Gregory Allan Fleming | Scholars@Duke

Gregory Allan Fleming
Professor of Pediatrics

Clinical interests include pediatric and adult congenital interventional cardiac catheterization and treatment of infants and children with acquired and congenital heart disease and adults with congenital heart disease

Research interests include assessment and development of interventional therapies for congenital heart disease, and perioperative management of infants and children with congenital heart disease requiring surgery.

Current Appointments & Affiliations

Professor of Pediatrics, Pediatrics, Cardiology, Pediatrics 2022

Contact Information

DUMC Box 3090, 7506 Hospital North, Durham, NC 27710
gregory.fleming@duke.edu (919) 681-6772

Background
Education, Training, & Certifications
- Pediatric Cardiology Interventional Fellowship, Pediatrics, Vanderbilt University 2009 - 2010
- Pediatric Cardiology Fellowship, Pediatrics, Vanderbilt University 2006 - 2009
- Internship & Residency, Pediatrics, Vanderbilt University 2003 - 2006
- M.D., University of South Carolina, Columbia 2003
Previous Appointments & Affiliations
- Associate Professor of Pediatrics, Pediatrics, Cardiology, Pediatrics 2021 - 2022
- Associate Professor of Pediatrics, Pediatrics, Cardiology, Pediatrics 2019 - 2020
- Assistant Professor of Pediatrics, Pediatrics, Cardiology, Pediatrics 2013 - 2019
- Medical Instructor in the Department of Pediatrics, Pediatrics, Cardiology, Pediatrics 2010 - 2012
Research
Selected Grants
- Harmony PAS awarded by Medtronic, Inc. 2022 - 2031
- COngenital Multicenter trial of Pulmonic vAlve dysfunction Studying the SAPIEN 3 interventIONal THV Post-Approval Study awarded by Edwards Lifesciences Corporation 2021 - 2026
- Multicenter Post-Approval Study of Congenital Pulmonic Valve Dysfunction Studying the Edwards SAPIEN 3 Transcatheter Pulmonary Valve System with Alterra Adaptive Prestent awarded by Edwards Lifesciences Corporation 2022 - 2024
- COngenital Multicenter trial of Pulmonic vAlve dysfunction Studying the SAPIEN 3 interventIONal THV awarded by Edwards Lifesciences Corporation 2016 - 2021
External Relationships
- Penumbra
- none
Publications & Artistic Works
Selected Publications
- Academic Articles
  - Lim, D Scott, Dennis Kim, Jamil Aboulhosn, Daniel Levi, Greg Fleming, Michael Hainstock, Robert Sommer, et al. “Congenital Pulmonic Valve Dysfunction Treated With SAPIEN 3 Transcatheter Heart Valve (from the COMPASSION S3 Trial).” Am J Cardiol 190 (January 4, 2023): 102–9. https://doi.org/10.1016/j.amjcard.2022.12.010.
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  - Thornton, Steven W., James M. Meza, Neel K. Prabhu, Lillian Kang, Mary E. Moya-Mendez, Lauren E. Parker, Gregory A. Fleming, Joseph W. Turek, and Nicholas D. Andersen. “Impact of Ventricular Dominance on Long-Term Fontan Outcomes: A 25-year Single-institution Study.” Ann Thorac Surg, December 18, 2022. https://doi.org/10.1016/j.athoracsur.2022.11.039.
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  - Carmon, Philip, Gregory A. Fleming, Piers C. A. Barker, Gregory M. Sturgeon, Joseph W. Turek, and Reid C. Chamberlain. “Whole-Chest Three-Dimensional Modeling Aids Hybrid Pulmonary Valve Replacement Following Double Switch Operation.” World J Pediatr Congenit Heart Surg, October 20, 2022, 21501351221132160. https://doi.org/10.1177/21501351221132161.
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  - Fleming, Gregory A., and Reid C. Chamberlain. “Ongoing Learning With Transcatheter Pulmonary Valve Replacement: Incremental Benefits Comparing Apples to Oranges.” Jacc Cardiovasc Interv 15, no. 2 (January 24, 2022): 176–78. https://doi.org/10.1016/j.jcin.2021.12.001.
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  - Prabhu, Neel K., Alexander Zhu, James M. Meza, Kevin D. Hill, Gregory A. Fleming, Reid C. Chamberlain, Andrew J. Lodge, Joseph W. Turek, and Nicholas D. Andersen. “Transition to Ductal Stenting for Single Ventricle Patients Led to Improved Survival: An Institutional Case Series.” World J Pediatr Congenit Heart Surg 12, no. 4 (July 2021): 518–26. https://doi.org/10.1177/21501351211007808.
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  - Zhu, Alexander, Carmelo A. Milano, Joseph W. Turek, Richard A. Krasuski, Gregory A. Fleming, Reid C. Chamberlain, and Nicholas D. Andersen. “Mustard Baffle Revision With Systemic Ventricular Assist Device Placement.” Ann Thorac Surg 110, no. 4 (October 2020): e279–80. https://doi.org/10.1016/j.athoracsur.2020.03.038.
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  - Chamberlain, Reid C., Kevin D. Hill, and Gregory A. Fleming. “Palliating Premature Infants With Obstructed Total Anomalous Pulmonary Venous Connection via Catheterization.” World J Pediatr Congenit Heart Surg 11, no. 4 (July 2020): NP164–67. https://doi.org/10.1177/2150135118782191.
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  - Chamberlain, Reid C., Jordan E. Ezekian, Gregory M. Sturgeon, Piers C. A. Barker, Kevin D. Hill, and Gregory A. Fleming. “Preprocedural three-dimensional planning aids in transcatheter ductal stent placement: A single-center experience.” Catheter Cardiovasc Interv 95, no. 6 (May 1, 2020): 1141–48. https://doi.org/10.1002/ccd.28669.
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  - Serfas, John D., Joseph Turek, John Haney, Richard A. Krasuski, and Gregory A. Fleming. “Hybrid transcatheter pulmonary valve replacement with a SAPIEN S3 valve after pulmonary artery banding via left lateral thoracotomy.” Catheter Cardiovasc Interv 95, no. 3 (February 15, 2020): E78–83. https://doi.org/10.1002/ccd.28591.
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  - Chamberlain, Reid C., Alexis C. Shindhelm, Chu Wang, Gregory A. Fleming, and Kevin D. Hill. “Estimating radiation exposure during paediatric cardiac catheterisation: a potential for radiation reduction with air gap technique.” Cardiol Young 29, no. 12 (December 2019): 1474–80. https://doi.org/10.1017/S1047951119002506.
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  - Thibault, Dylan, Amelia S. Wallace, Marshall L. Jacobs, Christoph P. Hornik, John M. Costello, Gregory F. Fleming, Jeffrey P. Jacobs, et al. “Postoperative Transcatheter Interventions in Children Undergoing Congenital Heart Surgery.” Circ Cardiovasc Interv 12, no. 6 (June 2019): e007853. https://doi.org/10.1161/CIRCINTERVENTIONS.119.007853.
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  - Kamyszek, Reed W., Harold J. Leraas, Uttara P. Nag, Lindsey A. Olivere, Amanda L. Nash, Hanna R. Kemeny, Jina Kim, et al. “Routine postprocedure ultrasound increases rate of detection of femoral arterial thrombosis in infants after cardiac catheterization.” Catheter Cardiovasc Interv 93, no. 4 (March 1, 2019): 652–59. https://doi.org/10.1002/ccd.28009.
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  - Hill, Kevin D., Wei Du, Gregory A. Fleming, Thomas J. Forbes, David G. Nykanen, Jaxk Reeves, Yan Du, and Daisuke Kobayashi. “Validation and refinement of the catheterization RISk score for pediatrics (CRISP score): An analysis from the congenital cardiac interventional study consortium.” Catheter Cardiovasc Interv 93, no. 1 (January 1, 2019): 97–104. https://doi.org/10.1002/ccd.27837.
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  - Hill, Kevin D., Steve D. Mann, Michael P. Carboni, Thomas P. Doyle, Salim F. Idriss, Dana F. Janssen, George T. Nicholson, Shyam Sathanandam, and Greg A. Fleming. “Variability in radiation dose and image quality: A comparison across fluoroscopy-system vendors, generations of equipment and institutions.” Catheter Cardiovasc Interv 92, no. 7 (December 1, 2018): E471–77. https://doi.org/10.1002/ccd.27793.
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  - Kenny, Damien, John F. Rhodes, Gregory A. Fleming, Saibal Kar, Evan M. Zahn, Julie Vincent, Girish S. Shirali, et al. “3-Year Outcomes of the Edwards SAPIEN Transcatheter Heart Valve for Conduit Failure in the Pulmonary Position From the COMPASSION Multicenter Clinical Trial.” Jacc Cardiovasc Interv 11, no. 19 (October 8, 2018): 1920–29. https://doi.org/10.1016/j.jcin.2018.06.001.
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  - Al-Subu, Awni, Edmund Jooste, Christoph P. Hornik, Gregory A. Fleming, Ira M. Cheifetz, and George Ofori-Amanfo. “Correlation between minute carbon dioxide elimination and pulmonary blood flow in single-ventricle patients after stage 1 palliation and 2-ventricle patients with intracardiac shunts: A pilot study.” Paediatr Anaesth 28, no. 7 (July 2018): 618–24. https://doi.org/10.1111/pan.13423.
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  - “Correction to: 2016 Scientific Sessions Abstract, Variability in Radiation Dose and Image Quality: A Comparison Across Fluoroscopy-system Vendors and Generations of Equipment.” Circulation 137, no. 17 (April 24, 2018). https://doi.org/10.1161/cir.0000000000000572.
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  - Gales, Jordan, Richard A. Krasuski, and Gregory A. Fleming. “Transcatheter Valve Replacement for Right-sided Valve Disease in Congenital Heart Patients.” Prog Cardiovasc Dis 61, no. 3–4 (2018): 347–59. https://doi.org/10.1016/j.pcad.2018.09.003.
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  - Bearl, David W., and Gregory A. Fleming. “Utilizing Hybrid Techniques to Maximize Clinical Outcomes in Congenital Heart Disease.” Curr Cardiol Rep 19, no. 8 (August 2017): 72. https://doi.org/10.1007/s11886-017-0878-2.
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  - Hill, Kevin D., Bryan H. Goldstein, Michael J. Angtuaco, Patricia Y. Chu, and Gregory A. Fleming. “Post-market surveillance to detect adverse events associated with Melody® valve implantation.” Cardiol Young 27, no. 6 (August 2017): 1090–97. https://doi.org/10.1017/S1047951116002092.
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  - Kim, Jina, Zhifei Sun, Ehsan Benrashid, Kevin W. Southerland, Jeffrey H. Lawson, Gregory A. Fleming, Kevin D. Hill, and Elisabeth T. Tracy. “The impact of femoral arterial thrombosis in paediatric cardiac catheterisation: a national study.” Cardiol Young 27, no. 5 (July 2017): 912–17. https://doi.org/10.1017/S104795111600161X.
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  - Hill, Kevin D., Chu Wang, Andrew J. Einstein, Natalie Januzis, Giao Nguyen, Jennifer S. Li, Gregory A. Fleming, and Terry K. Yoshizumi. “Impact of imaging approach on radiation dose and associated cancer risk in children undergoing cardiac catheterization.” Catheter Cardiovasc Interv 89, no. 5 (April 2017): 888–97. https://doi.org/10.1002/ccd.26630.
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  - Plummer, Sarah T., Christoph P. Hornik, Hamilton Baker, Gregory A. Fleming, Susan Foerster, M Eric Ferguson, Andrew C. Glatz, et al. “Maladaptive aortic properties after the Norwood procedure: An angiographic analysis of the Pediatric Heart Network Single Ventricle Reconstruction Trial.” J Thorac Cardiovasc Surg 152, no. 2 (August 2016): 471-479.e3. https://doi.org/10.1016/j.jtcvs.2016.03.091.
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  - Torok, Rachel D., Gregory A. Fleming, and Kevin D. Hill. “Transcatheter pulmonary embolectomy after fontan.” Catheter Cardiovasc Interv 87, no. 5 (April 2016): 939–44. https://doi.org/10.1002/ccd.26096.
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  - Nykanen, David G., Thomas J. Forbes, Wei Du, Abhay A. Divekar, Jaxk H. Reeves, Donald J. Hagler, Thomas E. Fagan, et al. “CRISP: Catheterization RISk score for Pediatrics: A Report from the Congenital Cardiac Interventional Study Consortium (CCISC).” Catheter Cardiovasc Interv 87, no. 2 (February 1, 2016): 302–9. https://doi.org/10.1002/ccd.26300.
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  - Torok, Rachel D., Michael J. Campbell, Gregory A. Fleming, and Kevin D. Hill. “Coarctation of the aorta: Management from infancy to adulthood.” World J Cardiol 7, no. 11 (November 26, 2015): 765–75. https://doi.org/10.4330/wjc.v7.i11.765.
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  - Plummer, Sarah T., Christoph P. Hornik, Hamilton Baker, Gregory A. Fleming, Susan Foerster, Eric Ferguson, Andrew Glatz, et al. “Maladaptive Aortic Properties after the Norwood Procedure: an Angiographic Analysis of the Pediatric Heart Network Single Ventricle Reconstruction Trial.” Circulation 130 (November 25, 2014).
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  - Tunks, Robert D., Piers C. A. Barker, Daniel K. Benjamin, Michael Cohen-Wolkowiez, Gregory A. Fleming, Matthew Laughon, Jennifer S. Li, and Kevin D. Hill. “Sildenafil exposure and hemodynamic effect after Fontan surgery.” Pediatr Crit Care Med 15, no. 1 (January 2014): 28–34. https://doi.org/10.1097/PCC.0000000000000007.
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  - Hill, Kevin D., John F. Rhodes, Ranjit Aiyagari, G Hamilton Baker, Lisa Bergersen, Paul J. Chai, Gregory A. Fleming, et al. “Intervention for recoarctation in the single ventricle reconstruction trial: incidence, risk, and outcomes.” Circulation 128, no. 9 (August 27, 2013): 954–61. https://doi.org/10.1161/CIRCULATIONAHA.112.000488.
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  - Hill, Kevin D., Robert D. Tunks, Piers C. A. Barker, Daniel K. Benjamin, Michael Cohen-Wolkowiez, Gregory A. Fleming, Matthew Laughon, and Jennifer S. Li. “Sildenafil exposure and hemodynamic effect after stage II single-ventricle surgery.” Pediatr Crit Care Med 14, no. 6 (July 2013): 593–600. https://doi.org/10.1097/PCC.0b013e31828aa5ee.
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  - Hill, Kevin D., Andrew J. Lodge, Daniel Forsha, Gregory A. Fleming, Amanda S. Green, and John F. Rhodes. “A strategy for atrial septal defect closure in small children that eliminates long-term wall erosion risk.” Catheter Cardiovasc Interv 81, no. 4 (March 2013): 654–59. https://doi.org/10.1002/ccd.24500.
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  - Hill, Kevin D., John F. Rhodes, Ranjit Aiyagari, G. H. Baker, Lisa Bergersen, Paul J. Chai, Gregory A. Fleming, et al. “Intervention for Re-coarctation in the Single Ventricle Reconstruction Trial: Incidence, Risk and Outcomes.” Circulation 126, no. 21 (November 20, 2012).
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  - Hill, Kevin D., Robert Tunks, Gregory A. Fleming, John F. Rhodes, Matthew Laughon, Michael Cohen-Wolkowiez, and Jennifer S. Li. “Sildenafil Pharmacokinetics, Hemodynamic Efficacy and Safety after Stage II Single Ventricle Surgery.” Circulation 126, no. 21 (November 20, 2012).
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  - Hill, Kevin D., Gregory Fleming, J. Curt Fudge, Erin L. Albers, Thomas P. Doyle, and John F. Rhodes. “Percutaneous interventions in high-risk patients following Mustard repair of transposition of the great arteries.” Catheter Cardiovasc Interv 80, no. 6 (November 15, 2012): 905–14. https://doi.org/10.1002/ccd.23470.
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  - Fleming, G. A., K. D. Hill, A. S. Green, and J. F. Rhodes. “Percutaneous pulmonary valve replacement.” Progress in Pediatric Cardiology 33, no. 2 (May 1, 2012): 143–50. https://doi.org/10.1016/j.ppedcard.2012.02.007.
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  - Fleming, Gregory A., Frederic T. Billings, Tom M. Klein, David P. Bichell, Karla G. Christian, and Mias Pretorius. “Angiotensin-converting enzyme inhibition alters the inflammatory and fibrinolytic response to cardiopulmonary bypass in children.” Pediatr Crit Care Med 12, no. 5 (September 2011): 532–38. https://doi.org/10.1097/PCC.0b013e3181fe3925.
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  - Fleming, Gregory A., Muhammed Khan, Dana Janssen, and Thomas Doyle. “Angiojet rheolytic thrombectomy in infants following cardiac surgery.” Catheter Cardiovasc Interv 76, no. 2 (August 1, 2010): 233–40. https://doi.org/10.1002/ccd.22544.
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  - Fleming, G. A., A. Bircher, A. Kavanaugh-McHugh, and M. R. Liske. “The cerebroplacental Doppler ratio predicts postnatal outcome in fetuses with congenital heart block.” J Perinatol 28, no. 12 (December 2008): 791–96. https://doi.org/10.1038/jp.2008.105.
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  - Fleming, Gregory A., Katherine T. Murray, Chang Yu, John G. Byrne, James P. Greelish, Michael R. Petracek, Steven J. Hoff, Stephen K. Ball, Nancy J. Brown, and Mias Pretorius. “Milrinone use is associated with postoperative atrial fibrillation after cardiac surgery.” Circulation 118, no. 16 (October 14, 2008): 1619–25. https://doi.org/10.1161/CIRCULATIONAHA.108.790162.
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  - Fleming, G. A., F. G. Scholl, A. Kavanaugh-McHugh, and M. R. Liske. “A case of an infant with flail tricuspid valve due to spontaneous papillary muscle rupture: was neonatal lupus the culprit?” Pediatr Cardiol 29, no. 2 (March 2008): 442–45. https://doi.org/10.1007/s00246-007-9109-8.
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  - Fleming, Gregory A., Haydar Frangoul, Terence S. Dermody, and Natasha Halasa. “A cord blood transplant recipient with Mycobacterium mucogenicum central venous catheter infection after infusion of tap water.” Pediatr Infect Dis J 25, no. 6 (June 2006): 567–69. https://doi.org/10.1097/01.inf.0000219406.06431.67.
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- Book Sections
  - Torok, Rachel D., Michael J. Campbell, Gregory A. Fleming, and Kevin D. Hill. “Coarctation of the Aorta.” In Diseases of the Aorta, 111–25. Springer International Publishing, 2019. https://doi.org/10.1007/978-3-030-11322-3_8.
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  - Hill, K. D., J. Roark, and G. A. Fleming. “Cardiac catheterization laboratory.” In Critical Heart Disease in Infants and Children, 465-479.e2, 2018. https://doi.org/10.1016/B978-1-4557-0760-7.00037-1.
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- Conference Papers
  - Wallace, Amelia S., Marshall L. Jacobs, Christoph P. Hornik, John M. Costello, Gregory A. Fleming, Jeffrey P. Jacobs, Robert D. Jaquiss, Bryan H. Goldstein, Reid C. Chamberlain, and Kevin D. Hill. “Post-operative Cardiac Catheterization in Children Undergoing Congenital Heart Surgery: An Analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database.” In Circulation, Vol. 136. LIPPINCOTT WILLIAMS & WILKINS, 2017.
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  - Kim, Jina, Ibtehaj Naqvi, Uttara P. Nag, Harold J. Leraas, James C. Otto, Alexandra J. Borst, Kevin D. Hill, Gregory A. Fleming, Bruce A. Sullenger, and Elisabeth T. Tracy. “Cell-Free DNA Is Elevated after Acute Arterial Injury in Infants.” In Blood, Vol. 128. AMER SOC HEMATOLOGY, 2016.
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Teaching & Mentoring
Recent Courses
Teaching Activities
- Director, Advanced fellowship in pediatric and adult congenital congenital interventional cardiology
Scholarly, Clinical, & Service Activities
Academic & Administrative Activities
- Medical Director, Pediatric and Adult Congenital Cardiac Cath Labs
  Co-director, Duke Fontan program

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Education, Training, & Certifications

Previous Appointments & Affiliations

Selected Grants

External Relationships

Selected Publications

Academic Articles

Book Sections

Conference Papers

Recent Courses

Teaching Activities

Academic & Administrative Activities