A discussion with William W. O’Neill, M.D., medical director, Center for Structural Heart Disease, Henry Ford Hospital, Detroit, about the creation of a national initiative to start percutaneous hemodynamic support first before beginning revascularization. O’Neill started the Detroit Cardiogenic Shock Initiative with several hospitals in 2016 and saw a 50 percent drop in mortality. Read the article “Detroit Cardiogenic Shock Initiative Goes National at TCT 2017.” Watch the VIDEO “Cardiogenic Shock Supported With Impella Shows Good Outcomes.”
VIDEO: How to Treat CTOs and Complex PCI Cases
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."
John Rhodes, M.D., co-director of the adult congenital heart program, Medical University of South Carolina, is the principal investigator for the REDUCE Trial, the FDA pivotal study using the Cardioform for PFO closure to prevent cryptogenic stroke. He discusses some of the data showing benefit for patients and debate around all the trials for PFO closure.
Read about the results of the REDUCE trial in the article “PFO Closure Shows Positive Results from REDUCE Clinical Study.” Read about the approval of the first PFO closure device in 2016. Watch the VIDEO "Addressing Adult Congenital Heart Referrals."
Juan Granada, M.D., Cardiovascular Research Foundation president and chief executive officer, shares his insights on what technologies he predicts will become main stream therapies in the coming years. DAIC spoke to him at the 2017 Transcatheter Cardiovascular Therapeutics (TCT) conference. Read the article “The Future of Cardiology: 17 Technologies to Watch.” Watch other VIDEOS with Granada, “Transcatheter Mitral Valve Therapies in Development.” “The Evolution of TAVR Technology,” and “Bioresorbable Stent Failure Modes, Technique, Patient Selection and Future Development.”
Philippe Genereux, M.D., co-director of the structural heart program at the Gagnon Cardiovascular Institute at Morristown Medical Center, part of Atlantic Health System, explains the EARLY TAVR trial evaluating the use of transcatheter aortic valve replacement compared to surveilLance for patients With asymptomatic severe aortic stenosis. Genereux is the principal investigator for the trial. Read more about the EARLY TAVR trial.
Stephen Worthley, MB, BS, Ph.D., director of cardiac catheterization, University of Adelaide, Australia, presents the MAVERIC Trial six-month outcomes using the Arto System at a press conferences at the 2017 Transcatheter Cardiovascular Therapeutics (TCT) annual meeting. Read more about the trial in the article “Arto System Shows Promise as Less-Invasive Therapy for Heart Failure Patients.” Watch a VIDEO interview with Worthley on “Drug-Filled Stents as an Alternative to Polymer Drug Carriers.”
A discussion with Ajay Kirtane, M.D., SM, director of the cardiac catheterization laboratories at New York-Presbyterian Hospital/Columbia University Medical Center, on the ABSORB III 3-year outcomes and other Absorb data presented at TCT 2017. He explains more on the poor outcomes for the bioresorbable stent compared to the Xience metallic stent and procedural issues based on operator technique and experience. Read the article “Abbott Will End Sales of Absorb Bioresorbable Stent.” Watch the VIDEO “Bioresorbable Stent Comparable to Xience at Two Years, With Concerns,” with Stephen Ellis, M.D. Watch the VIDEO “Poor Outcomes for Bioresorbable Stents in Small Coronary Arteries,” with Gregg Stone, M.D.
Ted Feldman, M.D., MSCAI FACC FESC, director of the cardiac cath lab, Evanston Hospital, explains the current state of transcatheter mitral valve technologies in development and in trials. He is involved in some of these trials and was the principal investigator for the pivotal MitraClip trial. Watch the VIDEO “Transcatheter Mitral Valve Technology, Anatomical Challenges” with Juan Granada, M.D.. Read the articles “Advances and Future Directions for Transcatheter Valves,” and “Transcatheter Mitral Valve Replacement Devices in Development.”
Adam Greenbaum, M.D., co-director of the structural heart program at Henry Ford Health System in Detroit, discusses the innovative approach to transcatheter aortic valve replacement (TAVR) being pioneered at HFHS. Read the article "How to Perform Transcaval TAVR Access."
A discussion with Mario Goessl, M.D., Ph.D., director of research and education at the Minneapolis Heart Institute. He presented research at ACC.17 on the cost savings and reduced patient recovery time achieved by using conscious sedation during transcatheter aortic valve repair (TAVR) procedures. Read the articles "Conscious Sedation TAVR Reduced Length-of-Stay and Hospital Costs," and "Moderate Sedation Shows Promise for TAVR Patients."
Bill Lombardi, M.D., director of complex coronary artery interventions at the University of Washington, discusses the principles, training and technologies required for treating chronic total occlusions (CTOs) at ACC.17. Watch the VIDEO “New Technology to Treat Chronic Total Occlusions (CTOs)” with Farouc Jaffer, M.D., Ph.D., director of coronary interventions at Massachusetts General Hospital. Read the article “When to Consider Revascularization of Coronary Chronic Total Occlusions.”
Farouc Jaffer, M.D., Ph.D., director of coronary interventions at Massachusetts General Hospital, discusses the newest advances and technologies for treating chronic total occlusions (CTOs) at ACC.17. Read the article "When to Consider Revascularization of Coronary Chronic Total Occlusions."
Ziyad Hijazi, M.D., MPH, MSCAI, FACC, director of the cardiac program and chair of the Department of Pediatrics at Sidra Medical and Research Center in Doha, Qatar, discusses the latest technologies for ASD and PFO closure at ACC.17. Read the article “Closing Holes in the Heart.”
Azeem Latib, M.D., MBBCh, FCP, interventional cardiologist at Columbus Hospital in Milan, Italy, discusses the latest innovations in mitral and tricuspid valve repair technologies at ACC.17. Read an article by Latib, “Transcatheter Annuloplasty For Repair Versus Replacement in Functional Mitral Regurgitation.” Watch the related VIDEO with Rebecca Hahn, M.D., "Transcatheter Tricuspid Valve Repair and Replacement Technologies."
This video case study, provided by Gore Medical, is titled "Tackling Complex Cases in Dialysis Access," by John Ross, M.D., director, Dialysis Access Institute, The Regional Medical Center, Orangeburg, S.C. It demonstrates in a recorded case how to surgically implant a Gore Hybrid Vascular Graft. To view the entire series of complex peripheral disease cases, visit medicalmastery.goremedical.com.
This video, provided by Ekos, demonstrates the EkoSonic endovascular System thrombolytic system to treat deep vein thrombosis (DVT), chronic deep vein thrombosis (Chronic DVT) and pulmonary embolism (PE). The Ekos system delivers catheter-directed fibrinolytics with the aid of high-frequency, low-energy ultrasound, which allows penetration of the drug deeper into the clot. Read the article “Acute Intermediate-Risk Pulmonary Embolism: A High-Stakes Conundrum.” Read the article “Aggressive Pulmonary Embolism Response and Evolving Technologies.” Read the article “Ultrasound-assisted Catheter-directed Thrombolysis Reduces Treatment Risks for Pulmonary Emboli.”
Shimadzu Medical Systems highlighted new features of its Trinias Interventional X-ray line at the America College of Cardiology (ACC) 2017. A key feature of Trinias, is the ability to image from fingertip to fingertip during a transradial approach, which makes for much shorter hospital stay with the patient up and moving almost immediately after the procedure. Features Like RSM-DSA, a type of motion correction subtraction, eliminating the artifacts from the patient motion during acquisition while STENTVIEW, is an enhanced visualization during stent placement in real-time. Shimadzu also highlighted its partnership with Raysafe and its real-time staff radiation dose monitoring solution. For more information: http://shimadzu.com/med/products/angio/index.html
Madhav Swaminathan, M.D., FASC, FAHA, clinical director of cardiothoracic anesthesiology, at Duke University Medical Center, discusses use of cardiac ultrasound in cardiac surgery and interventional structural heart procedures at the 2017 American Society of Echocardiography (ASE) annual meeting. Watch the related VIDEO "What is Required for Interventional Echo - Discussion With Rebecca Hahn," or read the article “Requirements for Interventional Echocardiographers.”
A discussion with Rebecca Hahn, M.D., FASE, director of interventional echocardiography and professor of medicine at Columbia University Medical Center / New York-Presbyterian Hospital, New York. She is the national principal investigator for the SCOUT I Trial for the Trialign Percutaneous Tricuspid Valve Annuloplasty System. For information on the development of transcatheter mitral valve technologies read the article "Transcatheter Mitral Valve Replacement Devices in Development." Watch a video with Hahn explaining the requirements for creating an interventional echo program to support structural heart interventions.
Andrea Natale, M.D., FACC, FHRS, FESC, executive medical director, Texas Cardiac Arrhythmia Institute at St. David's Medical Center, discusses how to build an electrophysiology (EP) program at the 2017 Heart Rhythm Society annual meeting. Read the article "Growing a Cardiac Rhythm Program in a Community Setting."
This video, provided by Spectranetics, demonstrates how to deploy the Bridge Occlusion Balloon used to seal accidental tears in the superior vena cava (SVC) during EP device lead extraction procedures. A review of post-market release data shown it can bridge the patient to open surgical repair and significantly reduce the usual 50 percent mortality associated with this complication. Read the article about the late-breaking clinical trial presentation from Heart Rhythm 2017.
Tom Kloetzly, sales and marketing VP for Shimadzu Medical Systems USA, explains the evolution of Shimadzu Corporation since its founding 142 years ago. Kloetzly focuses on the Trinias Interventional X-ray line shown at RSNA 2016. Kloetzly states “A key feature of Trinias, is the ability to image from fingertip to fingertip during a transradial approach which makes for much shorter hospital stay with the patient up and moving almost immediately after the procedure. Features Like RSM-DSA, a type of motion correction subtraction, eliminates patient movement during acquisition while STENTVIEW, is an enhanced visualization during stent placement in real-time." For more information: www.shimadzu.com/med/products/angio/index.html.
This video, provided by Medtronic, demonstrates the Resolute Onyx coronary stent. It was cleared by the FDA and launched into the U.S. market May 1, 2017. The stent is designed for greater deliverability and conformability to the vessel wall. It uses a radiopaque inner core wire to enhance visibility for accurate placement. Read the article "FDA Approves Medtronic’s Resolute Onyx Drug-eluting Stent."
A discussion with William O'Neill, M.D., FACC, FSCAI, medical director of the Center for Structural Heart Disease at Henry Ford Hospital, Detroit. He presented a late-breaking study on the outcomes for 15,259 U.S. patients with acute MI in cardiogenic shock supported with the Impella percutenous ventricular assist device. Read more about the Detroit Cardiogenic Shock Initiative.
DAIC Editor Dave Fornell takes a tour of some of the interesting new technologies from the vendor booths on the expo floor at the 2017 meeting of the American College of Cardiology (ACC). For key technology trends at ACC.17, watch the VIDEO "Cardiac Technology Trends at ACC.17."
Stephen Ellis, M.D., professor of medicine and director of interventional cardiology at Cleveland Clinic, discusses the two year outcomes of the ABSORB III trial of Absorb vs. Xience. The late-breaking trial was presented at ACC 2017. Read the article on the ABSORB III results. Watch a VIDEO with Gregg Stone, M.D., "Poor Outcomes for Bioresorbable Stents in Small Coronary Arteries."
MDBuyline analyst Tom Watson shares some of the most important trends in cardiac technology he saw at the 2017 American College of Cardiology (ACC) Scientific Sessions. For a list of late-breaking trials and links to related articles read "ACC 2017 Late-Breaking Trials." Watch a VIDEO of Watson's assessment of trends at ACC.16.
Michael Reardon, M.D., professor of cardiothoracic surgery at Houston Methodist DeBakey Heart and Vascular Center, discusses the positive results of the SURTAVI trial that were presented at ACC.17. Reardon was the principal investigator for the SURTAVI trial. Read the article "TAVR Stands Equal to Surgical Valve Replacement."
Justin Davies, MBBS, of Imperial College London, and Matthias Götberg, M.D, Ph.D., of Skane University Hospital, detail the positive results of the DEFINE-FLAIR and IFR-SWEDEHEART trials presented at ACC.17. Read the article “Easier to Use iFR Equal to Outcomes of FFR in Coronary Lesion Evaluation.”
This video, provided by Abiomed, demonstrates the Impella percutaneous ventricular assist devices (pVAD). It offers between 2.5 and 5 liters of flow per minute to help off load the heart and aid organ perfusion in patients with significantly compromised cardiac output. The Impella has an FDA indication for cardiogenic shock and is the key device being used in the Detroit Cardiogenic Shock Initiative, which was launched in 2017. Read the article "Collaboration by Metro Detroit Cardiologists Increases Cardiogenic Shock Survival Rate."
Pam Rush, RN, MS, clinical program director, cardiovascular service line, and Craig Strauss, M.D., MPH, medical director, explain how MHI achieved significant savings by leveraging analytics software for reductions in patient complications, better vendor negotiations and other areas. Read the article “Advanced Analytics Software for Cardiology.”
ITN Editor Dave Fornell takes a tour of some of the most innovative new technology that was displayed on the expo floor at the 2017 Healthcare Information and Management Systems Society (HIMSS) annual meeting. The two most significant technology advances are discussed in Fornell's blog "Two Technologies That Offer a Paradigm Shift in Medicine at HIMSS 2017."
This video, provided by Tryton, demonstrates the implantation of the Tryton Side Branch Stent. It became the first bifurcation stent cleared by the FDA in March 2017. The stent is deployed in the side branch artery using a standard single wire balloon-expandable stent delivery system. A conventional drug eluting stent is then placed in the main vessel. Read the articles "FDA Clears First Dedicated Coronary Bifurcation Stent" and "New Designs May Ease Bifurcation Stenting."
The supplies you use in your cath lab are complex and very valuable. Protecting your investment and uncovering new opportunities to cut waste and help improve the total cost of care means it’s more important than ever before to have a strong pulse on your inventory. Using data analytics, you can uncover trends for product standardization, optimize par levels and better control costs.
When a pediatric patient at Children’s Hospital Los Angeles needed a custom-build stent to repair his pulmonary artery, pediatric interventional cardiologist Frank Ing, M.D., used 3-D printed models from the patient's CT scans. The model helped make sure the stent they made would fit. The model also was used to plan and guide the procedure. This video is made up of clips complied by the hospital and includes some narration of the case by Ing, ending with the final angiographic result with the new stent. Read the article “Children's Hospital Los Angeles Cardiologist Creates Modified Stent for 18-month-old Using Printed 3-D Model.”
This video, provided by BioVentrix Inc., demonstrates how to implant the Revivent TC System to reduce the volume of the left ventricle (LV) in heart failure patients. Reducing the size of the LV can help make pumping more efficient, helping to reduce the workload of a failing heart. It is a minimally invasive, catheter-based, closed-chest alternative to conventional surgical ventricular restoration (SVR). It uses catheter-deployed anchors designed to exclude scarred myocardial tissue from the LV to help restore its more natural conical shape. Read about the system gaining European approval. Read about system starting its U.S. clinical trial.
Detailed imaging is needed to support complex interventions for the assessment and procedure guidance. See how the GE Healthcare cardiovascular ultrasound systems fit into the in Interventional space – from the Vivid E95 with cSound premium system to the Vivid iq compact system. For more information, go to www3.gehealthcare.com/en/products/categories/ultrasound/vivid/vivid_e95.
ITN and DAIC Editor Dave Fornell takes a tour of some of the most innovative new technologies being displayed on the expo floor at the Radiological Society of North America (RSNA) 2016 meeting. For key take away trends at RSNA, watch the video "Key Trends, New Technology at RSNA 2016."
This video, provided by Valtech, demonstrates the Cardioband transcatheter mitral annuloplasty system. It allows transcatheter repair of functional mitral regurgitation (FMR). It has a CE mark in Europe and a study to evaluate its safety and efficacy is planned in the United States. Read the article “Transcatheter Annuloplasty For Repair Versus Replacement in Functional Mitral Regurgitation.”
Mahadevappa Mahesh, MS, Ph.D., chief physicist and professor of radiology and radiological science at Johns Hopkins Hospital, explains the basics of medical imaging dose monitoring technologies. This includes monitoring and recording software meet new Joint Commission requirements, state dose laws and to improve patient safety regarding X-ray radiation exposure. Read the article “The Role of Dose Tracking Systems in Radiation Safety Programs.”
Shimadzu's latest generation interventional lab angiography imaging system, the Trinias, enables advanced imaging capabilities, including reduced patient dose, 3-D rotation angiography acquisitions table side, and stent enhancement software. This video tour of the system was created at the 2016 Transcatheter Cardiovascular Therapeutics (TCT) meeting. For more information: www.shimadzu.com/med/products/angio/index.html.