Allison Cabalka, M.D. – a leading woman interventionalist in a male-dominated subspecialty

Allison Cabalka, M.D. (PD ’99), is a woman interventionalist. She works in a heavily male-dominated subspecialty. According to research by the Society for Cardiovascular Angiography and Interventions’ Women in Innovations group, only 4.5 percent of interventional cardiologists are women.

“It hasn’t been difficult to be one of few women in our division at Mayo Clinic,” she says. “Our staff is very stable, so there aren’t a lot of openings. People who take jobs here usually end up retiring from here because it’s a great place to be.”

While Dr. Cabalka grew up in the shadow of Mayo Clinic in Rochester, Minnesota, she didn’t necessarily see herself working there one day. “Of course, growing up in Rochester probably fostered my interest in medicine, but I didn’t envision myself living in Rochester forever.”

Robert H. Feldt, M.D. (PD ’63, PDC ’65), a consultant in the Division of Pediatric Cardiology at Mayo Clinic (now deceased), was a good friend of her family, however, and he influenced her early on … even if she didn’t know the role he’d play in her choice of subspecialty and location until later.

“When I was in college at Madison (Wisconsin) and home on breaks, he took me on rounds with him,” she says.

During medical school at the University of Minnesota, Dr. Cabalka became interested in pediatrics – a side effect of her mentorship by Dr. Feldt. Then, during residency at the University of Wisconsin, her interest became further refined toward pediatric cardiology. “I was interested in critical care and enjoyed procedures. It was the perfect blend of the two,” she says. “I liked the continuity of being able to take care of patients from infancy onward.”

After a fellowship in pediatric cardiology at Texas Children’s Hospital and Baylor College of Medicine in Houston, Texas, she worked at Children’s Hospitals and Clinics of Minnesota in Minneapolis for seven years. Then, in 1999, she was recruited back to Mayo Clinic – again, by the influence of Dr. Feldt.

“I’d interviewed at Mayo for a fellowship and met Dr. David Driscoll (PDC ’81) through Dr. Feldt. Pediatric cardiology is a pretty small world, and Dr. Driscoll contacted me about a position. It wasn’t about returning to my hometown but, rather, about the opportunity to work in a world-class institution with amazing colleagues.”

Eighteen years later, she still thinks it’s a great place to be. “The collegiality in the division is very good, and the cath lab has a great relationship with Dr. (Charanjit) Rihal (I ’89, CV ’93) and the adult structural team (Division of Cardiovascular Diseases),” she says. “Many interventional procedures we do require our combined skills, and we’ve accomplished a lot in the cath lab because of that partnership.”

Those accomplishments include leading the country in transcatheter valve replacement – inserting a valve via a catheter to extend the life of a failing valve to avoid a repeat open heart surgery for patients who often have had multiple surgical procedures. Dr. Cabalka and her colleagues also use catheters to close holes or plug vessels in the heart such as atrial septal defect, ventricular septal defect and patent ductus arteriosus in patients who otherwise would need surgery.

“We’re able to push the cutting edge of invasive therapeutics for children and adults with congenital heart disease because we work hand in hand, not only with our pediatric colleagues but also with the adult congenital and adult cardiology program, without preconceived limitations on what we could do for patient care.”

Dr. Cabalka has been involved in Melody (Medtronic) valve implantation since the Food and Drug Administration (FDA) approved this transcatheter pulmonary valve in 2010, participating in the post-approval study and was the national principal investigator for the Melody valve implanted into a bioprosthetic pulmonary valve study. She was involved in the multicenter Coarctation of the Aorta Stent Trial (COAST), studying covered stents for coarctation of the aorta – approved by the FDA last year – and co-authored a key paper on the subject. She’s gearing up to participate in a multicenter trial of the new Harmony transcatheter pulmonary valve for treatment of pulmonary regurgitation, and another trial of a device to close larger atrial septal defects.

“It’s nice to be part of multicenter cutting-edge clinical trials in the cath lab so we can offer better treatment options to our patients,” she says.

 

Fast 5 with Dr. Cabalka

1. Were your parents involved in health care?

   My father was a dentist, and my mother was a nurse who ran the master’s in nursing program for Winona State University. Despite growing up in Rochester, I was the first Mayo employee in the family.

2. What do you do in your spare time?

   Mostly road cycling and travel. Half of my travel is doing cath lab work on international missions. My husband and I have gone to Kenya, Nepal, Bolivia and Kurdistan. He often does community work while I provide health care. We participate with For Hearts and Souls, an NGO; Children’s Heart Project and World Medical Mission of Samaritan’s Purse. When we go to Kurdistan, we’re in Dohuk, where the refugees from Mosul (Iraq) are located. He works in the refugee camp, and I do interventional cardiac catheterizations along with screenings, echocardiograms, clinical management, training and education. The heart hospital in Kurdistan is pretty well equipped. In addition to providing definitive treatment in the catheterization lab, our team helps with accurate diagnosis and planning care management in addition to nursing care and bedside education – giving the hospital team help in many aspects of the care of pediatric cardiology patients.

3. What do you get out of doing international mission work?

   We’ve been blessed in so many ways. This is a way to share resources and support programs that are trying to grow and develop. If I didn’t have to work, I’d do mission work full time. Mission work overseas expands my view and makes me thankful every day for my job at Mayo Clinic, with our enormous, fairly unlimited resources and great team-oriented colleagues. Also, doing this gives me a much better perspective on the natural history of congenital heart disease because we see things we’d never see in the U.S. Here, these conditions are diagnosed in infancy. Overseas, you see the effects of unrepaired heart disease and consequences of rheumatic fever.

4. Who else at Mayo has influenced you?

   Dr. John Woods (S ’66, PLS ‘68) has been an example of a doctor who could put it all together. He has strong faith and is an inspiration. I met Dr. Woods early in my career at Mayo, and he’s been a key supporter and encourager of our international work.

5. What’s been key to your professional success?

   I wouldn’t be able to do anything I do without the support of my husband and family. He was a stay-at-home dad to our two now-grown children. That was key for our family life. Also, our church and the Rochester community are very supportive and help take care of international guests, including those who come here for treatment through the Children’s Heart Project. Knowing patients have that kind of support makes my job a lot easier.