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."
VIDEO: Teleflex Talks Complex Interventions at TCT 2018
In 2009, the GuideLiner Catheter revolutionized the concept of guide extension, creating new possibilities in interventional cardiology. Now in its third generation, the GuideLiner V3 Catheter continues to build on a history of innovation and performance — one that has been demonstrated with more than half a million catheters in cath labs around the world.
Teleflex also offers a family of Turnpike Catheters. These contain a robust multi-layer shaft that provides impressive flexibility, torque and tracking over a 0.014” guidewire in complex coronary and peripheral interventions. The unique five-layer composite shaft provides an ideal combination of flexibility and torque response to help navigate through complex anatomy while the outer polymer layer paired with a 60 cm distal hydrophilic coating facilitates smooth catheter delivery. This portfolio consists of the Turnpike Catheter (standard version), the Turnpike Spiral Catheter, the Turnpike Gold Catheter, and the Turnpike LP Catheter. Each catheter configuration contains a specific design element to address various clinical challenges in complex procedures
This year, Teleflex acquired two well-known PTCA balloon catheters. The Chocolate XD PTCA Balloon Catheter is a specialty angioplasty balloon, used in the pre-dilatation and treatment of coronary lesions. The balloon’s proprietary nitinol constraining structure creates “pillows” and “grooves” that are designed to provide controlled dilatation while minimizing vessel wall trauma.
The Glider PTCA Balloon Catheter is a semi-compliant balloon with a skived tip and low entry profile. The tip design, coupled with hydrophilic coating and an innovative, torqueable shaft, allows for precise tip orientation for use in crossing complex lesions and stent struts.
For more information: www.teleflex.com
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.
Corindus Vascular Robotics received U.S. Food and Drug Administration (FDA) 510(k) clearance for its CorPath GRX, the second generation of its vascular robotic system. The system builds upon the original CorPath platform, adding a significant number of key upgrades that increase precision, improve workflow and extend the capabilities and range of interventional procedures that can be performed robotically. These features include Active Guide Management, which enables control of the guide catheter along with robotic control of the guidewire and balloon or stent catheter, with 1 millimeter advancement, from the Control Console. This precise positioning will enable physicians to adjust guide catheter position during PCI procedures, and may expand use of CorPath to more complex cases. The new system also features a completely redesigned Bedside Unit, featuring an Extended Reach Arm and a touchscreen display to streamline workflow. The CorPath GRX was displayed for the first time at the Transcatheter Cardiovascular Therapeutics (TCT) 2016 conference. Read more about the FDA approval.
DAIC Editor Dave Fornell takes a video tour of some of the most innovative new interventional cardiology technologies he found at the Transcatheter Cardiovascular Therapeutics (TCT) 2016 meeting. Watch the related VIDEO “Editor's Choice of the Most Innovative New Technologies at TCT 2015.”
A discussion with Torsten Vahl, M.D., about advancements in transcatheter valve repair technology, including new devices for the aortic, mitral and tricuspid valves. Vahl is director of experimental and translational research and assistant professor of medicine, Columbia University Medical Center, Center for Interventional Vascular Therapy. The interview took place at the Transcatheter Cardiovascular Therapeutics (TCT) 2016 annual meeting. Read the articles “Advances and Future Directions for Transcatheter Valves,” and “Transcatheter Mitral Valve Replacement Devices in Development.”
A discussion with guidewire expert Dimitri Karmpaliotis, M.D., Ph.D., FACC, about the basics of interventional guidewire design and function. He is, assistant professor of medicine, Columbia University Medical Center, and director of CTO, complex and high-risk angioplasty program at the Center for Interventional Vascular Therapy, NewYork Presbyterian Hospital. He spoke with DAIC at the Transcatheter Cardiovascular Therapeutics (TCT) 2016 annual meeting. Read the article “Understanding the Design and Function of Guidewire Technology.”
A discussion with Juan Granada, M.D., about transcatheter mitral valve advancements and device challenges at the Transcatheter Cardiovascular Therapeutics (TCT) 2016 annual meeting. Granada is executive director and chief scientific officer of the Cardiovascular Research Foundation's Skirball Center for Innovation. Read the articles “Advances and Future Directions for Transcatheter Valves,” and “Transcatheter Mitral Valve Replacement Devices in Development.”
A discussion with Simon Dixon, M.D., MBChB, on the use of fractional flow reserve-computed tomography (FFR-CT) to evaluate chest pain patients in the emergency department. He is chairman of the Department of Cardiovascular Medicine at Beaumont Health System and a professor of Medicine at the Oakland University William Beaumont School of Medicine. He discussed the first year of experience with FFR-CT at Beaumont Hospital in Royal Oak, Mich., during the Transcatheter Cardiovascular Therapeutics (TCT) 2016 annual meeting. Read the article “Clinical Applications of FFR-CT.”
A discussion with Todd Brinton, M.D., about the newly FDA-cleared Shockwave Medical Lithoplasty System, at the Transcatheter Cardiovascular Therapeutics (TCT) 2016 annual meeting. Brinton is clinical associate professor and adjunct associate professor of bioengineering at Stanford University Medical Center. Read the article “FDA Clears Lithoplasty Balloon That Shatters Calcified Lesions With Ultrasound.”
William Abraham, M.D., FACC, discusses advances in heart failure device treatment technologies at the Transcatheter Cardiovascular Therapeutics (TCT) 2016 annual meeting. He is director of the division of cardiovascular medicine and a professor of internal medicine, physiology and cell biology at The Ohio State University Wexner Medical Center. He also served as principal investigator of the CHAMPION Trial for the CardioMEMS device. Read the article "Reducing Heart Failure Readmissions."
A discussion with Michael Reardon, M.D. about the state of transcatheter aortic valve replacement (TAVR) as of late 2016. He is a professor of cardiothoracic surgery at Houston Methodist DeBakey Heart and Vascular Center, was the chairman of the patient screening committee for the CoreValve U.S. pivotal trial, nation PI on the Lotus Pivotal Trial, and the national PI of the ongoing the CoreValve intermediate and low-risk trials. Read more in the article "Trends in Transcatheter Aortic Valve Replacement (TAVR)."
Brijeshwar Maini, M.D., and Brian Bethea, M.D., from Tenet Florida’s structural heart program, explain the importance of building a good heart team and how that team should interact. They gave a presentation on image guidance for structural heart procedures at TCT 2016, but focused repeatedly on the need for close collaboration to be successful. Read more in the article "Requirements for Interventional Echocardiographers."
Juan Granada, M.D., executive director and chief scientific officer of the Cardiovascular Research Foundation's Skirball Center for Innovation, explains the shortcomings of the first bioresorbable stent on the U.S. market, proper patient selection and what new BRS technologies are in development. Granada presented numerous sessions on bioresorbable scaffolds at TCT 2016. Read more about bioresorbable stents in "Tempering the Bioresorbable Stent Euphoria Following FDA Clearance of the Absorb."
Krishna Rocha-Singh, M.D., Prairie Vascular Institute, Springfield, Ill., explains advancements in device therapy for hypertension at the Transcatheter Cardiovascular Therapeutics (TCT) 2016 annual meeting. He was involved in the SYMPLICITY HTN-3 denervation trial and is the principal investigator for the ongoing Rox Coupler arteriovenous device trial. Watch the VIDEO “New Approaches to Denervation Therapy.”
David Kandzari, M.D., director of interventional cardiology and chief scientific officer, Piedmont Heart Institute, Atlanta, Ga., explains the impact of the EXCEL Trial at TCT 2016. Piedmont recruited the highest number of patients for the large, randomized trial found the Xience V drug-eluting stent had comparable outcomes to coronary artery bypass graft surgery. This is the first time this parity has been shown in a large trial. Read the article "Stents, Bypass Surgery Equally Safe and Effective for Many With Left Main Heart Disease."
Studies have shown transcatheter aortic valve replacement (TAVR) has an increased risk of stroke and cerebral damage due to emboli released during the procedure. Recent clinical data show the extent of this damage on MRI. Several TAVR embolic protection systems are being developed to reduce this damage. This video explains one of those systems. Read about trial data presented at TCT 2016 "Delirium Significantly Associated With Brain Lesions in Patients Post-TAVR." Read the article, “TAVR Embolic Protection Did Not Reduce Emboli Brain Lesions,” which was a second trial presented at TCT 2016.
This video, provided by Zoll, demonstrates how cardiologists can explain sudden cardiac death to patients. It is critical to educate patients who are at risk of sudden cardiac arrest (SCA), so Rahul Doshi, M.D., director of electrophysiology, associate professor of clinical medicine, Keck Medical Center of University of Southern California, explains sudden cardiac death (SCD) to his patients using a simple illustration. Visit SCDFacts.org for additional resources for you and your team to support the SCD conversation with your patients. One in five post-AMI patients have been shown to be at high risk of dying after PCI.1 The majority of mortality in AMI patients post-PCI occurs in the first three months — one out of every 10 high-risk patients die, with about 60 percent of this mortality due to SCD.[1,2]
With quality of care and cost efficiency at the top of your mind, there is no room in your hospital for waste from high-value supplies. However, managing your critical supplies in the cath lab can be a challenge. How can you get the supply waste in your facility under control? Watch this short video to learn how an automated inventory management solution could help you reduce the waste in your hospital while improving your total cost of care. For more information visit www.cardinalhealth.com.
With bundled payments putting increased pressure on hospitals to manage supply costs while providing quality patient care, there is no room in your cath lab for high-value medical device waste. An automated inventory management solution could help you find and reduce the waste hiding in your supply chain while helping to improve your total cost of care. Visit cardinalhealth.com/CIMS.
This video, provided by Shockwave Medical, demonstrates the Lithoplasty System. It uses ultrasonic waves to treatment calcified plaque in patients with peripheral artery disease (PAD). It was cleared by the U.S. FDA in September 2016. The technology is the first of its kind in interventional cardiovascular medicine. Using similar lithotripsy technology that is already in use to break up kidney stones, the balloon catheter cracks and breaks up calcium in vessel walls, without the need to over inflate the balloon, which can lead to extensive vessel damage. Read the article "FDA Clears Lithoplasty Balloon That Shatters Calcified Lesions With Ultrasound."
Pacemakers, stents and bandages — keeping tracking of what is on hand and accurately capturing charges can be a challenge. What if you could track, manage and analyze your cath lab inventory – low cost to high value – to reveal powerful business intelligence and shine a light on new savings and revenue capture?
You have bigger priorities than managing inventory. Patient safety, quality care and clinician satisfaction top the list. But automated technology can help you improve the way you purchase, control and manage your cath lab inventory, allowing you to positively support your top priorities – and your hospital’s overall performance. For more information, watch this archived webinar on inventory management in the cath lab
Interview with Stephen Little, M.D., medical director of the Valve Clinic at the Houston Methodist DeBakey Heart and Vascular Center, at the American Society of Echocardiography (ASE) 2016 annual meeting. He explains the technologies his center is using to aid transcatheter structural heart procedure navigation, including TAVR, transcatheter mitral valve replacement (TMVR), LAA occlusion, and septal defect occlusions. Read the article “Requirements for Interventional Echocardiographers.” Also, watch the VIDEO "What is Required for Interventional Echo - Discussion With Rebecca Hahn."
Interview with Rebecca Hahn, M.D., FASE, Columbia University Medical Center, New York, at the American Society of Echocardiography (ASE) 2016 meeting. She is an expert in the new subspecialty of interventional echo and discussed considerations for hospitals thinking of creating interventional echo programs to help guide complex transcatheter structural heart procedures in the cath lab or hybrid OR. Read the article “Requirements for Interventional Echocardiographers.” Also, watch the related VIDEO "Transcatheter Structural Heart Procedure Navigation Technology Advances."
This is an animation, supplied by Gore, demonstrated how the Cardioform Septal Occluder is implanted for the transcatheter closure of ASDs or PFOs. It is a permanent implant consisting of a wire frame covered with a thin ePTFE membrane. The wire frame is made of a nitinol alloy. Read more about closing holes in the heart.
DAIC Editor Dave Fornell takes a tour of some of the trends and interesting new technologies from the vendor booths on the expo floor at the 2016 meeting of the American College of Cardiology (ACC).
David Holmes, M.D., professor of medicine, Mayo Clinic College of Medicine and consultant, Department of Internal Medicine, Division of Cardiovascular Diseases, shares details from his presentations at ACC.16 regarding the Watchman left atrial appendage occluder.
MDbuyline clinical analyst Tom Watson, BS, RCVT, explains the new hemodynamic system technology trends at ACC.16. All technologies are being increasingly integrated into the electronic medical record. Read the article “Improving Cath Lab Efficiency With Today’s Hemodynamic Systems.”