This video, provided by Abiomed, demonstrates the Impella percutaneous ventricular assist devices (pVAD). It offers between 2.5 and 5 liters of flow per minute to help off load the heart and aid organ perfusion in patients with significantly compromised cardiac output. The Impella has an FDA indication for cardiogenic shock and is the key device being used in the Detroit Cardiogenic Shock Initiative, which was launched in 2017. Read the article "Collaboration by Metro Detroit Cardiologists Increases Cardiogenic Shock Survival Rate."
VIDEO: New Cholesterol Guidelines Support CT Calcium Scoring for Risk Assessment
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.
Pam Rush, RN, MS, clinical program director, cardiovascular service line, and Craig Strauss, M.D., MPH, medical director, explain how MHI achieved significant savings by leveraging analytics software for reductions in patient complications, better vendor negotiations and other areas. Read the article “Advanced Analytics Software for Cardiology.”
ITN Editor Dave Fornell takes a tour of some of the most innovative new technology that was displayed on the expo floor at the 2017 Healthcare Information and Management Systems Society (HIMSS) annual meeting. The two most significant technology advances are discussed in Fornell's blog "Two Technologies That Offer a Paradigm Shift in Medicine at HIMSS 2017."
This video, provided by Tryton, demonstrates the implantation of the Tryton Side Branch Stent. It became the first bifurcation stent cleared by the FDA in March 2017. The stent is deployed in the side branch artery using a standard single wire balloon-expandable stent delivery system. A conventional drug eluting stent is then placed in the main vessel. Read the articles "FDA Clears First Dedicated Coronary Bifurcation Stent" and "New Designs May Ease Bifurcation Stenting."
Enterprise imaging system expert Louis Lannum was in charge of Cleveland Clinic's efforts to connect images and other data from 33 of its departments into a single, centralized database that could deliver the content through a viewer in the electronic medical record. He spoke on the key requirements for enterprise imaging systems at HIMSS 2017. Read the article and watch related videos at "RSNA Technology Report 2016: Enterprise Imaging."
Machine learning is now being commercialized in medical imaging products designed to help improve workflow efficiency and augment the clinical user, not replace them. Steve Holloway with the U.K.-based healthcare market intelligence firm Signify Research discussed the expanding roles of artificial intelligence in imaging applications at the 2017 HIMSS healthcare IT conference. Read the article from HIMSS 2017 "How Artificial Intelligence Will Change Medical Imaging."
Ursula Wright, MSN/MBA, FNP-BC, from Mercy Health System, explains how the nation's fifth largest Catholic health system used heart failure pathways and order sets to reduce length of stay and $14 million in costs to treat heart failure patients. Mercy earned the 2016 HIMSS Enterprise Davies Award for its leverage of information technology to impact its clinical outcomes and reduce healthcare costs. Read the article “Device Technologies to Reduce Heart Failure Readmissions.”
The supplies you use in your cath lab are complex and very valuable. Protecting your investment and uncovering new opportunities to cut waste and help improve the total cost of care means it’s more important than ever before to have a strong pulse on your inventory. Using data analytics, you can uncover trends for product standardization, optimize par levels and better control costs.
When a pediatric patient at Children’s Hospital Los Angeles needed a custom-build stent to repair his pulmonary artery, pediatric interventional cardiologist Frank Ing, M.D., used 3-D printed models from the patient's CT scans. The model helped make sure the stent they made would fit. The model also was used to plan and guide the procedure. This video is made up of clips complied by the hospital and includes some narration of the case by Ing, ending with the final angiographic result with the new stent. Read the article “Children's Hospital Los Angeles Cardiologist Creates Modified Stent for 18-month-old Using Printed 3-D Model.”
This video, provided by BioVentrix Inc., demonstrates how to implant the Revivent TC System to reduce the volume of the left ventricle (LV) in heart failure patients. Reducing the size of the LV can help make pumping more efficient, helping to reduce the workload of a failing heart. It is a minimally invasive, catheter-based, closed-chest alternative to conventional surgical ventricular restoration (SVR). It uses catheter-deployed anchors designed to exclude scarred myocardial tissue from the LV to help restore its more natural conical shape. Read about the system gaining European approval. Read about system starting its U.S. clinical trial.
This video, provided by Medtronic, demonstrates the CardioInsight electro-anatomical mapping system. It was cleared by the FDA in early 2017. It uses an ECG lead vest to noninvasively create a 3-D electrophysiology (EP) electro-map of the heart to help identify arrhythmia and plan catheter ablation procedures. Read the related article on the technology.
Detailed imaging is needed to support complex interventions for the assessment and procedure guidance. See how the GE Healthcare cardiovascular ultrasound systems fit into the in Interventional space – from the Vivid E95 with cSound premium system to the Vivid iq compact system. For more information, go to www3.gehealthcare.com/en/products/categories/ultrasound/vivid/vivid_e95.
ITN and DAIC Editor Dave Fornell takes a tour of some of the most innovative new technologies being displayed on the expo floor at the Radiological Society of North America (RSNA) 2016 meeting. For key take away trends at RSNA, watch the video "Key Trends, New Technology at RSNA 2016."
This video, provided by Valtech, demonstrates the Cardioband transcatheter mitral annuloplasty system. It allows transcatheter repair of functional mitral regurgitation (FMR). It has a CE mark in Europe and a study to evaluate its safety and efficacy is planned in the United States. Read the article “Transcatheter Annuloplasty For Repair Versus Replacement in Functional Mitral Regurgitation.”
Mahadevappa Mahesh, MS, Ph.D., chief physicist and professor of radiology and radiological science at Johns Hopkins Hospital, explains the basics of medical imaging dose monitoring technologies. This includes monitoring and recording software meet new Joint Commission requirements, state dose laws and to improve patient safety regarding X-ray radiation exposure. Read the article “The Role of Dose Tracking Systems in Radiation Safety Programs.”
At RSNA 2016, the key buzzwords were “deep learning,” “machine learning” and “artificial intelligence.” Vendors and major academic centers are developing a wide array of artificial intelligence neuro networks to aid radiologists in clinical diagnosis and clinical decision support. Here are two examples of how the IBM Watson system examines a mammography and cardiac patient imaging studies. Watch the VIDEO “Development of Artificial Intelligence to Aid Radiology,” an interview with Mark Michalski, M.D., director of the Center for Clinical Data Science at Massachusetts General Hospital, explaining the basis of artificial intelligence in radiology.
Emanuel Kanal, M.D., director of MRI services and professor of radiology and neuroradiology at the University of Pittsburgh Medical Center, explains what is known about MRI contrast retention in the brain and other MRI safety concerns. He spoke to ITN at RSNA 2016. Read the article "Gadolinium May Remain in Brain after Contrast MRI."
Mark Michalski, M.D., director of the Center for Clinical Data Science at Massachusetts General Hospital, explains the basis of the utilization of artificial intelligence (aka deep learning and machine learning) in radiology. He also explains where things are at in development of these neuro networks at RSNA 2016. Watch the VIDEO “Examples of Artificial Intelligence in Medical Imaging Diagnostics.”
A post-game roundup by Imaging Technology News (ITN) Contributing Editor Greg Freiherr and Diagnostic and Interventional Cardiology (DAIC) and ITN Editor Dave Fornell on the trends and new tech seen on the show floor at the Radiological Society of North America (RSNA) 2016 meeting.
Shimadzu's latest generation interventional lab angiography imaging system, the Trinias, enables advanced imaging capabilities, including reduced patient dose, 3-D rotation angiography acquisitions table side, and stent enhancement software. This video tour of the system was created at the 2016 Transcatheter Cardiovascular Therapeutics (TCT) meeting. For more information: www.shimadzu.com/med/products/angio/index.html.
Corindus Vascular Robotics received U.S. Food and Drug Administration (FDA) 510(k) clearance for its CorPath GRX, the second generation of its vascular robotic system. The system builds upon the original CorPath platform, adding a significant number of key upgrades that increase precision, improve workflow and extend the capabilities and range of interventional procedures that can be performed robotically. These features include Active Guide Management, which enables control of the guide catheter along with robotic control of the guidewire and balloon or stent catheter, with 1 millimeter advancement, from the Control Console. This precise positioning will enable physicians to adjust guide catheter position during PCI procedures, and may expand use of CorPath to more complex cases. The new system also features a completely redesigned Bedside Unit, featuring an Extended Reach Arm and a touchscreen display to streamline workflow. The CorPath GRX was displayed for the first time at the Transcatheter Cardiovascular Therapeutics (TCT) 2016 conference. Read more about the FDA approval.
DAIC Editor Dave Fornell takes a video tour of some of the most innovative new interventional cardiology technologies he found at the Transcatheter Cardiovascular Therapeutics (TCT) 2016 meeting. Watch the related VIDEO “Editor's Choice of the Most Innovative New Technologies at TCT 2015.”
A discussion with Juan Granada, M.D., about transcatheter mitral valve advancements and device challenges at the Transcatheter Cardiovascular Therapeutics (TCT) 2016 annual meeting. Granada is executive director and chief scientific officer of the Cardiovascular Research Foundation's Skirball Center for Innovation. Read the articles “Advances and Future Directions for Transcatheter Valves,” and “Transcatheter Mitral Valve Replacement Devices in Development.”
A discussion with Torsten Vahl, M.D., about advancements in transcatheter valve repair technology, including new devices for the aortic, mitral and tricuspid valves. Vahl is director of experimental and translational research and assistant professor of medicine, Columbia University Medical Center, Center for Interventional Vascular Therapy. The interview took place at the Transcatheter Cardiovascular Therapeutics (TCT) 2016 annual meeting. Read the articles “Advances and Future Directions for Transcatheter Valves,” and “Transcatheter Mitral Valve Replacement Devices in Development.”
A discussion with guidewire expert Dimitri Karmpaliotis, M.D., Ph.D., FACC, about the basics of interventional guidewire design and function. He is, assistant professor of medicine, Columbia University Medical Center, and director of CTO, complex and high-risk angioplasty program at the Center for Interventional Vascular Therapy, NewYork Presbyterian Hospital. He spoke with DAIC at the Transcatheter Cardiovascular Therapeutics (TCT) 2016 annual meeting. Read the article “Understanding the Design and Function of Guidewire Technology.”
A discussion with Simon Dixon, M.D., MBChB, on the use of fractional flow reserve-computed tomography (FFR-CT) to evaluate chest pain patients in the emergency department. He is chairman of the Department of Cardiovascular Medicine at Beaumont Health System and a professor of Medicine at the Oakland University William Beaumont School of Medicine. He discussed the first year of experience with FFR-CT at Beaumont Hospital in Royal Oak, Mich., during the Transcatheter Cardiovascular Therapeutics (TCT) 2016 annual meeting. Read the article “Clinical Applications of FFR-CT.”
A discussion with Todd Brinton, M.D., about the newly FDA-cleared Shockwave Medical Lithoplasty System, at the Transcatheter Cardiovascular Therapeutics (TCT) 2016 annual meeting. Brinton is clinical associate professor and adjunct associate professor of bioengineering at Stanford University Medical Center. Read the article “FDA Clears Lithoplasty Balloon That Shatters Calcified Lesions With Ultrasound.”
William Abraham, M.D., FACC, discusses advances in heart failure device treatment technologies at the Transcatheter Cardiovascular Therapeutics (TCT) 2016 annual meeting. He is director of the division of cardiovascular medicine and a professor of internal medicine, physiology and cell biology at The Ohio State University Wexner Medical Center. He also served as principal investigator of the CHAMPION Trial for the CardioMEMS device. Read the article "Reducing Heart Failure Readmissions."
A discussion with Michael Reardon, M.D. about the state of transcatheter aortic valve replacement (TAVR) as of late 2016. He is a professor of cardiothoracic surgery at Houston Methodist DeBakey Heart and Vascular Center, was the chairman of the patient screening committee for the CoreValve U.S. pivotal trial, nation PI on the Lotus Pivotal Trial, and the national PI of the ongoing the CoreValve intermediate and low-risk trials. Read more in the article "Trends in Transcatheter Aortic Valve Replacement (TAVR)."
Brijeshwar Maini, M.D., and Brian Bethea, M.D., from Tenet Florida’s structural heart program, explain the importance of building a good heart team and how that team should interact. They gave a presentation on image guidance for structural heart procedures at TCT 2016, but focused repeatedly on the need for close collaboration to be successful. Read more in the article "Requirements for Interventional Echocardiographers."
Juan Granada, M.D., executive director and chief scientific officer of the Cardiovascular Research Foundation's Skirball Center for Innovation, explains the shortcomings of the first bioresorbable stent on the U.S. market, proper patient selection and what new BRS technologies are in development. Granada presented numerous sessions on bioresorbable scaffolds at TCT 2016. Read more about bioresorbable stents in "Tempering the Bioresorbable Stent Euphoria Following FDA Clearance of the Absorb."
Krishna Rocha-Singh, M.D., Prairie Vascular Institute, Springfield, Ill., explains advancements in device therapy for hypertension at the Transcatheter Cardiovascular Therapeutics (TCT) 2016 annual meeting. He was involved in the SYMPLICITY HTN-3 denervation trial and is the principal investigator for the ongoing Rox Coupler arteriovenous device trial. Watch the VIDEO “New Approaches to Denervation Therapy.”
David Kandzari, M.D., director of interventional cardiology and chief scientific officer, Piedmont Heart Institute, Atlanta, Ga., explains the impact of the EXCEL Trial at TCT 2016. Piedmont recruited the highest number of patients for the large, randomized trial found the Xience V drug-eluting stent had comparable outcomes to coronary artery bypass graft surgery. This is the first time this parity has been shown in a large trial. Read the article "Stents, Bypass Surgery Equally Safe and Effective for Many With Left Main Heart Disease."
Studies have shown transcatheter aortic valve replacement (TAVR) has an increased risk of stroke and cerebral damage due to emboli released during the procedure. Recent clinical data show the extent of this damage on MRI. Several TAVR embolic protection systems are being developed to reduce this damage. This video explains one of those systems. Read about trial data presented at TCT 2016 "Delirium Significantly Associated With Brain Lesions in Patients Post-TAVR." Read the article, “TAVR Embolic Protection Did Not Reduce Emboli Brain Lesions,” which was a second trial presented at TCT 2016.
This video, provided by Zoll, demonstrates how cardiologists can explain sudden cardiac death to patients. It is critical to educate patients who are at risk of sudden cardiac arrest (SCA), so Rahul Doshi, M.D., director of electrophysiology, associate professor of clinical medicine, Keck Medical Center of University of Southern California, explains sudden cardiac death (SCD) to his patients using a simple illustration. Visit SCDFacts.org for additional resources for you and your team to support the SCD conversation with your patients. One in five post-AMI patients have been shown to be at high risk of dying after PCI.1 The majority of mortality in AMI patients post-PCI occurs in the first three months — one out of every 10 high-risk patients die, with about 60 percent of this mortality due to SCD.[1,2]
With quality of care and cost efficiency at the top of your mind, there is no room in your hospital for waste from high-value supplies. However, managing your critical supplies in the cath lab can be a challenge. How can you get the supply waste in your facility under control? Watch this short video to learn how an automated inventory management solution could help you reduce the waste in your hospital while improving your total cost of care. For more information visit www.cardinalhealth.com.
This video, provided by Xeltis, demonstrates the world’s first bioresorbable heart valve enabling cardiovascular restoration for pediatric patients. The Xplore-I clinical study of Xeltis bioabsorbable pulmonary heart valve, is a a multi-centered feasibility trial currently enrolling pediatric patients from 2 to 21 years of age in leading heart centers in Europe. Read the article “First Bioresorbable Heart Valves Implanted to Enable Cardiovascular Restoration.”
With bundled payments putting increased pressure on hospitals to manage supply costs while providing quality patient care, there is no room in your cath lab for high-value medical device waste. An automated inventory management solution could help you find and reduce the waste hiding in your supply chain while helping to improve your total cost of care. Visit cardinalhealth.com/CIMS.
This video, provided by Shockwave Medical, demonstrates the Lithoplasty System. It uses ultrasonic waves to treatment calcified plaque in patients with peripheral artery disease (PAD). It was cleared by the U.S. FDA in September 2016. The technology is the first of its kind in interventional cardiovascular medicine. Using similar lithotripsy technology that is already in use to break up kidney stones, the balloon catheter cracks and breaks up calcium in vessel walls, without the need to over inflate the balloon, which can lead to extensive vessel damage. Read the article "FDA Clears Lithoplasty Balloon That Shatters Calcified Lesions With Ultrasound."