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VIDEO: Trends in Radial Access for Percutaneous Coronary Interventions

Radial Access | October 22, 2019

Sunil Rao, M.D., chief of cardiology, Durham VA Health System and a professor at Duke University, and Prashant Kaul, M.D., director of the cath lab, Piedmont, Atlanta, discuss trends in radial access at the 2019 Transcatheter Cardiovascular Therapeutics (TCT) annual meeting. They discuss how radial access adoption has grown rapidly in the past few years and now makes up between 40-50 percent of percutaneous coronary intervention (PCI) procedural volume in the United States. They also discuss recent clinical trial data and the new concept of using distal radial access. 

 

Related Radial Access Content:

Transradial Access Celebrates 25 Years

VIDEO: History of Radial Artery Access — Interview with Ferdinand Kiemeneij, M.D.

VIDEO: New Frontiers in Radial Access — Interview with Mladen I. Vidovich, M.D.

Find more news and on transradial access technique and technology

 

 

Cath Lab

Radial Access | October 22, 2019

Sunil Rao, M.D., chief of cardiology, Durham VA Health System and a professor at Duke University, and Prashant Kaul, M.D., director of the cath lab, Piedmont, Atlanta, discuss trends in radial access at the 2019 Transcatheter Cardiovascular Therapeutics (TCT) annual meeting. They discuss how radial access adoption has grown rapidly in the past few years and now makes up between 40-50 percent of percutaneous coronary intervention (PCI) procedural volume in the United States. They also discuss recent clinical trial data and the new concept of using distal radial access. 

 

Related Radial Access Content:

Transradial Access Celebrates 25 Years

VIDEO: History of Radial Artery Access — Interview with Ferdinand Kiemeneij, M.D.

VIDEO: New Frontiers in Radial Access — Interview with Mladen I. Vidovich, M.D.

Find more news and on transradial access technique and technology

 

 

Vascular Closure Devices | October 17, 2019

Ashish Pershad, M.D., chief of interventional cardiology, Banner University Medical Center, Phoenix, explains the trend of using closure devices to seal larger vascular access sites from the use of TAVR, EVAR, TMVR and hemodynamic support devices at the 2019 Transcatheter Cardiovascular Therapeutics (TCT) meeting. He was one of the moderators on a session on this topic at TCT 2019.

 

Related Large Bore Vascular Closure Device Content:

VIDEO: How to Achieve Hemostasis With Large Bore Device Access — Interview with Philippe Genereux, M.D.

First-in-Human Results Show Early Bird Device Effective in Early Detection of Internal Bleeding

Advances and Trends in Vascular Closure Devices

Manta Large-Bore Vascular Closure Device Cleared by the FDA

PerQseal Large Bore Closure Device Launches in Europe

Teleflex Acquires Essential Medical

 

Related Content With Dr. Pershad:

National Coverage Determination Will Make TAVR Available to More Patients at More Centers

VIDEO: Comparison Between Watchman vs. Amulet LAA Occluders
 

Antiplatelet and Anticoagulation Therapies | October 17, 2019

Roxana Mehran, M.D., FACC, FACP, FCCP, FESC, FAHA, FSCAI, professor of medicine and director of interventional cardiovascular research and clinical trials at the Zena and Michael A. Wiener Cardiovascular Institute at Mount Sinai School of Medicine, explains the use of short dual antiplatelet therapy (DAPT) in minorities from the PLATINUM Diversity Trial. The first trial data was released in 2017, and she presented new data from the study at the 2019 Transcatheter Cardiovascular Therapeutics (TCT) meeting. 

The study looked at use of the Promus Element Plus Post-Approval Study and the clinical impact of dual-antiplatelet therapy (DAPT) cessation within 12 months of drug-eluting stent implantation in caucasians and minorities. It is one of the first large trials to stress the importance of diversity in clinical trials, which tent to reflect a population of older white men.

 

Find more news and videos from TCT 2019

Hemodynamic Support Devices | October 16, 2019

Jeffrey J. Popma, M.D., director of interventional cardiology clinical services at Beth Israel Deaconess Medical Center, professor of medicine at Harvard Medical School, explains the results of the PROTECT II and the new PROTECT III Study at the 2019 Transcatheter Cardiovascular Therapeutics (TCT) meeting. PROTECT III is the follow up to PROTECT II RCT and the largest-ever FDA study of hemodynamically supported, high-risk PCI patients. 

He discusses the PROTECT II and PROTECT III studies, and real-life patient data from the Impella IQ Database. 

 

Find more news and videos from TCT 2019

Structural Heart | October 16, 2019

Vivian Ng, M.D., assistant professor of medicine and an interventional cardiologist at the NewYork-Presbyterian/Columbia University Medical Center Structural Heart and Valve Center, helped organize the first Women in Structural Heart (WISH) event at the 2019 Transcatheter Cardiovascular Therapeutics (TCT) meeting. The evening session was standing room only and highlighted structural heart case presentations and discussion panels made up of all women. The session panelists and presenters were a whose-who of well known women in cardiology. The event was organized as a way to break the glass ceiling in the subspecialty of interventional cardiology, where women make up less than 5 percent of the operators.

 

Previous Video Interviews With Speakers and Panelists Involved in the WISH Session:

VIDEO: The Importance of the Neo-LVOT in Transcatheter Mitral Valve Replacement — Interview with Dee Dee Wang, M.D.

VIDEO: The Value of the Cardiovascular Service Line — Interview with Linda Gillam, M.D.,

VIDEO: Can We Live in 3-D Echo? — Interview with Lissa Sugeng, M.D.

VIDEO: Tricuspid Valve Imaging and Interventions Developing Hand-in-hand — Interview with Rebecca Hahn, M.D.

VIDEO: Strategies to Avoid Acute Kidney Injury Caused by Cath Lab Contrast — Interview with Roxana Mehran, M.D.,

 

 

Find more news and videos from TCT 2019

Antiplatelet and Anticoagulation Therapies | October 11, 2019

Ajay J. Kirtane, M.D., associate professor of medicine at Columbia University Irving Medical Center and director of the cardiac catheterization laboratories at NewYork-Presbyterian (NYP) Hospital, shares the findings of the late-breaking EVOLVE Short DAPT study presented as a late-breaking trial at the 2019 Transcatheter Cardiovascular Therapeutics (TCT) meeting. It evaluated the safety of early dual antiplatelet therapy (DAPT) discontinuation in patients with high bleeding risk treated with the a Boston Scientific Synergy bioabsorbable polymer coated drug-eluting stent (DES).

With the advancement of new DES technologies using thinner struts and new types of drug-carrier polymer techniques, the risk of late-stent thrombosis has been greatly reduced, meaning there is less need for long-term DAPT. For patients who are at high risk for bleeding, who have ulcers or other types of gastrointestinal (GI) bleeding, or those going into surgery, it would be beneficial to reduce the time period for DAPT, and several late-breaking trials examined this at TCT 2019.
 

Here are the other late-breaking DAPT studies:

 

Find more news and videos from TCT 2019

Antiplatelet and Anticoagulation Therapies | October 10, 2019

Roxana Mehran, M.D., FACC, FACP, FCCP, FESC, FAHA, FSCAI, professor of medicine and director of interventional cardiovascular research and clinical trials at the Zena and Michael A. Wiener Cardiovascular Institute at Mount Sinai School of Medicine, explains insights from the Ticagrelor With Asprin or Alone in High-Risk patients after Coronary Intervention (TWILGHT) Trial. She presented this late-breaking study at the 2019 Transcatheter Cardiovascular Therapeutics (TCT) meeting. Here is a link to the article on the TWILIGHT Trial.

 

Related Short DAPT Content:

VIDEO: Overview of Short DAPT in High-risk Bleeding Patients Who Receive Stents — Interview with AHA President Robert Harrington, M.D. at TCT 2019 

Onyx ONE: A Randomized Trial of a Durable-Polymer Drug-Eluting Stent vs a Polymer-Free Drug-Coated Stent in Patients at High Risk of Bleeding Treated With 1-Month DAPT - TCT 2019 late-breaker

IDEAL-LM: A Randomized Trial of a Bioabsorbable Polymer DES With 4-Month DAPT vs a Durable Polymer DES With 12-Month DAPT in Patients With Left Main Coronary Artery Disease - TCT 2019 late-breaker 

EVOLVE Short DAPT: A Single Arm Study of 3-Month DAPT in Patients at High Bleeding Risk Treated a Bioabsorbable Polymer-Based Everolimus-Eluting Stent - TCT 2019 late-breaker 

New Directions and Trends in Coronary Metallic Stents

Questions Remain on DAPT Prolongation

 

 

Find more TCT late-breaking news and video

Heart Valve Technology | October 09, 2019

Torsten Vahl, M.D., director of experimental and translational research, Structural Heart and Valve Center and at the Center for Interventional Vascular Therapy at NewYork-Presbyterian Hospital/Columbia University Medical Center, explains the current state of transcatheter arctic valve replacement (TAVR) following the U.S. Food and Drug Administration (FDA) clearance of TAVR in all surgical risk patient categories. Europe also cleared the use of the Sapien 3 device for low risk patients in November 2019.

He spoke on TAVR at the Transcatheter Cardiovascular Therapeutics (TCT) 2019 meeting. In August 2019, the FDA cleared the use of TAVR in all surgical risk classes of patients using the Edwards Sapien 3 and Medtronic CoreValve devices. This means the heart team made up of a cardiac surgeon, interventional cardiologist and cardiac imaging specialist can determine if surgical aortic valve replacement (SAVR) or TAVR should be used. It is widely expected TAVR use will rapidly rise in the next five years to take over 50 to 70 percent of the aortic valve replacement procedural volume. It is expected surgical volumes will drop to about 20 percent of patients who do not qualify for TAVR because of anatomic issues or other variables that make SAVR a safer option.

 

Related Transcatheter Valve Content:

FDA Approves TAVR for Low-risk Patients Creates A Paradigm Shift in Cardiology

Edwards Sapien 3 TAVI Granted European Approval to Treat Low-risk Patients

VIDEO: Tracking Transcatheter Valve Outcomes in the STS-ACC TVT Registry — John Carroll, M.D.

VIDEO: Transcatheter Mitral Valve Replacement Planning — Interview with Joao Cavalcante, M.D.

VIDEO: Overview of University of Colorado Structural Heart Program — Interview with John Carroll, M.D., Robert Quaife, M.D., and James Chen, Ph.D.

Advances in Transcatheter Tricuspid Valve Technologies

 

VIDEO: Update of Mitral Valve Repair and Replacement Technologies at TCT 2017 — Interview with Ted Feldman, M.D.,

TAVR Operator and Hospital Requirements Outlined in 2018 AATS/ACC/SCAI/STS Expert Consensus

VIDEO: Tricuspid Device Clinical Trial Overview — Interview with Ori Ben-Yehuda, M.D.

Recent Advances in Transcatheter Valve Technology

 

VIDEO: Tricuspid Valve Imaging and Interventions Developing Hand-in-hand at ASE 2018— Interview with Rebecca Hahn, M.D.

Hospital Consolidation May Increase Access to TAVR, New Cardiac Technologies

VIDEO: TAVR for Degenerated Surgical Valves - 2017 Update— Valve-in-Valve TAVR Procedures — Interview with Sammy Elmariah, M.D.

How to Perform Transcaval TAVR Access

 

VIDEO: The Essentials of CT Transcatheter Valve Imaging — Interview with Jonathon Leipsic, M.D.

Advances in Heart Valve Technology in 2017

VIDEO: TAVR For Asymptomatic Severe Aortic Stenosis — Interview with Philippe Genereux, M.D.

VIDEO: Conscious Sedation for TAVR Procedures — Interview with Mario Goessl, M.D.

 

VIDEO: Overview of the Henry Ford Hospital Structural Heart Program

Advances and Future Directions for Transcatheter Valves

Transcatheter Mitral Valve Replacement Devices in Development

 

 

 

 

Antiplatelet and Anticoagulation Therapies | October 08, 2019

American Heart Association President Robert Harrington, M.D., interventional cardiologist and the Arthur L. Bloomfield Professor of Medicine and chairman of the Department of Medicine at Stanford University, explains the reasons for shorter duration dual-antiplatelet therapy (DAPT) in high-risk bleeding patients. Newer-generation drug-eluting stents are designed for faster vessel healing and endothelialization, so the time required for DAPT can be reduced from 12 months to a shorter time period. At the 2019 Transcatheter Cardiovascular Therapeutics (TCT) meeting there were several late-breaking trials that looked at shorter duration DAPT or use of mono-therapy with ticagrelor. 

Related Short DAPT Content:

TWILIGHT: A Randomized Trial of Ticagrelor Monotherapy vs Ticagrelor Plus Aspirin Beginning at 3 Months in High-risk Patients Undergoing PCI - TCT 2019 late-breaker

Onyx ONE: A Randomized Trial of a Durable-Polymer Drug-Eluting Stent vs a Polymer-Free Drug-Coated Stent in Patients at High Risk of Bleeding Treated With 1-Month DAPT  - TCT 2019 late-breaker

IDEAL-LM: A Randomized Trial of a Bioabsorbable Polymer DES With 4-Month DAPT vs a Durable Polymer DES With 12-Month DAPT in Patients With Left Main Coronary Artery Disease - TCT 2019 late-breaker

EVOLVE Short DAPT: A Single Arm Study of 3-Month DAPT in Patients at High Bleeding Risk Treated a Bioabsorbable Polymer-Based Everolimus-Eluting Stent  - TCT 2019 late-breaker

 

Cardiogenic Shock | October 08, 2019

William O’Neill, M.D., medical director of the Center for Structural Heart Disease at Henry Ford Hospital, Detroit, explains data on first 250 patients in the National Cardiogenic Shock Initiative Study (NCSI) and new escalation protocols during the Transcatheter Cardiovascular Therapeutics (TCT) 2019 meeting. By implementing a protocol of using Impella hemodynamic support prior to percutaneous coronary intervention (PCI), the 80 centers involved in the initiative have been able to increase survival by 50 percent.

 

Related Cardiogenic Shock Content:

VIDEO: How to Reduce Cardiogenic Shock Mortality by 50 Percent — Interview with h Babar Basir, D.O.

SCAI Releases New Consensus Document on Classification Stages of Cardiogenic Shock

VIDEO: The Importance of Ventricular Unloading in AMI and Cardiogenic Shock — Interview with Nevin Kapur, M.D.

10 Reasons Why it is Time to Learn More About Cardiogenic Shock — by Emmanouil S. Brilakis, M.D.

New Approaches to Reduce Cardiogenic Shock Mortality

VIDEO: Overview of the National Cardiogenic Shock Initiative — Interview with William O’Neill, M.D.

 

Find more TCT late-breaking news and video

 

 

TCT | October 04, 2019

Chandan Devireddy, M.D., offers insights about what he saw as the top take aways from the 2019 Transcatheter Cardiovascular Therapeutics (TCT) annual meeting. He is cath lab director at Emory University Hospital Midtown, associate professor of medicine of interventional cardiology at Emory University, and chairperson for the Society of Cardiovascular Angiography and Interventions (SCAI) Communications Committee. 

Devireddy said his key take aways from TCT 2019 were:

   • The poor results of the Boston Scientific Acurate Neo self-explaining TAVR system compared to the current devices on the U.S. market;

   • Results of the Abbott Portico TAVR system;

   • Levant Trial shows no increased mortality due to use of a paclitaxel-coated balloon; and

   • CT study of TAVR valve leaflet thrombosis.

 

Find more TCT late-breaking news and video

 

University of Colorado Hospital | October 02, 2019

Interview with John Carroll, M.D., director of interventional cardiology, Robert Quaife, M.D., director of advanced cardiac imaging, and James Chen, Ph.D., associate professor of medicine and director of the 3-D imaging lab at the Cardiac and Vascular Center at the University of Colorado Hospital. They discuss how the structural heart program was created and how they invested in advanced imaging to grow into one of the most advanced programs in the country. They explain how the program now incorporates transcatheter aortic valve replacement (TAVR), transcatheter mitral valve repair, transcatheter mitral valve replacement (TMVR), left atrial appendage (LAA) occlusion and transcatheter closure of holes in the heart. 

The heart team in this video stressed the need for advanced imaging to plan and guide the procedures. They explain how the center developed its own 3-D imaging software and worked with Philips healthcare to commercialize some of the technologies, including the EchoNavigator system used to fuse live angiography with live transesophageal echo (TEE).

 

Related University of Colorado Hospital Content:

Highlighting Innovation at the University of Colorado Hospital Cardiology Program

VIDEO: Evolution of Transcatheter Mitral Valve Repair at the University of Colorado — Interview with John Carroll, M.D., and Robert Quaife, M.D.

VIDEO: The Role of Advanced Imaging in Structural Heart Interventions — Interview with Robert Quaife, M.D.

VIDEO: Advice For Hospitals Starting a Structural Heart Program — Interview with John Carroll, M.D.

VIDEO: The Evolution of Complex PCI at University of Colorado — Interview with John Messenger, M.D., and Kevin Rogers, M.D.

VIDEO: Developing New Cath Lab Technologies With Real-time Collaboration Between Industry, Doctors

360 View of the TEE Echo Workstation During a MitraClip Procedure

VIDEO: Walk Through of a Hybrid Cath Lab at the University of Colorado Hospital

VIDEO: Cath Lab Walk Through at the University of Colorado Hospital

VIDEO: The Cardiac Surgeon Perspective on Transcatheter Mitral Valve Repair — Interview with Joe Cleveland, M.D.

VIDEO: An Overview of PFO Closure to Treat Cryptogenic Stroke — Interview with Karen Orjuela, M.D.,

 

(This video was originally posted in May 2019 and was updated Oct. 2, 2019)

 

Heart Valve Technology | September 30, 2019

Marvin Eng, M.D., structural fellowship director at Henry Ford Health System, and William O'Neill, M.D., director of the Henry Ford Hospital structural heart program, explain the mitral valve repair program at Henry Ford. 

The hospital performs a large number of transcatheter mitral valve repairs, including MitraClip and with its involvement in trials for investigational device technologies. 

Watch the VIDEO: Overview of the Henry Ford Hospital Structural Heart Program

Find more news and video from Henry Ford Hospital

(Editor's note - this article was originally published in March 2019 and was revised Sept. 30, 2019)

 

 

 

Structural Heart | September 30, 2019

A discussion with William O’Neill, M.D., director of the Henry Ford structural heart program, Ruth Fisher, MBA, vice president of the program, and Janet Wyman, NP, program manager. Henry Ford Hospital has built a large, high-volume structural heart program that includes use of cutting edge new technologies and devices. 

Watch the related VIDEO: How to Get Referral Patients Into a Structural Heart Program — Henry Ford Hospital shares insights from its program.
 

Additional articles and videos on Henry Ford Hospital 
 

(Editor's note - this video was originally published in September 2018 and was revised September 2019)

Cardiovascular Business | September 30, 2019

A discussion with Ruth Fisher, MBA, vice president of the Henry Ford Hospital structural heart program, and Janet Wyman, NP, program manager. They explain how Henry Ford has been able to build its program and work with hospitals throughout Michigan, including those with their own transcatheter aortic valve replacement (TAVR) programs. They said building relationships with referral centers as partners and ensuring the patients go back to their local physicians for followups and regular care is key. 

Watch the related VIDEO: Overview of the Henry Ford Hospital Structural Heart Program.

(Editor's note - this article was originally published in April 2019 and was revised Oct. 1, 2019)

Additional articles and videos on Henry Ford Hospital 

 

 

 

Chronic Total Occlusion (CTO) | September 28, 2019

A discussion with Khaldoon Alaswad, M.D., director, cardiac catheterization lab, Henry Ford Hospital, on treating chronic total occlusions (CTOs) and other complex PCI cases. Watch the VIDEO: Treating Chronic Total Occlusions with Bill Lombardi, M.D., director of complex coronary artery interventions at the University of Washington. Read the article "How to Tackle Coronary CTOs."

Additional articles and videos on Henry Ford Hospital 

 

Related Chronic Total Occlusion Content: 

VIDEO: New Technology to Treat Chronic Total Occlusions (CTOs), an interview with Farouc Jaffer, M.D., Ph.D.

When to Consider Revascularization of Coronary Chronic Total Occlusions

VIDEO: Treating Chronic Total Occlusions, an interview with Bill Lombardi, M.D.

VIDEO: The Evolution of Complex PCI at University of Colorado  — Interview with John Messenger, M.D., and Kevin Rogers, M.D.

How to Tackle Coronary CTOs

 

(Editor's note - this video was originally published in September 2018 and was revised September 2019)

Cath Lab | September 28, 2019

A discussion with Nicolas Bevins, Ph.D., vice chair, physics and research, and Jessica Harrington, RCIS. They explain the use of shields, technique and use of newer angiography technologies to reduce X-ray radiation dose in the cardiac cath labs at Henry Ford Hospital, Detroit.

Watch the VIDEO: Technologies and Techniques to Reduce Radiation Dose in the Cardiac Cath Lab — Interview with Akshay Khandelwal, M.D., director of medical operations at the Henry Ford Heart and Vascular Institute

Additional articles and videos on Henry Ford Hospital 

 

For more on how to reduce dose in the cath lan, read these related articles:

Cardiology Societies Call for Better Radiation Dose Tracking

Defining the Cath Lab Workplace Radiation Safety Hazard

Dose-Lowering Practices for Cath Lab Angiography

5 Technologies to Reduce Cath Lab Radiation Exposure

VIDEO: Heart Surgeon Shares Effects of Fluoroscopic Radiation Exposure

Helping Interventional Cardiologists Reduce Exposure to Ionizing Radiation

14 Ways to Reduce Radiation Exposure in the Cath Lab

 

(Editor's note - this video was originally published in September 2018 and was revised September 2019)

September 27, 2019

Akshay Khandelwal, M.D., director of medical operations at the Henry Ford Heart and Vascular Institute, Detroit, and associate professor of cardiology at Wayne State University, explains how his center has reduced X-ray radiation dose in the cardiac catheterization labs.

Watch the related VIDEO: Reducing Cath Lab Radiation Dose at Henry Ford Hospital — Discussion with Nicolas Bevins, Ph.D., vice chair, physics and research, and Jessica Harrington, RCIS, Henry Ford Hospital.

Additional articles and videos on Henry Ford Hospital 

 

For more on how to reduce dose in the cath lan, read these related articles:

Cardiology Societies Call for Better Radiation Dose Tracking

Defining the Cath Lab Workplace Radiation Safety Hazard

Dose-Lowering Practices for Cath Lab Angiography

5 Technologies to Reduce Cath Lab Radiation Exposure

VIDEO: Heart Surgeon Shares Effects of Fluoroscopic Radiation Exposure

Helping Interventional Cardiologists Reduce Exposure to Ionizing Radiation

14 Ways to Reduce Radiation Exposure in the Cath Lab

 

(Editor's note - this video was originally published in November 2018 and was revised September 2019)

 

Hemodynamic Support Devices | September 22, 2019

There was a 77 percent increase in survival in cardiogenic shock patients treated using a new protocol in the National Cardiogenic Shock Initiative. The data was presented at the 2018 Transcatheter Cardiovascular Therapeutics (TCT) meeting. The details are discussed here with Babar Basir, D.O., and William O'Neill, M.D., from Henry Ford Hospital

Watch the related VIDEO: Overview of the National Cardiogenic Shock Initiative

Watch the related VIDEO: Support Protocols at Henry Ford Hospital

Additional articles and videos on Henry Ford Hospital 

(Editor's note - this video was originally published in September 2018 and was revised September 2019)

Hemodynamic Support Devices | September 12, 2019

A discussion with William O'Neill, M.D., director of the structural heart program, Henry Ford Hospital, and Michele Voeltz, M.D., fellowship program director, interventional cardiology, explaining their process for selecting various levels of hemodynamic support.

Henry Ford Hospital also helped spearhead the Detroit Cardiogenic Shock Initiative that morphed into the National Cardiogenic Shock Initiative using these same protocols. Watch an interview with O'Neill explaining the national initiative.

Additional articles and videos on Henry Ford Hospital 

(Editor's note - this video was originally published in September 2018 and was revised September 2019)

 

 

Chronic Total Occlusion (CTO) | August 23, 2019

Interview with Kevin Rogers, M.D., director of vascular medicine at the University of Colorado Hospital. He explains what wires he uses for chronic total occlusions (CTOs). The university of Colorado is a high-volume CTO center. Read more about the Innovation at the University of Colorado Hospital Cardiology Program.

 

Related Chronic Total Occlusion Content: 

VIDEO: How to Treat CTOs and Complex PCI Cases — Interview with Khaldoon Alaswad, M.D.

Recent Advances in Interventional Guidewire Technology

VIDEO: New Technology to Treat Chronic Total Occlusions (CTOs), an interview with Farouc Jaffer, M.D., Ph.D.

When to Consider Revascularization of Coronary Chronic Total Occlusions

VIDEO: Treating Chronic Total Occlusions, an interview with Bill Lombardi, M.D.

VIDEO: The Evolution of Complex PCI at University of Colorado  — Interview with John Messenger, M.D., and Kevin Rogers, M.D.

How to Tackle Coronary CTOs

Heart Failure | June 28, 2019

Federico Asch, M.D., FASE, director of cardiac imaging research and director of the cardiovascular imaging lab, MedStar Health Research Institute, Washington, D.C., explains the importance of the COAPT Trial and the cardiac ultrasound findings from the study. It was presented as a late-breaking study at the American College of Cardiology (ACC) 2019 meeting and the sub-study was discussed in several sessions at the 2019 American Society of Echocardiography (ASE) conference.

The trial showed the Abbott MitraClip can be used to help large numbers of patients with heart failure who experience increasing levels of mitral valve regurgitation due to the enlargement of their hearts. 

Read more about the COAPT Trial

VIDEO: MitraClip to Treat Heart Failure - Results of the COAPT Trial — Interview with William Abraham M.D. 

VIDEO: Impact of the COAPT Trial on Heart Failure Patients With Functional Mitral Regurgitation — Interview with Andreas Brieke, M.D.

FDA Approves MitraClip for Use in Heart Failure Patients With Functional Mitral Regurgitation

360 View of the TEE Echo Workstation During a MitraClip Procedure

 

 

 

 

Cath Lab | June 26, 2019

Thomas Porter, M.D., FASE, the Theordore F. Hubbard Distinguished Chair of Cardiology and a professor of medicine at the University of Nebraska Medical Center, explains a new study on how cardiac ultrasound imaging combined with bubble contrast was able to break down blood clots and restore blood flow to blocked vessels in STEMI heart attack patients. He gave an update on this new potential therapeutic direction for ultrasound at the 2019 American Society Of Echocardiography (ASE) meeting.

The Brazilian study used this approach in about 100 ST-elevated myocardial infarction (STEMI) patients and was recently published in the Journal of the American College of Cardiology (JACC). Porter said about 50 percent of patients had their ST resolved by the time they made it to the cath lab for percutaneous coronary intervention (PCI). Two more studies in Amsterdam and Pittsburgh are now starting to see if this technique can be used while transporting patients in an ambulance to further improve heart attack outcomes and to reduce infarct size.

Porter also explains recent research that shows ultrasound pulses promote ATP and nitric acid production, which have a lasting beneficial effect on small vessel perfusion in the area treated and down stream for hours after the use of the transducer. 

Watch the VIDEO: Therapeutic Applications for Contrast Ultrasound — another  interview with Porter. 

 

 

Cath Lab | May 20, 2019

This is a walk through of the primary structural heart hybrid cath lab at Henry Ford Hospital in Detroit, Mich. It is the hospital's newest lab and is centered around a Philips Azurion angiography system, which is a low dose imaging system that significantly reduces dose exposure compared to previous generation systems. As seen in the video, the lab is also equipped with a vascular access ultrasound system, transesophageal echo (TEE) system, an Abiomed Impella console, a large number of storage cabinets, surgical lighting for cases that convert over to open surgery or for transapical TAVR access, movable radiation shielding and ample space to accommodate surgical equipment and extra staff involved in structural heart procedures. There also is an electrosurgical cutter unit in the lab, which Henry Ford operators use to perform transcaval access TAVR procedures for patients who have anatomical challenges to the femoral access route. 

Watch the related VIDEO: Overview of the Henry Ford Hospital Structural Heart Program

 

Find more Henry Ford videos and news.

 

Heart Valve Technology | May 20, 2019

A demonstration of how to calculate the neo-left ventricular outflow tract (neo-LVOT) on CT imaging for a transcatheter mitral valve replacement using Circle Imaging's advanced visualization software. The demonstration looks at the use of an Edward's Sapien valve being implanted for a mitral valve-in-valve procedure. The overhang of the Sapien can block the LVOT blood flow, which can be catastrophic for the patient. So, assessment of the neo-LVOT in a simulation of the implant is required prior to the procedure to find the ideal landing zone and assess if the patient's anatomy is compatible with this technique.  

Watch the related VIDEO: The Importance of the Neo-LVOT in Transcatheter Mitral Valve Replacement — an interview with Dee Dee Wang, M.D., director of structural heart imaging, Henry Ford Hospital. 

This clip was recorded on the expo floor at the 2018 Society of Cardiovascular Computed Tomography (SCCT).

 

Stroke | May 16, 2019

This is an example of a carotid artery reporting module from Change Healthcare at 2018 Radiological Society of North America (RSNA) annual meeting. It shows how the PACS can bring in ultrasound imaging of the carotid artery and the graphical report can be modified to match the patient anatomy. The text and modifications made to the vessel tree convert into text to help auto-fill fields in the written report to help speed workflow. The vessel tree is similar to cath lab reporting systems that use a similar model of the coronaries that can be modified and helps auto complete the cath report.

 

Related Content:

VIDEO: What to Look for in PACS Workflow Efficiency

6 Key Health Information Technology Trends at HIMSS 2019

The Building Blocks of Enterprise Imaging

Technology Report: Enterprise Imaging

Find more RSNA 2018 coverage.

 

 

Structural Heart | May 06, 2019

John Carroll, M.D., FACC, FSCAI, director of interventional cardiology and co-director of the Cardiac and Vascular Center at the University of Colorado Hospital, offers an overview of the Society of Thoracic Surgeons and American College of Cardiology (STS/ACC) Transcatheter Valve Therapy (TVT) Registry and how it is being used.  The data from the registry is being used to accelerate advancement of transcatheter valve repair and replacement technology and facilitate faster regulatory reviews. This included the FDA's adding of a new indication for the use of current TAVR valves for valve-in-valve procedures. The registry also offers comparisons for things like surgical aortic valve replacement (SAVR) vs. transcatheter aortic valve replacement (TAVR) and how procedural volume impacts outcomes.

Additional videos and coverage of the University of Colorado Hospital 

Reference:

1. John D. Carroll. STS/ACC TVT Registry: Multiple Benefits For All Stakeholders. JACC Mar 13, 2019. 

Cath Lab Navigation Aids | May 01, 2019

Alex Haak, Ph.D., clinical scientist at Philips Health Systems North America, is based at the University of Colorado Hospital, to work directly with physicians in the cath lab to gather immediate feedback and improve next generation fusion imaging technologies used for structural heart interventions. Philips worked with the University of Colorado to develop the EchoNavigator, which fuses 3-D anatomical imaging, live transesophageal echo (TEE) and live fluoroscopy in the cath lab to help guide structural heart procedures. Haak is permanently based at the hospital to help trouble shoot and tweak the new EchoNavigator and other interventional guidance technologies being alpha-tested there prior to final commercialization.

Additional videos and coverage of the University of Colorado Hospital

 

 

Structural Heart | April 25, 2019

Dee Dee Wang, M.D., director of structural heart imaging, Henry Ford Hospital, Detroit, Mich., explains how patient survival depends on keeping the left ventricular outflow track (LVOT) clear and using 3-D imaging to predict what the neo-LVOT will look like prior to transcatheter mitral valve replacement (TMVR) procedures. The close proximity between the aortic and mitral valves in the left ventricle anatomy makes it critical to assess any mitral valve overhang that will obstruct blood flow out of the left ventricle. This issue has been raised in several cardiovascular imaging structural heart intervention planning sessions at conferences over the past two years, most notably at the Society of Cardiovascular Computed Tomography (SCCT).

Read the related article Interventional Imagers: The Conductors of the Heart Team Orchestra, which Wang helped author.

Watch the related VIDEO: Overview of the Henry Ford Hospital Structural Heart Program.

 

Additional articles and videos on Henry Ford Hospital 

 

 

Left Atrial Appendage (LAA) Occluders | April 25, 2019

This video offers an overview of the Watchman left atrial appendage (LAA) occluder system, including information of its design, implantation and clinical data supporting its use. Catheter-based LAA occlusion is used to seal off the LAA in the heart, which is the source of most stroke-causing clots in patients with atrial fibrillation (Afib). The device be used in place of anticoagulation therapy for stroke prevention. 

 

Related LAA Occlusion Content:

VIDEO: New Data on LAA Occlusion From the PREVAIL and PROTECT Trials — Interview with Vivek Reddy, M.D.

Occluding the Left Atrial Appendage (LAA)

VIDEO: Comparison Between Watchman vs. Amulet LAA Occluders — Interview with Ashish Pershad, M.D.

Device-related Thrombus After Watchman LAA Closure Occurs in Small Number of Patients

Closure of Left Atrial Appendage During Heart Surgery Protects the Brain

 

March 28, 2019

Interview with Frederick Masoudi, M.D., FACC, FAHA, professor of cardiology at the University of Colorado Hospital, and a physician leader of the National Cardiovascular Data Registry (NCDR). The NCDR is the American College of Cardiology's suite of cardiovascular data registries helping hospitals and private practices measure and improve the quality of care they provide.

Additional videos and coverage of the University of Colorado Hospital

 

Hemodynamic Support Devices | March 06, 2019

Perwaiz Meraj, M.D., FACC, FSCAI, director of interventional cardiology, assistant professor, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health System discusses the importance of hemodynamic support to safely perform a percutaneous coronary intervention (PCI) with prior coronary artery bypass graft (CABG) surgery and comorbidities. Learn more at ProtectedPCI.com/DAIC.

In this video, Meraj discuss a complex coronary intervention of a 77-year-old woman with stage 4 CKD, prior CABG, hypertension, hyperlipidemia, diabetes, who presented with angina and NSTEMI with an ejection fraction of 40 percent. The team at Northwell consulted with cardiac surgeons and the heart team, and determined that this patient was too high risk for another bypass surgery. Read more on this case.

 

Related Impella Video Content:

VIDEO: Analysis of Outcomes for 15,259 U.S. Patients with AMICS Supported with the Impella Device — Interview with William O'Neill, M.D.

VIDEO: The Door-to-Unloading (DTU) STEMI Safety and Feasibility Trial — Interview with Navin Kapur, M.D.

VIDEO: Cardiogenic Shock Case with Impella CP Support — Case study with Michael Amponsah, M.D.,

 

 

Heart Failure | February 13, 2019

William O'Neill, M.D., highlights best practice protocols based on Impella Quality database and real-world evidence showing improved outcomes in cardiogenic shock. Learn more at ProtectedPCI.com/DAIC

 

Related Impella Video Content:

VIDEO: Complex PCI Involving Prior CABG and Comorbidities — Interview with Perwaiz Meraj, M.D.

VIDEO: The Door-to-Unloading (DTU) STEMI Safety and Feasibility Trial — Interview with Navin Kapur, M.D.

VIDEO: Cardiogenic Shock Case with Impella CP Support — Case study with Michael Amponsah, M.D.,

 

Angiography | February 08, 2019

This is an example of an arterial venous malformation (AVM) in the brain imaged on a Canon Alphenix Alpha angiography system. It shjows a contrast injection highlighting the vessels, which have been color coded to show the position of the veins and arteries involved in this vascular defect. 

Read more about advances in angiography imaging systems. 

Heart Valve Technology | January 25, 2019

Joe Cleveland, M.D., professor of cardiothoracic surgery, at the University of Colorado Hospital, offers a cardiac surgeon's perspective as part of the heart team for reviewing patient cases for transcatheter mitral and aortic interventions. He spoke about evaluating patients for MitraClip, transcatheter aortic valve replacement (TAVR) and transcatheter mitral valve replacement (TMVR) procedures. He helps determine if a patient will benefit more from a transcatheter or surgical procedure. Cleveland also explains the impact of these transcatheter procedures on surgical volumes.

Watch the VIDEO: Evolution of Transcatheter Mitral Valve Repair at the University of Colorado.
 

Additional videos and coverage of the University of Colorado Hospital

January 10, 2019

Mark Anderson, M.D., FACS, vice chair of cardiac surgery services and cardiothoracic surgeon at Hackensack University Medical Group, outlines a multi-disciplinary heart team approach in treament decision-making for patients in cardiogenic shock. Learn more at ProtectedPCI.com/DAIC.

Anderson discusses improving outcomes for patients in cardiogenic shock through the early use of mechanical circulatory support and the development of a shock protocol with the heart team. He outlines Hackensack University Medical Center’s multi-disciplinary, heart team approach in treatment decision-making for patients in cardiogenic shock. The team includes cardiac surgeons, interventional cardiologists, heart failure specialists and intensivists. 

 

 

Cath Lab Navigation Aids | January 08, 2019

Robert Quaife, M.D., director of advanced cardiac imaging, University of Colorado Hospital, explains why advanced imaging techniques are required to tackle complex transcatheter procedures and structural heart interventions. The University of Colorado Hospital helped develop the Philips EchoNavigator live image fusion technology, and this video offers an overview of how it came to be and where the technology is going.

Watch the related VIDEO: Evolution of Transcatheter Mitral Valve Repair at the University of Colorado, which shows examples of the navigation technology is use during a MitraClip procedure. 

VIDEO: Overview of University of Colorado Structural Heart Program — Interview with John Carroll, M.D., Robert Quaife, M.D., and James Chen, Ph.D.

Highlighting Innovation at the University of Colorado Hospital Cardiology Program

Additional videos and coverage of the University of Colorado Hospital

 

 

Structural Heart Occluders | January 07, 2019

Karen Orjuela, M.D., assistant professor of neurology at the University of Colorado Stroke and Brain Aneurysm Center, explains the heart-brain team approach to screening cryptogenic stroke patients for transcatheter patent foramen ovale (PFO) closure. 

Additional videos and coverage of the University of Colorado Hospital

 

Related PFO Closure Content:

VIDEO: How Transcatheter PFO Closure Can Reduce Cryptogenic Stroke — Interview with 
John Rhodes, M.D., on the REDUCE PFO Trial

PFO Closure Shows Positive Results from REDUCE Clinical Study

VIDEO: PFO Closure Found Beneficial for Cryptogenic Stroke — Presentation of RESPECT Trial results by John Carroll,  M.D.

PFO Closure May Improve Outcomes Over Medical Therapy in Cryptogenic Stroke: Results of the RESPECT Trial
 

 

 

 

Structural Heart | January 07, 2019

John Carroll, M.D., FACC, FSCAI, director of interventional cardiology, and Robert Quaife, M.D., director of advanced cardiac imaging, explain the development of the transcatheter mitral valve repair program at the University of Colorado Hospital. The video include footage during a MitraClip procedure. 

VIDEO: Overview of University of Colorado Structural Heart Program — Interview with John Carroll, M.D., Robert Quaife, M.D., and James Chen, Ph.D.

Highlighting Innovation at the University of Colorado Hospital Cardiology Program

Additional videos and coverage of the University of Colorado Hospital

Chronic Total Occlusion (CTO) | January 03, 2019

Interview with John Messenger, M.D., FACC, FSCAI, director of the cardiac cath labs and director of the cardiovascular ICU/stepdown unit, and Kevin Rogers, M.D., director of vascular medicine at the University of Colorado Hospital. They explain the trend toward more complex procedures, including chronic total occlusions (CTOs) and complex high-risk indicated procedure (CHIP) patients. They explain how they minimize X-ray and contrast dose during these longer procedures, the tools they use to perform the procedures and offer advice for centers expanding into complex PCI.

Watch a VIDEO walk through of this cath lab at the University of Colorado Hospital.

VIDEO: Overview of University of Colorado Structural Heart Program — Interview with John Carroll, M.D., Robert Quaife, M.D., and James Chen, Ph.D.

Highlighting Innovation at the University of Colorado Hospital Cardiology Program

Find more content from the University of Colorado Hospital.

 

 

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