Over the last 30 years, the technological advances and increased use of minimally invasive therapy have already helped create breakthroughs for cardiac patients. For me, the big success stories are the evolution of balloon therapy, stenting, drug-eluting stents and now bioresorbable scaffolds that give the temporary mechanical support needed for healing the coronary artery.
Another important breakthrough is the use of smart guide wires that measures ischemia (when the heart muscle doesn’t receive enough oxygen) functionally instead of just visually. Fractional flow reserve (FFR) helps decide which patients are suitable candidates for percutaneous coronary intervention (PCI). With FFR, the evidence is clear: it reduces the number of stents placed and prevents the over-therapy of patients, which may enhance patient care and help manage costs in the healthcare system.
Another innovation is the combination of angiography with ultrasound. Although still not widely utilized in an integrated fashion, fusion imaging of ultrasound and X-ray provides a visualization of your devices with X-ray and a high quality image of the soft tissue with ultrasound. This combination then provides a unique view of the procedure and what steps interventional cardiologists need to take next. This technique shows to be beneficial in structural heart procedures.
These are obviously huge steps forward, and the benefits they bring are just as apparent. For patients, it helps to improve outcomes in terms of quality of life, life expectancy, a reduction in complications, shorter hospitalization and the increased comfort from the use of minimally invasive procedures.
And for physicians? Interventional cardiologists perform many procedures, standing in a lab wearing a lead apron for long periods of time. It can be quite a physical job, so technology that guides and confirms treatment with a low X-ray dose may also enhance their and their staff’s experience. Other technologies, such as robotic technologies and alternative devices, have the potential to further reduce ionizing radiation exposure to the operator. Hopefully, one day, we will have technology that allows stent placement without wearing lead, without radiation and with less contrast for the patient.