Imagine that you go in for your annual checkup 20 years down the road and your doctor performs an internal scan of your heart. They find a small hole between the chambers — a red flag for structural heart disease. Using health technology, they can show you, in a vivid 3D image, exactly how the blood is flowing incorrectly through your ventricles and atria, increasing your risk of stroke and other complications.
Your doctor isn't worried, though, because treatment is just a matter of using those images to create a biologically compatible patch and placing it over the hole. Your doctor has the 3D printer in their office and can perform it that day.
Three experts in Abbott's structural heart business — Dr. Augusto Pichard, Rick Olson and Barathi Sethuraman. Ph.D. — envision this as a realistic future, one in which health technology helps doctors identify and treat structural heart disease early and effectively to extend quality of life.
Forewarned is forearmed
According to the University of Chicago Medical Center, structural heart diseases can result in shortness of breath, loss of energy, strokes and mini-strokes, migraines, chest pain, coronary artery disease and potentially heart failure and death.
"Many people carry this disease silently, and so they don't have the opportunity for diagnosis and treatment until it becomes a problem," says Dr. Pichard, the medical director of Abbott's structural heart division and a professor of medicine at Georgetown University. Future treatment options will be able to detect issues sooner.
A better view
Currently, clinicians rely on technologies such as X-rays, CT scans, echocardiograms, ECGs and MRIs, but the next two decades will see a vast improvement in imaging studies.
"Our imaging today is hardly primitive, but compared to where it will be in the next 20 years, it will certainly seem that way in the future," says Olson, the divisional vice president of product development of Abbott's structural heart division. "With these advanced imaging techniques, we will be able to identify people with structural problems before the disease state becomes problematic."
"Enhanced CT imaging, the availability of 3D printing, new technologies for X-ray enhancement and software will allow us to do 3D vision in the cath lab," Dr. Pichard explains. "Integrating these imaging technologies, CT, echo, and X-ray will open up great windows to better understand the problem and how to better treat it."
Future healthcare technology will likely allow the physician to visualise the internal structures of the heart in high-definition 3D, complete with enhancements that denote electrical impulses and the oxygenation levels of the blood flowing through these structures. 3D printers could create the perfectly shaped device to fit that person's individual anatomy, right at the bedside.
Barathi Sethuraman, Ph.D., Abbott's divisional vice president of global clinical affairs, envisions that the treatment of structural heart disease will feature new health technology that will minimise — and possibly eliminate — the complications that come with today's treatments. In the future, through bioabsorbable technology or another method, the risks will no longer be an issue.
"There are biocompatible polymers that have been developed that provide a structure for the body to repair its own tissues," Olson said. "Over time, we expect that those polymers will become advanced enough to be reabsorbed by the body, and then you are left with a completely healed, all-natural-tissue heart."
A biotechnology approach would also resolve another pressing issue that faces the structural heart scientists of today: durability.
Today's artificial valves have a functional lifespan of about 15 years. While this is helpful, it's a pittance compared to the enduring quality of the heart's natural tissue. In the next 20 years, health technology could allow the heart to regenerate durable heart tissue that a person can depend on — with fewer adverse side effects.
Dr. Pichard firmly believes that the future of treating structural heart conditions will rely heavily on artificial intelligence.
"AI technology will be used to better understand the patients' needs and the best way to do the procedures, and it will give us a clearer understanding of outcomes," he said.
By aggregating and processing important patient data, genetics, history and clinical indicators from people around the globe, sophisticated software could create algorithms to guide treatment decisions.
Olson is optimistic that through advances in structural heart healthcare technology, clinicians will capture a segment of the population that is still waiting for its big breakthrough: people with heart failure.
"As we evolve in these products, we keep in mind how we can better utilise them to capture these heart failure patients before they progress down the disease path when there's nothing we can do to improve the quality or extend the length of their lives."
Sethuraman extends her vision beyond the next two decades to reveal an exciting prospect: treatments that are even less invasive, reducing the potential for complications.
"Today, we deliver these very small devices through very large catheters, which are extremely long," she said. "There may be a day when our products are injected and programmed to go to the affected area of the heart, and once there, they do what they need to do."
The impact of better structural heart care
"People fear stroke more than they fear death," Olson said.
Preventing stroke through better identification of structural heart conditions and treating them more effectively with fewer complications means:
- A longer lifespan for people with structural heart conditions
- Greater quality of life through improved autonomy
- Less strain on caregivers
- Decreased stress on the healthcare system
- Reduced healthcare spending
Future technologies can open up solutions and applications beyond today's treatment options. The landscape of structural heart treatments is on the brink of a revolution. With Abbott's innovative experts thinking beyond the realm of current possibility, further life-changing technologies for people with structural heart disease are on the horizon.
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