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VIDEO: Better Flow Quantification and Rise of PET Among Trends in Cardiac Nuclear Imaging

Nuclear Imaging | November 07, 2019

Rob Beanlands, M.D., FASNC, 2019 American Society of Nuclear Cardiology (ASNC) president, shares a couple trends he sees in cardiac nuclear imaging. He is the Vered Chair and division head of cardiology and director of the National Cardiac PET Centre at the University of Ottawa Heart Institute, Canada.

He said overall trends he sees in nuclear cardiology include the use of better myocardial reserve quantification so it is clear whether revascularization would help patients. Beanlands also said there is increasing interest in positron emission tomography (PET) imaging because of its superior image quality and increasing access to PET radiotracers. New tracers on the horizon will also increase the image quality and flexibility of PET to accommodate exercise stress.

He spoke on artificial intelligence (AI) development for medical imaging in sessions at the 2019 American Society of Nuclear Cardiology (ASNC) annual meeting. 

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Nuclear Imaging | November 07, 2019

Rob Beanlands, M.D., FASNC, 2019 American Society of Nuclear Cardiology (ASNC) president, shares a couple trends he sees in cardiac nuclear imaging. He is the Vered Chair and division head of cardiology and director of the National Cardiac PET Centre at the University of Ottawa Heart Institute, Canada.

He said overall trends he sees in nuclear cardiology include the use of better myocardial reserve quantification so it is clear whether revascularization would help patients. Beanlands also said there is increasing interest in positron emission tomography (PET) imaging because of its superior image quality and increasing access to PET radiotracers. New tracers on the horizon will also increase the image quality and flexibility of PET to accommodate exercise stress.

He spoke on artificial intelligence (AI) development for medical imaging in sessions at the 2019 American Society of Nuclear Cardiology (ASNC) annual meeting. 

Artificial Intelligence | November 07, 2019

Piotr J. Slomka, Ph.D., FACC, research scientist in the Artificial Intelligence in Medicine Program, Department of Medicine at Cedars-Sinai, and professor of medicine in-residence of the David Geffen School of Medicine, UCLA. He explains how his team at Cedars-Sinai is working on intelligent patient risk prediction algorithms that will automatically extract information from medical imaging. He spoke on artificial intelligence (AI) development for medical imaging in sessions at the 2019 American Society of Nuclear Cardiology (ASNC) annual meeting. 

Find more articles and video on AI

 

Nuclear Imaging | November 06, 2019

Robert C. Hendel, M.D., explains some of the new cardiac radiotracers in the pipeline that were discussed in sessions at the American Society of Nuclear Cardiology (ASNC) 2019 meeting. Hendel is a professor of medicine and radiology and the Sidney W. And Marilyn S. Lassen Chair in Cardiovascular Medicine, Tulane University. He also serves as the chief of the section of cardiology and director of the Tulane University Heart and Vascular Institute. 

He outlined three new radiotracers that may impact cardiac imaging:

   • Flurpiridaz F-18 PET perfusion agent that offers high quality images and can be used with exercise stress;

   • MIBG imaging to help better assess heart failure classes and if patients may need an ICD;

   • New F-18 agents to image cardiac amyloidosis; and

   • Nuclear agents to enable annexin imaging, allowing direct vsualization of myocardial apoptotic cells.

 

PET-CT | October 30, 2019

Rupa Sanghani, M.D., FASNC, associate professor, Rush Medical College, director of nuclear cardiology and stress laboratory, Rush University Medical Center, and associate director, Rush Heart Center for Women, explains how to create a high-volume cardiac positron emission tomography (PET) imaging program. She spoke on this topic at the 2019 meeting of the American Society Nuclear Cardiology (ASNC) and led a tour for attendees of the PET-CT system at Rush, which was located close to the conference. 

Sanghani said the advantages of PET myocardial perfusion imaging include faster exam times and allowing additional information from coronary reserve flow assessments to better understand if revascularization will help a patient's heart recover. The 16-slice CT scanner is used not only to attenuate the PET images, but to perform a CT calcium scoring exam to assess the patient's risk for future cardiovascular events. The Rubidium-82 radiotracer used for PET exams only has a 75 second half life, so it can help increase the number of exams a center is able to perform each day. At higher volume centers, PET is optimized to handle all the patients who require pharmacological stress exams. 

In the video, Sanghani  outlines what Rush did to design its room, covers basics on training, what to look for in a scanner and other considerations when creating a PET program.

Find more coverage of the ASNC

Find more news on nuclear imaging

 

 

Cardiac Diagnostics | October 29, 2019

Clyde Yancy, M.D., MSc, cardiology chief and vice dean for diversity and inclusion at Northwestern University, Feinberg School of Medicine, was a keynote speaker at the 2019 American Society of Nuclear Cardiology (ASNC) annual meeting. He said the traditional biases of seeing a patient and automatically making clinical assumptions because they are a certain race or gender are obsolete. For example, he said not all black patients have hypertension. Yancy added that genetics, especially with racial intermarriage over the past several generations, no longer predisposes patients to what is typically assumed for certain ethnic or racial backgrounds.

Yancy also said new research is showing how diet plays a major role in patient health and disease progression for things previously thought to be based on genetics. This includes the people who live in "food deserts" in urban areas where there are no sources of fresh food and vegetables, so they consume large amounts of packaged and processed foods that contain high levels of salt, phosphates and preservatives. He said these chemicals and diet may be the root cause of hypertension and diabetes in black populations in low income areas, rather than genetics as previously thought.

 

Related Content: 

VIDEO: Reducing Hypertension Among African-Americans — Interview with Kim Allan Williams, Sr., M.D.

VIDEO: Use of Plant-Based Diet to Reduce Cardiovascular Disease Risk — Interview with Kim Allan Williams, Sr., M.D.

VIDEO: New PLATINUM Diversity Data Shows Early DAPT Cessation OK in Minorities With New Generation Stent — Interview with Roxana Mehran, M.D., 

 

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

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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)

 

Ablation Systems | September 26, 2019

Clifford Robinson, M.D., associate professor of radiation oncology, chief of the SBRT service, director of clinical trials, Washington University, St. Louis, Washington University School of Medicine in St. Louis, explains the longer term results of cardiac radiotherapy ablation to treat ventricular tachycardia

The results of the ENCORE-VT study were presented at ASTRO 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)

 

 

Interventional Radiology | September 10, 2019

Scott Schwartz, M.D., interventional radiologist and program director for IR residencies and the vascular and interventional radiology fellowship at Henry Ford Hospital, explains how the department uses Yttrium-90 (Y90) embolization therapy to treat liver cancer.

Additional articles and videos on Henry Ford Hospital 

 

Related Articles on Y-90 Radiotherapy:

Current Advances in Targeted Radionuclide Therapy

A Look Ahead in Targeted Radionuclide Therapy

Radioactive Bead Therapy Now Used for Head, Neck Tumors

NCCN Guidelines Recommend Y-90 Microspheres for Metastatic Colorectal Cancer Treatment

 

(Editor's note - this video was originally published in November 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

Advanced Visualization | August 09, 2019

An example of Siemens' photo-realistic Cinematic image reconstruction. This image is from a CTA exam from a Siemens Force CT scanner. 

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. 

 

Find more news and videos from the SCCT meeting

CT Angiography (CTA) | August 08, 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. 

 

 

 

CT Angiography (CTA) | August 08, 2019

This is an example of an automated calcium scoring software to speed review of coronary artery calcium (CAC) scoring cardiac computed tomography (CT) scans. This advanced visualization software from Ziosoft uses artificial intelligence to segment the coronary vessels, identify valves and the aorta and then color code tag the calcium deposits and quantify the amount of calcified plaque in each vessel. It tallies the score into a table and computes an overall Agatston risk score. This risk score correlates to that patient's risk for a heart attack in the future. The software notes calcium in the heart outside the coronaries in valve leaflets and the aorta, but excludes this data. This type of automation is now offered by most advanced visualization and CT system vendors. This automation can save a large amount of post-processing time and make it easier for hospitals to offer low-cost CAC CT screening programs. 

CAC scans can be used to determine if a patient needs to go on statin therapy. An Agatston score of zero means the patient has no risk of coronary disease. 

Calcium in arteries is a marker for damage caused by vessel wall inflammation from atherosclerosis. Calcium can form from previously ruptured necrotic, lipid core plaques, also referred to as vulnerable plaques. These are the types of plaque responsible for heart attacks. When the core of these plaques rupture, the blood reacts to the exposed core similar to a wound and begins to clot, forming a thrombus in the vessel, which can block the blood flow. When the vessel heals over time it calcifies, leaving behind an easily identifiable marker on CT imaging. 

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

 

Related CT Calcium Scorining Content:

VIDEO: The History of CT Calcium Scoring — Interview with Arthur Agatston, M.D.

VIDEO: New Cholesterol Guidelines Support CT Calcium Scoring for Risk Assessment — Interview with Matthew Budoff, M.D.

CT Calcium Scoring Becoming a Key Risk Factor Assessment

ACC and AHA Release Updated Cholesterol Guidelines for 2018

VIDEO: CT Calcium Scoring to Screen For Who Should Take Statins — Interview with Matthew Budoff, M.D.

 

 

Computed Tomography (CT) | August 07, 2019

This is an example of in-stent restenosis shown using spectral CT imaging. This example was demonstrated by Philips Healthcare at the 2019 meeting of the Society Of Cardiovascular Computed Tomography (SCCT). It can sometimes be difficult to determine if showing inside a stent of CT is artifact or real. Spectral CT can definitely help make a diagnosis. This example shows Philips’ Effective Z visualization, where the image is created based on the atomic number of the elements present in the image. After removal of iodine from the image, it shows the shadow in the stent has the same atomic composition as the vessel intima.  

This example is from a Philips IQon dual-energy CT scanner. This system has spectral imaging always on without any need to change protocols. This allows the spectral to be used when needed for additional information without need to rescan a patient.

Read more on this CT system.

VIDEO: Applications of Spectral CT — Interview with Suhny Abbara, M.D.

 

Cardiac Imaging | July 30, 2019

Nate Bachman, graduate research assistant in the Human Cardiovascular Physiology Lab of the Dept. of Health and Exercise Science at Colorado State University, describes how he and fellow researchers used multiple types of cardiac imaging to evaluate the cardiovascular health of athletes who compete in endurance events lasting six hours or more, and what the results may suggest for future screening.

EP Lab | July 26, 2019

Mark Ibrahim, M.D., FACC, assistant professor of medicine and radiology, associate program director, advanced cardiac imaging fellowship, University of Utah, explains what radiologists and cardiologists need to know what is needed from CT imaging prior to ablation procedures for atrial fibrillation (AF) and ventricular fibrillation (VF). He spoke at a joint session of the Heart Rhythm Society (HRS) and the Society of Cardiovascular Computed Tomography (SCCT) at the 2019 SCCT meeting. 

 

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CT Angiography (CTA) | July 26, 2019

Andrew Choi, M.D., FACC, FSCCT, co-director, cardiac CT and MRI, assistant professor of medicine and radiology, George Washington University, Division of Cardiology, Washington, D.C., explains the role of social media to extend the reach of cardiovascular research from peer review journals. He spoke on this topic in multiple sessions at the Society of Cardiovascular Computed Tomography (SCCT) 2019 meeting.

 

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EP Lab | July 25, 2019

Pierre Qian, MBBS, cardiac electrophysiologist fellow, Brigham and Women's Hospital, explains how his facility is working with radiation oncology to use radio therapy to noninvasively ablate ventricular tachycardia (VT). He spoke on this topics during a joint electrophysiology session by the Heart Rhythm Society (HRS) and the Society of Cardiovascular Computed Tomography (SCCT) at the SCCT 2019 meeting.

Here is a link to another radiotherapy EP project Qian recently had published - A Novel Microwave Catheter Can Perform Noncontact Circumferential Endocardial Ablation in a Model of Pulmonary Vein Isolation

 

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Heart Valve Technology | July 24, 2019

Joao Cavalcante, M.D., FSCCT, director of structural heart CT and cardiac MRI, Minneapolis Heart Institute, discusses transcatheter mitral valve replacement (TMVR) imaging requirements at the Society of Cardiovascular Computed Tomography (SCCT) 2019 meeting. SCCT held its first TMVR planning hands-on workshop, which he was involved in. TMVR is expanding with currently FDA cleared valve-in-valve (VIV) and valve-in-ring (VIR) procedures.

 

Related TMVR Content:

Interventional Imagers: The Conductors of the Heart Team Orchestra

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

VIDEO: Transcatheter Structural Heart Procedure Navigation Technology Advances  — Interview with Stephen Little, M.D.

Recent Advances in Transcatheter Valve Technology

Abbott Begins Tendyne Transcatheter Mitral Valve U.S. Pivotal Trial

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

New LAMPOON Technique Reduces LVOT Obstruction in Transcatheter Mitral Valve Replacement

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CT Angiography (CTA) | July 24, 2019

Arthur Agatston, M.D., clinical professor of medicine, Florida International University, Herbert Wertheim College of Medicine, is the name-sake of the Agatston score used in CT calcium scoring. He explains the history of the scoring system from the early 1990s and the evolution of CT technology for cardiac imaging. The latest American Heart Association (AHA) 2018 cholesterol guidelines now include the use of CT calcium scoring, which was a big topic at the Society of Cardiovascular Computed Tomography (SCCT) 2019 meeting.

Read the article How the Agatston Calcium Score Was Created and its Impact on Heart Attack Prevention.

See a quick example of a CT calcium scoring exam in the VIDEO: Example of an Automated CT Cardiac Calcium Scoring Exam.

 

 

Related CT Calcium Scorining Content:

VIDEO: New Cholesterol Guidelines Support CT Calcium Scoring for Risk Assessment — Interview with Matthew Budoff, M.D.

CT Calcium Scoring Becoming a Key Risk Factor Assessment

ACC and AHA Release Updated Cholesterol Guidelines for 2018

VIDEO: CT Calcium Scoring to Screen For Who Should Take Statins — Interview with Matthew Budoff, M.D.

 

Find more SCCT news and videos

 

SCCT | July 19, 2019

Ron Blankstein, M.D., director of cardiac computed tomography, Brigham and Women's Hospital, and associate professor of medicine and radiology, Harvard Medical School, and current SCCT president, offers an overview of the recent trends in cardiac CT and some of the new highlights at the Society of Cardiovascular Computed Tomography (SCCT) 2019 meeting. The  said key topics included integration of artificial intelligence into CT systems, the integration of CT calcium scoring into the 2018 American Heart Association (AHA) cholesterol management guidelines, structural heart assessments for transcatheter valve and left atrial appendage (LAA) occlusion, and partner sessions with TCT and HRS that explain the roll of CT in interventional cardiology and electrophysiology.

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CT Angiography (CTA) | July 19, 2019

Quynh Truong, M.D., MPH, associate professor of radiology and medicine at Weill Cornell and director of cardiac CT, NewYork Presbyterian Hospital, offers 10 tips to help improve image quality for cardiovascular computed tomography (CTA) exams. She spoke on this topic at the Society of Cardiovascular Computed Tomography (SCCT) 2019 meeting.

Her discussion includes:

1. Practice the breath hold

2. Give nitrate to vasodilate

3. Slow the heart rate

4. Acquire multiple phases with padding

5. Include systolic imaging for irregular heart beats

6. Consider cauo-cranial imaging to avoid contrast enhancement issues

7. Use a high contrast injection rate

8. Right ventricular opacification for function

9. Use a hard kernel

10. Know your post-processing software

 

VIDEO: Tips and Tricks to Aid Cardiac CT Technologist Workflow

VIDEO: How to Prepare a Patient for a Cardiac CT Scan

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