by
Robert Garment, Executive Editor | March 16, 2016
From the March 2016 issue of HealthCare Business News magazine
Dr. Anthony Hilliard, an interventional cardiologist at Loma Linda University Medical Center in California, is particularly enthusiastic about the possibilities of what he calls interventional echocardiography, a technology he relies on in his practice. He finds interventional echocardiography so valuable because it provides him with real-time guidance from a colleague performing the echocardiogram while he’s working on a structural heart disease case.
This is how the procedure works: The patient is generally put to sleep, and a probe is placed down into the esophagus. The result is a 3-D echocardiogram, which means that two views can be taken at the same time — and those images can be turned into 3D images using a computer algorithm.
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What that means for Hilliard is he can look at his fluoroscopy — a standard way of imaging the heart arteries and structure — and look at the echo in real time to determine if he put a plug across a defect properly. Two of the variables he needs to consider as he does the procedure include how the plug sits across the defect and if it’s the right size. “[Interventional echocardiography] is taking a technology that we’ve had for a long time and turning it into real-time assistance for interventional cardiology,” says Hilliard, who chairs the ACC’s Early Career Council.
He also taps interventional echocardiography in situations where a patient has had a traditional heart valve implanted during open heart surgery and later experiences a leak around the valve. The leaks occur when one or two sutures break away and the patient has a leak through the resulting hole, he explains. Hilliard notes that sutures can break, even under the hands of the most skilled surgeon.
While historically the remedy would have been another open heart surgery to fix the valve, Hilliard says that with interventional echocardiography, he can determine if the patient’s tissue can withstand the suture. The availability of this technology means that patients can possibly avoid a redo on their open heart surgery, “which is obviously transformative in the practice of medicine,” he says.
