Cardiovascular Intervention

Dr. Robert Lederman is a practicing interventional cardiologist with experience in early phase human device clinical protocols who has worked for over a decade at the NHLBI intramural research program developing new non-surgical devices and image guidance to treat cardiovascular disease. Now a tenured investigator, Dr. Lederman leads a team of adult and pediatric interventional cardiologists, engineers, and physicists that has developed completely new approaches to cardiac structural intervention oriented around real-time MRI and X-ray. His team has introduced MRI hemodynamic catheterization into standard clinical practice at the NIH Clinical Center. Through CRADA partnerships, image guidance technology has been developed into commercial clinical prototypes, including MRI and X-ray co-registration to enhance conventional interventional procedures, and including a real-time MRI user interface now in routine clinical use.

Dr. Lederman's group and collaborators have conceived and translated several completely new transcatheter structural heart interventional procedures into patients, including transcaval access for TAVR, mitral cerclage annuloplasty, intentional laceration of the anterior mitral leaflet to prevent LVOT obstruction during TMVR (LAMPOON) and to release Mitraclips (ELASTACLIP), intentional laceration of the aortic leaflets to prevent coronary obstruction after TAVR (BASILICA), pledget assisted suture tricuspid annuloplasty (PASTA), transcatheter superior cavopulmonary (Glenn) shunt, and others not yet reported. The team collaborates closely with luminary cardiologists across the country to bring solutions to patients without good clinical options. They have shepherded these projects from conception, to prototyping, to in vivo testing, to compassionate human use, to systematic IDE investigation in patients, and in some cases to broad dissemination and education. They have a pipeline of new techniques, devices, and clinical research protocols under development to address right- and left-ventricular failure, tricuspid and mitral valve regurgitation, bioprosthetic failure, and congenital heart disease.