Princeton is First to Use Pressure-Volume Loop System for Cardiac Patients in Alabama

Mohammad Sarraf, MD utilizing a PV loop to treat a patient in the cath lab at Princeton

Princeton Baptist Medical Center's cardiovascular program has undergone a major transformation, hiring an additional cardiologist, structural heart physician, and two cardiovascular surgeons as well as launching a number of major capital projects.

In addition to breaking ground on a new electrophysiology lab followed by a new catheterization laboratory, the structural heart department has become the first in Alabama to utilize the Pressure-Volume (PV) Loop System, the world's only clinical PV loop system, which promises to improve patient outcomes by way of advanced hemodynamic monitoring.

Mohommad Sarraf, MD, interventional cardiologist and director of the Structural Heart Program at Princeton, brings several years of experience at Mayo Clinic with this technology. The system, which has been approved for patients in clinical practice, allows physicians to evaluate the pathophysiology of the different forms of cardiovascular diseases in detail, especially structural heart disease and patients with heart failure.

The PV Loop System is a process that can be considered a more comprehensive heart catheterization that helps a patient and physician decide what procedure is likely to benefit them. It can also be used intra-operatively to assess the heart in real time.

"We can tell within seconds whether the heart has been improved or not. In other words, we treat the patients, not their echo images," Sarraf said. "We can analyze the heart from either the left or right ventricle. Of the 29 hospitals in the United States that have this technology, we are the only non-university based hospital to own it. Our hospital is not affiliated with any university, but it is academically oriented."

Sarraf, who has trained on this process for several years with leaders in the field, is a strong proponent, although he agrees there are some obstacles, which may explain why some hospitals are slower to adopt it.

"Many physicians choose not to use it because of its sophisticated protocols and a lack of reimbursement to the hospital," he said. "In addition, the procedure can be quite time consuming, adding at least an hour to the process. But we have a sophisticated, academic mindset in our hospital. It's not about how many patients we do, but how much good we can do for the patients."

Sarraf is working with Columbia University, the University of Zurich, and the Mayo Clinic in this highly specialized area of science. "When physicians see the value of the PV loop, they realize the benefits associated with this technology," he said. "That extra hour provides a lot more information for the referring physician, for the operator, but, most importantly, for the patients. I can tell my patients before I bring them for any procedure whether they are going to feel better after the procedure, and if so, how much. As such, we don't give false hope to our patients. I firmly believe that, it's going to change the practice of cardiovascular medicine in Alabama in the next few years. Meanwhile we are using the information to move science forward and provide optimal care to our patients."

Sarraf is currently the only physician who performs the procedure at Princeton, but he is training others. "I don't believe it is right to silo a procedure to one or two operators," he said. "By the end of the year, I hope there will be another two or three physicians doing this. Placing the catheter is not the challenge. Anyone can do that. It's not about doing the procedure, but what you do with the data. The art of translating data to information takes time."

Sarraf says the growth and transformation of the cardiology department at Princeton is just the beginning of an ongoing process that will take time. "We are dedicated to building the highest level structural heart program with our new team," he said. "We are proposing novel imaging techniques from different imaging modalities. We are working closely with a number of other hospitals to learn from our patients and analyze the information at a deeper level. Soon we will bring more novel technologies to Birmingham. By this time next year we expect to introduce at least three novel modalities that only a handful of hospitals around the world have access to. By next summer, we can bring these technologies that are absolutely futuristic. We are trying to stay ahead of the curve."


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MD; PV loop system, Princeton Baptist Medical Center; Pressure-Volume Loop System; cardiac; Princeto


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