Press Release
hTEE Essential Tool for Mechanical Circulatory Support Patients
Standing Room Only
as Physicians Share hTEE Value at Symposium Held During ISHLT Annual Meeting
GARDEN CITY, NY -April 25, 2013 - (Excerpted, please click here to read the full press release) "Direct visualization of ventricular function reduces the complexity associated with the post-operative care of heart failure patients," said Peter Lee MD, Cardiothoracic Surgeon at Stanford Hospital. "hTEE has become an essential tool in our ICU to meet the critical, patient management needs created by use of these evolving, life-saving MCS technologies."
"The key to hTEE's impact on the care of MCS patients is the ability to assess the RV," commented Scott Roth MD, the Co-Founder/CMO of ImaCor. "RV dysfunction is prevalent in MCS patients, compounding their already high-risk profile. hTEE continuously provides a window to the RV, enabling clinicians to manage dysfunction from its inception. There is simply no other way to do this easily at the ICU bedside."
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The Jefferson Hemodynamic Transesophageal Echocardiography Conference Philadelphia, PA |
Photos
 | | Vanessa Cowen MD from Columbia University Medical Center assessing a patient with hTEE. |
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 | | Mary Sorensen MD from the Oregon Health and Science University accessing the three views tutorial on the Zura EVO. |
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 | | Attendees at the CT Trauma Conference gather around the ImaCor booth to learn about hTEE. |
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 | | Margarita Camacho MD presents at the hTEE Symposium in Montreal. |
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 | | Here, a physician asks a question of the speaker panel during the hTEE Symposium. |
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 Since 2009, the CTS Advanced Practice Team comprised of Acute Care Nurse Practitioners (NPs) and Physician Assistants (PAs) at Henry Ford Hospital (Detroit, MI) has been responsible for providing 24/7 coverage in the Cardiovascular Intensive Care Unit (CVICU). Working with senior staff surgical and intensive care physicians, they are responsible for initial assessment, initiation of treatment protocols, and continual assessment of critically ill patients during the pre- and post-op period following advanced cardiac and aortic vascular surgery.
hTEE PROTOCOLS
The hTEE probe is used on any cardiac surgery patient with an intraoperative or postoperative complicated course. It is also employed for patients with otherwise unanticipated hemodynamic instability, not responding as anticipated to conventional therapies. In addition, hTEE is protocol on all VAD patients.
CONCLUSION - A REPLICABLE MODEL FOR INCORPORATING hTEE IN THE CVICU
Henry Ford Hospital has demonstrated that hTEE technology can be successfully employed in the CVICU through the use of mid-level providers and protocols for usage in patients with complicated surgical or postoperative courses, unanticipated hemodynamic instability or VAD placement.
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hTEE-guided Resuscitation of a MVA patient
Dudley Benjamin Christie, III MD
Assistant Professor of Trauma/Critical Care/General Surgery
The Medical Center of Central Georgia, Macon, GA
(Excerpted, please click for full case report)
 A 58 year-old male involved in a motor vehicle accident suffered multiple fractures and a lacerated spleen. The patient was sent to the OR for surgery and transferred to the ICU. The patient became unstable within hours despite the large volume of resuscitation in the OR: HR 120 BPM, BP 90, lactate 3.5.
The patient was transferred to the ICU and remained intubated. Despite the seemingly large volume of resuscitation the patient received in the operating room, he remained tachycardic (HR 120-130's) with systolic blood pressure in the mid-90's.
(Figure 1: click here to link to cineloop)
hTEE Exam I
The mid-esophageal view revealed a tiny right ventricular chamber and hyperdynamic cardiac wall motion. The SVC view demonstrated a very collapsible and thin SVC (Figure 1), indicative of volume responsiveness. The transgastric view showed a left ventricular chamber with hyperdynamic wall-to-wall motion.
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Economic Opportunity in Critical Care
Richard Lanzillotto
Director of Regulatory Affairs and Quality Assurance
(Excerpted, please click to read full article)
Healthcare enterprises find their feet held to the fire due to increasing emphasis on doing more with less. More, meaning better clinical outcomes, and less, signifying the available resources that can be committed to the clinical tasks at hand. The enterprises are feeling pressure from insurance payers, Congress and taxpayers, all of which increasingly scrutinize the effectiveness and value of healthcare providers. The providers are responding in kind. Process improvement initiatives like Six Sigma are growing in popularity. These are designed to reduce the variation and uncertainty in patient care and hence reduce cost. Accountable Care organizations are being formed not only to deliver quality healthcare but to be incentive-based profit-making business structures.
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Heart Failure Leaders Present at hTEE Symposium in Montreal
Four leaders in critical care cardiac surgery presented at the hTEE Symposium on April 24th during the ISHLT 33rd Annual Meeting in Montreal, Canada. The speakers, Margarita Camacho MD and Claudia Gidea MD from Newark Beth Israel, Nicholas Cavarocchi MD from Thomas Jefferson University Hospital and Peter Lee MD from Stanford University Medical Center described the impact hTEE has made in their respective practices. Highlights of the event were captured by a videographer.
To view the 3-minute video of Margarita Camacho MD's presentation, please click here.
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Multidisciplinary transplant teams joined us in Montreal for the hTEE Symposium to learn from physicians how hTEE is used to optimize the care of transplant, ventricular assist device and extracorporeal membrane oxygenation patients. Turnout was high, and the clinical discussion was extremely rewarding. "hTEE has been an invaluable tool, and it has made a huge impact in our practice. I have been waiting for this technology for 20 years" commented Margarita Camacho MD during the symposium. "hTEE has become an essential tool in our ICU," added Peter Lee MD, Cardiothoracic Surgeon at Stanford Hospital. I thank Margarita Camacho MD and Claudia Gidea MD of Newark Beth Israel, Nicholas Cavarocchi MD from Thomas Jefferson University Hospital, and Peter Lee MD of Stanford University Medical Center for their efforts in educating their peers on hTEE.
There is a growing trend that advanced practice providers like nurse practitioners (NPs) and physician assistants (PAs) are taking on greater clinical responsibilities in the ICU. This trend is not surprising, as the most complex, critically-ill patients require more attention and resources, consuming over 80% of overall ICU costs. Patients with multiple comorbidities are often the norm in this environment, and their hemodynamic instability can lead to a cascade of complications. At ImaCor we are seeing a similar growing trend of advanced practice providers using hTEE with greater frequency and effectiveness.
Sharon Matkosky ACNP-BC from Henry Ford Hospital is a leader in implementing hTEE with advanced practice provider teams and authored this month's clinical insights article. It is a testament to their skills that "consistent levels of advanced clinical support has contributed to the decrease in episodes of 'failure-to-rescue,' improved continuity of care, improved patient/physician satisfaction, and a substantial improvement in the adherence to quality core initiatives." I thank Sharon for her valuable contributions, and believe we have only scratched the surface of the more prominent role that advanced practice providers, NPs and PAs, will play in the future.
We welcome two new distinguished users to our family - the University of Cincinnati Hospital and San Antonio Military Medical Center.
With kind regards,
Peter Pellerito
President & CEO
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