BC Cardiovascular Community at the Canadian Cardiovascular Congress

Rising Stars – Dr. David Wood

DWood

Dr. David Wood is an Associate Clinical Professor in the Division of Cardiology at the University of British Columbia. He works as a structural and interventional cardiologist at both St. Paul’s and Vancouver General Hospital and is a founding member of the Centre for Heart Valve Innovation in Vancouver. He obtained subspecialty training at Lenox Hill Heart and Vascular Institute of New York. His primary research interests include transcatheter management of structural and valvular heart disease, advanced cardiac imaging, new device development, and novel strategies for treating acute coronary syndromes. Dr. Wood has co-authored over 100 publications in peer reviewed journals including “Current Status of TAVR” in JACC. He was recently selected to receive the 2014 Canadian Cardiovascular Society Young Investigator of the Year runner-up award.

Lay summary of program/project:

Dr. Wood’s two main areas of research include minimally invasive therapies to treat structural and valvular heart disease, and novel strategies for treating acute coronary syndromes (heart attack). He is currently trying to answer two simple but important clinical questions: 1. Is there a safer and more efficient way to replace a patient’s failing heart valve? 2. When a patient has a heart attack and their culprit blocked artery is successfully opened with a stent, should other blockages that are incidentally discovered also be treated? To answer the first question, Dr. Wood is leading the 10 centre North American 3M TAVR Trial. When a patient’s aortic valve fails, blood is unable to efficiently leave the heart and reach the rest of the body. Patients develop chest pain and shortness of breath and often die within one to three years. Conventional open heart surgery, and more recently minimally invasive transcatheter aortic valve replacement (TAVR), are used to treat this condition. With both surgery and TAVR, patients are often in hospital for a week or more and take several months to recover. Dr. Wood and the team at CHVI have helped pioneer the Vancouver Multidisciplinary, Multimodality, but Minimalist (3M) Clinical Pathway, in which carefully selected patients are awake when they undergo TAVR and are typically walking 4 hours later and safely discharged home the following day. Results from the 3M TAVR trial are expected in 2016 and may establish the Vancouver 3M Clinical Pathway as the new gold standard of care. To answer the second question, Dr. Wood is the co-principal investigator of the 4000 patient COMPLETE Trial. After a patient has a heart attack and had their culprit blocked artery successfully opened at over 300 participating centres worldwide, they are being randomized to either stenting of their other incidentally found blocked arteries or medical management. At present, physicians do not know the best option. Results of the COMPLETE Trial will be available in 4 years and will likely change global clinical practice.

Medical summary of program/project:

Dr. Wood is a founding member of the Centre for Heart Valve Innovation (CHVI) in Vancouver. His primary research interests include transcatheter management of structural and valvular heart disease, advanced cardiac imaging, new device development, and novel strategies for treating acute coronary syndromes. He is principal investigator of the investigator-initiated North American 3M TAVR Trial (n = 400, 10 sites) and co – principal investigator of the CIHR funded COMPLETE trial (n = 4000, 300 international sites). With both trials, Dr. Wood is trying to answer two different but important clinical questions: 1. Can the Vancouver 3M Clinical Pathway not only facilitate safe next day discharge home in high risk patients with severe symptomatic aortic stenosis (AS) but also improve VARC-2 outcomes versus usual care? 2. Is a strategy of multi-vessel revascularization involving staged PCI of all suitable non-infarct related stenoses superior to a strategy of culprit lesion only revascularization in patients with multi-vessel disease who have undergone successful culprit lesion primary PCI for STEMI? To answer the first question, Dr. Wood and the team at CHVI pioneered the Vancouver Multidisciplinary, Multimodality, but Minimalist (3M) Clinical Pathway, in which carefully selected patients are awake when they undergo TAVR and are typically walking 4 hours later and safely discharged home the following day. Results from the 3M TAVR trial are expected in 2016 and may establish the Vancouver 3M Clinical Pathway as the new gold standard of care for treating AS. To answer the second question, patients who have undergone successful primary PCI for STEMI are currently being randomized to either staged PCI of their non culprit lesions or medical management at over 300 participating centres worldwide. Results of the COMPLETE Trial will be available in 4 years and will likely change global clinical practice.