From the March 2013 issue of HealthCare Business News magazine
Room for growth
It’s hard to get a good number on the amount of hybrid ORs out there. According to our conversations with vendors and analysts, about 100 to 200 hybrid ORs are built in the United States every year. Grant estimates that about half of all hybrid ORs were built in the past two years. In Europe, the market grows 15 percent every year, according to Frost and Sullivan’s Eramangalath.
Imaging vendors typically won’t share exact sales numbers, but most of the companies DOTmed News spoke with said they’re all experiencing strong growth, even if the hybrid OR market remains a tiny slice of the total interventional pie. Robert Schapiro, vice president of interventional X-ray for the eastern U.S. with Philips Healthcare, says the total interventional market in the United States is 900 to 1,000 units a year. Of those, 100 to 150 are purchased for a hybrid OR.
Worldwide, Philips estimates it has probably only a few hundred units installed. Its rival Siemens Healthcare says growth for its floor-mounted zeego C-arm, introduced in 2010 and specially designed for hybrids, has far outpaced its ceiling-mounted, non-hybrid-designed siblings. Sudhir Kulkarni, segment director for hybrid OR with Siemens’ angiography business unit, says in the last three years zeego sales have increased at a rate three times higher than that for its ceiling-mounted brethren.
Toshiba also didn’t share hard numbers, but Allan Berthe, the company’s senior cardiology product manger, says he recently surveyed sales specialists, and many of its customers are at least discussing hybrid ORs. “Do they end up with that as a final program today? Well, over 50 percent of larger hospitals show interest and then approximately half of those end up installing at least one hybrid system,” Berthe tells DOTmed News.
Rikki-Tikki TAVI
Why build hybrid ORs? A leading reason is projected growth in minimally invasive cardiovascular procedures, such as percutaenous coronary interventions. These procedures need fluoroscopic guidance, but oftentimes hospitals that do PCIs also need an OR on standby in case, say, a coronary artery is ruptured. Similarly, with abdominal aortic aneurysm repair, if the aorta gets perforated, you need to open the patient right away. A recent Advisory Board study found, in fact, that 80 percent of surveyed sites with hybrid ORs used them for aortic aneurysm repairs.
“You don’t have time to move the patient elsewhere,” Siemens’ Kulkarni says.
Arguably one of the biggest pushes has been from transcatheter aortic valve replacement, or TAVR (also known as transcatheter aortic valve implantation, or TAVI). In this, an aortic valve with severe stenosis is replaced with a prosthetic valve that’s threaded up the body through a catheter, instead of during open surgery. The procedure has been available in Europe for nearly six years, but it’s new in the United States. The Food and Drug Administration approved Edwards Lifesciences’ Sapien valve only in the fall of 2011. Initially, the indication was limited to patients ruled totally ineligible for open surgery, but last year it was expanded to include simply high-risk patients.
