Nov 02 2011

Heart valve improves quality of life while looking good

Published by under healthcare,news,process,technique

Update: The FDA approved the Edwards valve – it is the first replacement for the aortic valve.

Patients that received a new heart valve and the manufacturer Edwards LifeSciences are both very happy today. New research announced at the American Heart Association’s annual meeting reported that many patients who received this transcatheter Sapien heart valve felt “like they were ten years younger.”

20080307 CS 9816 Heart valve improves quality of life while looking good

The valve was ready for its close-up

I was able to see the new valve up close while I was taking photos for the Cedars-Sinai Medical Center’s Fall 2008 research magazine Discoveries. There was a cover story about one of the clinical trials at the hospital that involved this experimental artificial heart valve. Instead of requiring open-heart surgery this valve is designed to be inserted up through the groin into the heart. It’s then expanded into place at the site of the current damaged heart valve by a balloon.

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The angiogram art approach to the valve

Editor Laura Grunberger, designer Diane Kuntz and I pondered the best way to create a cover photo for the valve story. There was the possibility of shooting a rare live surgery of a trial patient, or a still life of the valve itself. We decided to explore both options. Live surgery presents its own shooting challenges, but I had recently been shooting in an angiogram suite and was impressed by the video images that are captured during the procedure.

I thought the balloon and wire mesh had great design possibilities and there could be an angiogram art approach to the story. But I didn’t count on the heart monitor (dark instrument on the right) getting in the way. It was still a contender though and there was room for type and copy that would fit a cover design.

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Showing a similar procedure in the angiogram suite

The second version involved going down to Edwards Lifesciences in Irvine to pick up an experimental valve. There I received my training on inflating the balloon and how not to destroy the sample. Back in my studio I had to operate the controls like the real surgeon above while putting it into place and keeping it damp without looking wet.

I had seen the more scientific depiction of the valve on the Edwards site and wanted to take a more dramatic approach. This involved setting up my own still-life surgery where the macro lens was inches away from the valve that was surrounded by lights, stands and reflectors.

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The studio shot was selected over the OR version

I loved the balloon and mesh and created this detailed shot that had an abstract feel. I gave Diane some room to move in a little tighter, she inserted the masthead and some copy blocks you have a cover shot.

Older patients that couldn’t survive open-heart surgery can now live longer, happier lives and the technique could move to wider use as the clinical trials progress.

Mark Harmel

harmelphoto.com

On Twitter:

@HarmelPhoto

@MarkHarmel

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2 responses so far

Mar 30 2010

I’ll take an emergency any day

I’ll even stage one if needed.

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A racing gurney and looks of concern make me happy

I’ve been fortunate to have done most of my healthcare photography at major medical institutions. Mostly at University of California, Los Angeles and recently at Cedars-Sinai Medical Center. These are major trauma and research centers. The places you want to go when you have a major health issue like a heart attack.

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An EKG and exam in the emergency room

This series was shot to illustrate an integrated team approach to handling a heart attack from the arrival and evaluation in the ER and the examination and potential intervention in the angiogram suite.

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Opening a blocked blood vessel in the angiogram suite

Even though this case was a simulated heart attack I always enjoy the challenge of making the cases look realistic. They need to pass “the hallway test” of colleagues who will see the photos when this “Report to the Community 2010″ is printed.

As fun as it is for me to shoot these emergent situations. An often overlooked part of healthcare is preventing problems in the first place. This could be teaching healthy eating practices in an elementary school.

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Eating fruit and yogurt at a nutrition lesson

Or having a trusted relationship with your primary care doctor.

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Personal interaction builds a bond of trust between patient and doctor

In real life, patient areas don’t have that refined TV look that you find on “House“, nor are research labs as stylish as they are on “Bones” and the “CSI” shows.

The first challenge is always to understand what’s going on in the lab and determine how to communicate that unique story. In this case the researcher is doing an advanced DNA screening of an individual patient to calculate the respond to an expensive chemotherapy medication. This is an early stage of personalized medicine.

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DNA screening to match effective treatment for a chemotherapy drug

Having cancer is about more than how your DNA reacts to treatment, it’s also about how you deal with the emotional aspect of the disease.

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A cancer survivor volunteers to hear patient's concerns

Prevention, bonding, research and emotional health are important part of care. I love showing it all.

But that still doesn’t beat sending a trauma team racing down the hall.

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Trauma team racing down a hallway

All these photos were taken for Cedars-Sinai Medical Center and were published in their “Report to the Community 2010“. A great interactive version of the report was created by the Doyle/Logan Company as well.

Mark Harmel

harmelphoto.com

Long on Twitter:

@HarmelPhoto

@MarkHarmel

Now on Facebook

2 responses so far

Oct 01 2009

the heart valve race

Published by under healthcare,press,process

UPDATE: 10/1/09

The New York Times today has a business feature on the race between Edwards and Medtronic to develop a replacement heart valve. the original post ran on March, 28, 2008.

I tend to be attracted to more free-range photographic subjects that live out in the real world rather than shooting in a studio. But with all photography the interplay of message, light and design still come into play.

Such was the case when I had the opportunity to shoot a transcathether heart valve. This is a device that serves as an artificial heart valve that could potentially be a significant advancement because it can be easily placed into the heart by threading it up through the groin instead of more invasive open heart surgery

One of the clinical trial sites is at Cedars-Sinai Medical Center where I have been shooting for their research magazine. This was an issue devoted to surgical advances and the hearh valve won out as the story to be featured on the cover. I was able to read a feature on the procedure that was published in the Cleveland Clinic Magazine and see some sample photos technical photos of the device and view a video of the insertion process.

The first approach was to attend a surgical insertion of the device and show the valve being placed by shooting real time view the surgeon sees on the angiogram monitor.

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The transcathether heart valve being inserted in a patient shown on an angiogram monitor

This had the potential to create an abstract art feel to a medical procedure where a trained eye could also see the mesh of the new heart valve and the shadow of the balloon being used to expand the valve. The attempt was a success, but the angiogram screen is still in the low definition phase and the editorial team decided that we wanted more detail and dimension that would be possible shooting the real valve.

Fortunately Edwards Lifesciences is in nearby Irvine, CA and I was able to pick up the valve and insertion device. I was attracted by both the balloon and the mesh around the valve and thought that I could make it come to life by getting very close and shining some light through the balloon and using the pattern of the mesh.

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Still life version showing the replacement valve on the insertion balloon

A version of this was on the cover of the Cedars-Sinai Discoveries magazine.

Mark Harmel
harmelphoto.com
@MarkHarmel

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