By Wayne Batchelor, MD; Matthew Sherwood, MD, MHS; Behnam Tehrani, MD; and Brett Atwater, MD
Heart disease is the number one cause of death in the United States. For those facing complex cardiovascular conditions, access to cutting-edge treatments can make all the difference. Inova Schar Heart and Vascular offers a comprehensive range of services, from preventive care to advanced interventions, for patients with cardiovascular or lung diseases. Here are a few examples of the latest cardiovascular care innovations available at Inova.
For Tricuspid Valve Disease: TriClip
The job of the heart’s tricuspid valve is to separate the heart’s top right chamber from its bottom right chamber. It acts like a one-way door, opening when the heart relaxes, letting blood flow through, and closing when the heart beats, stopping blood from flowing the wrong way. When the tricuspid valve stops working effectively, blood can flow back into the upper chamber instead of moving into the lower chamber. This is called “tricuspid valve regurgitation” — and it can be difficult to treat.
That changed in April 2024 with the U.S. Food and Drug Administration’s (FDA) approval of TriClip, the only minimally invasive option to treat severe tricuspid regurgitation. TriClip gives hope to patients whose symptoms, such as fatigue and shortness of breath, are affecting their quality of life, even with medication, but who may not be able to undergo open heart surgery to fix it.
Inova’s multidisciplinary structural heart team has extensive experience in repairing and replacing all types of heart valves and was a top enroller in the clinical trial that demonstrated this device’s safety and effectiveness. The TriClip procedure requires the expertise of heart failure cardiologists, precise advanced cardiac imaging, cardiothoracic surgery and interventional cardiology, all working as a team. The breadth and depth of knowledge at Inova Schar Heart and Vascular, combined with well-coordinated teamwork, makes it possible for Inova to offer this promising new treatment.
For Coronary Artery Disease: In-Stent Restenosis
Cardiac catheterization and placement of cardiac stents is a highly effective, common procedure to treat blockage of the coronary artery. However, up to 10 percent of coronary artery stent procedures develop blockages that return at the site of the stent. Inova Schar Heart and Vascular at Inova Fairfax Hospital was the only hospital in the Washington, DC, metropolitan area selected to participate in the clinical trial used to demonstrate the effectiveness of a device to treat in-stent restenosis.
The AGENT Drug-Coated Balloon, now fully approved by the FDA, is a procedure available in a limited number of U.S. hospitals including Inova Fairfax Hospital. It is performed in a cardiac catheterization lab, with most patients returning home the same day.
Prior to the introduction of the new procedure, interventional cardiology teams were limited to conventional balloon angioplasty as the primary treatment strategy. Data from the clinical trial demonstrated the use of the AGENT device as a lower-risk treatment.
For Uncontrolled High Blood Pressure: Ultrasound-Based Renal Denervation Therapy (uRDN)
uRDN is a promising new first-of-its-kind ultrasound-based therapy that can potentially, in a one-time procedure, treat uncontrolled high blood pressure for life. It is available for patients whose blood pressure remains high despite lifestyle changes and who already take three or more blood pressure medications.
Inova is proud to introduce uRDN to the region. It is a long-awaited treatment option that marks a significant milestone in Inova’s commitment to innovative healthcare solutions. Inova’s team is hopeful about the broader impact of uRDN across the spectrum of cardiovascular disease.
For Atrial Fibrillation (AFib): Pulsed Field Ablation (PFA)
In the U.S., only 60 to 90 percent of traditional thermal ablations used to treat AFib are successful. Since 2021, Inova Schar Heart and Vascular has participated in several clinical trials for PFA. Instead of using heat or cold thermal energy to interrupt misfiring electric signals in the heart that are causing heart rhythm problems, PFA uses short bursts of high-frequency electricity. Compared to thermal ablation, PFA may improve the safety and effectiveness of ablation procedures, particularly for patients with persistent AFib.
In 2023, Inova began offering PFA for AFib by participating in clinical trials. In 2024, Inova began offering PFA using FDA-approved systems. Most recently, Inova has added the Affera PFA system for more advanced forms of AFib, specifically those who have been in AFib for many years.
Inova’s commitment to pioneering promising new devices and techniques, whether through early adoption or in clinical trials, benefits patients by providing them therapeutic solutions not widely available.
To Prevent Dangerous Heart Rhythms: Extravascular ICD (Implantable Cardioverter-Defibrillator)
Recently approved by the FDA, the Aurora EV-ICD system, an extravascular ICD, includes several methods for interrupting dangerous heart rhythms before they can cause sudden death. The device is implanted under the skin and the breastbone rather than inside the heart, potentially reducing the likelihood of damage to heart valves and blood stream infection.
Inova is one of the first hospitals in the region to offer this technology. To be able treat dangerous heart rhythms with less pain and without risking damage to the heart valves or increasing infection risk is a key breakthrough.
Two Pacemaker Innovations: Bachmann’s Bundle Pacing and AVEIR Dual Chamber Leadless Pacemaker
Inova is the only hospital in the Washington, DC, metropolitan area to offer Bachmann’s bundle pacing – a new method of atrial pacing that may reduce the risk of AFib after a pacemaker implantation. By stimulating Bachmann’s bundle, which connects the heart’s left and right upper chambers, pacing closely approximates the normal electrical conduction pathway, leading to reduced risk of AFib.
The AVEIR dual chamber leadless pacemaker is a third-generation technology that expands the number of patients who can use a leadless pacemaker. It is a major step forward that allows beat-to-beat synchrony while providing heart-rhythm control therapy to both the atrium and ventricle. This device can also treat patients who have both sinus node dysfunction and atrioventricular block.
Better Heart Imaging for Heart Valve Procedures: VeriSight Pro
Many heart procedures rely on specialized cardiac imaging technologies to plan and execute procedures. The latest technology at Inova brings intracardiac echocardiography into the future by miniaturizing the 3D ultrasound catheter. Physicians thread a tiny, wire-like catheter up into the heart from a blood vessel in the groin. From there, they take high-quality, 3D ultrasound images of the heart from within the heart itself.
This means that instead of having to undergo a transesophageal echocardiogram, which requires the patient to go under general anesthesia, heart teams can get these detailed images with a much less invasive procedure. It uses less anesthesia, is less invasive and is easier to recover from, so most patients are able to go home the day of the procedure. It makes a big difference in patient care, while providing the same high-quality, detailed images of the heart.
The technology is useful for heart valve procedures such as for tricuspid valve regurgitation and stroke risk reduction procedures for AFib.
Wayne Batchelor, MD, MHS, MBA, FACC, FSCAI, who formerly served in several senior leadership roles within Inova Schar Heart and Vascular including as System Director of Interventional Cardiology, is now President, Inova Medicine Service Line.
Matthew Sherwood, MD, MHS, is System Director for Interventional Cardiology and Co-Director of Inova’s Structural Heart Disease Program.
Behnam Tehrani, MD, is Associate System Director for Interventional Cardiology and Executive Director of Cardiac Catheterization Laboratories for Inova Schar Heart and Vascular.
Brett Atwater, MD, FHRS, is D’Aniello Chair, Atrial Fibrillation and Section Chief, Electrophysiology at Inova Schar Heart and Vascular.
Feature image, stock.adobe.com
