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A Conversation with William W. O’Neill, MD, FACC, FSCAI
For this issue, Dr. Bhatt talks with William W. O’Neill, MD, FACC, FSCAI, medical director of the Center for Structural Heart Disease at Henry Ford Hospital, Detroit. O’Neill began his career at the University of Michigan and became corporate chief of cardiology for William Beaumont Hospital, Royal Oak, Michigan. In 2006 he moved to Florida, where he became chief medical officer of the University of Miami Health System and a professor of medicine and vice dean at the University of Miami’s Miller School of Medicine. In 2012, he returned to Michigan to helm the new structural heart disease center at Henry Ford.
O’Neill has been at the forefront of many advances in interventional cardiology. He was among the first to perform emergency angioplasty, intracoronary streptokinase therapy, transcatheter aortic valve replacement and mechanical rotational atherectomy, among other breakthroughs.
O’Neill, a founding member of the American Board of Internal Medicine’s interventional cardiology board, has authored more than 450 peer-reviewed articles and abstracts and has won a number of awards, including the Transcatheter Cardiovascular Therapeutics Lifetime Achievement Award in 2002.
What area of research in intervention most interests you right now, and why?
Dr. O’Neill: I have switched my focus from coronary disease, angioplasty and stenting to structural heart disease, primarily because a lot of the big challenges in CAD and interventional cardiology have largely been solved, and people are just nibbling at the edges, trying to fine-tune nuances. Structural heart disease has become much more interesting. Around 2000, I got involved with PVT (Percutaneous Valve Technologies), the forerunner of the Edwards Lifesciences transcatheter aortic valve. I implanted the first valve in 2005, and that whole area exploded. Along with Adam B. Greenbaum, MD, and Robert J. Lederman, MD, I performed the world’s first transcaval TAVR in 2013. Now, I think aortic valve disease has largely been conquered, and I’m turning my attention to mitral and tricuspid valves.
What advice would you offer a student in medical school today?
Deepak L. Bhatt
Dr. O’Neill: Try to find a field that is new and open. That’s where the biggest advances are going to be, and where there is more likelihood of having success. Then see if you can identify a mentor or group of mentors who are willing to teach and provide advice and tell you whether you are headed down the right path. Keep your eyes open to see what’s hot and new. If you’re lucky enough, you can be in the right place at the right time with a new field. When I was a cardiology fellow, in my first year, we started doing intracoronary streptokinase therapy. It looked like it was going to be incredible, so I got really involved. In my first year of practice, angioplasty was starting to catch on, so I set up an angioplasty program. That was also huge. Early involvement is a great way to have a successful career.
William W. O’Neill
Have you ever been fortunate enough to witness or be part of medical history in the making?
Dr. O’Neill: Yes, numerous times. I’ve been incredibly lucky to be involved with the first rotablator atherectomy system. I performed the first rotablator atherectomy in the world along with a group from Mainz, West Germany, in 1986. I did the first transmyocardial laser revascularization procedure and the first Sapien mitral valve implant for mitral stenosis. I also did the first stem-cell injection in the United States. I was part of a lot of interesting innovations from being in the right place at the right time.
What do you enjoy doing to relax?
Dr. O’Neill: I’m a political news junkie, so I really like watching the news and seeing what’s going on in politics. I’m an avid reader and read a lot of books on planes. I’m not a very good writer on the plane, so I don’t do a lot of work on airplanes, even though a lot of my friends do and they find it a very good time for that. But I just enjoy the peace and quiet of a plane and I really love to get into a good book.
What’s up next for you?
Dr. O’Neill: I want to continue to develop the structural heart program at Henry Ford. Along with Adam B. Greenbaum, MD, and Marvin H. Eng, MD, we are going to push the frontiers of where we are going with structural heart interventions. By making TAVR less and less invasive, I think it will become routine, and almost everyone over age 75 years with aortic stenosis is going to be treated with TAVR. It’s going to become largely a 1-day stay in the hospital. Also, we are trying to figure out how to treat the mitral valve and the tricuspid valve. In the near term, that’s going to be the next focus of our research at Henry Ford.
Disclosure: O’Neill reports holding equity in Neovasc.