I am fascinated with how technology has advanced and how it works, especially to fix cardiovascular diseases. I would like to share with everyone the coolest procedure that fixes aortic stenosis, called transcatheter aortic valve replacement, best known as TAVR. This procedure is for patients who suffer from severe aortic stenosis and whose advanced age puts them at high risk for death if they were to have open-heart surgery. The University of Iowa Heart and Vascular Center is one of a select group of centers across the nation, and the first in Iowa to offer this procedure to those qualified candidates (University of Iowa Hospitals and Clinics, 2015). In 2011, this center was the first in the nation to receive certification for its cardiac valve program from The Joint Commission (University of Iowa Hospitals and Clinics, 2015). It is important to note that this procedure is minimally invasive for the repair and replacement of the aortic valve. This procedure can be performed through two distinct sites, either from the patient’s thigh through the femoral artery or through a small incision on the lower left side of the patient’s chest. Sometimes the elderly have disease of the leg blood vessels; hence, the chest can be an alternative site (University of Iowa Hospitals and Clinics, 2015).

Basically, with this procedure, the damaged aortic valve is replaced with a prosthetic valve. This new technology uses a catheter inserted through a small incision in a patient’s thigh that travels though blood vessels and can be used to replace a person’s failing heart valve in the aortic artery. This procedure involves a team of interventional cardiologists, cardiac surgeons, and imaging specialists of the heart (University of Iowa Hospitals and Clinics, 2015). The recovery of this procedure is faster as opposed to open-heart surgery and it has proven to be a successful procedure. As we know, the blood passes through the aortic valve and then into our body where it perfusses our tissues and organs. If the valve is stenotic, then small amounts of blood can pass through this valve and symptoms develop such as shortness of breath and one can easily become tired. In the story of a 90-year-old woman, she would complain of being tired on a day-to-day basis and that led her to visit her doctor (University of Iowa Hospitals and Clinics, 2015). She then was diagnosed with aortic stenosis and the doctor recommended for this procedure. She agreed to undergo TARV and she admits it was the best decision made for improving her health. After four days, she was allowed to go home and she says she had no pain at all after the procedure (University of Iowa Hospitals and Clinics, 2015). She recommends this procedure for those who need it and overall she is doing well. Patients who don’t get treated for aortic stenosis can develop heart failure or cardiac arrest, and most importantly can die within a year of this problem (University of Iowa Hospitals and Clinics, 2015). By the way, check out the article below and you can watch the animated video of this procedure, which is amazing!

Reference:

University of Iowa Hospitals and Clinics. (2015). Transcatheter aortic valve replacement. Retrieved    from        http://www.uihealthcare.org/2column.aspx?id=227967

University of Iowa Hospitals and Clinics. (2015).

Alma’s story: New lease on life.       Retrieved from    http://www.uihealthcare.org/2column.aspx?id=230803

While conducting research for this week’s assignment regarding the newest cardiovascular technology, I came across this great article discussing heart implants and them being “tailor-made” (Bourzac, 2014). Current cardiac implants, such as pacemakers and defibrillators, are not custom made as they are basically “one size fits all” (Bourzac, 2014, para. 1). The article discusses researchers who have created a personalized heart sensor using a 3-D printer and their utilization of a stretchy material to create a perfect fit that would increase the level of monitoring and treatment of cardiac implants (Bourzac, 2014). The stretchy material would increase the effectiveness of oxygen monitoring, strain gauges, electrodes, and temperature monitoring as it would be customized to the person’s heart (Bourzac, 2014). An interesting concept presented in the article is the idea of sensors being placed on cardiac implants that could measure acidic conditions (Bourzac, 2014). In addition, light sensors could be placed on this stretchy material and would “provide information about heart-tissue health by identifying areas with poorly oxygenated blood, which is less transparent to light,” and could ultimately identify the occurrence of a myocardial infarction (Bourzac, 2014, para. 5). I think any time we are able to customize a treatment, we are able to better serve our patients and this concept of 3-D printing will most certainly contribute to higher quality patient care.

References:

Bourzac, K. (2014). Heart Implants, 3-D- – Printed to Order. Retrieved from:http://www.technologyreview.com/news/525221/heart-implants-3-d-printed-to-  order/

Due to the advancements of technology, Jenna and I thought it would be beneficial to research current cardiac applications available on our smart phones from the patient’s perspective; HeartDecide was quickly discovered. This free application, available for all Apple products, introduced an all-encompassing cardiovascular easy-to-use tool for patients to understand their respective cardiac anatomy, conditions, and procedures. Although this application was released in 2012 by Orca Health, Inc. at Harvard University, it is continuously updating its information with a copyright date until 2015. Once downloaded, the user has the option of entering the application as a doctor, nurse, or patient. We reviewed the information as if we were a patient, browsing to find a specific medical condition. For instance, we searched “heart attack” via the “conditions” tab and found a simple video lasting 1 minute and 32 seconds. In addition, there are written materials provided after the video by swiping the screen to the left. Here we found a frequently asked question and answer section detailing “what is a heart attack,” “what causes a heart attack,” “what are the symptoms,” and “how is a heart attack treated.” Furthermore, there are numerous conditions available to search such as angina, atherosclerosis, atrial fibrillation, sudden cardiac death, heart failure, and many more. We both believe this to be a great informational tool for patients in order to understand more about their clinical condition.

HeartDecide can be used as a supplemental tool to the education provided by the cardiologist. Often, when patients are newly diagnosed with a cardiac condition or a trauma occurs, they are not able to fully comprehend and/or process the education provided by the clinicians. They can learn great detail about their condition(s) on their own time once they are psychologically prepared to do so. Therefore, we highly recommend this application to all clients with a cardiac condition <3

Recognizing those at risk for CVD is a primary prevention. I found a study that compared a the use of a non-laboratory, paper-based CVD risk assessment chart tool to a mobile phone CVD risk assessment application. The goal was to compare the time it would take to train community health workers, the duration of screening. The paper-based tool was created to avoid laboratory costs; the tool substitutes the body-mass-index for blood lipid level to calculate the CVD risks. This makes screening easier and the best part is that it is cost effective. The development of the mobile device was so it could automatically calculate CVD risks scores with less room for error due to manual calculations and so it could be directly carried into communities. This is an excellent resource that is being used in low-resource settings. The mobile device is also better than the paper-based tool because it can be used by those with a lower set of skills.
The use of the mobile device had some pros and cons. One positive outcome was that it took less time to train personnel in the use of the mobile device compared with the paper-based tool. The mobile device was faster at yielding results. Many of the health care workers felt that there was less room for error because they did not have to manually do calculations. Some cons were that in previous times the visual chart was being used to explain to clients what their results meant. Many also felt that having the detailed chart gave them a better understanding of calculating the risk but with the phone everything was basically done for them.
I really liked this article because it talked about how technology is being used in lower income settings were detecting those at risk for CVD is a high priority. This mobile device it taken into communities, which in my opinion is the way to go because some clients have difficulties with transportation. The device can then calculate the client’s CVD risk and they are then educated or referred to a health care provider. Having a tool that requires little training, has little room for error, and yields quicker results will enhance CVD screening. This is important because the more people that are being screened the more people we can prevent from developing CVD. A con that I would also have trouble with is the fact that the machine is doing everything and when compared to the paper-tool where the calculations were being done and understood by the workers I am not sure how well the workers would understand what the results actually mean when using this technology. The article mentioned that this is being done in South Africa but this would be nice to have in our communities where many are not screened for CVD as a result of more than one obstacle.

References

Surka, S., Edirippulige, S., Steyn, K., Gaziano, T., Puoane, T., & Levitt, N. (2014). Evaluating the use of mobile phone technology to enhance cardiovascular disease screening by community health workers. International Journal Of Medical Informatics, 83(9), 648-654. doi:10.1016/j.ijmedinf.2014.06.008