The technology and treatments involved in caring for your heart are always changing. With the help of ongoing research and clinical trials, cardiologists are able to provide services safer – and to even sicker patients – than ever before. Advancements, from new surgical tools and procedures to building out larger, more specialized teams, have helped open the door to not only improve patient outcomes, but also bring care to more people who need it.
Here, several cardiologists break down ways heart care is at the forefront of patient care and provide insight to new developments in heart treatment and research.
What’s Happening Now
Heart care has come a long way, even in the past few months. Experts across departments are collaborating to find new ways of treating common heart-related complications. Even with heart imaging alone, doctors are able to reach a faster diagnosis.
While there is always something new being studied and tested by experts around the world, here are some ways that care has advanced in recent history:
Tools and resources
- EVOQUE Tricuspid valve replacement system. This procedure involves implanting an artificial valve to help replace a leaky tricuspid valve. According to Tiberio Frisoli, M.D., FACC, an interventional cardiologist at Henry Ford Health, historically, less than 5% of patients with isolated tricuspid valve regurgitation underwent corrective surgery. “This new technology was just FDA-approved, so while we still have lots to learn, we are so excited that this journey will likely open the door for tricuspid interventions for so many that previously went untreated,” says Dr. Frisoli. “We hope that this new system will allow us to improve the quality of life of many patients with tricuspid valve disease.”
- Intravascular lithotripsy procedure. This procedure uses sonic waves to break up calcium buildup in the coronary arteries, peripheral arteries and in heart valves. Similar to procedures that are used to break up kidney stones, research has found that this approach to modifying calcium is safe and effective.
- 3D printing. Interventional cardiologists focused on structural heart disease use 3D printed models of a patient’s heart to help better understand each person’s unique heart structure. “It’s beneficial for the team to be able to visualize cardiac structures and how different cardiac devices may or may not fit inside a specific patient's heart,” says Dr. Frisoli. “These 3D prints can allow us to determine the best approach for treatment, and patients really love seeing them!”
- Complex and high-risk interventions. Doctors are increasingly performing minimally invasive procedures on patients. These procedures allow patients to return home sooner and recover faster. “The cardiac catheterization lab continues to revolutionize our abilities to help patients receive complex procedures using minimally invasive techniques,” says Babar Basir, D.O., an interventional cardiologist at Henry Ford Health. “In the past, patients who needed high-risk bypass surgeries but were too old or too sick to be candidates for surgery often went untreated. However, now, in the cath lab we use small balloons, wires and stents and can treat almost any blockage with very high success rates and safety.”
- Mitral valve repair advancements. The PASCAL valve is an FDA-approved device that acts like a clip to help repair a leaky mitral valve. This device is implanted using a minimally invasively approach to cut down on the risk of open-heart surgery previously needed to repair the mitral valve.
- Aspiration thrombectomy. This procedure involves using a vacuum-like device to suck clots, and typically was done on the right side of the heart. Since 2018, experts at Henry Ford have been able to safely adapt this procedure to treat clots on the left side of the heart as well.
- National Cardiogenic Shock Initiative. This initiative, studied and revolutionized in Detroit, uses an algorithm to treat patients in cardiogenic shock (when the heart is too damaged to pump blood and oxygen to the rest of the body). “The goal is to treat patients as soon as possible with artificial heart pumps to restore circulation, treat their blocked arteries and reduce the risk of death,” says Dr. Basir. This initiative is now used by hundreds of other health systems around the world.
- Novel strategies to treat and monitor heart failure. In the past, those with severe heart failure had few options outside of taking medication. Now, different therapies are available that allow for better patient outcomes. Microsensors can be placed into a patient’s pulmonary artery to allow hospital staff to monitor the status of their heart failure without being in the hospital – meaning patients can be in the comfort of their own home. For when those with severe heart failure that don’t see results with medication, a left ventricular assist device (LVAD) may be implanted to aid their failing heart. These therapies open the door for more patients to get a heart transplant.
Better teams, better results
Heart Care At Henry Ford
Years ago, most cardiology teams were simple – often with only one or two doctors who were trained to perform the most complex operations. Today, teams are larger, more specialized and therefore stacked with top-trained experts.
“The goal is to bring a higher-level of care to wherever people are at,” says Jennifer Cowger, M.D., M.S., FACC, a cardiologist at Henry Ford Health. “We are taking the patient into account every step of the way by making sure they understand their condition and have access to medication and necessary procedures near home.”
Additionally, more expertise in the field has allowed for multidisciplinary specialty clinics to be established – with the goal of treating rare and complex cardiovascular disease cases. With coordination from experts in fields such as cardiologist, pulmonology, hematology and surgery, doctors are able to work together across specialties to determine the best care plan for each patient.
What’s On The Horizon
As for what’s on the cutting edge, these are only a some of the procedures and treatments currently being explored that could add to the arsenal of heart care advancements that are changing patient care:
- Mechanical circulatory support advancements. Mechanical circulatory support (MCS) are devices that are used to help when a patient’s heart struggles to pump blood to the rest of the body. The devices many be used only for a few days or as permanent support. Doctors at Henry Ford are some of the first in the world to use a new temporary heart pump called the Impella ECP.
- LVAD therapy trials. Starting in 2024-2025, new trails will examine the benefit of a new, smaller LVAD called the BrioVAD. Additionally, experts are also looking at the use of the HeartMate 3 heart pump for LVAD therapy in patients that are at home but at high risk of death because of heart failure. “For patients with heart failure that is so severe that medications will not prolong survival, these trails are promising,” says Dr. Cowger. “These devices are meant to permanently support people with severe heart failure, some of whom may go on to get a heart transplant.”
- Bleeding detection systems. Cardiologists are evaluating a new bleeding detection device that can help to lower the risk of bleeding complications during complex and high-risk interventions.
- JenaValve trail for aortic valve repair. This trail valve is expected to help patients with severe aortic regurgitation who typically aren’t good candidates for surgery. The valve works to stop the aortic valve from leaking and allow the heart muscles to return to a more normal size.
- SAPIEN M3 trail for mitral valve replacement. Trials are being done to explore using this valve as a replacement mitral valve in cases where a patient has severe regurgitation. This valve would offer doctors a way of replacing this valve in patients that are typically too sick for major surgery.
- Personalized medicine study. Researchers are looking into ways to better understand how to best treat your body based on genome sequencing. In this study (called Cardioseq), experts are analyzing participants’ blood samples and heart conditions that can affect them with hopes of opening the door to more personalized care. Through testing, they are able to learn how different samples respond to medication so future heart issues can be successfully treated.
- Drug-coated balloons. Trails are being done to see how drug-coated balloons can help improve on patients’ safety. These devices allow medication to be administered during minimally invasive surgery without the use of a metal stent.
Reviewed by Dr. Tiberio Frisoli, an interventional cardiologist and the Medical Director of the Henry Ford Center for Structural Heart Disease. He sees patients at Henry Ford Hospital in Detroit, Henry Ford Health Center – Brownstown and Henry Ford Jackson Hospital.
Reviewed by Dr. Babar M. Basir, an interventional cardiologist and the Director of the Acute Mechanical Circulatory Support Program. He sees patients at Henry Ford Hospital and Henry Ford Medical Center – Second Avenue.
Reviewed by Dr. Jennifer Cowger, a cardiologist specializing in heart failure and heart transplant and the Section Head of the Advanced Heart Failure Program. She sees patients at Henry Ford Hospital and Henry Ford Medical Center – Bloomfield Township.
