By: David Pacitti

Roughly half a decade ago, major cardiovascular surgeries required nothing short of opening up the patient’s chest — an action that invited a host of potential complications. Often, recovery time was extremely slow, and morbidities ran high. Elderly patients, in particular, struggled to heal following aortic valve surgery. And the road back from even more complex repairs of the mitral valve and the left atrial appendage? Those journeys were an even longer and more arduous climb.

But a brave new world is dawning in cardiovascular repair — one illuminated by information that only medical imaging can provide. The groundbreaking procedure known as trans-catheter aortic valve replacement (TAVR) is enabling minimally invasive repair of a damaged aortic valve, with a computed tomography (CT) scan and real-time X-ray imaging, or fluoroscopy, offering physicians a vital land map for this revolutionary treatment option. Also, a CT scan now helps physicians determine whether the patient is even a viable candidate for TAVR, which may spare unnecessary surgery.

Similarly, a trans-esophageal echocardiogram (TEE) now guides physicians in their repair of the mitral valve and the left atrial appendage by providing highly coveted, minimally invasive access to the left side of the heart, where those delicate structures reside. Clearly, medical imaging is a crucial component of this dynamic new form of cardiovascular care, which can alleviate pain and anguish for patients in addition to shortening hospital stays.


Looking ahead, we can expect medical images to inform cardiovascular surgical procedures on a more routine basis, prompting an unprecedented level of synergy between radiologists, echo-cardiologists and interventional radiologists. Witnessing this blending of medical professionals is exciting for someone like me, who has a long history in the cardiovascular field. But, more significantly, the rise of these new image-guided therapies ushers in a higher quality of care at a time when fewer post-operative complications, reduced cases of infection, more rapid recovery times and more positive patient quality scores are all vitally important for hospitals if they are to survive — and thrive — in the changing U.S. health care landscape.

In addition to this increased incorporation of imaging in cardiovascular surgical procedures, we will see a change in the business structure of cardiovascular care delivery. Providers will be judged not just on the quality of care they provide, but also by the kinds of services they offer. Hospitals that can perform more advanced procedures such as mitral valve and left atrial appendage repair will tout this ability to offer “specialists within a specialty."

Where once the interventionalist performed a broad array of invasive cardiovascular procedures, a general interventional cardiologist will increasingly handle basic angioplasty, while another specialist will perform peripheral vascular procedures, along with interventional radiologists or vascular surgeons.


A recent health episode with my 86-year-old father (one that involved major surgery, heavy anesthesia and an extended recovery period) has further underscored for me the importance of less invasive, imaging- assisted cardiovascular procedures that can help ensure a better quality of life — particularly for our nation’s aging and elderly citizens. This rapidly growing segment of the U.S. population, which includes most of the baby boomer generation, deserves the best health care that we can provide. As president of a company with a broad portfolio of high-tech innovations that includes medical imaging systems, I’m gratified by the unmistakable signs I’m seeing that imaging is helping to create a picture of better cardiovascular health for thousands of Americans.

David Pacitti is president of Siemens Healthcare North America.