Based on my observations and those of the doctors on the Diagnostic & Interventional Cardiology Editorial Advisory Board, we created the following list of predictions of what will be hot trends to watch in 2012.
• FFR-CT: A potential “game-changer” technology that was recently introduced is fractional flow reserve computed tomography (FFR-CT), which computationally models coronary blood flow, pressure and physiology from static typically acquired by CT scans. The information may be able to determine if a specific stenosis needs to be stented without the need for invasive, catheter FFR measurements in the cath lab.
• Transcatheter Heart Valves: With the U.S. Food and Drug Administration (FDA) clearance of the Edwards Sapien valve, transcatheter aortic valve implantation (TAVI) is taking center stage at several conferences. Also in FDA trials are Medtronic’s CoreValve aortic valve and Abbott’s MitraClip device for mitral valve repair.
• Percutaneous Renal Nerve Ablation: Medtronic purchased Ardian, which developed the Symplicity renal nerve ablation catheter currently in FDA trial. Data so far has shown the therapy may greatly reduce drug-resistant hypertension.
• Left Atrial Appendage (LAA) Occluders: These transcatheter occluders are designed to prevent atrial fibrillation-induced emboli and replace the current standard of warfarin therapy. In 2011 the CoHerex WaveCrest entered first-in-man trials and Boston Scientific purchased Atritech’s Watchman LAA occluder.
• Drug-Eluting Balloons: Several DEBs are already available in Europe and several vendors are seeking FDA clearance. Lutonix (purchased by C.R. Bard in December) has an ongoing FDA trial. Medrad, Cook and Medtronic/Invatec are working with the FDA to begin U.S. trials.
• Hybrid Operating Rooms: While hybrid ORs are not a new concept, the approval of the first transcatheter aortic valve and increasingly more complex minimally invasive surgeries and interventional procedures are driving their adoption. Vendors are increasingly emphasizing the hybrid OR applications of their products due to rising interest.
• Robotics in the Cath Lab: The Corindus CorPath 200 cath lab robotic system entered its FDA pivotal clinical trial with possible final review in 2012. Boston Scientific and Philips both partnered with robotic system vendors for closer integration. Hansen Medical is also developing a peripheral artery disease interventional robotic system it hopes will be reviewed in 2012 by the FDA.
I am always interested in hearing readers’ thoughts on technologies or trial data from the past year, or in their predictions for what technologies to watch in the coming year.