The Making of an Interventional Cardiologist: A Fellow’s Perspective on the Use of Robotics
Kusum Lata, MD
Disclosure: Dr. Lata reports no conflicts of interest regarding the content herein.
The time I have spent as an interventional cardiology fellow at Detroit Medical Center (DMC) has been an extremely satisfying experience. I chose the fellowship program at DMC for several reasons; key among them is DMC’s reputation as one of the best high-volume centers in the U.S. for interventional cardiology. Its cardiac catheterization lab is also one of the few that maintains a 24-hour, in-house interventional team ready to handle acute, complex and referral cases. In fact, complex coronary and structural interventions are performed daily at DMC.
As someone with a keen passion for interventional cardiology, and complex cases in particular, I appreciate my all-inclusive training and experiences at DMC. Their program is designed to help fellows achieve high competency and aptitude in this sub-specialty. The program is made even more compelling with the opportunity to learn from recognized international leaders in the field, such as Drs. Theodore Schreiber and Cindy Grines. My choice to become a fellow at DMC has proven to be a great decision.
To me, the most attractive aspects of interventional cardiology over other sub-specialties are the challenges and opportunities it presents for driving innovation. In addition, the varying degrees of uncertainty about any case make this field thought-provoking and exciting, especially in extreme situations. I have discovered that training, in and of itself, is not enough to complete your education in this field; you must be a creative and active learner. I view interventional cardiology as malleable in that it offers numerous opportunities to practice based on your education and skills.
As part of mastering procedural excellence, I have been fortunate to train with Dr. Grines to learn how to perform interventional procedures using robotic technology. I’ve found the use of robotic therapy for PCI to be very user-friendly with a relatively short learning curve. To maximize the benefits of robotics, I believe it is important to not pick and choose which cases to use robotics for but, instead, to take an all-comers approach while you are increasing your robotic skill set. Although while you are learning, some cases may take longer to perform using robotics instead of manual procedures, in the end, I believe it is worth it to develop skills with the robot.
Robotic technology in the cath lab offers unique protection to the medical staff against occupational health hazards associated with radiation exposure. This should be a key consideration for all interventionalists, although particularly for physicians who are performing high-risk, complex procedures that require more time in the cath lab. Robotics makes a huge difference by allowing physicians to sit behind a radiation-shielded cockpit without needing to wear heavy lead protective gear. Radiation protection is a process and physicians need to remain cognizant at all times of how they are utilizing fluoroscopy and take measures to reduce radiation to the patient and the staff working in the cath lab. The introduction of robotic technology in the cath lab to protect against radiation exposure and associated risks will have a huge future impact on both patient and physician care.
This September, I will be moving on to my next career opportunity as my interventional cardiology fellowship at DMC ends. Based on my experiences at DMC, I look forward to not only advancing my skill in this sub-specialty, but intend to pursue the advantages and broader use that robotics technology brings to the field of cardiology.