The Heart Beat

Picture this: twice a year, over 30,000 cardiologists from all over the United States — and increasingly throughout the world — get together to discuss the latest and greatest research findings that will shape the way they provide care.  It may not sound like your idea of a party, but it’s an amazing tour de force which ultimately will impact the treatments that become available to you down the line.

Here are three of the hottest questions that we hope to get answered at the upcoming American College of Cardiology meeting in New Orleans, which center around the invasive procedures that we do — or perhaps should be doing differently.

(1) Can we replace heart valves without surgery? One of the most exciting new technologies is heart valve replacements (of the aortic valve) performed without open heart surgery, but rather through a catheter-based procedure through a small incision in the groin.  Researchers will present results of a study which will answer the question of whether the less invasive procedure is as safe or effective as the current surgical standard of care.  There will also be a cost-effectiveness study presented that will try to address the cost issues related to this new technology.

(2) Are coronary stenting procedures performed through blood vessels in the wrist as safe and effective as those done via the groin in urgent situations (i.e. heart attacks)? Currently the standard of care is to perform these procedures through the groin, which carries certain known risks and inconveniences to our patients.  Rates of complications may be higher in women for these procedures.  This study could significantly impact the way your cardiologist does these procedures in the future, and may require additional training for physicians less experienced in wrist-based procedures.

(3) Are we placing too many coronary stents? Currently, metal stents are implanted in coronary arteries for two main reasons — to restore blood flow to the heart muscle during a heart attack or an impending heart attack, and to reduce symptoms of angina.  However, research does suggest that medications and surgery are underutilized to reduce symptoms, particularly as stenting procedures have become more commonplace.  Some cardiologists are also placing stents inappropriately in patients without symptoms.  Researchers will present a nationwide review of over 500,000 procedures that will effectively provide a report card on whether cardiologists are doing too many of these procedures.  Given the current economic health care environment, this study has the potential (hopefully) to make some physicians think twice before doing some invasive procedures.

So get ready for a party!  At least the meeting is in New Orleans this year – try for a moment to imagine 30,000 cardiologists on Bourbon Street.  Okay, maybe don’t… but I’ll provide an update after the meeting!