New treatments for America’s leading health problem

November 29, 2018 | by Mark Goodwin, M.D.
Categories: Healthy Driven Hearts

(This story is adapted from Crain’s Custom Media “Cardiac Care Roundtable.”)

Cardiovascular disease is our nation’s leading health problem, with more than 600,000 Americans dying from heart disease each year, according to the Centers for Disease Control and Prevention.

Mark Goodwin, M.D., system medical director for the Cardiac Innovations and Structural Heart Center® at Edward-Elmhurst Health, shared his insights on the latest research and treatment with Crain’s Custom Media.

What developments have you seen in cardiac care over the last five years?

Dr. Mark Goodwin: Increasingly, complex coronary artery disease can be treated with stents. Recent surgical innovations enable patients who are considered too high-risk for open heart surgery to have a new lease on life. One example is new technology that allows physicians to remove chronic blockages by going through the patient’s blood vessels.

What makes your institution stand out in its cardiac care?

MG: Our heart team’s collaboration includes the use of cutting-edge procedures and devices, ongoing research and clinical trials. We’re also a teaching site where physicians come from across the country and around the world to be trained in the latest techniques. We’re a leader in Illinois in specialized procedures and use of devices, including fractional flow reserve with coronary CT angiography (FFRct). The technology uses noninvasive coronary CT angiography and artificial intelligence to create a personalized 3D model of each patient’s arteries. It uses a powerful complex algorithm and provides actionable information for physicians by assessing the impact of blockages on blood flow.

What unique surgical and other treatment options do you offer cardiac care patients?

MG: We treat a number of complex heart conditions with minimally invasive options. For patients who have been told traditional surgery is too risky, we provide lifesaving procedures that aren't available in most community hospitals, including leading-edge treatments for severe aortic stenosis, degenerative mitral regurgitation, atrial fibrillation (AFib), chronic total occlusions and advanced heart failure.

What role does technology play in your institution’s cardiac care offerings?

MG: Edward-Elmhurst uses a variety of new procedures and devices, such as valve replacements, implant alternatives and other minimally invasive techniques, to treat a wider range of diseases. Artificial intelligence allows us to diagnose patients easier, less invasively and more accurately.

What clinical trials are available to cardiac patients at your institution?

MG: Our clinical trials feature transcaval TAVR, a noninvasive, through-the-skin procedure for heart valve replacement developed for patients with small pelvic arteries, or who otherwise are considered too high-risk for the traditional TAVR procedure. Other clinical trials at Edward-Elmhurst Health include studying the effectiveness of procedures and devices to: break up plaque in peripheral arteries; treat atrial fibrillation, pulmonary emboli and acute myocardial infarction; assess the use and performance of stents; protect patients at high risk of acute kidney injury; and reduce the risk of stroke without the need for blood-thinning medication.

How does your institution identify individuals at risk for cardiovascular disease, and help them manage that risk?

MG: HeartAware, a free online health risk assessment, helps determine an individual’s risk for heart disease. High-risk individuals then receive a special offer for a heart scan, also known as cardiac calcium scoring. It’s the safest and most accurate screening tool for detecting early build-up of calcium in the coronary arteries — the most common cause of heart disease. Heart scans are simple, painless and take just 15 minutes. Twice a year, Edward-Elmhurst Health offers heart scans at a discounted rate to anyone age 40 or over who’s concerned about their heart health. Patients also receive a blood pressure check, and cholesterol and blood sugar screenings. A registered nurse meets with each individual to review scores and help develop a customized plan, including more testing if an issue is detected.

How does your institution support cardiac care patients and their families?

MG: Our Cardiac Innovations & Structural Heart Center evaluates patients, determines next steps and puts a plan in place all in the same day so there’s no waiting and worrying. Educating families about the disease and what to expect is part of the process. Social services and spiritual support are available to all. Our cardiac rehabilitation program ensures a bridge from the hospital to normal activities. Plus, for patients with heart failure and their caregivers, we offer a special wellness-focused clinic and support group.

How is your institution involved with efforts to prevent heart disease?

MG: Our heart and vascular experts work with patients to provide ongoing support. We offer medically-supervised lifestyle management and healthy eating programs, smoking cessation, heart failure support groups, prediabetes prevention and diabetes clinics, and even assistance for cancer patients whose treatment may cause unwanted heart-related side effects. In addition, we offer community education classes throughout the year on different heart-related topics, such as information on AFib and heart arrhythmias, and women and heart health.

What impact is America’s aging population having on cardiovascular disease diagnosis and treatment?

MG: Prevention and screening are even more important. Increasingly more patients require treatment with medical therapy as well as minimally invasive procedures. With the use of genomics and artificial intelligence, developments in cardiac related technology will likely grow quickly to try to keep up with the aging population.

What developments do you expect to see in cardiac care in the next five years?

MG: We’ll see continued improvements in medical therapy with genomics and artificial intelligence. Technology will allow doctors to utilize virtual or remote visits, and artificial intelligence will lead the way to better therapy for each patient. With these advances, fewer people will die from heart-related issues such as cardiogenic shock, where the heart can’t pump enough blood, which can result in a heart attack.

Learn more about Dr. Goodwin.

Learn more about the Cardiac Innovations & Structural Heart Center.

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