Welcome Dr. Bernard Chi

The heart is the only organ in the body that orchestrates a constant cycle of events. Every component of the heart has to work perfectly and in just the right sequence. The timing, tempo, and pitch highlight the musical nature of the heart, while imaging technologies illustrate its intricate architecture.

—Dr. Bernard Chi, assistant professor of cardiology at Cummings School

The interconnectedness and complexity of the heart is a natural draw for Dr. Bernard Chi, whose father is a physician and his mother a classical musician. Uniquely trained in the newest veterinary cardiac technologies, Chi joins the cardiology team at Henry and Lois Foster Hospital for Small Animals (FHSA) as an assistant professor in the Department of Clinical Sciences at Cummings School of Veterinary Medicine at Tufts University.

Originally from Taiwan, Chi played several instruments during his childhood (his favorite is guitar) and knew early on that he wanted to become a veterinarian. While earning his D.V.M. from National Taiwan University (NTU), he participated in externships at clinics that specialized in cardiology.

As president of NTU’s veterinary student association, Chi gave a campus tour to visiting professors from Colorado State University (CSU). That tour turned out to be pivotal to his career path and stoked an interest in pursuing veterinary training abroad. After graduating, Chi spent two years in general practice before deciding to experience veterinary medicine outside of Taiwan. He reached out to the CSU professors from the tour, who encouraged him to apply for the master’s degree program in toxicology at CSU’s College of Veterinary Science and Biomedical Sciences.

Colorado would be Chi’s home for nearly a decade, as he found himself presented with serendipitous opportunities too interesting to pass up. While completing his M.S., Chi was enamored with the innovative spirit at CSU.

“CSU was a great introduction to the concept of generating knowledge and new solutions to problems, to be creative in how we prove things in a scientific way,” says Chi. “From a fundamental level, it changed me and sparked my interest in academia.”

Between classes, Chi spent as much time in the CSU Veterinary Teaching Hospital as he could, observing how veterinary medicine was practiced in the United States, accompanying clinicians on rounds, and pitching in when needed. When an intern left unexpectedly, Chi was by then a familiar fixture at the hospital and a logical choice to fill in as the new small animal medicine and surgery rotating intern. “It was a time full of unexpected opportunities,” he says.  

As the internship wrapped up, one of Chi’s mentors approached him with an unusual opportunity after CSU had just built a new cardiac catheterization suite and purchased a state-of-the-art computed tomography (CT) scanner. Among its many sophisticated capabilities is cardiac gating technology, enabling imaging at precise timing during the heartbeat to prevent blurring and for much clearer images. CSU needed an in-house expert on how to fully utilize, optimize, and train others on this new technology for cardiac imaging. Chi’s work with the CT scanner evolved into his Ph.D.

“It was a booming point for the cardiology program at CSU,” says Chi. “The main focus of my Ph.D. was to figure out what these new technologies were capable of.”

Through much practice and trial and error, Chi developed many effective skills in cardiac imaging. He became especially adept at transesophageal echocardiography (TEE), performing ultrasound imaging of the heart from the vantage point of inside the body, using a long, tubular ultrasound probe positioned in the esophagus. TEE captures more precise imaging before and during transcatheter cardiac procedures.

“TEE is basically the eye of the operator; it’s extremely valuable,” says Chi. “My only job was to figure out what you can get out of it. Initially, it was very much exploratory. I went from playing around to a point where the cardiologists would ask me to be there for every single cardiac procedure because of the imaging it can provide.”

Chi explains that during transcatheter procedures, interventionists typically use fluoroscopy (X-ray imaging in real time) for a two-dimensional projection of the heart.

“The heart is a complex structure,” says Chi. “With X-ray and fluoroscopy, it can be hard to understand what you’re looking at because you can only see the silhouette of a given structure. We can use cardiac CT to predict the optimal fluoroscopic angulation to project the heart so that the anatomy of the heart makes more sense to the operator in real-time.”

While earning his Ph.D., Chi also completed his residency in cardiology at CSU. “It’s a dream-come-true moment because the goal seemed almost impossible when I came to the United States. No one from Taiwan has ever completed specialty training in cardiology in the United States—I feel truly honored and fortunate to be the first person to achieve that.”

Chi collaborated with cardiologists at Cummings School on a few projects. He traveled with CSU colleagues to Shanghai to acquire a device for a new surgical procedure, transcatheter edge-to-edge repair (TEER) of the mitral valve in dogs. TEER surgery requires just a small incision in the heart to insert a catheter, and using TEE, the operator can guide the catheter and position this device to treat degenerative mitral valve disease, the most common heart condition in dogs.

“There’s such high demand for this procedure. It’s a historical milestone for veterinary medicine, especially cardiology,” says Chi.

The CSU team reached out to other veterinary institutions about this new surgery. Cummings School faculty visited CSU to observe the procedure, and CSU clinicians traveled to Grafton to help train the FHSA cardiology, surgery, and anesthesia teams. Two years ago, Cummings School clinicians performed the first of many TEER procedures based on this collaboration with Chi and CSU (see story “An Innovative New Surgery for Dogs with Congestive Heart Failure”).

After finishing up his Ph.D. and residency at CSU, Chi joined the cardiology team at FHSA this past January. “Knowing the cardiology team here and how hard they work to push boundaries, I decided to come to Cummings School.”

Chi will be integral to the recently launched cardiac CT program at Cummings School. At the forefront of acquiring state-of-the-art equipment to enable advanced diagnostics for patients, Cummings School recently installed the Canon Aquilion Exceed LB™ with Qalibra™ system, which aligns with Chi’s clinical and research interests (see story “Advanced CT Scanner to Bring New Capabilities to Cummings School”).

While the scanner has been utilized at both FHSA and Hospital for Large Animals (HLA) in a variety of capacities, it has not yet been tapped for cardiac patients. Chi will take the lead in collaborating with clinicians across multiple departments, including radiology, cardiology, oncology, and other interested services, to unleash the full potential of the technology.

In the short time he’s been with Cummings School, Chi has enjoyed teaching residents on the clinic floor and recently delivered his first lectures on echocardiograms to second-year D.V.M. students. He has a few clinical research ideas he’d like to pursue on potential novel treatments for patients.

“There are a lot of projects going on within the cardiology group here at Tufts [Cummings School],” says Chi. “I’m really excited about exploring new diagnostic and treatment options for our patients, whether it’s in cardiology or in collaboration with other specialties in the hospital. I like how eager people are to learn what you have to share and help you succeed however they can. It’s been welcoming and heartwarming.”