Jennifer Cowger
@preventfailure
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2K
Following
2K
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818
I have a degree in failure...in fact I’m an advanced failure doctor...
United States
Joined April 2013
Please stop the “MitraClip for Cardiogenic shock with low EF” madness!!! COME ON PEOPLE- part of being a good doc is knowing when NOT to do something!!!!.
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When I round in the ICU, I try to wear funny T-shirts to lighten the mood. The pink shirt is the lungs sharing oxygen with the heart and the heart saying she’s gonna give it to everyone.
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Thank you @OhioStateMed. You took a chance on me in 1997. My dad died suddenly, 1 month before MCATS and I didn’t perform- my world was wrecked. I lacked mentors to guide me. I had the grades but at a tiny undergrad. I am here in ♥️ transplant bc of OSU.
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I have a patient with a swan in place. Right atrial pressure 8. Wedge pressure 30. Nephro just asked me to do POC ultrasound to assess volume status. 😲🙄🫥.
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Why are more advance heart failure pts not referred for LVAD? Pts with advanced melanoma/lung CA have a poor prognosis. Yet you refer them to oncology for chemo. Many get sick. Some get infections. The patients take chemo because they want to try. EMPOWER CHF patients. REFER!.
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#THT2022 images of pig heart transplanted- hyper dynamic LVEF, good relaxation! Has been off the vent watching football and wished the surgeon happy birthday! Congrats to Univ of Maryland team and (equally important) the patient.
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Cleveland Clinic has these two amazing ladies on their campus as critical care and adv hf fellows (fellas). Ohio is lucky to have gained these dynamos for the next year. @SarahGorgis and @vbluml
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TEER is a wonderful scientific advancement. TEER however has NOT shown robust clinical trial benefit in 1) Cardiogenic shock 2) EF of 10%. STOP the madness. A dead pump is a dead pump. Love, your Advanced HF specialists across the US.
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Henry Ford Heart & Vasc Institute via Drs Basir and Koenig placed the first Aortix microimpellar (Procyrion, Inc) in the US! The device is trialed for pts with CardioRenal Syndrome and persistent congestion, sitting just above the renal arteries. Cant wait for pt #2!
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She had ARVD and had to stop running. Why run a mini-triathlon less than a year posttransplant? Because she can. @HFHCardioFellow @HenryFordNews
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This is Nancy. Some programs would have discriminated against her due to a high BMI (49). Our program did not and we took it one step further- we gave her the tools to overcome failure…Heart Failure….and Obesity. @HenryFordHealth @HenryFordTXP LVAD CHAMPIONS
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#heartfailure patient presents with syncope in cardiogenic shock. Heart rate shown (in cath lab with SBP 70/50) and biopsy. What’s going on?
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I am in a debate tomorrow about LVAD therapy…I scared Dr Mandeep Mehra off…He conceded before hitting the podium. I have no doubt Dr. Sweitzer can give me a fair challenge.#HFSA2021 #lvad @HFHCardioFellow.
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I love that the field is asking questions, challenging concerns over implicit bias and care access to VAD, and asking for improvement in the 2018 heart allocation to address inequity in transplant access in VAD pts. Asking questions leads to change.🫀🤎❤️🩹.
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My opinion- the sudden abandonment of durable LVAD- largely driven by an inability to transplant VAD pts after 2018 allocation change- has really hurt our field. ⬇️R&D, ⬇️growth of DT, ⬇️trials. #HFLeadership.
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Michigan docs connect to save lives! Thanks to our referring docs at Beaumont, DMC, St Johns, McLaren, St Joes and beyond: Henry Ford Transplant and VAD program saved more lives through VAD/Transplant than ever in Ford history! Only happens with teamwork! Thank you MI docs!.
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Name a major LVAD clinical trial with a female listed as FIRST or Last/senior author/investigator. I’m not talking about Substudy. Go. tick tick tick tick.
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#HFSA2023 our field’s messaging about dLVAD is critical. Everyone can’t get a transplant. Monocular vision about txp will cause one to miss those pts in the periphery.
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The best are gathering in Detroit. Where broken hearts are fixed.❤️❤️❤️@DrAmirKaki @Babar_Basir @HFHCardioFellow @HenryFordNews
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Durable Mechanical Circulatory Support: JACC Scientific Statement - ScienceDirect
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Our cardiology colleagues don’t see value in us. Our cardiology leadership do not see value in us: We are “diuretic doctors” and don’t have a unique tool.#HFLeadership.
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These fellows are my “why”and inspire me.❤️Congrats on the match👏🏻:. Sarah Gorgis- Cleveland Clinic Critical Care 👍. Lindsey Aurora- Univ of Michigan Advanced Heart Failure (my mentors!)👍. Ferras Dabbagh- Emory Interventional and Critical Care.👍. @HFHCardioFellow.
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Just because “others” are submitting Unos ❤️exceptions does not mean it’s the right thing to do. The ❤️ regional review boards are being asked to now VERY carefully consider if the UNOS exceptions are fairly requested. Don’t cheat the system. Don’t put your program at risk.
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Tech and Heart Failure Conference Feb2022! Fellows Registration is FREE! Learn from Daniel Burkhoff and other field experts #LVAD #HeartFailure #THT2022 @HFHCardioFellow @BurkhoffMd @manreetkanwar
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When insurance does not feel malignant VT is urgent. @Humana do not tell me you don’t have clinicals. No such thing as elective heart transplant! Shame!
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Scai Shock 2021. Chronic HF with shock - act fast. decongest. mind the RV. refer for VAD/transplant bc recovery not likely and 6-12 mo survival poor. #lvad #CardioTwitter.
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That HALFTIME SHOW was AMAZING. My son may be scarred for life after seeing me dance but 🤷🏼♀️.
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Dr Basir hitting a home run on shock and acute MCS at the NYU heart failure conference. 💪🏻🫀 @Babar_Basir @HenryFordHealth @HFHCardioFellow
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Thank you to JCF for offering the simultaneous publication of this analysis. We have much to learn about infection and bleeding mitigation. @manreetkanwar #ISHLT2022
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Equitable Access to Advanced Heart Failure Therapies in the United States – A Call to Action - Journal of Cardiac Failure. Look within so we can rise above. @manreetkanwar @PalakShahMD @rcogswell_umn @TomCascinoMD
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So honored to have Dr Jason Katz speak about Critical Care Cardiology at Henry Ford Cardiology Grand Rounds. What a wealth of phenomenal information provided! Thank You Jason! @JasonKatzMD @HFHCardioFellow.
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The mindset of heart failure management needs to evolve- care takes a village. The local providers are integral to patient success. The advanced HF doc can help manage and offer surgical therapies when needed. Team based care is best care.
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Listen to these ladies talk about heart health! Dr Grafton can share her tips and tricks on developing a successful Cardiomems program! @gfgrafton
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My mind just was fed by an amazing talk on the importance of microcirculation resuscitation in cardiogenic shock.Dr Fraser #ELSO2022
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#shockweek- just learned that cruise ships in the Caribbean can intubate and support pts until they reach land. Where can I sign up for this moonlighting gig? @Babar_Basir @gfgrafton @HFHCardioFellow.
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You can’t talk about heart failure without mentioning the RV. @RyanTedfordMD reminds us fixing the left side may not fix the patient #nhlbi
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#HFSA2023 Cardiogenic Shock Working Group- over 100 pubs, multidisciplinary, and inter-institutional. Thank you for your efforts, mentorship and science. @manreetkanwar @NavinKapur4 @tonkhueMdPhd @VorovichHeartMD @JHMontfort10 @ShashankSinhaMD
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It’s time to tear down healthcare silos and respond to the shock syndrome. Educate to enable staff awareness, treat is fast (like a STEMI or stroke) and develop care paths to enable FAST interventions.
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#ELSO2022 what used to be a small meeting on ECMO has grown into quite the large ECMO conference!
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My mind is blown! Apparently you can have nonLVH HCM?! Dr Dessai at CCF says 10% of his pts have HCM obstruction withOUT the “H”! Is this the same or a different pathophysiology? #ACC22.
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#HFSA2021 Michigan surgeons leading HFSA VAD session- Dr Nemeh (Henry Ford Hospital) and Dr Pagani (University of Michigan). Proud of the Mitten state!
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Honored to have Dr Susan Joseph give Grand Rnds today on her experience at Univ of Maryland on Xenotransplantation @SusanJosephMD @HFHCardioFellow
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#heartfailure #lvad patient presents with recurrent heart failure symptoms. LDH 250, flow 2.0 liters at 5600.
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Why did I love THT: thinking outside the box; challenging norms; considering how we can improve outcomes.
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My FIL is in hospice. Can’t walk. The cost of 12 hours of nursing care per day in our home per month- $10,800. We do transplants/LVAD etc but elders can’t die at home w/ family and have it covered by Medicare. Hospice stops by 2 days weekly…not enough.😢.
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Stop-RVF calculator- created at Utah, externally validated in part @HenryFordHealth - use this for a more personalized estimate of postal LVAD RVF
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How many of you looked at your Will and Trust this year just in case. ? I did.
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NHLBI workshop now- keeping our field pertinent to the community and discussing how we improve outcomes and address disparities. @manreetkanwar @dranulala @StavrosDrakos @rcogswell_umn @mcolvin89 @RyanTedfordMD
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My Med stud- Sean McCarthy- did a great job presenting on LVAD outflow narrowing at #ISHLT2022. @HFHCardioFellow @HenryFordHealth
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Our field is slowly exsanguinating itself: CRS devices aren’t needed- “use more diuretics.” We pit LVAD vs Transplant when both are needed tools. Let’s give out certificates so our fellowship training is further subjugated. Would EP/IC do this?.
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Abbott User’s meeting 2022. Let’s not forget the benefit of MCS. Look at the lives saved. Let’s think about the promise of the future.
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Dear all (response to JACC “survey” comment): if my mom had endstage HF, I’d refer her for VAD. She’s a terrible transplant candidate. Sorry mom. I trust in my therapy. @RyanTedfordMD @DrNasrien @rcogswell_umn @manreetkanwar.
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Thank you to @HenryFordHealth for taking such great care of my husband today at West Bloomfield. Very courteous and patient centered care.
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The Society of Thoracic Surgeons Intermacs 2020 Annual Report - The Annals of Thoracic Surgery. It’s available online now. Record VAD volume! Great survival!Real world data! @PalakShahMD
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Friday March 19 (Ignore dare beliw). Cardiogenic Shock. Dan Burkhoff. Enough said. #cardiotwitter
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This is so important- pts needs txp fast- if they are over 50 days listed at ANY status they are high risk for death or delisting- this is esp true for nonWhite. Use your durable LVAD!!! Stopping waiting.
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Gordon did not disappoint! Wow! That is all I can say. So much energy and excitement and potential for the field of MCS. Thank you Bob Kormos, Kurt Dasse, Aditi Nayak and Seraina Dual!
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ISHLT MCS academy- come to Chicago and enjoy education and then go shopping!!! Nov 4 @ISHLT
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You know you are a large cardiogenic shock program when you have a crash cart for your crash cart.
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@dranulala @rupikaur_ @MariellJessup @mrchrtfaildoc @BiykemB @DonnaMancini11 @HornEvelyn @shelleyhallmd @manreetkanwar @noshreza @DrMarthaGulati @ShelleyZieroth @LindenfeldJoann Love this… t shirt needed. You ladies- while spread afar- mean a lot to me. You bring hope for my 6 yo daughter and are a source of inspiration and validation. 😘
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@HenryFordHealth, Dr Alqarqaz and @Procyrion putting in the first Aortix perc intravascular perirenal endo vascular assist device for cardiorenal syndrome. DARIN-HF study.
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#shockweek continues! Don’t fall prey to shock, MSOF and PV loops! 🦈🦈🦈🦈🦈 Join Drs Basir, Kapur, Burkhoff, and team Saturday! @Babar_Basir @NavinKapur4 @BurkhoffMd @HFHCardioFellow
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We were honored to have Dr Joseph Rogers at Henry Ford Grand Rounds today. @HFHCardioFellow @HenryFordHealth
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This is not your father’s ultrafiltration device- Henry Ford is using this therapy to treat your complex patients with ADHF. Let us help you help your patients!!
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I propose a debate:.more upfront durable BIVADS for young shock pts—> rehab —> txp vs direct txp off TCS or ECMO? Where do you stand? Why? @JHMontfort10 @shelleyhallmd @MKIttlesonMD @PalakShahMD @LiviuKlein @tonkhueMdPhd @rcogswell_umn @mcolvin89 @manreetkanwar @ZekeMolinaMD.
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Lvad Core. What’s the what? Do you:.1) do nothing.2) check urine Ca and serum Ca.3) Check an ACE level.4) send Enterovirus Ab panel, Covid19 test, hiv.#lvad @HFHCardioFellow #heartfailure @akshaydesaimd @manreetkanwar @MattLanderMD
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Why are more advance heart failure patients not referred for LVAD? Patients with CKD 5 are referred for dialysis. They go, Catheter in place, 3 days a week to survive. Few go on to kidney transplant. Yet they show up. EMPOWER your CHF patients with CHOICE. Refer!.
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Shock week continues- Let’s talk degree of tMCS support and the MICROcirculation. @HFHCardioFellow @davebaran @Babar_Basir
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#ISHLT2022 renal function, dialysis, UNa…can’t escape the kidneys. Nephrologists are our best friends…
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@AditiNayakMD Congrats on Phillip Caves Award #ISHLT2022! We are all very excited to see your future!! 💃💃💃.@amorrismd.
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@RanaAwdish and friends had a wonderful exhibit at Northville Art House. Healing arts. Truly regenerating. Great fundraiser for a great cause. Thank you Rana and Jennifer!
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Rough weekend with MCS? Recover with the U-CARS recovery conference online. Be there. be engaged.
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#HFSA2023 Dr Lindsey Aurora have an outstanding talk. in 10 minutes. on device selection in Cardiogenic Shock @LAuroraMD
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HF Program Leadership: Join Us!! Brain Storm to Improve Education and Experience for future Heart Failure Trainees
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Warning for our heart patients. Nice paper by Henry Ford EP team on ICD/iPhone EMI.
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United HealthCare @UHC Asks for prior auth for clearly indicated cath yet system is down for days and can’t approve?! Can’t talk to a rep. How do we allow this in US healthcare? @GovWhitmer where are patient rights to excellence in healthcare?.
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Happy 2021 to all! 2020 reminded us how very fragile our US healthcare system is. The covid crisis has enforced our need to break down healthcare silos and work across institutions. Everyone deserves excellent care. Let’s do this together. Connect the docs.
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#TCT2021 Amazing decongestion with the Procyrion Aortix device in patients with cardiorenal syndrome. Nice job Dr Basir and Procyrion.
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Conversation Q: if a program won’t accept a 🫀donor >60 yr why do we have increasing 🫀txp recipients >70? I am NOT saying it’s wrong but honestly wonder what donor families/society, med staff think.@EiranGorodeski @AndrewJSauer .@RyanTedfordMD @AditiNayakMD .@ssilvestryMD.
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Thank you to Abbott, Dr Desai, Dr Hall, Dr Morris, Dr Wilcox and Dr Phancao for a fun and engaging Fellows Heart Failure Conference!.
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What’s next for our field? How do we move on? #lvad #cardiotwitter #heartfailure @FPaganiMD @PalakShahMD @AndrewJSauer @rcogswell_umn @manreetkanwar @RyanTedfordMD @tonkhueMdPhd @ZekeMolinaMD @EiranGorodeski @iHaririMD @shelleyhallmd.
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Weknow there are disparities in heart txp. Black pts are LESS likely to be txp and have poorer outcomes postTxp. They are LESS likely to be referred than White. They are more likely to have modifiable risks that exclude them from txp. stop.
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Lots of excitement over Aortix for pts w/ cardiorenal syndrome. ⬇️CVP, ⬇️PCWP, ⬆️Uo. At THIRTY days, ⬇️cr, eGFR and BNP #THT2023
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How amazing is it that we live in an era of even trying to fixing gene defects in cardiomyopathy?. Study on Danon’s by Dr Greenberg. #HFSA2021
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ACC NERD HERD ALERT! It’ll be fun and lively. It’ll be shocking!!! (Ok. terrible nerdy pun)@HenryFordNews @HFHCardioFellow @umichCVC @UMichCardiology @AscensionM_CV @BeaumontCards @OaklanduSHS
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