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| Vol. 22, No. 9 |
| May 15, 2000 |
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New, Minimally Invasive Cardiac Procedures Demonstrated at UT Symposium
Live televised cases of new catheter-based surgical techniques were the highlights of the fourth annual Frontiers in Interventional Cardiology Symposium, held in Houston April 26-29. The symposium was jointly sponsored by The University of Texas-Houston Medical School and Memorial Hermann Healthcare System. Approximately 300 symposium participants viewed live - via fiber optic connections - demonstrations of new technology and interventional cardiology techniques while the cardiologists and surgeons performing them discussed the procedures with an expert panel of physicians from around the world. The symposium was held at the Post Oak Doubletree Hotel. Images of the procedures were viewed on 40-foot square screens. In use for about six weeks at the Memorial Hermann Heart Center's cardiac catheterization lab, three-dimensional rotational angiography was demonstrated. Following the contrast injection (a special dye - injected into the patient's artery via the catheter - that highlights the vessel's entire shape in detail), the angiogram scan rotates 180 degrees around the supine patient. Damaged vessels are viewed in three-dimensional pictures.
"This is a valuable tool in the treatment of cerebral vascular disease," says Dr. Richard Smalling, who demonstrated the new angiography for the symposium participants. "The three-dimensional rotation helps define the anatomy that we are faced with. Vessels tend to overlap, so this technique gives the opportunity to spin and look at the vessels from many views," says Dr. Smalling. Importantly, the three-dimensional rotational angiography allows physicians to use the measurements to determine appropriate stent size (used to repair damaged vessels) and stent placement. "Using the computer tools, we can essentially customize the stents for individual patients - rather than having to look at several two-dimensional pictures and estimate the correct size," says Dr. Smalling. "Before the actual stent placement, we are able - with this new technology - to dissect and closely look at the area of interest, because we've captured images in three dimensions. It even helps us decide what angle to set the x-ray tube for optimal visualization of the artery during the procedure - all of this prior to the procedure itself." Also critical in the development of this new technology are cardiologist Dr. Oscar Rosales, Dr. Rick Kirkeeide, biomedical engineer; Dr. Morgan Campbell, interventional neurologist; and Dr. Michael Lefkowitz, interventional neurosurgeon. Another catheter-based device previewed at the symposium was the CardioSEAL Closure Device, a dime-sized device that, collapsed, is inserted via catheter (through a puncture in the groin) to the heart where it is used to patch a hole in the upper chambers of the heart. Once the device is advanced to the site of the hole, it is expanded and "sandwiches" the hole closing it between the "clamshell" sides of the device. "In about 10 percent of stroke cases, it is just very difficult to find a cause, but we think it's attributable to these small holes in the heart, which can serve as a gateway for a clot from veins in the pelvis or legs which then goes onto the brain," says Dr. Smalling. "This procedure appears to compare favorably with what was done previously - invasive open heart surgery or long-term blood thinning medications." Another minimally invasive treatment for the repair of aortic aneurysms was also demonstrated by Drs. Hazim Safi, cardiovascular surgeon, Alan Cohen, interventional radiologist, and Dr. Smalling at the symposium. Placement of the ANCURE Device involves small incisions in the groin, where the artificial graft is inserted and advanced to the site of the aneurysm. A balloon catheter follows the ANCURE endovascular graft, and is expanded at the attachment sites causing the graft to affix itself with small hooks proximal and distal to the weakened portion of the aorta. The patient typically resumes eating the same day and goes home the following day - as compared to the typical surgical abdominal aortic aneurysm repair, which requires a much larger incision and a prolonged recovery. - SANDRA HENRY, ROGER WIDMEYER
©2006 Texas Medical Center E-Mail: tmcinfo@texmedctr.tmc.edu URL: http://www.tmc.edu/tmcnews/05_15_00/page_01.html |
