Priya Kothapalli, MD

Nearing the end of her training, this fellow sees her passion for design as complementary to her mindset for intervention.

Kothapalli headshot smallPriya Kothapalli, MD, is a coronary and structural heart disease fellow at the University of Texas at Austin, Ascension Seton Medical Center Austin, where she also completed her general cardiology training and served as the inaugural fellow for both programs. A second-generation interventional cardiologist, Kothapalli grew up with the field, eagerly accompanying her father to the catheterization lab where she could observe the latest technologies and color on paper angiograms. After completing a 7-year undergraduate and medical degree at Temple University (Philadelphia, PA), she moved to Houston Methodist Hospital for internal medicine training and a postdoctoral research fellowship. With her final 6 months of training ahead of her, Kothapalli is looking forward to a hybrid career where she can perform coronary and structural interventions as well as participate in medical education.

What initially interested you in a career in cardiology?

I attribute my initial interest in interventional cardiology to early exposure to the field. My dad is an interventional cardiologist, and I essentially grew up in the catheterization lab. In the summertime, my most fond memories involve early morning trips with my dad to the lab to observe cases. I had no idea what was going on medically at that point, but I really loved being in that dynamic environment surrounded by a great team of people. As time went on and my interests matured, I was fortunate to find exceptional mentors who helped me develop my skills. I feel very fortunate to have had the early exposure, as many people don’t learn about this field until they are quite far into their training.

While I enjoyed science and math growing up, I also really loved design in any form. I painted in mixed media, trained in classical dance for 14 years, and even spent time in fashion—all these seemingly disconnected things. Over time, I’ve realized what an amazingly synergistic relationship these broadly varied skill sets have had within my career as an interventional cardiologist. My interventional program director, Peter Monteleone, MD, also shares a love for creativity in the form of art and construction. We often discuss the elegant intersection of evidence-based medicine with the art of intervention—the need for innovative solutions in the face of ever-evolving challenges. I think the creative element brings these worlds together nicely.

What were some of your first memories of being introduced to interventional cardiology?

I have a very clear memory of those paper coronary angiogram charts, which I don't think anybody in my generation will ever see or use. Essentially, you were charting the findings from your angiogram onto a piece of paper. You’d have to draw where you put your stent and where your bypass grafts connected. I remember those papers so distinctly because I was allowed to color along during cases. That experience made me feel like I was a part of the team. 

Aside from that, I remember loving the team dynamic within the lab. It was an environment that depended upon the perfect harmony of several moving parts. Every member of the team was working in a disciplined and unspoken coordination with the rest of the team to provide lifesaving treatment. Regardless of how stressful the situation was, the team worked together in a beautifully concerted way. I loved the team sport aspect of being in the lab.

What has it been like following in your dad’s career footsteps?

I am a first-generation Indian American. I am one generation removed from a farm and the most educated woman in my family. My dad beat the odds to become who he is today, and he has been in practice for about 30 years now. He still does STEMI call because he absolutely loves it. It gives him immeasurable joy to care for multiple generations of families in our community and to perform humanitarian work. I used to follow him around because I was fascinated by his life. Now, as I near the end of my medical training, it is much more meaningful. We have daddy-daughter journal clubs to discuss cutting-edge science, and we do case reviews together. We are planning a medical mission trip together to perform free-of-cost interventions in rural India once I finish my training. It has been incredible to have that aspect of our relationship and I am lucky to have him as a mentor.

Why did you decide to train at an institution that was only beginning its general and interventional cardiology fellowship programs?

I was absolutely enamored with the idea of being at a "start-up” fellowship. I loved the prospect of molding a program that challenged the existing paradigm of medical education. I was confident that it was the right choice after meeting my now mentors. I really ended up choosing this program for the people. When I came down for my interview, Mark Pirwitz, MD, the CEO of our group and chief of cardiology at the medical school, took extra time out of his busy schedule to sit with me to ask: What do you want out of your fellowship program, and how can we help you get to where you want to be? It was a no-brainer for me after that point that I needed to be here, and I am grateful for the tremendous growth that came with this experience. 

Did you face any challenges as you began to train in cardiology?

The unique part of being in a newer program is that you are intimately engaged with multiple aspects of the training model. You are not only doing the job of the fellow, but you are also helping to create the curriculum and shape the culture of the place. While this may not be the right fit for everyone, I have enjoyed the process greatly. It has been an opportunity for growth in several areas—problem-solving in the face of unexpected challenges, becoming an effective communicator and leader, promoting a positive work culture. Everybody pitches in, has a voice, and, at the end of the day, witnesses the program grow exponentially—that is your legacy, essentially.

What are your research interests and what led you to doing a postdoc research fellowship?

During my research fellowship, I worked with the department of cardiovascular medicine in collaboration with Siemens to develop image-fusion technology to guide minimally invasive procedures. There was this novel interplay between multimodality imaging and intervention. Developing this technology required collaboration among multiple disciplines within medicine and engineering. It was a very dynamic environment. And again, it goes back to this whole idea of collaboration—put the right people in a room together with the right tools and the possibilities are endless. That was the biggest takeaway that I had from the research fellowship.

In terms of current interests, I have always been fascinated by vulnerable plaque. In fact, this is what drew me to the field of intervention as I went through my residency training. Despite tremendous advances within the field of interventional cardiology, there remains much to be discovered in this space. Leveraging the tools of invasive imaging with OCT and NIRS-IVUS, Lorenz Räber’s group was able to very elegantly demonstrate a therapeutic effect of lipid-lowering therapy on plaque morphology in PACMAN-AMI. This field is still very much in its infancy and there remains a need for work in this area. Along these lines, my clinical interests include intravascular imaging and coronary physiology. 

Looking back on your training journey so far, what has surprised you the most about becoming an interventional cardiologist?

That is a tough question. There are a lot of surprises. The journey to becoming a proficient interventional cardiologist never ends; being dedicated to lifelong learning is a critical piece of the puzzle. The team dynamic is so incredibly important within the lab. It takes mastery of a plethora of intangible skills to work in harmony with others while also being an effective leader. Our work requires a certain humility and grace, a healthy respect for the unknown. These are all valuable lessons learned through my training experiences.

What do you see as the biggest challenge facing cardiology fellows today?

I was part of the pandemic era of education, and so I think the ability to collaborate with and meet others across institutions has been a bit of a challenge. We as a community have overcome some of these challenges using social media and virtual meetings. There is, however, something to be said about in-person, face-to-face interaction.  Thankfully, as we transition back to in-person meetings, there are ample opportunities to form friendships and collaborations with colleagues across institutional and geographic borders.

Tell us about a mentor who has had a profound effect on your career.

I have a tremendous amount of respect and appreciation for my mentor here in Austin, Mark Pirwitz. I think he is a fantastic human. He is the person who essentially started this group and built the collaboration with the medical school. He successfully recruited leaders within the field including Peter Monteleone. They built something phenomenal here. It is a very forward-thinking place that embraces a true startup mentality. Mark Pirwitz is one of those master clinicians who can get through any case with grace. He really knows how to unify a team to work toward a common vision. He taught me several important lessons beyond clinical medicine: lead by example, promote a culture of collaboration, show up early and with a good attitude. These subtle leadership qualities are so incredibly important, and I saw firsthand how an individual person can have such a pronounced impact on a larger group.

What are you most looking forward to after finishing your training and finally taking that next step?

It’s a lifelong journey, right? You never really stop learning. I am excited to move on to the next phase of my career as an attending. I hope to bring a new perspective to the field of intervention, to offer services to patients with unmet needs, to promote a culture of diversity and inclusion within the field.

What is something that people might not know about you?

I’ve always been a bit shy to tell people about my passion for design. I had this misconception that being different wasn’t a good thing. I wanted to be taken seriously as an interventional cardiologist, and I was acutely aware for most of my medical training that I did not necessarily fit the stereotype. However, I think my love for design has helped me along my journey and is an important part of my story. It has shaped my personality and interests within and beyond medicine. I love creating beautiful experiences that unite and inspire people, whether that is through art, events, or spaces. I love nurturing the creative part of my brain. My most recent project involves renovating an Art Nouveau property built in the 1890s along with my husband, Moritz Wyler von Ballmoos, MD. I’ve loved learning about the history, architecture, and style of that period.

What her nominator, Peter Monteleone, says:

Dr. Kothapalli was our inaugural fellow here in the IC track at UT Austin. She has helped us develop our program and served as a remarkable ambassador of our fellowship to the world. She is extremely active with SCAI, ACC, and Texas ACC and has served as a fellow representative and social media representative for multiple regional and national societies. She will no doubt continue to grow into a transformative leader in our field for decades to come. As our inaugural fellow, she has also carried the unique position of helping our program support women in interventional cardiology from the program’s very start. She has mentored female physicians with an interest in interventional cardiology even from this early time in her career. We are incredibly proud of her successes and look forward to her continued remarkable rise.

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