Videos

VIDEO: One on One with Hal Wolf, FHIMSS, HIMSS President and CEO

HIMSS | March 05, 2024

Industry trade shows and conferences seem to be making their comeback in 2024. And the Healthcare Information and Management Systems Society (HIMSS) Global Conference and Exhibition seems particularly poised to deliver the best of the best when it comes to digital transformation in both the delivery of healthcare, but also the delivery of a quality experience for those in this demanding, rapidly evolving industry. This month in our ongoing One on One series with industry leaders, we are talking with Hal Wolf, FHIMSS, president and CEO of HIMSS. He offered insights on the society’s new partnership with Informa Markets, key topics being covered at HIMSS24, AI’s impact on the industry, and his thoughts on healthcare sustainability.

Find more HIMSS24 conference coverage here

A New Partnership for Growth

Last August, Informa Markets and HIMSS announced a landmark partnership to propel the growth and evolution of the HIMSS Global Health Conference and Exhibition, recognized as the most influential healthcare technology event of the year, and in North America. It draws 40,000 health professionals, tech leaders, providers and governmental organizations from across the globe. Informa Markets, the world’s largest exhibition organizer, took on management of the HIMSS Exhibition, while HIMSS continues to oversee developing expert content and programming.

Exciting New Features at HIMSS24

At HIMSS2024, with this new collaboration comes new features, including:

Related content:

Find more HIMSS24 conference coverage here

HIMSS Launches Modernized Infrastructure Adoption Model to Support Global Digital Health Transformation

Top Public Policy Experts at HIMSS24 to Address Global AI Landscape and Digital Transformation in Healthcare

VIDEO: Using Maturity Models to Measure Digital Health

VIDEO: Moving Digital Transformation Forward in Healthcare

VIDEO: Key Components to Creating and Implementing AI and Digital Transformation Solutions

VIDEO: The Benefits and Pitfalls of Artificial Intelligence in Healthcare

VIDEO: A Look at Cybersecurity and How Healthcare is at Risk

Recent Video

Structural Heart | October 15, 2021

Dr. Neil Moat, MBBS, chief medical officer of Abbott's structural heart business, was a cardiac surgeon specializing in the mitral valve prior to taking on his current role where he oversees Abbott's advancements in transcatheter valve technologies. 

He explains some of the evolution in the industry as surgical repairs now are offered side-by-side with transcatheter valve replacement and repair technologies. He notes that the number of heart valve patients being treated has increased with the introduction of transcatheter technologies, and that surgical volumes have not been impacted as much as people thing because more patients overall are now being treated for valve disease.

Related Transcatheter Valve Trends Content:

TAVR Expected to See Rapid Growth in Next 5 years

FDA Approves TAVR for Low-risk Patients Creates A Paradigm Shift in Cardiology

VIDEO: The Expansion of TAVR Following the FDA Clearing its Use in All Patients — Interview with Torsten Vahl, M.D.

VIDEO: Overview of the TAVR Program at Tufts Medical Center — Interview with Andrew Weintraub, M.D.

VIDEO: Tracking Transcatheter Valve Outcomes in the STS-ACC TVT Registry — John Carroll, 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.

VIDEO: Abbott Structural Heart Technology Advances in 2021  — Interview with Neil Moat, MBBS
 

EP Mapping and Imaging Systems | October 14, 2021

An example of the Acutus Medical AcQMap High Resolution Imaging and Mapping System to guide electrophysiology (EP) cardiac ablations. The electrical mapping of the heart shows irregular atrial fibrillation (AFib) prior to an ablation. 

The system uses a basket catheter with 48 electrodes combined with 48 tiny ultrasound transducers. The basket can be manually rotated around inside the atrium to rapidly “paint” a very accurate combined electro- and anatomical map simultaneously in about five minutes. Conventional EP mapping systems can take 20 minutes or longer to complete the mapping process. The electrodes do not need to contact the walls of the heart because the vendor said they can detect the electrical field created by cardiac contractions. The system has both FDA and European CE mark approvals. 

Related EP Mapping Content:

FDA Clears Second-Generation AcQMap 3D EP Imaging and Mapping Catheter

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Acutus Gains European CE Mark for Suite of Next Generation EP Products

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Identifying Hubs of Re-entry Driving Persistent Atrial Fibrillation May Improve Treatment
 

Structural Heart | October 14, 2021

Tiberio Frisoli, M.D., interventional structural cardiologist, senior staff physician, Henry Ford Hospital, explains how his center performs transcaval transcatheter aortic valve replacement (TAVR) access for patients who have suboptimal abdominal aortic and femoral vascular anatomy. Transcaval access was pioneered at Henry Ford Hospital and involves using femoral vein access and then using a surgical radio frequency cutter to bore a hole from the interior venacava into the aorta to allow the TAVR delivery catheter to path through. 

This procedure was developed to enable more patients to receive TAVR via the preferred femoral access route. Some patients are not candidates for femoral artery access because of calcified lesions and heart atherosclerotic plaque, which narrows the vessel lumen, and makes it difficult to thread catheters through. The transcaval access technique can bypass the restricted arteries or heavy calcified plaques to still enable a minimally invasive procedure without the need for surgery. 

This video was produced in partnership from Henry Ford Hospital.

Related Transcaval TAVR Content:

VIDEO: Transcaval Access in TAVR Procedures — Interview with Adam Greenbaum, M.D.

How to Perform Transcaval TAVR Access

VIDEO: Walk Through of the Henry Ford Hospital Structural Heart Cath Lab

Study Deems Transcaval Valve Replacement Pioneered at Henry Ford Hospital Successful

First Transcaval Aortic Valve Replacement Performed in Europe

Additional articles and videos on Henry Ford Hospital 

Find more structural heart technology content

 

Stem Cell Therapies | October 04, 2021

Mechanical engineering Professor Nathan Sniadecki, associate chair for research and infrastructure, mechanical engineering, University of Washington, Seattle, explains his department's development of engineered heart tissue that can beat. The "heart or organ in a dish" technology allows cardiac myocytes to be tested in a lab with various drugs or other influences to see what the impact would be on the heart. 

This technology developed at UW was sent to the International Space Station in 2020 to help evaluate the impact of zero-gravity on the heart. This research plays a critical role in understanding the impact on the human heart in long-duration space flights to places like Mars or beyond. 

The bioengineered tissue is the length of a couple grains of rice set between two posts so the tightening and stretching of cardiac muscles can be measured. 

Read more details in the article Tiny Beating Hearts Created With Stem Cells at the University of Washington.

 

EP Lab | October 04, 2021

Khaldoun Tarakji, M.D., MPH, associate section head, cardiac electrophysiology, Heart and Vascular Institute at Cleveland Clinic, was the lead author on a followup study to the landmark WRAP-IT trial that showed the Tyrx bioresorbable antibacterial envelope was shown it significantly lower infection risk for patients who receive cardiac implantable electronic devices (CIED) and develop hematomas.[1] 

The study results showed an 82% reduction in major infection among patients with hematoma in patients who had received the Tyrx. It is a antimicrobial envelope that is used to place implantable electrophysiology (EP) devices inside prior to closing the device pocket. While the envelope itself did not prevent hemotomas, as the rate was the same in the control group with out it, the Tyrx did lower infection rates in patients with hemotomas.

Read more in the article Tyrx Absorbable Antibacterial Envelope Effectively Reduces Infections in Cardiac Device Patients with Hematomas.

 

Reference:

1. Khaldoun G. Tarakji, Panagiotis Korantzopoulos, Francois Philippon, Jeff D. Lande, Swathi Seshadri, Bruce L. Wilkoff, et al. Infectious consequences of hematoma from cardiac implantable electronic device procedures and the role of the antibiotic envelope: A WRAP-IT Trial Analysis. Heart Rhythm. Punlished online July 16, 2021. DOI:https://doi.org/10.1016/j.hrthm.2021.07.011.

 

Structural Heart | September 28, 2021

Tom Jones, M.D., director, cardiac cath labs, Seattle Children’s Hospital, and principle investigator of the Medtronic Harmony transcatheter pulmonary valve trial, explains the differences between the Melody and Harmony valves. He also explains the history of congenital heart transcatheter valve development over the past 20 years and how adult structural heart devices also developed side-by-side with these devices. 

Patients with tetralogy of fallot often received the ventricular outflow tract (RVOT) in an initial surgery and a second surgery in needed later for a pulmonary valve. As valves wear out, additional open heart surgeries are needed. The Harmony and Melody help reduce the number of open heart surgeries in these patients. Jones said the Harmony valve may help reduce or eliminate the need for open heart surgeries.

The Melody was the first transcatheter valve to gain approval for use in the United States. It was designed to treat patients who already had a surgically placed RVOT. The Harmony valve was then developed to address patients who also needed the RVOT. Between the two valves, Jones said the majority of congenital heart issues can now be treat.

Jones said about 40,000-50,000 babies are born each year in the United States with congenital heart defects that the Harmony and Melody valves might be used to help. He said the Melody valve was able to help about 25% of these patients, and the Harmony valve now can help the rest of these patients with a transcatheter solution. 
 

Related Congenital Heart Content:

VIDEO: Harmony Transcatheter Pulmonary Valve Has Good Outcomes at 1 Year — Interview with Tom Jones, M.D.

FDA Clears First Device to Treat Right Ventricular Outflow Tract Congenital Heart Disease 

FDA Expands Indication for Melody Transcatheter Valve for Failed Surgical Valves

VIDEO: The Heart Team Approach in Congenital Structural Heart Interventions — Interview with Tom Jones, M.D.

 

VIDEO: Advances in Congenital Heart Therapy Technologies — Interview with Tom Jones, M.D.

VIDEO: Use of Virtual Reality to Aid Congenital Heart Disease — Interview with David M. Axelrod, M.D.

Medtronic Shares Two-Year Harmony Transcatheter Pulmonary Valve Results

Find more congenital heart disease (CHD) content

Structural Heart | September 20, 2021

Dr. Neil Moat, MBBS, chief medical officer of Abbott's structural heart business, explains the latest advances in Abbott's structural heart device program. He discusses data on the MitraClip G4 device, the Global EXPAND registry study looking at its use in a real-world population, and the large amount of interest in treating heart failure patients with this device following the COAPT Trial, which showed dramatically improve outcomes. Moat also discusses advances using the TriClip G4 system, a tricuspid valve version of the MitraClip tailored for this valve position.  

Moat also discusses some of the other new technologies Abbott is developing in the structural heart space. This includes the Tendyne transcatheter mitral valve replacement (TMVR) device, the Portico transcatheter aortic valve replacement (TAVR) device, and the second generation Navitor TAVR valve. He also mentioned Abbott's Amulet transcatheter left atrial appendage (LAA) occlusion device, which gained U.S. FDA clearance this past summer.
 

Hear more about Dr. Moat's views in the VIDEO: Abbott Structural Heart CMO Shares Views on Future of Valve Interventions.

 

Related MitraClip, Triclip, Amulet and Portico Content:

MitraClip Reduces Mortality for Heart Failure Patients With Secondary Mitral Regurgitation

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

VIDEO: Echocardiographic Findings in the COAPT Trial — Interview with Federico Asch, M.D.

FDA Approves MitraClip for Use in Heart Failure Patients With Functional Mitral Regurgitation

 

VIDEO: Impact of the COAPT Trial on Heart Failure Patients With Functional Mitral Regurgitation — Interview with Andreas Brieke, M.D.

Transcatheter Mitral Valve Repair is Cost-Effective in Heart Failure Patients

TAVR Expected to See Rapid Growth in Next 5 years

FDA Clears Abbott Amplatzer Amulet LAA Occluder to Reduce Stroke in People With Atrial Fibrillation

 

Portico TAVR System Found Safe and Effective for High-Risk Surgical Patients

Portico TAVR System Reduces Severe Aortic Stenosis at 30 Days in Real-World Setting

VIDEO: Comparison Between Watchman vs. Amulet LAA Occluders
 

Congenital Heart | September 15, 2021

Tom Jones, M.D., director, cardiac cath labs, Seattle Children’s Hospital, explains the importance of the heart team approach on congenital heart interventions and explains the development of adult congenital interventional specialists. Jones explains the role of pediatric and adult congenital interventionists and structural heart specialists and the importance of the team approach with complex congenital heart patient cases.

He also explains the history of interventions and congenital heart disease over the last few decades and how these helped shape transcatheter adult structural heart interventions today. 

 

Related Congenital Heart Content:

 

VIDEO: Harmony Transcatheter Pulmonary Valve Has Good Outcomes at 1 Year — Interview with Tom Jones, M.D.

VIDEO: Use of Virtual Reality to Aid Congenital Heart Disease — Interview with David M. Axelrod, M.D.

FDA Clears First Device to Treat Right Ventricular Outflow Tract Congenital Heart Disease 

FDA Clears Sapien for Pulmonary Valve

Medtronic Harmony Transcatheter Pulmonary Valve Demonstrates Positive Early Clinical Outcomes at One Year

Medtronic Shares Two-Year Harmony Transcatheter Pulmonary Valve Results

FDA Expands Indication for Melody Transcatheter Valve for Failed Surgical Valves

Find more congenital heart disease (CHD) content

September 13, 2021

About 80% of cardiovascular diseases (CVD) are preventable. This is why it is important to identify the people at highest risk of CVDs and ensue they receive appropriate treatment to prevent premature deaths. A simple, inexpensive test could be a big help. A computed tomography (CT) calcium score test measures calcium buildup in the arteries that supply blood to the heart. It can help patients and doctors better understand a person’s risk for cardiovascular diseases, and may help guide treatment for those with low to moderate risk of heart disease or help those whose heart disease risk is not clear. This includes the ability to determine if statins will benefit a patient, or if they do not need them.

This video is designed as an information graphical presentation for patients explaining calcium scoring and what it means for them.

We are especially grateful to Anthony C. Pearson, M.D., FACC from the Saint Louis University School of Medicine. His clinical expertise helped guide us in making a movie we hope will become a conversation starter for people everywhere. Tremendousness created the video. The design firm believes in the power of visual storytelling to inspire change. It works with a variety of corporate and non-profit clients, helping to make complex ideas understandable and engaging by using visual storytelling, information design and co-creation to empower people and organizations to humanize transformation and change, accelerate innovation, and power sales, marketing, and thought leadership. Learn more about the company http://tremendo.us.

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VIDEO: The History of CT Calcium Scoring — Interview with the name-sake of the Agatston, 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

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

VIDEO: Artificial Intelligence to Automate CT Calcium Scoring and Radiomics — Interview with Todd Villines, M.D.

 

Cardiovascular Information Systems (CVIS) | August 31, 2021

One of the trends in cardiovascular information system (CVIS) and radiology PACS at the Healthcare Information Management Systems Society (HIMSS) 2021 conference was the deeper integration of third-party image analysis software and artificial intelligence (AI) into these systems. This eliminates software sitting on top of the CVIS or PACS, separate logins or needing to us a different screen or manually transferring information from the third-party app in into the final report.

A good example of this was Siemens Healthineers, which demonstrated a deep integration with Epsilon Imaging’s echocardiography strain imaging analysis software. The integration eliminates the need for a separate login to the software, and automated quantification and images are carried over directly into the syngo echo report.

Strain can be used to assess cardiac function more precisely than regular cardiac ultrasound exams. It has grown in its use for cardio-oncology programs, assessing a baseline cardiac function and the. Performing serial exams over the course of a cancer patient’s chemotherapy. Strain has seen growing interest and has been a hot topic the past couple years at the American Society of Echocardiography (ASE) meeting. Interest also has expanded greatly recently with reimbursement now available in the U.S.

Siemens said there also has been increased interest in strain this past year because it can show early indicators of cardiac issues in COVID-19 patients and can be used to help monitor COVID myocarditis patients.
 

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Advances in CVIS and Enterprise iImaging at HIMSS 21

VIDEO: Cardiology AI Aggregates Patient Data and Enables Interactive Risk Assessments

Photo Gallery of New Technologies at HIMSS 2021

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Cardiovascular Information Systems (CVIS) | August 31, 2021

The vendor MediCardia demonstrated smart software to aggregate cardiology patient data from numerous locations into one place at the 2021 Healthcare Information Management Systems Society (HIMSS) conference. This enables one dashboard view of the patient's relevant cardiac history, prior exams, imaging, ECGs, labs and procedures. It also uses artificial intelligence (AI) to pull key data elements about the patient to automatically create risk assessments based on current guidelines in a graphical format.

The interactive system also allows the cardiologist to adjust parameters in the patient risk score to immediately show the patient any impact on their score. This includes if they stopped smoking, began taking statins, etc. The dynamic graphics of the system are also designed to be more engaging with a patient during consultations, rather than plain white pages of reports.

MediCardia HeartChart is a cardiology-focused virtual care platform that serves as a unified and common interface for EHRs and remote technologies including wearables, consumer home medical devices, and implanted cardiac rhythm devices. 

Related HIMSS CVIS and PACS Content:

Read about more advances in PACS and enterprise imaging at HIMSS 21.

VIDEO: Example of Epsilon Strain Imaging Deep Integration With Siemens CVIS

Photo Gallery of New Technologies at HIMSS 2021

VIDEO: Importance of Body Part Labeling in Enterprise Imaging — Interview with Alex Towbin, M.D.

VIDEO: Coordinating Followup for Radiology Incidental Findings — Interview with David Danhauer, M.D.

Cardiovascular Ultrasound | August 17, 2021

A new ultrasound imaging technology that may offer novel ways to diagnose and better understand cardiac diseases using dynamic blood flow imaging. This allows imaging of individual blood cells or contrast bubbles as they travel through the heart and vessels, showing detail in how the blood moves and swirls. These motions, including the formation of vortices, may offer new insight into different disease states and allow earlier diagnosis and a understand better when to intervene.

The examples shown in this short video are from Hitachi and GE Healthcare, both of which have highlighted this technology at the American Society of Echocardiography (ASE) annual meetings over the past four years.

Ultrasound vendors use different technology approaches, including vector flow imaging, particle imaging velocimetry and blood speckle tracking. All of them show small lines or arrows to indicate the direction the blood cells or bubbles are traveling, and color codes to indicate velocity. Some vendors offer quantification for some new measures of blood flow, but as of yet, there are no guidelines or standardized indexes as to what these numbers mean.

This technology has been discussed in research sessions at the IEEE and the ASE over the past several years. However, more research is needed to show the prognostic value of the technology. Research to date shows it is possible that the swirling of blood can indicate less efficient flow, which may have implications in the development of heart failure, pulmonary hypertension and advancement of valvular disease. In the coronary arteries, research has shown there may be a connection between sheer stresses and disrupted blood flow in the formation of plaques on artery walls.

Companies that have developed echo blood flow dynamics imaging on their ultrasound systems to date include Hitachi, GE Healthcare, Fujifilm, Mindray and BK Medical. 

Read more about this technology from ASE 2021 in the article Development of Echo Blood Flow Dynamics Imaging.
 

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EP Lab | August 02, 2021

Jass Brooks, vice president of global strategic marketing, Biosense Webster, explains four over-arching electrophysiology (EP) trends at the 2021 Heart Rhythm Society (HRS) meeting. The vendor is working on developing, or has introduced, new technologies in each of these four areas.  She said the key technology trends include:

   • Pulsed field ablation (also called electroporation) as a new way to ablate cardiac tissue without damaging underlying structures like the esophagus. 

   • The introduction of 3D/4D intra-cardiac echo (ICE) imaging to better guide procedures.

   • High-density electromapping systems that create more accurate maps of the electrical activity in the heart and can do so faster than previous generation mapping systems.

   • The introduction of artificial intelligence (AI) into EP systems to speed workflow.

Key among this company's new product introductions at HRS 2021 was the Octaray high-density electro-mapping catheter, which enables faster mapping with a larger number of points. This enables more detailed maps of the heart's electrical activity and may imporve ablation procedure guidance and outcomes. Recent changes to the Carto electro-mapping system now enables integration of this new technology.

Biosense Webster also introduced the Nuvision 4-D intra-cardiac echo (ICE) ultrasound catheter with imaging support from GE Healthcare Vivid Ultra Edition ultrasound systems. This moved ICE beyond 2-D imaging to real-time 3-D and 4-D imaging inside the heart to enable better procedural navigation and visualization of the catheters within in the heart.

Find additional HRS 2021 late breaking trials

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EP Lab | August 02, 2021

Samir Saba, M.D., co-director of the University of Pittsburgh Medical Center Heart and Vascular Institute, and chief, Division of Cardiology, explains the SMART MSP (Multi-Site Pacing) study. This late-breaking clinical trial was presented at the 2021 Heart Rhythm Society (HRS) meeting. It evaluated the safety and effectiveness of multi-site pacing in initial non-responders to conventional cardiac resynchronization therapy with the goal of increasing response cardiac resynchronization therapy (CRT).

CRT nonresponders make up a sizable minority of patients, about one-third. Saba said this trial, was designed to try and chip away and reduce that number. Multi-site pacing has been debated as alternative to single site pacing for several years and this trial offers additional data in support of MSP.

The trial tested the efficacy and safety of the Boston Scientific Resonate X4 CRT-D system. This device allows multi-site pacing to be turned on or off at any time by the electrophysiologist. In the study, patients who did not respond had the multi-site pacing feature turned on, which resulted in 51% of the nonresponders to respond to therapy. 

Find additional HRS 2021 late breaking trials

Find more EP device news

Find more HRS 2021 conference news

 

 

Stethoscopes | July 16, 2021

Nelson B. Schiller, M.D., FACC, professor of medicine and the John J. Sampson and Lucy Stearn Endowed Chair of Cardiology, University of California San Francisco (UCSF) and founder the Adult Echocardiography Laboratory and Adult Congenital Heart Disease Clinic at UCSF, explains the how he uses a digital stethoscope to improve the quality of his care. He said the digital stethoscope can record heart sounds more accurately and filter out ambient noise to improve diagnostics. The system he uses also integrates an ECG so the waveforms can help determine if noises are diastolic or systolic in patients with fast heart rates. 

Schiller explains key features clinicians should consider when buying a stethoscope and gives an overview of his digital HD Steth device.

The HD Steth combines three products into one. This includes a stethoscope, phonocardiograph and electrocardiograph (ECG), enabling clinicians to visualize heart sounds and ECG waveforms on a smart device and help detect multiple cardiac abnormalities while providing the unique ability to capture, record, and replay patient heart sounds for improved readings and analysis.

More Than 50,000 Children Screened for Congenital Heart Defects Using AI-enabled Stethoscopes 

Find more news on digital stethoscope technology
 

Structural Heart | July 14, 2021

Doctor Andreas Ruck, interventional cardiologist and head of the mitral/tricuspid program, Karolinska University Hospital, Stockholm, Sweden, explains the latest data on the Boston Scientific Acurate neo2 transcatheter aortic valve replacement (TAVR) system. It demonstrated positive procedural performance, including low rates of paravalvular leak (PVL) and permanent pacemaker implementation, in data presented in late-breaking sessions at the EuroPCR 2021 congress. These areas improved from the trials using the first generation valve. 

The Acurate neo2 valve design enhancements include a 60% larger outer sealing skirt to better conform to challenging anatomies to better minimized PVL.

Boston Scientific said the ACURATE IDE pivotal U.S. trial is currently enrolling patients to evaluate the safety of the ACURATE neo2 Aortic Valve System. In April 2021, the company received FDA approval to modify the trial design to study patients with severe, symptomatic aortic stenosis who are at low risk for open-heart surgery, in addition to those at intermediate, high and extreme risk.

 

Related Acurate neo TAVR Valve Content:

Acurate neo2 TAVR Valve Demonstrate Reduced Paravalvular Leak and Low Permanent Pacemaker Rates 

Boston Scientific Makes a Comeback With Positive Clinical Data for its Second Iteration Acurate neo2 TAVR Valve

TAVR Is Now Dominant Form of Aortic Valve Replacement in the United States

Boston Scientific Launches Acurate neo2 Transcatheter Aortic Valve System in Europe

 

New Acurate neo Self-expanding TAVR Device Does Not Meet Non-Inferiority Compared to Sapien 3

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Artificial Intelligence | July 01, 2021

Federico Asch, M.D., FASE, director of cardiovascular core labs, cardiovascular imaging, MedStar Health Research Institute, Washington, D.C., was involved in a study that used artificial intelligence (AI) to evaluate echocardiograms to identify COVID-19 patients who were at high risk for complications and mortality. The study also compared human vs. AI variability in reading the stories and found much less variability with the machine reviews. He presented the results from the WASE-COVID Study at the American College of Cardiology (ACC) and American Society of Echocardiography (ASE) 2021 meetings. 

Asch also offers insights about AI applications in echocardiography and how the technology will help improve imaging and reduce the variability in how measurements are made, which will decrease the current level of variability in how exams are performed by human operators. He also explains AI is now available to help guide novice ultrasound users to get optimal cardiac ultrasound images.

Find more content on artificial intelligence in cardiology

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Congenital Heart | May 26, 2021

Tom Jones, M.D., director, cardiac catheterization laboratories, Seattle Children’s Hospital, explains some of the new technologies being used to treat congenital heart disease. He discusses the recent trial he served as principle investigator for the new Harmony transcatheter pulmonary valve, the development of a bioresorbable transcatheter septal occluder device, development of large bioresorbable stents for use in pediatric cases, and use of virtual and augmented reality to better understand and guide very complex congenital heart procedures. Jones also explains a patient case where a 3-D printed heart and vessels from the patient helped the heart team understand all the options and how to tackle a valve replacement in a child with a single ventricle.

Jones shared some of these advances in congenital heart intervention sessions at the Society of Cardiovascular Angiography and Interventions (SCAI) 2021 meeting. 

 

Recent Technology Advances in Congenital Heart:

FDA Clears First Device to Treat Right Ventricular Outflow Tract Congenital Heart Disease 

VIDEO: Harmony Transcatheter Pulmonary Valve Has Good Outcomes at 1 Year — Interview with Tom Jones, M.D.

Medtronic Harmony Transcatheter Pulmonary Valve Demonstrates Positive Early Clinical Outcomes at One Year

FDA Expands Indication for Melody Transcatheter Valve for Failed Surgical Valves

VIDEO: Use of Virtual Reality to Aid Congenital Heart Disease — Interview with David M. Axelrod, M.D.

 

Bioresorbable Pulmonary Valve Replacement May Enable Cardiovascular Regeneration

VIDEO: Transcatheter Closure of Holes in the Heart — Interview with Ziyad Hijazi, M.D.

Nemours Children's Health System Uses 3-D Printing to Deliver Personalized Care

Children's Hospital Los Angeles Cardiologist Creates Modified Stent for 18-month-old Using Printed 3-D Model

PolyVascular Awarded $2 Million Small Business Innovation Research Grant to Bring the First Polymer-Based Heart Valve for Children to Clinical Trials

 

Bioresorbable ASD Occluder Prepares to Enter U.S. Clinical Trial

FDA Approves Abbott's Amplatzer Piccolo Occluder

Critical Need for Pediatric Electrophysiology Devices is Focus of Medical Device Competition 

Lab-created Heart Valves Can Grow With the Patient

SCAI Issues Position Statement on Adult Congenital Cardiac Interventional Training, Competencies and Organizational Recommendations

 

Abbott Receives European CE Mark for Two Pediatric Heart Devices

ASE Releases Guidelines for Transesophageal Echo in Congenital Heart Disease

Find more congenital heart disease (CHD) content

Robotic Systems | May 18, 2021

Ehtisham Mahmud, M.D., division chief of cardiovascular medicine, director of interventional cardiology and the cardiac cath lab at the University of California at San Diego Health, explains how cath lab robotic systems may soon enable interventionalists to perform emergency stroke thrombectomy in patients hundreds of miles away. Corindus/Siemens Healthineers is developing its Corpath GRX robotic system to enable remote telemedicine procedures. Mahmud said this could help significantly improve access to acute stroke care interventions in rural areas. 

Today, the standard of care for stroke is similar to STEMI heart attacks from 40 years ago where tissue plasminogen activator (tPA) is administered in attempts to break up the clot causing ischemic strokes. Outcomes in STEMI greatly improved in the late 1980s and 1990s with the proliferation of angioplasty and percutaneous coronary intervention (PCI) stenting procedures, which became the standard of care in cardiology. Mahmud said acute stroke interventions are following a similar path, but there just are not enough neuro-interventional operators to create large networks for stroke similar to what is now established for STEMI.

He said the Corpath robotic interventions are already conducted remotely from across the room in the cath lab. The idea is that it does not matter if a patient is 10 feet away in the same room or 200 miles away at a smaller hospital to conduct these procedures. This could go a long way to overcoming vast healthcare disparities in smaller, rural hospitals that are far removed from larger centers that are better equipped, and more importantly, have the specialities needed for these procedures.

Once this technology is cleared for use, Mahmud said cardiologists already have the technical skills to perform emergency thrombectomies, but need to learn more about the neuro-vascular bed and how to deal with any adverse events during or after a procedure. He said this lays the ground for creating neuro-cardiology partnerships or care teams to enable this type of care in the near future. 

 

Related Robots in the Cath Lab Content:

VIDEO: Robotic PCI Performed Well in Real-World Population in the PRECISION GRX Study — Ehtisham Mahmud, M.D.

Second Generation Robotic PCI System Performs Well Across Spectrum of Lesion Complexity

VIDEO: Standardizing PCI Through Smart Robotic Procedural Automation

Corindus Launches technIQ 1 Smart Procedural Automation Series for CorPath GRX Cath lab Robotic System

FDA Clears Corindus CorPath GRX for Peripheral Vascular Interventions

VIDEO: Corindus CorPath Robotic PCI System For The Cardiac Cath Lab

Corindus CorPath Used in World's First-in-Human Telerobotic Coronary Intervention

14 Ways to Reduce Radiation Exposure in the Cath Lab

Corindus Seeking Neurovascular Intervention Clearance for CorPath GRX Vascular Robotic System

Innovations Driving the Cath Lab Technology of Tomorrow

Siemens Completes Acquisition of Cath Lab Robotics Vendor Corindus

First Robotic Coronary Angioplasties Performed With Robocath System in Germany

Hoag Performs First Robotic Carotid Artery Stenting on West Coast
 

Find more news from the SCAI 2021 virtual meeting

 

 

Robotic Systems | May 18, 2021

Ehtisham Mahmud, M.D., division chief of cardiovascular medicine, director of interventional cardiology and the cardiac cath lab at the University of California at San Diego Health, was the principle investigator for a trial that looked at the latest generation of cath lab robotics in a real-world patient population. 

The late-breaking PRECISION GRX Study was presented at the Society of Cardiovascular Angiography and Interventions (SCAI) 2021 meeting. It looked at the use of robotic PCI in real-world patients across a spectrum of lesion complexity. This included use in total chronic occlusions (CTOs), and ostial and bifurcation lesions. 

The robot system allows the operator to sit in a lead-lined booth outside the radiation field to perform the procedures sitting down, and they do not need to wear lead.

Read more on this study — Second Generation Robotic PCI System Performs Well Across Spectrum of Lesion Complexity

 

Related Robots in the Cath Lab Content:

VIDEO: Standardizing PCI Through Smart Robotic Procedural Automation

Corindus Launches technIQ 1 Smart Procedural Automation Series for CorPath GRX Cath lab Robotic System

FDA Clears Corindus CorPath GRX for Peripheral Vascular Interventions

VIDEO: Corindus CorPath Robotic PCI System For The Cardiac Cath Lab

Corindus CorPath Used in World's First-in-Human Telerobotic Coronary Intervention

14 Ways to Reduce Radiation Exposure in the Cath Lab

Corindus Seeking Neurovascular Intervention Clearance for CorPath GRX Vascular Robotic System

Innovations Driving the Cath Lab Technology of Tomorrow

Siemens Completes Acquisition of Cath Lab Robotics Vendor Corindus

First Robotic Coronary Angioplasties Performed With Robocath System in Germany

Hoag Performs First Robotic Carotid Artery Stenting on West Coast
 

Find more news from the SCAI 2021 virtual meeting

Structural Heart | May 13, 2021

Tom Jones, M.D., director, cardiac catheterization laboratories, Seattle Children’s Hospital, and principle investigator of the Medtronic Harmony transcatheter pulmonary valve (TPV) trial 1-year results that were presented as a late breaking trial at  Society of Cardiovascular Angiography and Interventions (SCAI) 2021 Scientific Sessions.

New study results validate the effectiveness of the Harmony TPV system for patients with congenital heart disease (CHD) and severe pulmonary regurgitation (PR). The Harmony TPV is designed to be a less invasive treatment option for patients with a congenital heart defect irregularity in their right ventricular outflow tract (RVOT) that requires a pulmonary valve placement to restore valve function. 

Read more details in th article One-year Results of the Harmony Transcatheter Pulmonary Valve Trial Presented at SCAI 2021. 
 

Related Pulmonary Valve Content:

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FDA Clears Sapien for Pulmonary Valve

Medtronic Harmony Transcatheter Pulmonary Valve Demonstrates Positive Early Clinical Outcomes at One Year

Medtronic Shares Two-Year Harmony Transcatheter Pulmonary Valve Results

FDA Expands Indication for Melody Transcatheter Valve for Failed Surgical Valves

Find more congenital heart disease (CHD) content

Structural Heart | May 10, 2021

Philippe Géneréux, M.D., director of the structural heart program at Atlantic Health System’s Morristown Medical Center, is the lead author of the new VARC-3 consensus document that defines endpoints and standardizes taxonomy for aortic valve research.[1] This document is important because it acts as a guide so all structural heart research is comparable and using the same terminology. He said this will become more important as long-term outcomes of 5 to 10 years become available and require apples-to-apples comparisons with newer valve technologies.

Key updates in VARC-3 include a new section on hospitalization or re-hospitalization, defining various levels of valve leaflet thrombosis, also known as hypo-attenuated leaflet thickening (HALT), and defining the stages of bio-prosthetic valve deterioration and valve failure. 

The Valve Academic Research Consortium (VARC), founded in 2010, was intended to identify appropriate clinical endpoints and standardize definitions of these endpoints for transcatheter and surgical aortic valve clinical trials. Rapid evolution of the field, including the emergence of new complications, expanding clinical indications, and novel therapy strategies have mandated further refinement and expansion of these definitions to ensure clinical relevance. This document provides an update of the most appropriate clinical endpoint definitions to be used in the conduct of transcatheter and surgical aortic valve clinical research.

Reference:

1. VARC-3 WRITING COMMITTEE: PhilippeGénéreux, Nicolo Piazza, Maria C. Aluc, Tamim Nazif, Rebecca T.Hahn, Philippe Pibarot, Jeroen J. Bax, Jonathon A.Leipsic, Philipp Blanke, Eugene H.Blackstone, Matthew T.Finn, Samir Kapadia, Axel Linke, Michael J.Mack, Raj Makkar, Roxana Mehranl, Jeffrey J. Popmam, Martin B.Leon, et al. Valve Academic Research Consortium 3: Updated Endpoint Definitions for Aortic Valve Clinical Research. Journal of the American College of Cardiology. Available online 19 April 2021. https://doi.org/10.1016/j.jacc.2021.02.038.

 

Radial Access | May 06, 2021

Arnold Seto, M.D., MPA, FSCAI, chief of cardiology, Long Beach Veterans Affairs Medical Center and director, interventional cardiology research, UCI Health, and Jordan Safirstein, M.D., FSCAI, director of transradial intervention, Atlantic Health's Morristown Medical Center, were involved in a physician-initiated study to find a new way to cut radial artery access site hemostasis by 50 percent. The late-breaking study presented at SCAI 2021 uses a combination of a StatSeal patch and the TR Band compression bracelet.

Cardiac catherization is increasingly bing performed using transradial approach, now making up 50 percent or more of the access used for U.S. interventional procedures. The Terumo TR Band is used to close the vascular access site. Standard protocols require the band to be left on for at least two hours following the procedure. 

Shorter compression times can help reduce complications with radial artery occlusion, so it is desirable to find ways to shorten compression times, Seto said. He explained clinicians often start to deflate the wrist band balloon after an hour and watch for ooze or blood. If there are signs the wound is not completely sealed, the band is reinflated. Reinflations occurs more that 67 percent of the time, he explained.

"We found with the Statseal, you almost never have to reinflate," Seto said. 

This study shows that time can be reduced in half and with fewer complications by using the additional patch device, which helps sped the clotting process. This can save staff time and possibly leading to faster patient discharge for same-day PCI programs. 

Read more in the article Radial Hemostasis Time Cut by 50 Percent With StatSeal in Combination With TR Band.

SCAI 2021 Late-breaking Clinical Study Results

Find more news from the SCAI 2021 virtual meeting

Coronavirus (COVID-19) | May 06, 2021

Payam Dehghani, M.D.,  FRCPC, FACC, FSCAI, co-director of Prairie Vascular Research and associate professor at the University of Saskatchewan, explains the findings of the North American COVID-19 Myocardial Infarction (NACMI) Registry. He presented this late-breaking study data at the at the Society of Cardiovascular Angiography and Interventions (SCAI) 2021 meeting.

The study found one third of patients will die who have COVID-19 (SARS-CoV-2) and suffer a ST-elevated myocardial infarction (STEMI), which is alarming high as compared to four-in-100 patients using a pre-pandemic control group.

 The prospective, ongoing observational registry was created under the guidance of the SCAI, Canadian Association of Interventional Cardiology (CAIC) and American College of Cardiology (ACC). The initial results of the registry were published in the Journal for American College of Cardiology (JACC) on April 27, 2021.

Important key findings from the registry data include:
   • Minorities were disproportionally affected: 55 percent of the STEMI patients had minority ethnicity, which was about evenly divided between Hispanics and blacks.
   • In-hospital mortality was high: 33 percent (4 percent for controls without COVID).
   • Symptoms were unique: majority (54 percent) presented with respiratory symptoms (shortness of breath) rather than chest pain.
   • Significant proportion of COVID-positive patients presented with high-risk STEMI: cardiogenic shock (18 percent) and cardiac arrest (11 percent), which may explain the high fatality rate.
   • Primary angioplasty remained the dominant revascularization modality during the pandemic with small treatment delays (at about 15 minutes). 
   • Diabetics are known to have some of the worst outcomes if they contract COVID, and this was reflected in the study, with 45 percent of patients having diabetes. 

Read more in the artice Third of COVID Patients With STEMI Heart Attacks Die.

Find more COVID-19 news and video

SCAI 2021 Late-breaking Clinical Study Results

Find more news from the SCAI 2021 virtual meeting

 

Cath Lab | May 05, 2021

Ashwin Nathan M.D., a cardiology fellow in the division of Cardiovascular Medicine at the Hospital of the University of Pennsylvania, presented a late-breaking study at the Society of Cardiovascular Angiography and Interventions (SCAI) 2021 meeting that looked at hospital-level percutaneous coronary intervention (PCI) performance data and simulated if what would happen if hospitals removed their highest risk patients. The findings suggest this risk avoidance strategy does not necessarily mean the hospital will get higher performance scores.

Read more in the article Avoiding High-risk Cath Lab Procedures Does Not Necessarily Improve Hospital Scores.

SCAI 2021 Late-breaking Clinical Study Results

Find more news from the SCAI 2021 virtual meeting

Structural Heart | April 30, 2021

Ashwin Nathan M.D., a cardiology fellow at the Hospital of the University of Pennsylvania, presented a late-breaking study on the socioeconomic and geographic access to transcatheter aortic valve replacement (TAVR) programs at the Society of Cardiovascular Angiography and Interventions (SCAI) 2021 Scientific Sessions.

The findings reveal inequitable access to TAVR programs for non-metropolitan or lower income areas across the country. Between 2012 and 2018, 554 hospitals developed new TAVR programs including 543 (98%) in metropolitan areas, and 293 (52.9%) in metropolitan areas with pre-existing TAVR programs. Compared with hospitals that did not start TAVR programs, hospitals that did start TAVR programs treated patients with higher median household incomes (difference $1,305, 95% CI $134 to $12,477, p=0.03). Furthermore, TAVR rates per 100,000 Medicare beneficiaries were higher in areas with higher median income, despite adjusting for age and clinical comorbidities.

The authors also acknowledge that increasing access to TAVR and structural heart programs will require foresight into how clinical trials and approval for procedures and technologies at hospitals are distributed.

Read more about this study

Find more news from the SCAI 2021 virtual meeting

Cardiogenic Shock | April 28, 2021

William O’Neill, M.D., medical director of the Center for Structural Heart Disease at Henry Ford Hospital, Detroit, explains final data from the National Cardiogenic Shock Initiative Study (NCSI), The study, presented as a late-breaker at the  Society for Cardiovascular Angiography and Interventions (SCAI) 2021 Virtual Scientific Sessions today, showed NCSI protocols increased cardiogenic shock survival from 50% to 72%. This involves using Impella hemodynamic support prior to percutaneous coronary intervention (PCI).

Find more news from the SCAI 2021 virtual meeting

 

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VIDEO: Cardiogenic Shock Initiative Continues to Reduce Mortality by 50 Percent — Interview with William O’Neill, M.D.

10 Reasons Why it is Time to Learn More About Cardiogenic Shock — by Emmanouil S. Brilakis, M.D.

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VIDEO: Overview of the National Cardiogenic Shock Initiative — Interview with William O’Neill, M.D.

Cath Lab | April 02, 2021

Corindus, a Siemens Healthineers company and a developer of vascular robotics, recently launched a new set of automated robotic movements in the technIQ Series designed for the CorPath GRX System.

Kate Drake, director of marketing for Corindus, talks with DAIC Editor Dave Fornell about how this software automation provides advanced device manipulation during complex coronary and peripheral procedures in the cath lab.

Corindus has added automated movements for catheter spin, wiggle, dotter and constant speed to help navigate tight lesions and tortuous anatomy.

Drake also discusses the first use of telerobotic procedures with the Corindus system, where the operator was 32 km away from their patient.

For more information: Corindus.com 

 

Related Corindus Robotic System Content:

First-in-Human Telerobotic Coronary Intervention Procedures Published in EClinicalMedicine

Final Results of the Multicenter PRECISION GRX Study of the CorPath in a real-world population across a spectrum of lesion complexity — SCAI 2021 late-breaker

Corindus Vascular Robotics to Be Acquired by Siemens Healthineers

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Find more information on robotic systems for the cath and EP labs

Coronavirus (COVID-19) | April 01, 2021

Behnood Bikdeli M.D., a cardiologist at the Brigham and Women’s Hospital, Harvard Medical School, Boston, offers an overview of numerous trials in progress testing a variety of anticoagulants and antiplatelet agents at different doses for inpatient, outpatient and severely ill ICU, and long-hauler COVID-19 (SARS-CoV-2) patients. Bikdeli is a cardiologist at the Brigham and Women’s Hospital, Harvard Medical School, Boston, and is involved in the Clinical Trials Center, Cardiovascular Research Foundation, New York, and Center for Outcomes Research and Evaluation (CORE), Yale School of Medicine, New Haven, Conn.

He is a the principal investigator for a comprehensive overview of clinical trials looking at anti-thrombotic drug therapies and dosing in coronavirus patients. The article "Recent Randomized Trials of Antithrombotic Therapy for Patients With COVID-19: JACC State-of-the-Art Review" was published online March 16, 2021.

Bikdeli gives an overview of more than 70 studies that are underway or recently completed. He also discussed the need to tailor therapy to specific patients, since there is no "one-size-fits all" approach.

COVID causes thromboembolitic events in patients, including deep vein thrombosis (DVT), pulmonary embolism (PE), stroke, heart attacks, and clots that can cause ischemia or infarcts in various organs. While consensus statements on how to treat or protect patients from COVID clotting were published last year, they were based on opinions, not on hard, clinical evidence. The current studies are hoped to offer answers on how to prophylax specific types of COVID patients in the next couple months. 

Bikdeli also served as lead author on the INSPIRATION Randomized Clinical Trial, which was published in March and looked at the effect of intermediate-dose vs. standard-dose prophylactic anticoagulation for COVID patients on extracorporeal membrane oxygenation (ECMO). He discusses the results of this study as well in the video.

Read the article Overview of Randomized Trials of Antithrombotic Therapy for COVID-19 Patients.

Find more COVID cardiology related news and video

COVID-19 Changes Properties Blood Cells
 

Point-of-Care Ultrasound (POCUS) | April 01, 2021

Here are two quick clinical examples of point-of-care ultrasound (POCUS) lung imaging and cardiac imaging using a GE Vscan Air device. The examples show an abnormal lung image with B-lines. The second clip shows a healthy heart in a parasternal color Doppler image.

The GE Healthcare Vscan Air is a cutting-edge, wireless pocket-sized ultrasound that provides crystal clear image quality, whole-body scanning capabilities, and intuitive software. The pocket-sized ultrasound system was originally introduced in 2010, and as of early 2021, there are over 30,000 Vscan systems in use. The new Vscan Air features a wireless ultrasound probe.

Read more in the article GE Healthcare Unveils Vscan Air Wireless Handheld Ultrasound

Find more POCUS news and video

Cath Lab | March 31, 2021

This is a quick example of clinical use of the Shockwave Medical Intravascular Lithotripsy system that uses sonic wave pulses and a low pressure 4 atm compliant balloon to break up heavy calcium without vessel trauma. Intravascular lithotripsy gained FDA clearance for peripheral artery disease (PAD) in 2016, and the company began working toward an additional indication for the coronaries. It was granted FDA clearance in February 2021. The FDA also recognized this technology as a breakthrough technology because it offers a solution to a long-standing clinical problem.

Related Intravascular Lithotripsy Content:

FDA Clears Coronary Intravascular Lithotripsy to Breakup Calcified Lesions With Sound Waves 

VIDEO: Intravascular Lithotripsy to Treat Severely Calcified Coronary Artery Lesions — Interview with Dean Kereiakes, M.D.

Intravascular Lithotripsy: Will This New Investigational Technology Crack Calcium’s Code in the U.S.? — Article by DISRUPT CAD III investigators  Dean Kereiakes, M.D., and Jonathan Hill, M.D.

FDA Grants Shockwave Medical Breakthrough Status for Coronary Intravascular Lithotripsy

 

BLOG: Coronary Lithotripsy May Become a Paradigm Shift in the Cath Lab

VIDEO: Breaking Up Calcified Lesions Without Vessel Trauma — Interview with Todd Brinton, M.D.

FDA Clears Lithoplasty Balloon That Shatters Calcified PAD Lesions With Ultrasound

Lithotripsy Safe and Effective in Calcified Stenotic Peripheral Arteries

 

Intravascular Lithotripsy May Offer Solution for Calcified Coronary Lesions — Article By Azeem Latib, M.D.

VIDEO: How a Lithoplasty Balloon Shatters Calcified Plaque in Arteries With Ultrasound

 VIDEO: Demonstration of Intravascular Lithotripsy Breaking Up Calcium.

Structural Heart | March 23, 2021

Interview with Scott E. Kasner, M.D., who served as the principle investigator for the Gore Cardioform REDUCE trial, and just published an update in March 2021 looking at the five-year outcomes of patent foramen ovale (PFO) closure vs. antiplatelet therapy for cryptogenic stroke.[1]  Kasner is the chief of the Division of Vascular Neurology, vice chair for clinical affairs for the department of neurology, and Ruth M. and Tristram C. Colket, Jr. President's Distinguished Professor of neurology at the University of Pennsylvania Perelman School of Medicine. He also is the director of the Comprehensive Stroke Center at the University of Pennsylvania Health System. 

The findings show continued benefit and safety of PFO closure out to five years. The initial REDUCE trial results were presented as a late-breaking trial in 2017 and showed benefit to PFO closure and led to the U.S. FDA clearance of the Gore Cardioform PFO Occluder devices. It became the second PFO occluder cleared for use in the United States along with the Abbott Amplatzer. 

He said an important part of the a PFO closure program is to have close collaboration between the interventional cardiologists and neurologists for patient selection, therapy and followup. Kasner said like any procedure, it is also important to have enough volume for one or two cardiologists to become proficient at the PFO occluder procedure. 

Related PFO Closure Content:

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

Gore Cardioform ASD Occluder Receives FDA Approval

VIDEO: Transcatheter PFO Closure to Prevent Stroke and Migraines — Interview with Carey Kimmelstiel, M.D.

SCAI Offers Recommendations for Safe Use of PFO Closure Technologies

VIDEO: An Overview of PFO Closure to Treat Cryptogenic Stroke — Interview with Karen Orjuela, M.D.

VIDEO: Demonstration of a Transcatheter PFO Occluder Implantation

VIDEO: Transcatheter Closure of Holes in the Heart — Interview with Ziyad Hijazi, M.D.

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.

 

Reference:

1. Five-Year Outcomes of PFO Closure or Antiplatelet Therapy for Cryptogenic Stroke. N Engl J Med/ Published March 11, 2021. 384:970-971. DOI: 10.1056/NEJMc2033779

 

Ventricular Assist Devices (VAD) | March 22, 2021

Surgeons at Penn State Heart and Vascular Institute were the second group in the nation to implant a newly-designed mechanical pump in a patient with severe heart failure. The EvaHeart2 Left Ventricular Assist System (LVAD), can be used as a destination therapy and as a bridge to transplant.

Rob Dowling, M.D., director of heart device research at Penn State Heart and Vascular Institute and Penn State College of Medicine, explains the benefits of the new  LVAD system. He was one of the cardiothoracic surgeons who implanted the pump and said the EvaHeart2 left ventricular assist system was designed to reduce the risk of post-implantation stroke, which affects approximately 8% of heart failure patients implanted with an LVAD.

The flush inflow ostium in the left ventricle, low profile inflow design, rotational apex suture cuff are designed to be forgiving on possible inflow cannula malposition and to minimize the risk of wedge thrombus.

“Imagine inserting the tip of a vacuum cleaner into the left ventricle of the heart to get the blood to the pump and out to the rest of the body,” Dowling said. “Sometimes the tip can move into an incorrect position even after proper surgical placement and can create suction against the walls of the heart. This may create blood clots that could cause strokes. This new device was designed in such a way that there is no tip, but rather the “vacuum” hose itself is surgically attached directly to into the lining of the walls of the heart, removing the need for a tip and thereby potentially reducing the risk of stroke.”

The procedure was part of the COMPETENCE Trial, a multi-center clinical study to evaluate EvaHeart2 that will include 40 clinical sites and 399 patients with severe heart failure through 2022.

Richard Huggins, 75, of Lock Haven, Pa., was the second patient in the nation to receive the EvaHeart2 Left Ventricular Assist System (LVAS). Surgeons at Penn State Heart and Vascular Institute implanted the device on Jan. 13.

Read more in the article Hershey Medical Center Second in the Nation to Implant EvaHeart2 LVAD.

 

ECMO Systems | February 16, 2021

An emotional reunion with COVID-19 patient Crystal Gutierrez and the clinicians and cardiologist who saved her life at HCA Houston Healthcare Medical Center and Houston Heart. Gutierrez, a young mother who earlier in 2020 fell seriously ill from the effects of COVID-19 after delivering her son Matthew, spent 152 days in the hospital fighting again and recovering from COVID. Due to profound respiratory failure, she was put on extracorporeal membrane oxygenation (ECMO) therapy to take over the oxygenation of her blood from the lungs, and to unload the work of the heart by circulating her blood. The ECMO procedure was performed by Keshava Rajagopal, M.D., Ph.D., at Houston Heart.

Crystal was reunited February 12, 2021, with the doctors and nurses of HCA Houston Healthcare Medical Center and Houston Heart who helped to save her life. 

DAIC's focus is coverage of cardiovascular technologies like ECMO, but this video drives home the message that these technologies are used to save lives and the work by clinicians and cardiologists has a profound effect on patients and their families. This is an impact is often academic in discussion and is rarely seen by people who do not work directly with patients in hospitals. 

Many hospitals now "clap out" severe COVID patients at discharge. It has become a sort of rite of passage in honor of these patients overcoming adversity and surviving a very dangerous bout with the pandemic virus. It is also often a moral boost to clinicians who participate, having helped the patient fight and survive. 

As of the publication of this video on DAIC Feb. 16, 2021, more than 487,000 Americans have died from the COVID-19. Worldwide there have been more than 2.41 million deaths.

Read more in the article COVID Mother Reunited With Caregivers After Saving Her Live With ECMO.
 

Related ECMO Use in COVID-19 Content:

FDA Approves ECMO to Treat COVID-19 Patients

VIDEO: ECMO Support Effective in Sickest COVID-19 Patients — Interview with Ryan Barbaro, M.D.

ECMO Used to Treat Adult Respiratory Distress Syndrome Case

ECMO Support Found Effective in Sickest of COVID-19 Patients

VIDEO: Multiple Cardiovascular Presentations of COVID-19 in New York — Interview with Justin Fried, M.D., explaining a case that used VV-ECMO abnd VAV-ECMO

 

Cath Lab | February 04, 2021

Cindy Grines, M.D., MSCAI, FACC, president of the Society for Cardiovascular Angiography and Interventions (SCAI), and chief scientific officer of the Northside Cardiovascular Institute in Atlanta, explains a survey showing patients fear catching COVID-19 more than heart attacks. The SCAI survey found this fear is now seen as playing a role in preventing people from going to the hospital if they do have a heart attack or stroke, or even seeing their doctors for checkups or for cardiac complaints they might be having. This is leading to an increase in patients showing up very late after the onset of heart attacks, leading to serious cardiac damage and worse outcomes.  This was a concern early on in the U.S. spread of the virus, but this recent survey shows patients attitudes and fears have not improved much since last spring.
 

SCAI Study Shows COVID Fears Continue to Cause Americans to Avoid Doctor Visits

VIDEO: Where Have all the STEMI Cases Gone Amid COVID-19? — Interview with Thomas Maddox, M.D.

Rapid Drop in Heart Attacks and Stroke at Hospitals Concerns ACC 

Find more cardiology related COVID content

EP Device Monitoring Systems | December 22, 2020

Robert Kowal, M.D., chief medical officer of the Medtronic cardiac rhythm and heart failure division, said there has been a large increase in interest in remote monitoring and programing capabilities of implantable electrophysiology (EP) devices since the start of the COVID-19 pandemic. 

Cardiologists are looking for ways to care for their patients without the need to have them come into the office for close, personal meetings and interrogation of their implanted EP devices. Remote monitoring of these devices has been around for a decade and the Heart Rhythm Society (HRS) urged use of this technology in a 2015 consensus statemement. However, it has been COVID that has really pushed clinicians and patients to use this technolgy to its fullest as a way to watch patients closely from a distance and not require them to have to come into the office. It also enables EP practices to reprogram devices or alerts remotely where ever the have access to an internet connection. 

Find more EP news and video

FFR Technologies | December 16, 2020

This is an example of the Medis Medical Imaging Quantitative Flow Ratio (QFR) system that offers a fractional flow reserve (FFR) blood flow measure in coronary vessels based on angiography imaging analysis alone. The FDA-cleared product allows the FFR-angio derived analysis to be performed table side in the cath lab when the patient is on the table for a procedure to determine if a patient requires a stent.

The QRF technology uses two angiography images with contrast, shot from different angles are used to create a 3-D model of the vessel segment and calculate FFR flow past a lesion. The model also can help plan for stenting.

This example was recorded by DAIC Editor Dave Fornell at the 2019 Transcatheter Cardiovascular Therapeutics (TCT) meeting.

Read more about this technology 

Robotic Systems | December 16, 2020

This is an example of the Siemens Corindus CorPath Cath lab robotic system being used for a percutaneous coronary intervention (PCI) stent implant simulation on the expo floor at the 2019 Transcatheter Cardiovascular Therapeutics (TCT) meeting. The system is mounted to the rail of the cath lab patient table and is manually loaded with catheters. The operator sits in a lead-lined booth outside the radiation field of the C-arm and uses joysticks to manipulate the catheters and advance them through vessels. The operators has the same controls for contrast and C-arm movement as they do using the tableside controls.

The main advantages of this systems are very precise catheter movements and removing the operator from the radiation field, so they can perform the procedure sitting down and without the need to wear heavy protective aprons.

The system is being tested to enable remote expert operators at one hospital to use high speed internet connections to perform a robotic PCI at another hospital many miles aways.
Read more 

 

 

Related Cardiovascular Robotics Content:

VIDEO: Standardizing PCI Through Smart Robotic Procedural Automation

Final Results of the Multicenter PRECISION GRX Study of the CorPath in a real-world population across a spectrum of lesion complexity — SCAI 2021 late-breaker

First-in-Human Telerobotic Coronary Intervention Procedures Published in EClinicalMedicine

Robocath Successfully Carries Out First Robotic Coronary Angioplasties in Humans

Corindus Vascular Robotics to Be Acquired by Siemens Healthineers

Corindus CorPath GRX Used in Live Complex Robotic-Assisted Coronary Intervention at EuroPCR 2019

Stereotaxis Announces Next-generation Robotic Magnetic Navigation and Imaging Systems

Reducing Physician Radiation Dose With Robotics

Corindus Seeking Neurovascular Intervention Clearance for CorPath GRX Vascular Robotic System

Corindus CorPath Used in World's First-in-Human Telerobotic Coronary Intervention

Robots in the Cath Lab

 

Coronavirus (COVID-19) | December 07, 2020

Todd Hurst, M.D., a cardiologist at Banner University Medicine Heart Institute, and an associate professor at the University of Arizona, explains some of the long-term COVID-19 (SARS-CoV-2) post-infection cardiovascular impacts. 

After the coronavirus is gone, many COVID-19 patients are finding they have long-term problems with shortness of breath, arrhythmias, fatigue and cognitive issues. Clinicians are now referring to these patients as "long-hauler" COVID patients. COVID is known to cause myocarditis in many seriously ill patients, but post mortal studies of COVID patients also show the virus kills heart cells and the long term impact of this is not yet known.

VIDEO: Lingering Myocardial Involvement After COVID-19 Infection — Interview with Aaron Baggish, M.D.

COVID-19 Changes Properties Blood Cells

COVID-19 Blood Vessel Damage May Cause Brain Fog and Other Long-hauler Symptoms

EP Lab | December 04, 2020

Oussama Wazni, M.D., section head, electrophysiology, Cleveland Clinic, discusses the results of the recent STOP AF First and Early AF trials. Both showed effectiveness in using early catheter ablation rather than drugs in atrial fibrillation (AF) patients. Both trials used cryo-ballon ablation, but Wazni said it is translatable to use of all cather ablation technologies.

Wazni a principal investigator for the STOP AF First trial and he shares information on the Early AF trial presented as a late-breaking study at the 2020 American Heart Association (AHA).

 

Related EP Ablation Technology Content:

VIDEO: Early Ablation Improved Outcomes in Atrial Fibrillation Patients —interview with Oussama Wazni, M.D.

Esophageal Cooling May Help Prevent Injury From Cardiac Ablations

VIDEO: Top New EP Technologies at Heart Rhythm Society 2020 — Interview with Andrew Krahn, M.D.

Biotronik Partners With Acutus Medical to Offer More Efficient Arrhythmia Diagnosis and Treatment

Contact Force Sensing Catheter Improved Outcomes in Persistent Atrial Fibrillation Ablation

New Technologies to Improve Atrial Fibrillation Ablation

VIDEO: Current State of Atrial Fibrillation Ablation Technologies, an interview with Hugh Calkins, M.D., at HRS 2017.

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