Technology and clinical advancements in cariology have accelerated in the last decade. Here, five leaders discuss which innovations excite them most.
Gopi Dandamudi, MD. Executive Medical Director of the Center for Cardiovascular Health at Virginia Mason Franciscan Health (Tacoma, Wash.): We instituted an artificial intelligence program in our cardiovascular service line, which allows us, in real time, to analyze the entire population we're caring for. We can look at which patients would benefit from other therapies and identify instantly who is not on the right drugs or needs different care based on current guidelines. It's an amazing amount of data that we got so quickly.
The AI can also identify the rate of progression based on all the risk factors for patients and help us better allocate limited resources. It can also help us manage low-risk patients differently and give us an overview of the community's risks. Given the staff shortages issues and the limited cardiologists expected to join the field in the future, we can't feasibly manage patients in the long run. Something has to change, and that's where I see AI helping.
Alina Joseph. Executive Director of Heart and Vascular Services at Kettering (Ohio) Health Network: We are living in an age of technology and some of the advances that are most interesting to me are related to minimally invasive and structural heart. The things we can do with a couple of portholes that's minimally invasive in heart surgery and thoracic surgery is just amazing. And they're constantly making new advances. We are about to get involved with an additional clinical research trial and we're about to celebrate our 1,000th TAVR here at the main campus, which is just a really great milestone. We're also starting to delve a lot more in valve replacements or valve repairs.
Meera Kondapaneni, MD. Chief of Cardiology at MetroHealth (Cleveland): The two things that excite me are first, the medications we have that can specifically treat inflammation and prevent heart attacks and heart disease; and second is transcatheter aortic valve replacement. We are now trying to do the transcatheter edge to edge repairs. It's not as sophisticated yet as the TAVR, but every year new ways to repair mitral and tricuspid valves with this TEER technique improve. We are able to get these impressive treatments to people who did not have options up until a decade or two ago.
Mitchell Weinberg, MD. Chair of the Department of Cardiology at Staten Island University Hospital (New York City): I think AI is truly important because it is going to potentially change healthcare as we distribute to large populations. AI really has the ability to prevent disease upstream even more effectively than humans. Once we overcome the boundaries for AI, we can change healthcare — and I think that's very exciting. It can also reform the provider-patient relationship. Healthcare providers often feel distant from the patient because of the heavy data burden that the electronic health records require. We're looking at the patient less, establishing less rapport and its wearing on people. But if AI can shoulder that burden instead of the provider, I think we'll be able to bring people and their providers together a little bit.
AI could also generate interpretation of diagnostics and do triage. The system could look at the variable presented and use big data to say "this patient is at risk for heart failure, and these are the next steps." In every part of healthcare, there's going to be opportunity, but the big challenge we're all struggling with is medical regulation and concerns about privacy. I think we're going to have to marry those two and create an appropriate compromise before we figure out the true timeline for implementing all AI can do.
Jonathan Weinsaft, MD. Chief of Cardiology at Weill Cornell Medicine and NewYork-Presbyterian (New York City): I think when we talk about vascular heart disease, I'm particularly excited about new technological developments for percutaneous valves that are even more similar to native valve physiology and more durable. I'm also excited about the potential of imaging to identify those patients who are going to have durable responses to … therapies and valve technologies and to inform how we should best insert those valves to get a good outcome is particularly exciting.
I think when we look at preventative cardiology, I'm particularly excited about leveraging the power of molecular cardiology of immunology to develop targeted therapeutics to not only treat established plaque but see plaque regression or actual ratio of plaque itself. I think that we're on the cusp of treating people with targeting immunotherapies and eliminating the presence of an atherosclerotic plaque in a vessel in a way that's durable.