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The continuing evolution of the cath lab

por John R. Fischer, Senior Reporter | April 12, 2021
Cardiology Operating Room
From the April 2021 issue of HealthCare Business News magazine

These advancements mean conditions that once required open surgery are now treatable with minimally invasive procedures, where patients can go home the same day.

“We don’t have to cut a patient open or stitch them up, so there’s a big trend to doing everything less invasive,” Dr. Shyam Sathanandam, director of the cardiac catheterization laboratory at Le Bonheur Children’s Hospital in Memphis, told HCB News. “As a result, the number of procedures performed in current cath labs throughout the country are going up, so more and more hospitals are building new cath labs. Even existing hospitals that have cath labs are adding more.”

And while regulatory changes have been a long-standing and difficult to overcome barrier, they have finally caught up to the science and permit ASC cath labs to grow in the therapeutic space, says Dr. Rick Snyder, an interventional cardiologist and president of HeartPlace, a cardiology and cath lab practice in Dallas. "Private payers started to pay for therapeutic procedures first years ago but Medicare was very resistant. Medicare did not even cover PCI (Percutaneous coronary intervention) until 2020 for the first time."

Modern Vascular: Cath labs today can perform fluoroscopy but also intravascular imaging, intravascular physiology, integrated CT imaging to guide procedures, and are equipped with newer left ventricular support devices.
(Photo courtesy of Modern Vascular)
Heading out of the hospital
Most patients want to avoid hospitals as much as possible, instead preferring ambulatory and outpatient settings, where they can typically receive the care they need at a lower price and closer to home.

“Especially in the COVID era, patients do not want to go to the hospital to have procedures performed. If procedures can be accomplished in the ambulatory setting, you can more carefully control that only COVID negative patients come through the doors; that’s not true in a hospital,” said Dr. J. Jeffrey Marshall, chief of the Northside Cardiovascular Institute. “In the future, due to technology like coronary CTA/FFRCT, the diagnostic procedures will and are starting to move out of the hospital and into the ambulatory surgical settings. Low-risk therapeutic procedures may stay in the ambulatory surgery centers, with only higher-risk therapeutic procedures being performed in the hospital.”

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