Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-08T15:31:07.696Z Has data issue: false hasContentIssue false
  • English
  • Français

Giving up knowledge is almost never a good idea: an interview with Dr Evan Zahn

Published online by Cambridge University Press:  30 October 2019

Sebastian Góreczny Open the ORCID record for Sebastian Góreczny [Opens in a new window]  and
Evan M. Zahn
Sebastian Góreczny*
Affiliation:
Department of Cardiology, Polish Mother’s Memorial Hospital, Research Institute, Lodz, Poland Department of Cardiology, Colorado Children’s Hospital, Aurora, CO, USA
Evan M. Zahn
Affiliation:
Guerin Family Congenital Heart Program, Smidt Heart Institute and Department of Pediatrics, Cedars-Sinai Medical Center, Los Angeles, CA, USA
*
Author for correspondence: S. Góreczny MD, PhD, Department of Cardiology, Polish Mother’s Memorial Hospital, Research Institute, 281/289 Rzgowska St, 93-338 Lodz, Poland. Tel: +48 42 271 14 78; Fax: +48 42 271 14 70; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Extract

The history of congenital interventional cardiology has seen numerous groundbreaking innovations typically related to the introduction of a new device or a novel treatment technique. Similarly, imaging of cardiac defects has changed dramatically over the past decades, although some of the advancements have seemed to omit the catheterisation laboratories. Rotational angiography, one of the imaging techniques for guidance of cardiac catheterisation currently referred to as “advanced”, in fact was described already in 1960s.1 More recently its improved version, including three-dimensional reconstruction (3DRA), became a valuable intra-procedural imaging tool in interventional cardiology and neuroradiology.2 Dr Evan Zahn was one of the pioneers of 3DRA in the field of congenital cardiology, setting an example for many to follow. With his innovative publication and subsequent lecture at 2011 Pediatric and Adult Interventional Cardiac Symposium (PICS-AICS) on “The Emerging Use of 3-Dimensional Rotational Angiography in Congenital Heart Disease” he motivated many to explore benefits of this modality to strive for improved procedural outcomes and reduced patients’ burden of cardiac catheterisation3. I was one of those to take Dr Zahn’s thoughts and implement them into routine workflow.4–6 However, almost a decade after Dr Zahn shared his important work, despite tremendous efforts by teams from Utrecht, (Netherlands) and Columbus (Ohio, United States of America) to popularise 3D imaging in catheterisation laboratory during dedicated meetings, two-dimensional (2D) angiography does not seem to be threatened in many, otherwise-progressive, laboratories. During the recent 30th Japanese Pediatric Interventional Cardiology (JPIC) meeting I had the opportunity to ask Dr Zahn why giving up knowledge is almost never a good idea, what is technology’s natural order of things, and why the technology has to be more than just exciting, pretty, and new.

Keywords

Congenital heart defectsCardiac catheterizationThree-dimensional imagingThree-dimensional guidanceFusion imagingPercutaneous interventions
Type
Interview
Information
Cardiology in the Young , Volume 29 , Issue 12 , December 2019 , pp. 1419 - 1425
Copyright
© Cambridge University Press 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Snider, JR, Klopfenstein, K, Mendelsohn, EA, Crow, NE. Rotational arch aortography. Am J Roentgenol Radium Ther Nucl Med 1967; 100: 341–343.CrossRefGoogle ScholarPubMed
van der Stelt, F, Siegerink, SN, Krings, GJ, Molenschot, MMC, Breur, JM. Three-dimensional rotational angiography in pediatric patients with congenital heart disease: a literature review. Pediatr Cardiol 2019; 40: 257–264.CrossRefGoogle ScholarPubMed
Zahn, EM. The emerging use of 3-dimensional rotational angiography in congenital heart disease. Congenital Cardiol Today 2011; 9: 1–13.Google Scholar
Góreczny, S, Dryżek, P, Moszura, T, et al. Rotational angiography in monitoring of covered CP stent implantation in patient with critical aortic coarctation and patent ductus arteriosus. Kardiol Pol 2012; 70: 505–507.Google ScholarPubMed
Moszura, T, Góreczny, S, Dryzek, P, Niwald, M. Three-year-old child with middle aortic syndrome treated by endovascular stent implantation. Pediatr Cardiol 2013; 34: 1027–1030.CrossRefGoogle ScholarPubMed
Góreczny, S, Dryżek, P, Moll, JA, Moszura, T. Left pulmonary artery stent implantation guided with three-dimensional rotational angiography (3DRA). Folia Cardiologica 2015; 10: 49–54.CrossRefGoogle Scholar
Berman, DP, Khan, DM, Gutierrez, Y, Zahn, EM. The use of three-dimensional rotational angiography to assess the pulmonary circulation following cavo-pulmonary connection in patients with single ventricle. Catheter Cardiovasc Interv 2012; 80: 922–930.CrossRefGoogle ScholarPubMed
Phillips, AB, Nevin, P, Shah, A, Olshove, V, Garg, R, Zahn, EM. Development of a novel hybrid strategy for transcatheter pulmonary valve placement in patients following transannular patch repair of tetralogy of fallot. Catheter Cardiovasc Interv 2016; 87: 403–410.CrossRefGoogle ScholarPubMed
Fagan, TE, Truong, UT, Jone, PN, et al. Multimodality 3-dimensional image integration for congenital cardiac catheterization. Methodist Debakey Cardiovasc J 2014; 10: 68–76.CrossRefGoogle ScholarPubMed
Hascoët, S, Warin-Fresse, K, Baruteau, AE, et al. Cardiac imaging of congenital heart diseases during interventional procedures continues to evolve: pros and cons of the main techniques. Arch Cardiovasc Dis 2016; 109: 128–142.CrossRefGoogle ScholarPubMed
Glöckler, M, Koch, A, Halbfaß, J, et al. Assessment of cavopulmonary connections by advanced imaging: value of flat-detector computed tomography. Cardiol Young 2013; 23: 18–26.CrossRefGoogle ScholarPubMed
van der Stelt, F, Krings, GJ, Molenschot, MC, Breur, JM. Additional value of three-dimensional rotational angiography in the diagnostic evaluation and percutaneous treatment of children with univentricular hearts. EuroIntervention 2018; 14: 637–644.CrossRefGoogle ScholarPubMed
Góreczny, S, Ivy, D, Anderson, R. “The person who influenced me most was the person who disagreed most strongly with me”: an interview with Professor Robert Anderson. Cardiol Young 2019; 29: 259–262.CrossRefGoogle ScholarPubMed
Stenger, A, Dittrich, S, Glöckler, M. Three-dimensional rotational angiography in the pediatric cath lab: optimizing aortic interventions. Pediatr Cardiol 2016; 37: 528–536.CrossRefGoogle ScholarPubMed
Starmans, NL, Krings, GJ, Molenschot, MM, van der Stelt, F, Breur, JM. Three-dimensional rotational angiography in children with an aortic coarctation. Neth Heart J 2016; 24: 666–674.CrossRefGoogle ScholarPubMed
Góreczny, S, Dryzek, P, Moszura, T, Kühne, T, Berger, F, Schubert, S. 3D image fusion for live guidance of stent implantation in aortic coarctation – magnetic resonance imaging and computed tomography image overlay enhances interventional technique. Postepy Kardiol Interwencyjnej 2017; 13: 269–272.Google ScholarPubMed
Sandoval, JP, Aristizabal, G, Zabal-Cerdeira, C. Aortic stent implantation using live 3-dimensional image fusion guidance. Rev Esp Cardiol (Engl Ed) 2018; 71: 750.CrossRefGoogle ScholarPubMed
Góreczny, S, Dryzek, P, Moszura, T. Novel 3-dimensional image fusion software for live guidance of percutaneous pulmonary valve implantation. Circ Cardiovasc Interv 2016; 9: e003711.CrossRefGoogle ScholarPubMed
Aldoss, O, Fonseca, BM, Truong, UT, et al. Diagnostic utility of three-dimensional rotational angiography in congenital cardiac catheterization. Pediatr Cardiol 2016; 37: 1211–1221.CrossRefGoogle ScholarPubMed
Góreczny, S, Moszura, T, Dryzek, P, et al. Three-dimensional image fusion guidance of percutaneous pulmonary valve implantation to reduce radiation exposure and contrast dose: a comparison with traditional two-dimensional and three-dimensional rotational angiographic guidance. Neth Heart J 2017; 25: 91–99.CrossRefGoogle ScholarPubMed
Góreczny, S, Zablah, J, McLennan, D, Ross, M, Morgan, G. Multi-modality imaging for percutaneous pulmonary valve implantation – getting serious about radiation and contrast reduction. Postepy Kardiol Interwencyjnej 2019; 15: 110–115.Google ScholarPubMed
Lescher, S, Gehrisch, S, Klein, S, Berkefeld, J. Time-resolved 3D rotational angiography: display of detailed neurovascular anatomy in patients with intracranial vascular malformations. J Neurointerv Surg 2017; 9: 887–894.CrossRefGoogle ScholarPubMed
Góreczny, S, Dryżek, P, Moszura, T, et al. Magnetic resonance and computed tomography imaging fusion for live guidance of percutaneous pulmonary valve implantation. Postepy Kardiol Interwencyjnej 2018; 14: 413–421.Google ScholarPubMed
Góreczny, S, Dryzek, P, Morgan, GJ, Lukaszewski, M, Moll, JA, Moszura, T. Novel three-dimensional image fusion software to facilitate guidance of complex cardiac catheterization. Pediatr Cardiol 2017; 38: 1133–1142.CrossRefGoogle ScholarPubMed
Nordmeyer, J, Kramer, P, Berger, F, Schubert, S. Successful exclusion of an aortic aneurysm with a novel PTFE-tube covered cobalt-chromium stent in a pediatric patient with native coarctation of the aorta. Catheter Cardiovasc Interv 2018; 92: 930–934.CrossRefGoogle Scholar
Góreczny, S, Moszura, T, Lukaszewski, M, Podgorski, M, Moll, JA, Dryzek, P. Three-dimensional image fusion of precatheter CT and MRI facilitates stent implantation in congenital heart defects. Rev Esp Cardiol (Engl Ed) 2019; 72: 512–514.Google ScholarPubMed
Manica, JL, Borges, MS, Medeiros, RF, Fischer Ldos, S, Broetto, G, Rossi Filho, RI. A comparison of radiation dose between standard and 3D angiography in congenital heart disease. Arq Bras Cardiol 2014; 103: 131–137.Google ScholarPubMed
Góreczny, S, Morgan, GJ, Dryzek, P, Moll, JA, Moszura, T. Initial experience with live three-dimensional image overlay for ductal stenting in hypoplastic left heart syndrome. EuroIntervention 2016; 12: 1527–1533.CrossRefGoogle ScholarPubMed
Minderhoud, SCS, van der Stelt, F, Molenschot, MMC, Koster, MS, Krings, GJ, Breur, JM. Dramatic dose reduction in three-dimensional rotational angiography after implementation of a simple dose reduction protocol. Pediatr Cardiol 2018; 39: 1635–1641.CrossRefGoogle ScholarPubMed
Ehret, N, Alkassar, M, Dittrich, S, et al. A new approach of three-dimensional guidance in paediatric cath lab: segmented and tessellated heart models for cardiovascular interventions in CHD. Cardiol Young 2018; 28: 661–667.CrossRefGoogle ScholarPubMed
Zbroński, K, Tomkiewicz-Pająk, L, Kochman, J, Huczek, Z. Percutaneous pulmonary valve implantation in patients after Ross procedure: role of intravascular ultrasound. Cardiol Young 2018: 1–3. doi: 10.1017/S1047951118002202. [Epub ahead of print].CrossRefGoogle Scholar
Rymuza, B, Grodecki, K, Kamiński, J, Scisło, P, Huczek, Z. Holographic imaging during transcatheter aortic valve implantation procedure in bicuspid aortic valve stenosis. Kardiol Pol 2017; 75: 1056.CrossRefGoogle ScholarPubMed
Ong, CS, Krishnan, A, Huang, CY, et al. Role of virtual reality in congenital heart disease. Congenit Heart Dis 2018; 13: 357–361.CrossRefGoogle ScholarPubMed
Tandon, A, Burkhardt, BEU, Batsis, M, et al. Sinus venosus defects: anatomic variants and transcatheter closure feasibility using virtual reality planning. JACC Cardiovasc Imaging 2019; 12: 921–924.CrossRefGoogle ScholarPubMed
Zahn, EM, Chang, JC, Armer, D, Garg, R. First human implant of the Alterra Adaptive PrestentTM: a new self-expanding device designed to remodel the right ventricular outflow tract. Catheter Cardiovasc Interv 2018; 91: 1125–1129.CrossRefGoogle ScholarPubMed
Biglino, G, Capelli, C, Bruse, J, Bosi, GM, Taylor, AM, Schievano, S. Computational modelling for congenital heart disease: how far are we from clinical translation? Heart 2017; 103: 98–103.CrossRefGoogle ScholarPubMed
Gundelwein, L, Miró, J, Gonzalez Barlatay, F, Lapierre, C, Rohr, K, Duong, L. Personalized stent design for congenital heart defects using pulsatile blood flow simulations. J Biomech 2018; 81: 68–75.CrossRefGoogle ScholarPubMed
Sabiniewicz, R, Meyer-Szary, J, Potaż, P, Jagielak, D, Moszura, T. Melody valve implantation pre-procedural planning using custom-made 3D printed model of the region of interest. Postepy Kardiol Interwencyjnej 2018; 14: 210–211.Google ScholarPubMed
Jone, PN, Ross, MM, Bracken, JA, Mulvahill, MJ, Di Maria, MV, Fagan, TE. Feasibility and safety of using a fused echocardiography/fluoroscopy imaging system in patients with congenital heart disease. J Am Soc Echocardiogr 2016; 29:513–521.CrossRefGoogle ScholarPubMed
McLennan, D, Góreczny, S, Jone, PN, Haak, A, Morgan, GJ. Left ventricular outflow tract pseudoaneurysm occlusion with fusion of live 3–dimensional transesophageal echocardiography and fluoroscopy. Kardiol Pol 2019; 77: 647–648.CrossRefGoogle Scholar
Rodríguez-Zanella, H, Sandoval, JP, García-Montes, JA, Zabal-Cerdeira, C, Arias-Godínez, JA. Echocardiographic-fluoroscopic fusion imaging to guide device occlusion of a complex left ventricle-to-right atrium shunt. Eur Heart J Cardiovasc Imaging 2019; pii: jez030. doi: 10.1093/ehjci/jez030. [Epub ahead of print].Google Scholar
Bruckheimer, E, Rotschild, C. Holography for imaging in structural heart disease. EuroIntervention 2016; 12: X81–X84.CrossRefGoogle ScholarPubMed
Borik, S, Volodina, S, Chaturvedi, R, Lee, KJ, Benson, LN. Three-dimensional rotational angiography in the assessment of vascular and airway compression in children after a cavopulmonary anastomosis. Pediatr Cardiol 2015; 36: 1083–1089.CrossRefGoogle ScholarPubMed
Truong, UT, Fagan, TE, Deterding, R, Ing, RJ, Fonseca, BM. Use of rotational angiography in assessing relationship of the airway to vasculature during cardiac catheterization. Catheter Cardiovasc Interv 2015; 86: 1068–1077.CrossRefGoogle ScholarPubMed