Vim & Vigor - Spring 2018 - University of Virginia - 5

ASK THE EXPERT BY LAURA LONGHINE
Kanwar Singh, MD,
interventional
cardiologist

OPENING
CLOGGED ARTERIES
Robotics help UVA doctors restore blood flow
with millimeter precision

TOP LEFT PHOTO BY GETTY IMAGES; TOP RIGHT BY UVA HEALTH SYSTEM

Coronary artery disease is the leading cause of death in the United States.
It happens when arteries to the heart become narrowed or blocked by
plaque. Doctors restore blood flow to the heart with a procedure known as
coronary angioplasty, using a small balloon to expand the walls of the artery.
Now, robotics and other innovations are making this procedure safer and easier.
Kanwar Singh, MD, an interventional cardiologist at UVA Heart and Vascular
Center and a nationally recognized expert on robotic coronary angioplasty,
explains more about this important advance.

How have robotics
improved the way doctors
at UVA perform coronary
angioplasties?
The robot allows for improvements
in precision and measuring that really
couldn't be performed before. It can
advance and retract devices in increments less than or equal to 1 millimeter. So with the push of a button, or the
deflection of a joystick, we can deliver
in a very precise way this equipment

that's so key to get exactly right.
It also removes the radiation risk
and ergonomic discomfort involved
in performing coronary angioplasties.
Using the robot allows us to remove
some of that operator-fatigue aspect,
which is subtle but is certainly important. Now, the care provider can control the procedure from a comfortable
cockpit with optimal viewing angles and
improved definition, so we can take the
best care of the patient.

When did UVA start using
robotics for opening clogged
arteries?
In 2014, UVA became one of the first 25
centers in the world to install a robotic
device for performing coronary angioplasties. Most recently, in February 2017,
we were one of the first three centers to
get the newest generation of the robot
when it was redesigned. So we're truly
one of the leaders in the world with
robotic coronary angioplasty. We've
been holding courses for the past two
years for visitors who are eager to learn
techniques and figure out how to adopt
a robotic program into current practice.

What improvements come
with the latest technology?
The new robot is just more
capable-it's quicker, more powerful
and more steerable. That's allowed us to
take on cases that, six months ago, we
wouldn't have even considered using the
robot for, and also to do more of any
given case with the robot. For example,
the earlier device could not control the
guide catheter, which is kind of like the
railroad tracks that everything else is
delivered on. During a procedure, with
the heart actively beating in the chest,
the delicate placement of the catheter
can move. Before, if that happened,
you would have to convert to a manual
procedure. Now the robot can drive the
guiding catheter also, which allows us to
do more of the work robotically. ■

SPRING 2018

Table of Contents for the Digital Edition of Vim & Vigor - Spring 2018 - University of Virginia