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)

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)

This is a quick video example of a cardiac computed tomography (CT) exam showing a Medtronic CoreValve transcatheter aortic valve replacement (TAVR) device implanted. The image was reconstructed using Canon Medical’s Global Illumination photo-realistic rendering advanced visualization post-processing software. Vendors who offer this realistic type of CT image rendering say it is not used for diagnostics. However, the technology can be helpful when explaining things to the patient and their family, educating physicians and staff, and for surgeons, since it offers a realistic view of the anatomy that is easier for most people to understand who are not familiar with cardiac anatomy as it appears in traditional CT multiplanar reconstruction (MPR) images. 

This example of software was demonstrated on the expo floor at the 2019 Society of Cardiovascular Computed Tomography (SCCT) meeting. 

This is an example of a cardiac echocardiography exam performed using an iPhone and the Butterfly IQ ultrasound transducer and app. The company is exhibiting at the American Society Of Echocardiography (ASE) 2019 meeting. This is the first “ultrasound system on a chip.” The Butterfly IQ ultrasound system consists of a transducer that connects to an iPhone or iPad to record ultrasound exams. The system has 18 different applications for specialized images, including cardiac imaging, vascular, lung, abdominal and others. The apps allow for quantification and offers many of the features of larger cart-based systems. The company is working on incorporating artificial intelligence technologies to automate some processes, such as auto ejection fractions.

This technology was picked as one of the big ultrasound advances in the VIDEO: 4 Recent Advances in Echocardiography Technology and in the VIDEO: Editor's Choice of the Most Innovative New Technology at RSNA 2018.

Partho Sengupta, M.D., MBBS, chief of cardiology, West Virginia Heart and Vascular Institute, explains how wearable, smartphone-based apps and medical devices, and artificial intelligence (AI) might be used to cost-effectively triage larger numbers of patients in rural areas and in the developing world for serious diseases. He spoke at the 2019 American Society Of Echocardiography (ASE) meeting.

Sengupta is involved with a pilot program using the Butterfly app and transducer to turn a smartphone into an inexpensive ultrasound system. He said the idea is to have novice ultrasound users screen more patients with these types of devices and the exams either being sent to a remote hospital for reading. He said AI algorithms also could be used to help flag any exams that show abnormalities, which would greatly speed reads and getting these patients treatment. 

Watch the related VIDEO: How Smartphones May Revolutionize Healthcare in the Developing World — Interview with Jacques Kpodonu, M.D.,

Find more news and video from ASE 2019

Marielle Scherrer-Crosbie, M.D., Ph.D., director of echocardiography at the Hospital of the University of Pennsylvania, and chair of the 2019 American Society Of Echocardiography (ASE) sessions, explains how cardiac ultrasound strain imaging is being used and where the technology is at the ASE 2019 meeting.  She is an expert in echo strain, which is gaining wider usage in echocardiography, especially for cardio-oncology assessments. She spoke at the 2019 American Society of Echocardiography (ASE) meeting.

Related Cardio-oncology Content:

VIDEO: Echocardiography Strain Fundamentals Made Easy 

Strain Imaging Improves Cardiac Surveillance of Certain Breast Cancer Patients

Assessing Cardiotoxicity Due to Cancer Therapy

VIDEO: Assessing Cardiotoxicity Response With Cardio-Oncology Echo Imaging — interview with Federico Asch, M.D.

New Echo Protocol Aids Monitoring Children’s Heart Abnormalities Due to Chemotherapy

Strain Imaging Improves Cardiac Surveillance of Certain Breast Cancer Patients

VIDEO: Characterization of Cardiac Structural Changes and Function Following Radiation Therapy

Study Demonstrates Strain Imaging Utility With Contrast-Echo Studies

VIDEO: Echocardiography Strain Fundamentals Made Easy 

Strain Imaging Improves Cardiac Surveillance of Certain Breast Cancer Patients

Automation Enhances, Streamlines Echocardiography

Find more ASE 2019 coverage

Jacques Kpodonu, M.D., FACC, cardiac surgeon, Beth Israel Deaconess Medical Center, and professor at Harvard Medical School, explains how medical devices and wearables that interface with smartphones and apps might be used to eliminate healthcare disparities in rural areas of the developed world and help raise the level of care in the developing world. He spoke at the 2019 AI-Med Cardiology conference. 

Related Smartphone and Wearable Content:

VIDEO: Use of Wearable Medical Devices for Cardiac Rehabilitation — Interview with Robert Klempfner, M.D.

VIDEO: Use of Wearables to Track Electrophysiology Patients — Interview with Khaldoun Tarakji, M.D.

Smartphones Used to Successfully Screen More than 60,000 for Atrial Fibrillation

VIDEO: The Future of Wearables in Healthcare — Interview with Karl Poterack, M.D.

VIDEO: Artificial Intelligence Applications for Cardiology — Interview with Anthony Chang, M.D.
 

David M. Axelrod, M.D., clinical associate professor in pediatrics (cardiology) at Stanford School of Medicine, explains how Stanford developed the Virtual Heart to help parents, patients and new physicians understand complex congenital heart anatomy and repairs. He said virtual reality (VR) will be a quantum leap in cardiovascular care, education and research.

He spoke at the 2019 Cardiology AI-Med conference. 

Related Augemented and Virtual Reality Content:

VIDEO: Users Can Touch This Virtual Reality Heart

VIDEO: Editor’s Choice of the Most Innovative Echo Technology at ASE 2018

Philips and Microsoft Showcase Augmented Reality for Image-Guided Minimally Invasive Therapies

VIDEO: Augmented Reality for Surgical Planning Example

Medivis SurgicalAR Gets FDA Clearance

Mixed Reality Offers Advantages of Virtual and Augmented Realities for Cardiology

6 Key Health Information Technology Trends at HIMSS 2019
 

Anthony Chang, M.D., chief artificial intelligence officer, Children’s Hospital of Orange County (CHOC), and founder, AIMed, explains the basic principles of artificial intelligence (AI) in medicine. He outlines some basic AI definitions, potential programming biases and use cases. He also explains the need for the Cardiology AI-Med conference, which held its inaugural meeting in June 2019 in Chicago.

Related AI Content:

Link to all the recorded AI-Med Cardiology conference sessions

VIDEO: Artificial Intelligence Applications for Cardiology — Interview with Anthony Chang, M.D.

PODCAST: Fitting Artificial Intelligence Into Cardiology — Interview with Anthony Chang, M.D.

VIDEO: How Hospitals Should Prepare for Artificial Intelligence Implementation — Interview with Paul Chang, M.D.

Technology Report: Artificial Intelligence 

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).

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.

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 

Paul Chang, M.D., professor of radiology, vice chair of radiology informatics and medical director for enterprise imaging, University of Chicago, explains some of the issues with artificial intelligence (AI) and how hospitals can better prepare for its eventual implementation across the field medicine. A key takeaway is that hospitals need an infrastructure and roadway for AI and deep-learning algorithms to operate. Chang said most health systems will not invest directly in AI, but will invest in analytics, which Chang said uses much of the same infrastructure required by AI.

Chang spoke on this topic at an AIMed breakfast briefing seminar in Chicago April 9, 2019. Listen to a webcast of this hour and 15 minute talk.

Karl Poterack, M.D., medical director, applied clinical informatics, Mayo Clinic, explains the role wearable devices will play in healthcare. He presented in several sessions at the 2019 Healthcare Information Management and Systems Society at (HIMSS) conference.

Poterack said there is a brewing tsunami of data in wearable technologies that healthcare systems will have to figure out how to integrate in the coming years. He said the key issue with wearable data is that there needs to be outcomes data showing the value of how many steps a patient accumulates, changes in heart rate over time, or blood pressure changes in patients with specific aliments. Without this , he said there is limited value in the information. 

Watch the related VIDEO: Use of Wearable Medical Devices for Cardiac Rehabilitation.

Look through a photo gallery of other new technologies at HIMSS19. 

Find news and videos from HIMSS 2019.

Anthony Chang, M.D., chief intelligence and innovation officer, Children's Hospital of Orange County (CHOC), and medical director of the Sharon Disney Lund Medical Intelligence and Innovation Institute. He is expert in artificial intelligence (AI). He spoke in several sessions at Healthcare Information and Management Systems Society (HIMSS) 2019 meeting on the integration of AI in healthcare. 

He said AI will play a big roll in imaging assessments of adult congenital heart disease to help relieve the burden on the small number of congenital cardiologists. 

Chang also explained there is a tsunami of data about to wash over healthcare as wearable devices begin to be integrated into patient care. AI will play a key role in sorting through all this data by monitoring the information to identify trends or disease markers and alert clinicians and the patient.

He was a keynote speaker at HIMSS19 with his session "Synergies Between Man and Machine — Future AI apps can be directed to help mitigate physician burnout by decreasing the EHR burden, improving medical education, and automating quality improvement."

Chang is head of the artificial intelligence organization AIMed, which hosts educational sessions and an annual meeting on AI applications in medicine.

Listen to Chang in the PODCAST: Fitting Artificial Intelligence Into Cardiology.
 

Read the article 6 Key Health Information Technology Trends at HIMSS 2019.

Look through a photo gallery of other new technologies at HIMSS19. 

Find news and videos from HIMSS 2019.

How wearable devices will play a role in healthcare was a big topic at the Healthcare Information Management and Systems Society (HIMSS) 2019 meeting. The biggest question is how to attached the data from consumer devices into a usable format for clinicians that interfaces with the electronic medical record (EMR). A good example of how wearables are being integrated in clinical care was demonstrated by the company Datos. It offers software that can integrate data from a wide variety of wearable devices from several makers into a mobile app, It can transfer the information to an EMR. The app also offers two way communication between the patient and the doctor’s office. It can prompt patients with a list of things they need to do each day to reach physician specified goals and displays analytics on a patient’s health data, including charts and graphs.

The system is used by Sheba Medical Center in Israel for a remote cardiac rehabilitation program. It now remotely monitors hundreds of patients and does not require them to come to the hospital for sessions, which has helped increase patient satisfaction and aided in increasing physical activity compliance. Watch the VIDEO: Use of Wearable Medical Devices for Cardiac Rehabilitation — an interview with Robert Klempfner, M.D., director of the Cardiovascular Prevention Institute, Sheba Medical Center.
 

Look through a photo gallery of other new technologies at HIMSS19. 

Find news and videos from HIMSS 2019.

Steve Holloway, principal analyst and company director for the healthcare market research firm Signify Research, explains the key trends he is seeing in enterprise imaging systems. He spoke to ITN at the 2019 Healthcare Information Management and Systems Society at (HIMSS) conference.  

Additional HIMSS 2019 coverage.

Look through a photo gallery of new technologies highlighted at HIMSS 2019.

Watch the RSNA 2018 VIDEO: Technology Report — Enterprise Imaging

DAIC Editor Dave Fornell takes a tour of some of the most interesting new artificial intelligence (AI) imaging technologies on the expo floor of 2018 Radiological Society of North America (RSNA) annual meeting. Several of the new AI apps aid in faster iidentification of stroke, help in interventional vascular guidance for live embolizations, and speed workflow in medical imaging and reporting systems.

Watch the related VIDEO: Editor's Choice of the Most Innovative New Imaging Technologies at RSNA 2018

Related AI Imaging Technology Content:

New Cardiac Imaging Technologies Unveiled at RSNA 2018

VIDEO: Overview of Artificial Intelligence and its Use in Cardiology — Interview with Anthony Chang, M.D.

VIDEO: How Hospitals Should Prepare for Artificial Intelligence Implementation — Interview with Paul Chang, M.D.

VIDEO: Managing a Multi-site Radiology Practice With AI-based Workflow — Interview with Andrew Deutsch, M.D.

VIDEO: Technology Report: Artificial Intelligence

VIDEO: RSNA Post-game Report on Artificial Intelligence — ITN editors Dave Fornell and Greg Freiherr discuss the AI trends they saw at RSNA 2018

VIDEO: RSNA President Vijay Rao Says Artificial Intelligence is Hottest Tech Advancement in Radiology 

How Artificial Intelligence Will Change Medical Imaging

How to Market Healthcare Artificial Intelligence Software

Increasing Presence of AI at RSNA Reflects Emphasis on Efficiency

VIDEO: AI, Analytics and Informatics: The Future is Here — Interview with RSNA 2017 keynote speaker Michael Recht, M.D.

VIDEO: A Walk Through the RSNA 2018 Machine Learning Showcase

Selecting an AI Marketplace for Radiology: Key Considerations for Healthcare Providers

Increasing Presence of AI at RSNA Reflects Emphasis on Efficiency

Technology Report: Artificial Intelligence at RSNA 2018

RSNA 2018 Key Takeaways from the Expo Floor

VIDEO: How iCad Uses AI to Speed Breast Tomosynthesis

VIDEO: How Imalogix Uses AI to Boost Performance

VIDEO: Collaboration as a Catalyst for AI Innovation

PODCAST: How to Make Artificial Intelligence a Success in Medicine

VIDEO: Example of AI-assisted Oncology Patient Record Dashboard

This is the newest cardiac cath lab at the University of Colorado Hospital in Aurora, Colorado. Construction was completed in June 2018. It is centered around a Philips Azurion Clarity IQ angiography system, which was chosen because its low X-ray dose imaging and guidance technologies that enable more complex, longer procedures. The room is use for the most involved complex percutaneous coronary interventions (PCI), including chronic total occlusions (CTOs) and complex high-risk indicated procedures (CHIP) patients. It is also used for transcatheter aortic valve replacement (TAVR), septal occluder procedures, transcatheter LAA closures and alcohol ablations.

The room is equipped for radial access procedures, which is used in a little more than 50 percent of cases at the hospital. It is also equipped with an Impella hemodynamic support system, wires and microcatheters for CTOs, and a SonoSite point of care ultrasound console for vascular access needle guidance.

See a 360 Degree View During a CTO Case in this room

Watch the VIDEO: The Evolution of Complex PCI at University of Colorado, which speaks with two of the operators who use this room.

Find more content from the University of Colorado Hospital.

This is a quick video tour of the Machine Learning Showcase at the Radiological Society Of North America (RSNA) 2018 meeting today. More than 150 vendors showed software for radiology incorporating artificial intelligence (AI) or deep learning.

Watch the video VIDEO: RSNA President Vijay Rao Says Artificial Intelligence is Hottest Tech Advancement in Radiology. 

Read more in the article “How Artificial Intelligence Will Change Medical Imaging.”

Watch the VIDEO AI Technogy Report from RSNA 2017.