Unique Multidisciplinary Interventional Cardiology Center of ExcellencePublished: Feb 22, 2023
By Tampa General Hospital
The ICC at the TGH Heart & Vascular Institute provides state-of-the-art care for patients presenting with coronary artery disease and structural heart disease. The Interventional Center of Excellence offers a multi-disciplinary, collaborative approach across all programs.
The ICC routinely offers intravascular imaging with optical coherence tomography and/or comprehensive intravascular physiology assessment to almost every patient prior to percutaneous coronary intervention. Both tools are now considered the gold standard of care by all national cardiovascular scientific organizations. Additionally, we offer assessment of coronary microvascular dysfunction with technology to measure coronary flow reserve, index of microcirculatory resistance and assessment of vasospastic angina with acetylcholine testing in the catheterization lab.
For patients requiring complex PCI, interventional cardiologists at the HVI are skilled in rotational, orbital, and laser atherectomy as well as intravascular lithotripsy. Patients needing complex PCI with cardiogenic shock and/or ischemic cardiomyopathy routinely receive mechanical circulatory support device-assisted PCI with Impella and ECMO. Intravascular brachytherapy is available for patients presenting with drug-eluting stent/in-stent restenosis.
The ICC houses a mature chronic total occlusion (CTO) program with operators skilled at performing antegrade and retrograde CTO PCI. All complex coronary revascularization decisions are made under the umbrella of a multidisciplinary team that includes cardiologists, cardiac surgeons skilled in hybrid revascularization techniques, including robotic LIMA, and interventional cardiologists.
MINIMALLY INVASIVE VALVE PROGRAM (MIVP)
Delivering transcatheter therapies or a minimally invasive surgical approach allows patients to recover more quickly and safely. The HVI takes a comprehen-sive approach to all cardiac valves and has the largest experience in the U.S. with the newest tricuspid valve therapy. Patients are considered for well-established therapies like TAVR and MitraClip but also for inves-tigational devices by means of enrollment in clinical trials or compassionate use of new technologies not yet approved by the FDA. Because this field is evolving extremely fast, providing access to new technology within an academic medical center gives patients more options, unavailable elsewhere.
All patients are seen in a multidisciplinary valve clinic in conjunction with an interventional cardiologist and cardiothoracic surgeon. Most transcatheter valve therapies involve minimal sedation without general anesthesia, resulting in hospital discharge within 24 hours.
INTERVENTIONAL HEART FAILURE PROGRAM
The Interventional Heart Failure Program provides a robust array of treatments complementing our already strong commitment to advanced heart failure. This multidisciplinary program includes a dedicated nurse navigator, a heart failure advanced practice provider in addition to structural interventionalists and heart failure physicians. It is a hub for the coordinated and seamless treatment of heart failure patients using implantable monitoring devices and interventional protocols.
Innovative interventions for HF include baroreflex activation therapy targeting the activated sympathetic system and investigational devices such as mechanical left ventricular cavity reduction and atrial decompression for HF with reduced and preserved ejection fraction.
CONGENITAL INTERVENTIONAL PROGRAM
TGH is the primary investigation site for the multi-center, multi-national STITCH trial, which is an IDE trial for the NobleStitch, a transcatheter suture delivery system designed to close patent foramen ovale (PFO) for stroke patients. Other indications for PFO closure include platypnea-orthodeoxia syndrome and decom-pression illness in scuba divers. Dr. James Thompson, who is leading the trial, was the first physician in the U.S. to perform this procedure and has performed over 400 PFO closures using the NobleStitch.
In addition, the HVI’s Adult Congenital Intervention Program offers a wide variety of procedures, including placement of transcatheter pulmonary valves, stent dilation of coarctation of the aorta and interrupted aortic arch, atrial septal defect (ASD) and ventricular septal defect (VSD) closure, and other more complex procedures.
Our Neuro-Cardiac Program features a collaboration with Neurology to offer important diagnostic and treatment to prevent future stroke. This includes left atrial appendage occlusion (LAAO). The program also includes data-driven pathways for PFO closure and post-stroke rhythm monitoring by either short-term patches or implantable methods. The HVI’s unique collaborative structure has led to active participation in major multi-center clinical trials. In the LAAO space, our researchers are involved in a novel device trial, as well as studies testing the efficacy of this treatment approach in high-risk, under-represented patient populations. In the monitoring space, the program played a foundational role in developing a unique decision pathway to guide monitor choice, which will be tested nationally in a clinical trial. The neuro-cardiac team will continue to explore multi-faceted means to prevent stroke through collaboration and novel device technology.
Being at the forefront of cardiovascular medicine, with a pervasive philosophy of always having the patient at the center of all decisions, has positioned the ICC at TGH’s Heart & Vascular Institute as a preferred destination for patients from the Tampa Bay region and beyond.