Amir Azarbal, MD

Drawing on advice from a mentor, this interventional cardiology fellow embraces the everchanging nature of his chosen field.

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Amir Azarbal, MD, is an interventional cardiology fellow at the University of Vermont Medical Center (Burlington, VT), where he also trained in general cardiology. He was educated at the Shahid Beheshti University of Medical Sciences (Tehran, Iran), and completed his internal medicine residency at University of Alabama, Huntsville. This summer Azarbal will move to Yale New Haven Hospital (New Haven, CT) to complete a year of training in structural heart disease interventions, a field in which he has already gained much experience. He has co-authored almost a dozen articles in peer-reviewed journals and has presented his research around the country. After training, Azarbal would like to practice in a hybrid academic and private setting where he can use his clinical knowledge and procedural skills to provide excellent clinical care to his patients while also teaching and participating in clinical research.

Tell us about yourself and how you’ve gotten to this point in your career.

I was raised in a family with many physicians. However, my main inspiration to become a doctor was my father, who is a practicing academic orthopedic surgeon in Iran. After finishing medical school, I decided to come to the United States for further education—I was interested in medicine and its problem-solving and cerebral nature. During internal medicine residency, I quickly realized cardiology is one of the most evidence-based and diverse specialties. What was appealing to me about cardiology was that it allowed me to combine procedures with clinical work, and during my general cardiology fellowship, I realized that interventional cardiology offered the unique privilege to make meaningful and immediate differences in patient survival and quality of life. This in combination with the exponential advancement of the innovative device and technology in the field boosted my passion to obtain advanced training.

I remember being at an American College of Cardiology meeting in my first year of general cardiology fellowship and I was in the arena where one of the TAVR intermediate-risk trials was being presented. Those positive results and outcomes solidified my interest to become a part of the structural heart intervention team. That was one of the pivotal moments of my decision-making.

What has your experience been like building your career in a different country from which you grew up?

What separates practice in the US, at least from my experience in Iran, is that you have firsthand exposure to the latest technology and innovation, especially in the field of interventional cardiology and now structural heart interventions. That's a great positive point that is appealing to me.

Thankfully, I have many family members in the United States. My sister is a dentist at University of Pittsburgh and I have cousins who are also interventional cardiologists. My parents travel very often to visit, so I have my loved ones close by.

What has surprised you the most about becoming an interventional cardiologist?

I was really surprised mainly by the constant new developments in all aspects of interventional cardiology, particularly in structural heart interventions. The range of transcatheter therapies that we have for a variety of structural heart diseases and their indications are expanding, the device platforms are getting better, and therefore we are able to treat a wider spectrum of patients. This has all been happening within such a short period of time.

It seems like you've done a lot of structural work, more than one would expect of a trainee who has only completed 1 year of interventional training. What has that been like for you?

That's correct. I’ve participated in TAVRs, MitraClips, as well as ASD and PFO closures, and I’ve also had the chance to participate in research in this field. I'm very fortunate to graduate from a program that got us involved in structural procedures from the start of our interventional cardiology training. The interventional program in Vermont is very unique in the sense that from the third year of general cardiology, the fellows who are in the interventional track get exposed to PCIs and each interventional fellow will spend a dedicated day in the structural lab every week, whether it's doing TAVRs or MitraClips.

What would you say is the biggest challenge facing interventional cardiology fellows today?

I think as the interventional cardiology field continues to expand in multiple directions beyond coronary interventions—such as structural, peripheral, complex coronary, and CTO interventions—it's important for interventional fellows to identify their interests and niche through reflection and appropriate mentorship and then focus on obtaining the appropriate training. This may require dedicating more time to further subspecialize in that area. Another challenge is constantly keeping ourselves updated with the latest data, techniques, and procedures and being open to new advancements and change after fellowship.

Thinking back on your career, what is the best piece of advice a mentor has given you and why?

One of my mentors told me that what he was doing 10 years into practice as an interventional attending was almost entirely different from when he graduated from fellowship—the pharmacology, procedures, techniques, and devices evolve so rapidly. Fellowship gives you the foundation to build your skill set, he said, but once you start your practice, it is crucial to constantly keep up to date with the cutting-edge advancements and be open to implementing change.

I consider myself very fortunate to be surrounded by numerous amazing people who have been excellent sources of knowledge, wisdom, and inspiration. First, I want to mention my father, who taught me the value of perseverance and integrity. In interventional cardiology, I've had the privilege to work with many great mentors. Particularly I would like to mention Harold Dauerman, MD. I think he's a perfect example of an academic interventional cardiologist who has guided me to conduct clinical research through constructive and prompt feedback. In the cath lab, I learn from his evidence-based approach and procedural pearls when facing complex coronary and structural interventions. And lastly, I'm always appreciative of the support and advocacy of my internal medicine program director, Lourdes Corman, MD.

What is something that people might not know about you?

I am a good tennis player, and in winters I enjoy skiing. I am also a fan of jazz music. I used to play the piano up until the final years of medical school and I'm hoping to get back to it soon.

What his nominator Harold Dauerman, MD (University of Vermont, Burlington), says:

When you consider that he arrived in the US after finishing medical school in Iran, his accomplishments are remarkable. I believe he has embraced all the US medical system has to offer fully and, through diligence and hard work, has made significant achievements. For example, Dr. Azarbal has set a high bar for achievement in interventional cardiology scholarship. His teaching of medical students and residents was recognized with a “Fellow of the Year Teaching Award” in 2017. He has excelled as a clinical fellow with respect to quality of care, attention to detail, communication with attendings, and positive interactions with nurses, house staff, and junior trainees. Over the past 2 years, Dr. Azarbal has worked with me on single and multicenter registry TAVR research. This has led to two abstract presentations and two manuscript publications on the novel single-center findings of acute kidney recovery after TAVR. His research was recognized for excellence by the UVM Department of Medicine as he was chosen as a “Top Fellow for Research” with his oral presentation at Medical Grand Rounds.

*To nominate a stellar cardiology fellow for the Featured Fellow section of TCTMD’s Fellows Forum, click here.

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