Management of coronary chronic total occlusion (CTO) is individualized depending on the severity of symptoms, ischemia and on the severity of concomitant coronary artery disease (CAD). Treatment should include anti-anginal and other therapies to promote vascular health. Patients who remain symptomatic or have a large burden of ischemia despite maximal medical therapy can be considered for revascularization.

Computer-aided detection (CAD) software constitutes a set of algorithms which, using a pattern-recognition technique, aids the radiologist in detecting potentially diseased regions and lesions. It uses clinical images obtained from various imaging modalities. CAD has long since left behind its branding as a mammography tool and has now widened its application areas, becoming a valuable tool for detection and diagnosis in cardiology.

While risk for sudden death is increased four- to six-fold in patients who have experienced myocardial infarction, it remains challenging to identify the specific patients who will benefit from the standard-of-care therapy, namely, implantation of an implantable cardioverter defibrillator (ICD).

Transcatheter heart valves are viewed as the poster children devices representing the latest in cutting-edge cardiac therapy technology. For this reason, it is not surprising nearly all the readers’ nominations for DAIC’s “Most Innovative Heart Centers” included hospitals that created minimally invasive structural heart programs using the Edwards Sapien aortic valve and the Medtronic Melody pulmonary valve. Implementation of these programs usually involves the creation of a hybrid operating room (OR) and close collaboration of numerous specialists using a team approach to evaluate patients and determine the best course of treatment. Various therapy approaches are used, which can all be performed in the hybrid OR in a single surgical session.

We are at an inflection point with many aspects of medicine, not the least of which concerns choosing the correct tool to discover and manage coronary artery disease. The American landscape of clinical and imaging service providers is going through a major reshuffle. Coronary computed tomography angiography (CTA) is growing in utilization, taking its place as an established modality with AHA, ACC and ACR society-derived appropriate use standards. However, this growth in CT utilization and the resultant growth in per capita radiation exposure have elevated a public debate about the risk of causing cancer versus the value of its information.

Hospitals that have built multimillion-dollar, specialized cardiovascular hybrid operating rooms (ORs) are hoping to make a return on investment (ROI) by attracting more referrals with the latest technology. However, many hospitals with hybrid rooms say it takes more than new, cutting-edge technology to be successful — the real secret is collaboration of several specialties to decide what is best for the patient.