A team of Christiana Care health professionals with Heart & Vascular Interventional Services organized the HVIS Conference, Nov. 1 at the John H. Ammon Medical Education Center.
The daylong event was devoted to developments in treatments for heart disease, such as transcatheter aortic valve (TAVR) replacement, procedures to relieve deep vein thrombosis and pulmonary embolisms, the latest stroke protocols and other innovations.
“We’ve seen tremendous advances in HVIS, and this conference is an opportunity to advance our knowledge of treatments so we can provide better care for our patients,” said electrophysiologist Brian H. Sarter, M.D, FACC, medical director of HVIS and associate section chief of operations, Cardiology.
Dr. Sarter reminded attendees that the many forms of heart disease are the leading cause of mortality in the U.S., resulting in 450,000 deaths each year. The conference built on information shared last year at a successful Christiana Care forum on electrophysiology and was expanded thi year to include an array of heart and vascular interventions that are minimally invasive. To give an example of the rate of innovation, Dr. Sarter told the history of the implantable cardioverter defibrillato (ICD) and how cardiologists realized in the mid-20th century that ventricular arrhythmias were causing a large number of patient deaths. Today, subcutaneous ICD therapy is one of the newest technologies and offers advantages over transvenous ICD: There is no risk of vascular injury during implantation, and subcutaneous ICD has a low risk of infection and reduces radiation exposure in patients by eliminating the need for fluoroscopy. Each year, Christiana Care does 400 to 500 procedures.
Wasif A. Qureshi, M.D., FACC, FSCAI, medical director of the Structural Heart Disease Program, talked about the latest treatments for high-risk patients with aortic stenosis, which affects about 7 percent of Americans over 65 (mostly men). With transcatheter aortic valve replacement (TAVR) procedures, a physician can use a small incision in the chest or groin to insert a catheter to deliver a collapsible replacement valve to an artery site.
Among the 310 U.S. hospitals performing TAVR, Christiana Care is in the top five for discharging patients to their homes, with a mean hospital stay of two days for transfemoral access procedures. In two and a half years, Christiana Care has done 55 TAVRs with patients of a median age of 84, and the
record of success has been favorable, Dr. Qureshi said.
Minimally invasive techniques for resolving blood clots have been extensively studied and treated at Christiana Care. George Kimbiris, M.D., chief of Vascular & Interventional Radiology, spoke on deep vein thrombosis (DVT)/pulmonary embolism and thrombosis management.
Chronic venous disease affects 80 million Americans and continues to increase, Dr. Kimbiris said. He explained that Christiana Care was the first hospital to perform pharmacomechanical thrombectomy and pioneer the rapid lysis technique for symptomatic DVT. The procedure makes use of a guided AngioJet, a high-speed saline- and medicine-delivering jet, which then vacuums out the clot, often shortening treatment length and hospital stays.
Under Mark J. Garcia, M.D., medical director of the Center for Comprehensive Venous Health, “we’ve made strides in studying and treating DVT, and over the years we’ve gained recognition for the rapid lysis technique, presenting at a lot of national meetings on this subject,” Dr. Kimbiris said.