his general cardiology and interventional fellowship in 2006. He completed his medical residency at Brown University Hospitals where he also served as Chief Medical Resident. He is a graduate of Pennsylvania State College of Medicine.

Ziad Ali is the Director of the DeMatteis Cardiovascular Institute, Director of Investigational Interventional Cardiology, and Director of Cardio-nephrology at St Francis Hospital & Heart Center in New York. He is also Director of the Angiographic Core Laboratory at Cardiovascular Research Foundation and Associate Professor of Medicine at Columbia University Medical Center. His clinical research interests focus on the use of intravascular imaging and physiology technologies such as optical coherence tomography, intravascular ultrasound, and flow wire assessment to optimize coronary interventions, for which he has served as a Global principal investigator on a number of trials. Dr. Ali is also a recognized innovator, playing an integral role in the development of the Resting Full-Cycle Ratio (RFR) and Shockwave intravascular lithotripsy. Clinically Dr. Ali developed pioneering techniques to perform vascular interventions without contrast administration, including IVUS-guided zero-contrast PCI and OCT using saline flush media, protecting patients with advanced kidney disease from acute kidney injury and the need for dialysis.