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VIDEO: Escalation of Support and Algorithms for Cardiogenic Shock

January 10, 2019

Mark Anderson, M.D., FACS, vice chair of cardiac surgery services and cardiothoracic surgeon at Hackensack University Medical Group, outlines a multi-disciplinary heart team approach in treament decision-making for patients in cardiogenic shock. Learn more at ProtectedPCI.com/DAIC.

Anderson discusses improving outcomes for patients in cardiogenic shock through the early use of mechanical circulatory support and the development of a shock protocol with the heart team. He outlines Hackensack University Medical Center’s multi-disciplinary, heart team approach in treatment decision-making for patients in cardiogenic shock. The team includes cardiac surgeons, interventional cardiologists, heart failure specialists and intensivists. 

 

 

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January 10, 2019

Mark Anderson, M.D., FACS, vice chair of cardiac surgery services and cardiothoracic surgeon at Hackensack University Medical Group, outlines a multi-disciplinary heart team approach in treament decision-making for patients in cardiogenic shock. Learn more at ProtectedPCI.com/DAIC.

Anderson discusses improving outcomes for patients in cardiogenic shock through the early use of mechanical circulatory support and the development of a shock protocol with the heart team. He outlines Hackensack University Medical Center’s multi-disciplinary, heart team approach in treatment decision-making for patients in cardiogenic shock. The team includes cardiac surgeons, interventional cardiologists, heart failure specialists and intensivists. 

 

 

Cath Lab Navigation Aids | January 08, 2019

Robert Quaife, M.D., director of advanced cardiac imaging, University of Colorado Hospital, explains why advanced imaging techniques are required to tackle complex transcatheter procedures and structural heart interventions. The University of Colorado Hospital helped develop the Philips EchoNavigator live image fusion technology, and this video offers an overview of how it came to be and where the technology is going.

Watch the related VIDEO: Evolution of Transcatheter Mitral Valve Repair at the University of Colorado, which shows examples of the navigation technology is use during a MitraClip procedure. 

 

Additional videos and coverage of the University of Colorado Hospital

 

 

Structural Heart Occluders | January 07, 2019

Karen Orjuela, M.D., assistant professor of neurology at the University of Colorado Stroke and Brain Aneurysm Center, explains the heart-brain team approach to screening cryptogenic stroke patients for transcatheter patent foramen ovale (PFO) closure. 

Additional videos and coverage of the University of Colorado Hospital

 

Related PFO Closure Content:

VIDEO: How Transcatheter PFO Closure Can Reduce Cryptogenic Stroke — Interview with 
John Rhodes, M.D., on the REDUCE PFO Trial

PFO Closure Shows Positive Results from REDUCE Clinical Study

VIDEO: PFO Closure Found Beneficial for Cryptogenic Stroke — Presentation of RESPECT Trial results by John Carroll,  M.D.

PFO Closure May Improve Outcomes Over Medical Therapy in Cryptogenic Stroke: Results of the RESPECT Trial
 

 

 

 

Structural Heart | January 07, 2019

John Carroll, M.D., FACC, FSCAI, director of interventional cardiology, and Robert Quaife, M.D., director of advanced cardiac imaging, explain the development of the transcatheter mitral valve repair program at the University of Colorado Hospital. The video include footage during a MitraClip procedure. 

Additional videos and coverage of the University of Colorado Hospital

Chronic Total Occlusion (CTO) | January 03, 2019

Interview with John Messenger, M.D., FACC, FSCAI, director of the cardiac cath labs and director of the cardiovascular ICU/stepdown unit, and Kevin Rogers, M.D., director of vascular medicine at the University of Colorado Hospital. They explain the trend toward more complex procedures, including chronic total occlusions (CTOs) and complex high-risk indicated procedure (CHIP) patients. They explain how they minimize X-ray and contrast dose during these longer procedures, the tools they use to perform the procedures and offer advice for centers expanding into complex PCI.

Watch a VIDEO walk through of this cath lab at the University of Colorado Hospital.
 

 

Find more content from the University of Colorado Hospital.

 

 

Cath Lab | January 03, 2019

This is walk through inside one of the cardiac hybrid cath labs at the University of Colorado Hospital in Aurora, Colorado. It is centered around a bi-plane Philips AlluraClarity angiography system. In the lab are two echo systems. There is a Philips Epiq system for transesophageal echo (TEE) and to enable the EchoNavigator live echo/fluoro fusion imaging. There also is a Siemens ultrasound system to enable use of intra-cardiac echo (ICE).

For hemodynamic support there is both an Abiomed Impella console and a Teleflex intra-aortic balloon pump (IABP) console. The lab is equipped with an Acist automated contrast Injector. Also note the radial access boards. There are three rolling radiation shields in addition to a boom mounted Mavig shield. Anethesia is used in MitraClip procedures, which the lab is being prepped for in this video. 

Watch the related VIDEO: Cath Lab Walk Through at the University of Colorado Hospital

 

 

EP Lab | January 03, 2019

This is a quick video tour of one of the dedicated electrophysiology (EP) labs at the University of Colorado Hospital. The room is built around a Siemens Artis Q.zen bi-plane angiography system. The system allows low radiation fluoro imaging, which reduced exposure to both patients and operators during long EP ablation procedures. 

Equipment in stock in this lab includes the Medtronic Artic Front cryoablation balloon.

Watch the VIDEO: Cryoballoon Ablation Best Practice Guidelines, an interview with Wilber Su, M.D.

Watch the related VIDEO: Cath Lab Walk Through at the University of Colorado Hospital
 

 

Cath Lab | January 03, 2019

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.

Find more content from the University of Colorado Hospital.

 

Structural Heart | December 20, 2018

John Carroll, M.D., FACC, FSCAI, director of interventional cardiology at the Cardiac and Vascular Center at the University of Colorado Hospital, shares his insights from his own experience on what is needed to build a successful structural heart program.

Take virtual tours of the University of Colorado's hybrid cath lab and newest cath lab where most of their structural heart procedures are performed.

Find more content from the University of Colorado Hospital.

 

 

Heart Failure | December 20, 2018

Andreas Brieke, M.D., director of mechanical circulatory support, heart failure physician and site principal investigator for the COAPT Trial at the University of Colorado Hospital, explains the impact of that study on the care of heart failure patients with functional mitral regurgitation. The trial used the MitraClip to treat patients with functional MR and showed it had a major impact on patient quality of life and heart function, offering a paradigm shift in care.  

Read the article "MitraClip Reduces Mortality for Heart Failure Patients With Secondary Mitral Regurgitation."

Watch the VIDEO: MitraClip to Treat Heart Failure — Results of the COAPT Trial, an interview with William Abraham, M.D.

Find more content from the University of Colorado Hospital.
 

 

 

Hemodynamic Support Devices | December 13, 2018

Michael Amponsah, M.D., FACC, an interventional cardiologist at Mohawk Valley Health System, shares a case of Impella CP for a non-ischemic cardiomyopathy patient who presented in cardiogenic shock. Learn more at ProtectedPCI.com/DAIC.

The patient, a 51-year-old male, was diagnosed with NYHA Class III non-ischemic systolic heart failure with an ejection fraction of 20 percent and an ICD. He presented to the emergency department with ICD shocks and his hemodynamics declined over a 12 hour period and blood work showed a 20 percent decline in kidney function. Amponsah placed a right heart cath and performed an echocardiogram showing LV dysfunction. The team decided to place an Impella CP in the cath lab to support the patient’s heart. This was effective in unloading the LV and organ perfusion. This also provided the team with time to transfer the patient to another facility.

 

December 12, 2018

This is a walk around of the new Spectrum Dynamics Veriton SPECT-CT nuclear imaging system introduced at the 2018 Radiological Society of North America (RSNA) meeting.

This is a walk around of an innovative new SPECT-CT nuclear imaging system shown at the Radiological Society Of North America (RSNA) 2018 meeting this week. It's CT system with comes in 16, 64 or 128 slice configurations. It has 12 SPECT detector robotic arms that automatically move toward the patient and use a sensor to stop a few millimeters from the skin to optimize photon counts and SPECT image quality. It also uses more sensitive CZT digital detectors, which allows either faster scan times, or use of only half the radiotracer dose of analog detector scans.

Read the article “Nuclear Imaging Moves Toward Digital Detector Technology.” 

Read the article "Spectrum Dynamics Sues GE for Theft, Misappropriation of Trade Secrets and Unfair Competition."

 

Cardiovascular Ultrasound | December 12, 2018

This is an example of the new Fetal HQ heart and vascular software from GE Healthcare for fetal ultrasound. The software, for the Voluson E10, helps evaluate the fetal heart shape, size and contractibility. A feature called Radiant Flow shows the blood flow in a 3-D view. It can also help show slow-flow blood, such as neuro-vascular circulation. This was shown for the first time at the 2018 Radiological Society of North America (RSNA) meeting.

 

Read more about this technology. 

 

Watch a VIDEO showing the fetal ventricular contractibility measures.

 

 

Advanced Visualization | December 12, 2018

This is an example of the FDA-cleared OpenSight augmented reality (AR) system for surgical planning from NovaRad at the Radiological Society Of North America (RSNA) 2018 meeting. It uses a HoloLens headset to register an overlay of the patient’s MR or CT scan in the patient. The operator can use hand movements to slice through and manipulate the images.

The vendor gained an FDA indication for AR to be used in surgical planning in 2018. NovaRad is working with the FDA for a second indication for use of the AR in the operating room during procedures.

This video is jerky, slightly misaligned and the hand movements did not always respond because itwas shot with an iPhone inside the visor. The image quality and hand movements are much better when actually wearing it on your head and aligned for the specific user.

Read more about this technology

Cybersecurity | December 12, 2018

Anton S. Becker, M.D., radiology resident at the University Hospital of Zurich, Switzerland, discusses the long-term risks of cyberattacks on medical imaging data at the 2018 Radiological Society of North America (RSNA) annual meeting.

Artificial Intelligence | December 12, 2018

This is an example of how artificial intelligence (AI) can help improve patient care by pulling together patient data from numerous sources n the elect if medical records that are specific to a patient’s diagnosis and treatment for a specific disease state. This is Siemens’ AI-Pathway Companion introduced at the Radiological Society Of North America (RSNA) 2018 meeting this week. In this examples. A prostate cancer patient has all their data on a single time line that can be accessed by single clicks on the points to open reports, images, procedures or labs.

At the end of the time line it integrates AI driven clinical decision support that recommends the next course of action based on clinical guidelines. The guidelines cited can also be opened for review by the clinician.

Interventional Radiology | November 20, 2018

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.

 

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

 

Cath Lab | November 15, 2018

Navin Kapur, M.D., discusses the results of the FDA STEMI Door-to-Unloading (DTU) safety and feasibility randomized controlled trial, presented as a late-breaking study at the 2018 American Heart Association meeting. Learn more at ProtectedPCI.com/DAIC.

 

 

Heart Failure | November 15, 2018

James Januzzi, M.D., Hutter Family Professor at Harvard Medical School and a cardiologist at Mass General Hospital,, Boston, spoke at the 2018 American Heart Association (AHA) meeting about blood biomarkers that can aid in assessing reverse remodeling in heart failure patients with reduced ejection fraction (HFrEF). 

Januzzi mentions the use of high sensitivity troponin in this video. Watch a VIDEO interview with Januzzi on his research with high sensitivity troponin.

 

 

EP Lab | November 15, 2018

Wilber Su, M.D., chief of cardiac electrophysiology, Banner University Medical Center, Phoenix, and clinical associate professor of medicine at the University of Arizona, explains the Heart Rhythm Society (HRS) best practices document on cryoballoon ablation. He led the development of that document. He spoke at the 2018 American Heart Association (AHA) meeting.

Read the HRS "Best practice guide for cryoballoon ablation in atrial fibrillation: The compilation experience of more than 3,000 procedures."

Read the related article "New Technologies to Improve Atrial Fibrillation Ablation."

 

 

Artificial Intelligence | November 14, 2018

James Januzzi, M.D., Hutter Family Professor at Harvard Medical School and a cardiologist at  Mass General Hospital, Boston, spoke at the 2018 American Heart Association (AHA) meeting about his use of artificial intelligence to data-mine patient records. He spoke at AHA on the use of an AI-driven model to predict acute kidney injury (AKI) in patients undergoing coronary angiography, and on the results from a catheter sampled blood archive in a cardiovascular disease study.

Read the related article "How Artificial Intelligence Will Change Medical Imaging."

 

 

 

Computed Tomography (CT) | November 14, 2018

Matthew Budoff, M.D., professor of medicine, David Geffen School of Medicine, UCLA, spoke at the 2018 American Heart Association (AHA) meeting on the new AHA guidelines for cholesterol, including the use of computed tomography (CT) calcium scoring scans to assess patient risk. Budoff has been involved in several of the coronary artery calcium (CAC) trials that supported the new recommendation.

Read the related article "CT Calcium Scoring Becoming a Key Risk Factor Assessment."

 

 

Pharmaceuticals | November 13, 2018

Deepak L. Bhatt, M.D., executive director of the interventional cardiovascular program, Brigham and Women’s Hospital Heart & Vascular Center and Harvard Medical School, explains the results of the late-breaking REDUCE-IT Trial at the 2018 American Heart Association (AHA) meeting. This is a landmark study that showed icosapent ethyl (Vaspeca) can significantly reduce major adverse cardiac and stroke events in patients with continued high triglyceride levels while on statin therapy.

Read the article on the REDUCE-IT Trial

Hypertension | November 07, 2018

Kim Allan Williams, Sr., M.D., chief of the Division of Cardiology and the James B. Herrick Professor at Rush University Medical Center, discusses the efforts being made by the Association of Black Cardiologists to reduce systemic hypertension in the African-American community. Williams is speaking on this topic at the American Heart Association 2018 meeting.

 

 

Cath Lab | November 07, 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

November 06, 2018

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.

 

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

 

Congenital Heart | November 01, 2018

Example of GE Healthcare’s FetalHQ software for the ultrasound imaging of fetal hearts. The new tool runs on GE Healthcare’s Voluson ultrasound systems and is the first tool to simultaneously examine the size, shape and function of the fetal heart echocardiography for congenital heart evaluations.

Read more about the technology in the article "Cardiac Ultrasound Software Streamlines Fetal Heart Exams."

 

 

Cath Lab | October 24, 2018

Michael Flaherty, M.D., discusses a study published in Circulation Research which finds that use of hemodynamic support with the Impella 2.5 heart pump during high-risk PCI can reduce the risk of AKI even when those patients had pre-existing kidney disease and a low ejection fraction. For more information: http://bit.ly/2Pfaqxh

October 11, 2018

Professor Ian Meredith, MBBS, Ph.D., global chief medical officer and executive vice president, Boston Scientific, explains key trial data presented at the 2018 Transcatheter Cardiovascular Therapeutics (TCT) conference. He also explained the company's recent purchase of numerous start-up companies to expand in areas of structural heart, venous interventions, electrophysiology and oncology. 

Hear Meredith's insights in the VIDEO: Future Research and Development Efforts in Cardiovascular Medicine

 

October 11, 2018

A discussion with Professor Ian Meredith, MBBS, Ph.D., global chief medical officer and executive vice president, Boston Scientific, on future directions for cardiology device technology development. He spoke to DAIC at the 2018 Transcatheter Cardiovascular Therapeutics (TCT) conference.

Hear Meredith's insights in the VIDEO: Boston Scientific's Recent Cardiology Advances and Technology Acquisitions

TCT | October 03, 2018

DAIC Editor Dave Fornell takes a tour of some of the most innovative new cardiovascular technology he found on the expo floor at the 2018 Transcatheter Cardiovascular Therapeutics (TCT) conference.

Here are links to other Editor's Choice videos at recent conferences:

VIDEO: Editor's Choice of Most Innovative New Cardiac Technology at ACC 2018

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

VIDEO: Editor's Choice of the Most Innovative New Imaging Technology at RSNA 2017

 

 

#TCT2018

Left Atrial Appendage (LAA) Occluders | October 01, 2018

Ashish Pershad, M.D., medical director, structural heart program, Banner University Medical Heart Institute, Phoenix, explains the difference he found between the FDA cleared Watchman left atrial appendage (LAA) occluder and the Abbott Amplatzer Amulet device now in U.S. trials. He spoke on these differences at the 2018 Transcatheter Cardiovascular Therapeutics (TCT) conference. 

Watch the VIDEO: New Data on LAA Occlusion From the PREVAIL and PROTECT Trials — Interview with Vivek Reddy, M.D.

Read the article "Occluding the Left Atrial Appendage (LAA)."

#TCT2018

Womens Cardiovascular Health | October 01, 2018

Cindy Grines, M.D., chair and professor, department of cardiology, Zucker School of Medicine, Hostra/Northwell, spoke on this topic in sessions at the 2018 Transcatheter Cardiovascular Therapeutics (TCT) conference. 

 

Related Women's Heart Health Content:

VIDEO: Sex Differences in Diagnosing Heart Disease in Women — Interview with Doreen DeFaria Yeh, M.D.

VIDEO: How to Build a Successful Women’s Heart Center — Interview with Malissa Wood, M.D.

VIDEO: Creating a Cardio-Obstetrics Team — Doreen DeFaria Yeh, M.D.

Find more articles on women's heart issues in the Women's Cardiovascular Health channel

 

Hemodynamic Support Devices | October 01, 2018

Nevin Kapur, M.D., FAHA, FACC, FSCAI, executive director, Cardiovascular Center for Research and Innovation, Tufts Medical Center, Boston, explains the importance of ventricular unloading in the management of acute myocardial infarction and cardiogenic shock. He spoke on this topic at the 2018 Transcatheter Cardiovascular Therapeutics (TCT) conference. 

 

Related Cardiogenic Shock Content:

New Approaches to Reduce Cardiogenic Shock Mortality

10 Reasons Why it is Time to Learn More About Cardiogenic Shock

VIDEO: How to Reduce Cardiogenic Shock Mortality by 50 Percent

Hemostasis Management | September 27, 2018

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 some of the technologies and techniques to close large vascular access sites due to TAVR, TEVAR and hemodynamic support devices. He was involved in a session on this topic at the 2018 Transcatheter Cardiovascular Therapeutics (TCT) conference. 

Read more about vascular closure devices.

 

#TCT2018

 

 

Artificial Intelligence | September 27, 2018

Rami Doukky, M.D., professor of medicine, preventative medicine and radiology, and chief of the Division of Cardiology at Cook County Health and Hospitals System, discusses how artificial intelligence (AI) will impact all medical imaging modalities at the 2018 American Society of Nuclear Cardiology (ASNC) annual meeting in San Francisco.

 

Related AI in Cardiac Imaging Content:

VIDEO: Artificial Intelligence in Cardiac Ultrasound — Interview with Partho Sengupta, M.D.

How Artificial Intelligence Will Change Medical Imaging

Combatting the World’s No. 1 Cause of Death With the Help of Artificial Intelligence and Advanced Technology

Advances in Cardiac Imaging Technologies at RSNA 2017
 

 

 

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