Ochsner Health System, New Orleans, LA
Ochsner Health System, New Orleans, LA
If there’s one thing physicians at Ochsner Heart & Vascular Institute (OHVI) are not, it’s camera shy. If their in-hospital TV studio isn’t convincing enough, just ask John Reilly, M.D., if he’s ever broadcasted a live procedure before.
“As a matter of fact, just last Friday we broadcasted some live cases to a meeting in Germany,” the associate director of OHVI’s cath lab said during a break one recent afternoon. “We also broadcasted to the TCT meeting in September. We actually have become pretty well accustomed to this type of work.”
So it may come as no surprise that the institute is hosting live case demonstrations during this year’s ACC (American College of Cardiology) interventional summit in New Orleans. OHVI’s prime location in the heart of the “Big Easy” probably didn’t hurt either.
Dr. Reilly isn’t the least bit nervous, however – he said OHVI has played major roles in several past conventions and believes its physicians have what it takes to impress the 30,000-plus observers coming in March.
“We see AHA (American Heart Association) come around here quite frequently as well, and we usually get to play if not a host role then a larger role,” he said.
And Dr. Reilly has other reasons to be confident: His institute has a well-known international reputation in heart disease management. It’s always developing new breakthrough approaches to cardiovascular disease as well as participating in national clinical trials.
OHVI’s main campus hospital has 45 dedicated cardiovascular beds and a 13-bed coronary care unit, clinic offices, 10 echocardiographic/vascular noninvasive laboratories and six fully equipped cath labs. It also has seven outpatient satellite clinics located in the Southeastern Louisiana region.
Although Dr. Reilly couldn’t say specifically what procedures will be broadcasted from the studio to ACC this year, he does hint that many different types of coronary procedures will be performed.
“Very likely there’ll be interventions of other vessels of the legs and renal arteries as well,” he said. “There will probably be a mixture of both coronary and peripheral vascular diseases that will be treated.”
A New Alternative to Amputation
Dr. Reilly is also one of the principal investigators of the XCELL clinical trial, which is the first U.S. study to evaluate Abbott Vascular’s Xpert self-expanding nitinol stent in blood vessels below the knee for treatment of severe peripheral arterial disease (PAD). OHVI is one of nine participating centers nationwide.
“[PAD] is a major cause for amputations due to nontraumatic reasons,” Dr. Reilly said, because of severe blockages that sometimes occur below the knee.
“This stent may provide an option for those patients who have ulcers that are failing to heal or infections in their feet or toes,” Dr. Reilly said. “It will provide them an opportunity to heal those infections and recover some of their tissue loss. It will also avoid or delay the need for amputation of a toe or foot or part of their leg.”
The procedure was successful last September in the treatment of an 87-year-old man with gangrenous ulcers on his left foot by opening the most critical blockage below his knee and restoring blood flow. He has been returning every few months for monitoring of the stents used to open the blockage in his left calf.
The primary endpoint of the study is avoidance of major amputation at 12-month follow-up after treatment. Right now Dr. Reilly says he is still in the preliminary stages of the trial, screening patients that meet all the required criteria.
An Extra Boost for the Heart
Ochsner was also the first U.S. hospital to offer a less invasive procedure for patients with obstructed neck arteries with the newly FDA-cleared Precise nitinol stent and Angioguard emboli capture guidewire carotid system, both by Cordis Endovascular.
OHVI Interventional Cardiology director Stephen Ramee, M.D., who helped perform the first procedure, said more and more practitioners prefer carotid stenting over endarterectomy in appropriate cases.
“Our first case was technically challenging because the patient had difficult bends in the artery and calcium in the lesion…” Dr. Ramee said.
OHVI is also part of a multicenter trial studying a new device called the Optimizer (by Impulse Dynamics), which delivers electrical impulses to the heart for patients who have moderate-to-severe heart failure, stimulating the heart as it’s beating.
While pacemakers and defibrillators intend to resolve problems with the heart’s rhythm, the Optimizer System is designed to modulate the strength of contraction of the heart muscle rather than its rhythm. It can actually sense when a heart beat is starting, and gives the heart an extra boost with an electrical signal.