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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

A future of evolution
Better dosing and radiation reduction technologies have decreased risk for overexposure by ten times compared to five years ago. Sathanandam sees this trend continuing. “Five years from now, I think X-rays will be replaced with other modalities in imaging, especially MR, which has no radiation,” he said. “I think, eventually, [cath labs] will perform procedures with MR guidance rather than X-ray guidance.”

On the therapeutic side, Bortnick is already seeing new devices that she believes will further the number and complexity of conditions that can be addressed in the cath lab. “There are new innovations in mitral and tricuspid valve technologies for valve repair and replacement. There will be an array of devices to support failing hearts. Those are areas I already see blossoming.”

Marshall says all these factors will be the catalyst for the cath lab’s biggest change: its transition from a diagnostic unit to a therapeutic place. “One of the worst things that inadvertently happens to patients is peri-procedural bleeding. With new access techniques, like radial access, you’re much less likely to have a bleeding complication. These techniques make it safer to do outpatient procedures with same-day discharge.”

Cath labs will also grow outside the hospital in more outpatient and ambulatory settings that will be well equipped to handle low-risk and some complex conditions. "As technologies and our techniques become more refined, less invasive endovascular procedures will continue to replace traditional open surgeries,” said Modern Vascular’s Bhatti. “Considering the reimbursement, enhanced convenience for both patients and providers, and access to the same, and sometimes better, tools when compared to the hospital, I see this trend of providing vascular care in an outpatient setting continuing.”

Ultimately, the modern-day cath lab is in several transitions that are expected to change the options and locations in which cardiac trouble can be diagnosed and treated, says Snyder. "We are kinda at the same stage where colonoscopy was 10-15 years ago when they were mostly done in the hospital outpatient department setting. Now most are done in an ASC."

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