A/Prof Jordan Fulcher

BSc(Med) MBBS MClinTRes PhD(Syd) FRACP FCSANZ
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A/Prof Jordan Fulcher

A/Prof Jordan Fulcher

  • Structural Heart Interventional Cardiologist
  • Royal Prince Alfred Hospital (Staff Specialist)
  • Strathfield Private Hospital (VMO)

A/Prof Jordan Fulcher is a Structural Heart Interventional Cardiologist. He performs transcatheter aortic valve implantation (TAVI), transcatheter mitral and tricuspid valve repair (TEER), mitral valvuloplasty, closure of atrial septal defects (ASD) and patent foramen ovale (PFO), left atrial appendage occlusion, renal denervation and percutaneous coronary intervention. Procedures are performed at Royal Prince Alfred Hospital and Strathfield Private Hospital, and consults at Central Sydney Cardiology in Newtown.

Procedures and clinical focus

  • TAVI — keyhole replacement of the aortic valve for aortic stenosis, without open-heart surgery.
  • TEER (mitral and tricuspid) — catheter-based edge-to-edge valve repair for selected patients with severe valve leak. A/Prof Fulcher assesses and works up all TEER candidates and performs TEER at RPA Hospital.
  • ASD and PFO closure — device closure of holes in the heart, including after stroke.
  • Left atrial appendage occlusion — a stroke-prevention alternative for people with atrial fibrillation who cannot take long-term blood thinners.
  • Mitral valvuloplasty — keyhole balloon dilation of the mitral valve, typically to treat rheumatic mitral valve narrowing.
  • Renal denervation — catheter-based treatment for resistant high blood pressure.
  • Complex invasive haemodynamic assessment — combined left and right heart catheter studies to clarify valve disease severity and unexplained breathlessness, including heart failure with preserved ejection fraction (HFpEF).
  • Coronary angiography and percutaneous coronary intervention.
  • Cardiovascular risk and lipid management.

Training

A/Prof Fulcher graduated in medicine from the University of New South Wales and completed physician and cardiology training at Royal Prince Alfred Hospital. He undertook interventional and structural cardiology fellowships at the Austin Hospital, Melbourne (2018–2020), followed by the ANZET-UK Structural Intervention Fellowship in transcatheter valve therapy at Leeds General Infirmary, UK (2021). He holds a PhD and a Master of Clinical Trials Research from the NHMRC Clinical Trials Centre, University of Sydney, is a Fellow of the Royal Australasian College of Physicians and the Cardiac Society of Australia and New Zealand, and is a member of the American College of Cardiology.

Hospital appointments and roles

  • Staff Specialist, Interventional and Structural Cardiology, Royal Prince Alfred Hospital
  • VMO and Structural Heart program lead, Strathfield Private Hospital
  • Clinical Associate Professor, Central Clinical School, University of Sydney
  • Member, RPA Structural Heart Disease Steering Committee
  • Member, Medtronic Structural Heart Emerging Leaders Committee

Research and teaching

His research at the NHMRC Clinical Trials Centre focuses on cardiovascular risk, lipid-lowering therapy and structural heart disease. He was a first author for the Cholesterol Treatment Trialists’ Collaboration in The Lancet, and has been an investigator in international TAVI trials including SMART and BHF PROTECT-TAVI. He teaches cardiology advanced trainees and fellows in the cardiac catheterisation laboratories at RPA, supervises Sydney Medical School students and lectures for Sydney Medical School.

Referrals

Referrals can be sent via HealthLink (EDI: centrasc), by fax to (02) 9336 2650 or by email to secretary@cardiology.sydney, marked to A/Prof Fulcher.

Structural heart referrals and clinician queries can also be sent directly to structuralheart@cardiology.sydney, which is reviewed by A/Prof Fulcher.

For urgent valve or structural cases, phone the rooms on (02) 9336 2600 (08:00–18:00, Monday to Friday). After hours, contact RPA Hospital on (02) 9515 6111 or Strathfield Private Hospital on (02) 9745 7444 and ask for the cardiologist on call.

A referral for TAVI or TEER assessment ideally includes the most recent echocardiogram report, an ECG, the current medication list and recent renal function.

Frequently asked questions

Which procedures does A/Prof Fulcher perform?
TAVI and valve-in-valve TAVI, transcatheter mitral and tricuspid valve repair (TEER) or replacement, ASD and PFO closure, left atrial appendage occlusion, mitral valvuloplasty, renal denervation, coronary angiography including complex left and right heart studies for invasive haemodynamic assessment, and percutaneous coronary intervention.

Where does he consult and operate?
Consultations are at Central Sydney Cardiology, Suite 407, 100 Carillon Avenue, Newtown. Procedures are performed at Royal Prince Alfred Hospital and Strathfield Private Hospital.

Do I need a referral?
Yes. A referral from your GP or specialist is needed for Medicare rebates to apply. Referrals are accepted via HealthLink (EDI: centrasc), by fax on (02) 9336 2650 or by email to secretary@cardiology.sydney.

What is structural heart intervention?
Treatment of heart valve disease and other structural problems through a catheter, usually inserted via the groin, instead of open-heart surgery. TAVI, TEER, ASD/PFO closure and left atrial appendage occlusion are all structural procedures. Hospital stays are typically short.

What should a referral include for TAVI or TEER assessment?
The most recent echocardiogram report, an ECG, the current medication list and recent renal function. Any further imaging, including the pre-procedure CT scan or invasive assessment, is arranged through our rooms. Referrers can contact structuralheart@cardiology.sydney directly with questions.

  • Structural heart intervention (TAVI, TEER, LAA occlusion, ASD/PFO closure, renal denervation, mitral valvuloplasty)
  • Invasive haemodynamic assessment (left and right heart catheterisation for valve disease and HFpEF)
  • CT planning for structural procedures
  • Coronary intervention
  • Lipid management and cardiovascular disease prevention
  • Clinical trials

Cholesterol Treatment Trialists’ (CTT) Collaboration (writing committee: Fulcher J*, O’Connell R, Voysey M, et al; *equal contribution). Efficacy and safety of LDL-lowering therapy among men and women: meta-analysis of individual data from 174 000 participants in 27 randomised trials. The Lancet. 2015;385:1397-405.
https://doi.org/10.1016/s0140-6736(14)61368-4

Cholesterol Treatment Trialists’ (CTT) Collaboration (writing committee: Fulcher J*, Mihaylova B*, O’Connell R, et al; *equal contribution). Efficacy and safety of statin therapy in older people: a meta-analysis of individual participant data from 28 randomised controlled trials. The Lancet. 2019;393:407-15.
https://doi.org/10.1016/S0140-6736(18)31942-1

Wang N, Fulcher J, Abeysuriya N, McGrady M, Wilcox I, Celermajer D, Lal S. Tricuspid regurgitation is associated with increased mortality independent of pulmonary pressures and right heart failure: a systematic review and meta-analysis. European Heart Journal. 2019;40(5):476-84.
https://doi.org/10.1093/eurheartj/ehy641

Cholesterol Treatment Trialists’ (CTT) Collaboration (writing committee: Herrington WG*, Emberson J*, Mihaylova B*, et al, incl. Fulcher J). Impact of renal function on the effects of LDL cholesterol lowering with statin-based regimens: a meta-analysis of individual participant data from 28 randomised trials. Lancet Diabetes & Endocrinology. 2016;4(10):829-39.
https://doi.org/10.1016/S2213-8587(16)30156-5

Cholesterol Treatment Trialists’ (CTT) Collaboration (incl. Fulcher J). Effect of statin therapy on muscle symptoms: an individual participant data meta-analysis of large-scale, randomised, double-blind trials. The Lancet. 2022;400(10355):832-45.
https://doi.org/10.1016/S0140-6736(22)01545-8

Wang N, Fulcher J, Abeysuriya N, Park L, Kumar S, Di Tanna GL, et al. Intensive LDL cholesterol-lowering treatment beyond current recommendations for the prevention of major vascular events: a systematic review and meta-analysis of randomised trials including 327 037 participants. Lancet Diabetes & Endocrinology. 2020;8(1):36-49.
https://doi.org/10.1016/S2213-8587(19)30388-2

Reith C, Preiss D, Blackwell L, et al (CTT Collaboration; incl. Fulcher J). Effects of statin therapy on diagnoses of new-onset diabetes and worsening glycaemia in large-scale randomised blinded statin trials: an individual participant data meta-analysis. Lancet Diabetes & Endocrinology. 2024;12(5):306-19.
https://doi.org/10.1016/S2213-8587(24)00040-8

Wang N, Fulcher J, Abeysuriya N, Adams M, Lal S. Predictors of successful chronic total occlusion percutaneous coronary interventions: a systematic review and meta-analysis. Heart. 2018;104:517-24.
https://doi.org/10.1136/heartjnl-2017-311986

Sivashanmugarajah A, Fulcher J, Sullivan D, Elam M, Jenkins A, Keech A. Suggested clinical approach for the diagnosis and management of ‘statin intolerance’ with an emphasis on muscle-related side-effects. Internal Medicine Journal. 2019;49(9):1081-91.
https://doi.org/10.1111/imj.14429

Cholesterol Treatment Trialists’ (CTT) Collaboration (writing committee: Reith C, Blackwell L, Emberson J, et al, incl. Fulcher J). Protocol for analyses of adverse event data from randomized controlled trials of statin therapy. American Heart Journal. 2016;176:63-9.
https://doi.org/10.1016/j.ahj.2016.01.016

Abed HS, Fulcher JR, Kilborn MJ, Keech AC. Inappropriate sinus tachycardia: focus on ivabradine. Internal Medicine Journal. 2016;46(8):875-83.
https://doi.org/10.1111/imj.13093

Hamilton GW, Koshy AN, Fulcher J, Tang GHL, Bapat V, Murphy A, et al. Meta-analysis Comparing Valve-In-Valve Transcatheter Aortic Valve Implantation With Self-Expanding Versus Balloon-Expandable Valves. American Journal of Cardiology. 2020;125(10):1558-65.
https://doi.org/10.1016/j.amjcard.2020.02.021

Fulcher J, Wilcox I. Basal Stress Cardiomyopathy Induced by Exogenous Catecholamines in Younger Adults. International Journal of Cardiology. 2013;168(6):e158-60.
https://doi.org/10.1016/j.ijcard.2013.08.067

Fulcher J*, Chia N*, Keech A (*co-first authors). Beta-blocker, angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, nitrate-hydralazine, diuretics, aldosterone antagonist, ivabradine, devices and digoxin (BANDAID²): an evidence-based mnemonic for the treatment of systolic heart failure. Internal Medicine Journal. 2016;46(6):653-62.
https://doi.org/10.1111/imj.12839

Hamilton GW, Dinh D, Yeoh J, Brennan AL, Fulcher J, Koshy AN, et al. Characteristics of Radial Artery Coronary Bypass Graft Failure and Outcomes Following Subsequent Percutaneous Coronary Intervention. JACC: Cardiovascular Interventions. 2023;16(4):457-67.
https://doi.org/10.1016/j.jcin.2022.11.035

Jenkins AJ, Scott E, Fulcher J, Kilov G, Januszewski AS. Management of Diabetes Mellitus. In: Toth P, Cannon C, eds. Comprehensive Cardiovascular Medicine in the Primary Care Setting. Springer; 2019.
https://doi.org/10.1007/978-3-319-97622-8

Koshy AN, Dinh DT, Fulcher J, Brennan AL, Murphy AC, Duffy SJ, et al. Long-term mortality in asymptomatic patients with stable ischemic heart disease undergoing percutaneous coronary intervention. American Heart Journal. 2022;244:77-85.
https://doi.org/10.1016/j.ahj.2021.10.190

Fulcher J, Patel S, Nicholls SJ, Bao S, Celermajer D. Optical coherence tomography for serial in vivo imaging of aortic plaque in the rabbit: a preliminary experience. Open Heart. 2015;2(1):e000314.
https://doi.org/10.1136/openhrt-2015-000314

Fulcher J*, Chin J*, Jenkins A, Keech A (*co-first authors). Is it Time to Repair a Fairly Fast SAAB Convertible? Testing an Evidence-based Mnemonic for the Secondary Prevention of Cardiovascular Disease. Heart, Lung & Circulation. 2015;24(5):480-7.
https://doi.org/10.1016/j.hlc.2014.11.016

Fulcher J, Keech A. The case for more intensive use of statins. Therapeutic Advances in Chronic Disease. 2012;3:201-10.
https://doi.org/10.1177/2040622312454045

Hamilton GW, Fletcher LR, Harley W, Azzopardi R, Chan RK, Fulcher J, Miles LF, Farouque O, Horrigan MCG. Differences in Direct Fick and Thermodilution Measurements of Cardiac Output: Impact on Pulmonary Hypertension Classification. Pulmonary Circulation. 2025;15(1):e70053.
https://doi.org/10.1002/pul2.70053

Drak D, Fulcher J, Kilian J, Chong JJH, Grover R, Sindone AP, et al. Guideline-based audit of the hospital management of heart failure with reduced ejection fraction. Internal Medicine Journal. 2023;53(9):1595-601.
https://doi.org/10.1111/imj.15830

Chen D, Fulcher J, Scott ES, Jenkins AJ. Precision Medicine Approaches for Management of Type 2 Diabetes. In: Basu R, ed. Precision Medicine in Diabetes: A Multidisciplinary Approach to an Emerging Paradigm. Cham: Springer International Publishing; 2022. p. 1-52.
https://doi.org/10.1007/978-3-030-98927-9_1

Sivashanmugarajah A, Fulcher J, Sullivan D, Elam M, Jenkins A, Keech A. Pharmacogenetics of statin intolerance — reply. Internal Medicine Journal. 2020;50(4):507-8.
https://doi.org/10.1111/imj.14785

Khandkar C, Fulcher J, Patel S, Keech A. Treatment of vulnerable atherosclerotic plaques: the PREVENT trial. The Lancet. 2024;404(10465):1811-2.
https://doi.org/10.1016/S0140-6736(24)02222-0

Ferguson C, William S, Allida SM, Fulcher J, Jenkins AJ, Lattimore J-D, Loch LJ, Keech A. The Development of Heart Failure Electronic-Message Driven Tips to Support Self-Management: Co-Design Case Study. JMIR Cardio. 2024;8:e57328.
https://doi.org/10.2196/57328

Fulcher J, Keech A, Simes S, Baigent C, Collins R. Questioning statin therapy for older patients — Authors’ reply. The Lancet. 2020;395(10240):1832-3.
https://doi.org/10.1016/S0140-6736(19)33159-9

Fulcher J, Keech A. Reducing cardiovascular risk in type 2 diabetes. Diabetes Management: A Journal for General Practitioners and Other Health Professionals. 2016;56:6-10.

Fulcher J, Keech A. Aspirin Use in People with Diabetes: The Evidence. Diabetes Management: A Journal for General Practitioners and Other Health Professionals. 2013;45:20-4.

Keech AC, Fulcher JR, Simes J. The role of statin therapy in patients with lower vascular risk. Medical Journal of Australia. 2012;197(3):130-1.
https://doi.org/10.5694/mja12.10925

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