How 3D models of coronary arteries are helping to transform heart patients’ lives
“Heartflow FFRct has become a firm part of our treatment pathway for patients with stable chronic chest pain.” Dr Simon Duckett, Consultant Cardiologist, University Hospitals of North Midlands
The AHSN (Academic Health Science Network) is highlighting latest technology that is helping clinicians rapidly diagnose patients with suspected coronary artery disease.
In the last year more than 6,300 tests have been performed in the UK using the HeartFlow FFRct Analysis. It works by using coronary Computed Tomography (CT) scans to create a 3D model of the coronary arteries.
It then assesses the impact of narrowing that may reduce blood flow to a patient’s heart muscle.
By providing this information the software has been shown to reduce the need for invasive diagnostic angiograms by about 61% in studies, benefiting the patient and saving clinicians time.
The system, which is endorsed for use by the National Institute of for Health and Care Excellence (NICE), is part of the Accelerated Access Collaborative’s (AAC) Rapid Uptake Products (RUP) programme and the new MedTech Funding Mandate.
The AHSN Network is a member of the AAC, an NHS England and NHS Improvement initiative to remove barriers and accelerate the introduction of groundbreaking new treatments and diagnostics.
The AHSN Network is the delivery arm of the RUP programme, with all 15 AHSNs working with their local health and care partners to support the uptake of the selected innovations.
University Hospitals of North Midlands NHS Trust (UHNM) covers a population of three million across Staffordshire. It has one of the top three busiest Regional Trauma centres and one of the five biggest cardiothoracic surgery centres in the UK, and generates a sizeable amount of cardiac and thoracic imaging work.
UHNM first adopted HeartFlow in April 2018 as part of the Innovation and Technology Payment (ITP) programme.
They were also signed up with the FORECAST clinical trial – a national study to understand the benefits of combining cardiac CT along with the non-invasive Fractional Flow Reserve (HeartFlow FFRct).
Patients would typically be referred from nurse-led chest pain clinics for a cardiac CTCA. Dependent on the results, they would either be discharged with appropriate medication or receive further layered tests. These tests would either be functional imaging or invasive imaging such as an invasive coronary angiogram.
Dr Simon Duckett, Consultant Cardiologist at University Hospitals of North Midlands NHS Trust said: “One of the main benefits of using HeartFlow in our current pathway is that we can understand the anatomy and physiology with one scan. This allows us to get more information about a patient’s condition much quicker, which helps with more efficient clinical decision making by avoiding the need for other tests, while gaining a better understanding of which patients require invasive tests.
“FFRct has become a firm part of our treatment pathway for patients with stable chronic chest pain.”
In the last year, UHNM performed about 2,000 coronary Computed Tomography Coronary Angiography (CTCA) scans, of which 205 were sent for HeartFlow FFRct.
A service evaluation showed approximately 50% patients that had FFRct did not have a significant narrowing and therefore did not require further investigations. Out of the patients who had a significant narrowing detected by FFRct and underwent invasive coronary angiography, 70-75% went on to have a revascularisation procedure.
This was either via a stent within one or more of the coronary artery or referral for coronary bypass surgery. The improved selection of patients requiring invasive angiography improves the cardiac catheter lab efficiency and reduces the risk to patients by limiting the need for invasive testing.
See the AAC website,to find out more about HeartFlow and the other RUPs.