The cures of tomorrow

Interventional cardiology and bioengineering, a revolution to be completed

From Tavi to percutaneous mitral valve repair procedures to 3D printing: how the engineering acumen and clinical mastery of the cardiologist are rewriting the rules of cardiac treatment

by Francesco Saia *, Alfredo Marchese **.

2' min read

Translated by AI
Versione italiana

2' min read

Translated by AI
Versione italiana

Bioengineering is rewriting the rules of interventional cardiology. Thanks to the synergy between the two disciplines, interventions are becoming more effective and precise, drastically improving patients' prognosis and quality of life. However, this is only half a revolution: the potential of the strategic alliance between bioengineering and interventional cardiology is only partially exploited. Until people learn to share expertise and acquire a common language, much of the potential of this union risks remaining unexploited. Never before has it been so necessary to make the most of this meeting of knowledge.

This will therefore be one of the major issues, crucial for the future, that will be addressed at our 46th national congress of the Italian Society of Interventional Cardiology (Gise), in Milan.

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The "Tavi case"

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The greatest impact of bioengineering is in the diagnosis and treatment of valvular diseases, as well as revolutionising the technological equipment of the interventional cardiologist.

For coronary interventions, the development of drug-eluting stents (Des) as new partially or fully resorbable stents and drug-coated balloons (DCBs), structures that perform their supportive function by minimising or eliminating permanent traces on the body, are discussed.

A key example of this collaboration is the Tavi (Transcatheter Aortic Valve Implantation) system. This system makes it possible to implant a collapsible, self-expanding valve through a small vascular access, avoiding open-heart surgery. Materials engineering and the mechanics of delivery systems are crucial to the success of this minimally invasive miracle.

The New Frontiers

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New generations of devices, from drug-eluting stents (Des) to future bioresorbable scaffolds (Bvs) and percutaneous procedures for mitral and tricuspid valve repair, are paving the way for less invasive solutions even for previously inoperable patients. The collaboration goes beyond mechanical systems, embracing biointerventional cardiology. Technologies such as Oct (Optical Coherence Tomography), the fruit of bioengineering, offer detailed anatomical and functional assessments of coronary lesions, allowing stents to be placed with micrometric precision.

AI and 3D in the field

Artificial intelligence and machine learning play a crucial role in reducing processing time, improving diagnostics, risk stratification and procedural planning. With 3D printing, it is possible to create physical models identical to the patient's heart, turning a digital concept into a tangible tool to simulate surgery and solve complex challenges before entering the theatre.

The success of these advances is the result of a constant interplay between the engineering acumen and clinical mastery of the interventional cardiologist: both are rewriting the rules of cardiac treatment. The frontier is no longer just fixing the heart, but predicting, regenerating and personalising treatment. By shifting research from the scalpel to the pixel and from metal to biomaterials, cardiovascular medicine promises a future in which heart disease will be addressed with increasingly precise, targeted and, above all, less traumatic strategies for the patient.

* Gise president
** Gise president-elect

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