A Conversation with Igor F. Palacios, MD

Issue: May/June 2017

For this issue, Dr. Bhatt talks with Igor F. Palacios, MD, professor of medicine at Harvard Medical School and a member of the Cardiology Today’s Intervention Editorial Board.

A nationally and internationally renowned cardiologist, Palacios has conducted important basic and clinical research as well as pioneered novel techniques in the field of valvular heart disease. However, he considers the opportunity to mentor and work with his fellows, many of whom he considers like family, to be his greatest contribution to medicine.

Inspired by his uncle to become a doctor, Palacios completed his medical training in his native country of Caracas, Venezuela, before coming to the United States in 1973 to work at Massachusetts General Hospital. Today, he currently serves there as director of interventional cardiology and director of interventional procedure for patients with structural heart disease.

What is the defining moment that led you to your field?

Dr. Palacios: It was not an easy decision. I love medicine, so I had difficulty deciding between being an internist or being a cardiologist. In the end, I decided to go into cardiology because I felt that it was more stimulating. Also, during my training, I had the opportunity to join a cardiology group at one of the hospitals in Venezuela. Many good people trained me and taught me about cardiology there, which also influenced my decision. I really enjoyed what I learned in Venezuela, and I am happy to have had all these opportunities to have what I consider to be a great career.

What advice would you offer a student in medical school today?

Dr. Palacios: Never take no for an answer and strive for your goals. I would also emphasize the importance of doing research — basic or clinical — before, during and after graduating from medical school and create a base for their future development as they join faculty at academic centers. Producing high-quality papers definitely pays off in the long term.

For students from abroad, the United States is a fantastic country full of opportunity. As long as they produce good work, they can thrive within the system. Personally, that was my experience. I was given opportunities for growth at Massachusetts General Hospital and given the support to climb to a higher position in the interventional program as well as become a full professor at Harvard Medical School. I hope that my experience is a model to help students and junior staff pursue their careers.

Have you been fortunate enough to be part of medical history in the making?

Dr. Palacios: Within interventional cardiology, I performed the first mitral balloon valvuloplasty in the Untied States and have been fortunate enough to become an expert in this technique. Together with Gus J. Vlahakes, MD, we performed the first transcatheter valve-in-valve replacement in the mitral valve position in a patient who couldn’t be operated on in our institution. I have also developed a technique to perform a pericardial window with the intention of making a hole in the pericardium to drain fluid that has accumulated there using a special technique with balloon catheters, which has now been accepted as an alternative to surgery to treat patients with pericardial effusion and pericardial tamponade.

What do you do to relax?

Dr. Palacios: My wife and I love music. She’s a great dancer, and we enjoy dancing. We used to go dancing almost every Saturday, even through my time in medical school. We don’t go out dancing as much anymore, but we still like dancing at parties. More than anything, though, I love my family and enjoy being with them. My wife and daughter have always supported me and continue to support me, even if it meant that we couldn’t spend as much time together due to my career. Now, my daughter, who is a lawyer at Tufts University, is married and has two beautiful girls. They only live about two blocks from my house, and it really is a great joy to see them when I finish work.

What’s up next for you?

Dr. Palacios: Right now, I want to continue my relationship with the fellows. I want to keep working on research with them and continue to teach and give lectures about what we have done and how that will apply to what they do. Additionally, I want to do as much as I can in my area of research, particularly related to the mitral valve. I’m participating now, but I want to see it to the end; I want to see the mitral valves to follow the path of the aortic valves so that we will be able to replace these valves. We are very close to being able to say that that is feasible.

Also, I have been a very busy clinical cardiologist and I plan to continue that. I really enjoy seeing patients, and even if I will not be performing their procedures, I may be able to help them make decisions and understand what procedures they are about to undergo.

Finally, I plan to work on what I think will be my major contribution to Latin America: the development of an international CV research effort. We are on the cusp of preparing all of these efforts, and that’s where I am planning to put most of my time in the future. – by Melissa Foster