The Ten-Minute Interview with: Laura Minarsch, RT(R), CVT, CCRP

I am continually searching for challenges and change, and am in the perfect place to fulfill both of these desires. The field of interventional cardiology became my career shortly after I graduated in 1978 from the radiologic technology program at St. Jude Hospital in Fullerton, California. With less than a month as a radiologic technologist (RT), I was hired at Presbyterian Intercommunity Hospital in Whittier, California as a cardiovascular technologist. Intrigued by the ability to work in both diagnostic and therapeutic cardiology, I was given the opportunity to learn in a new cardiovascular (CV) lab. My training focused on a teamwork concept. We worked together in a continuing rotation of all aspects of the lab, including imaging, monitoring, scrubbing, and nursing support. Learning with the early equipment, from angioplasty and inflation tools to more complex atherectomy, ablation, stenting and valvuloplasty devices, I found it to be an exciting time to be a part of interventional cardiology. However, in a quest to continue to pursue personal challenges, serendipity knocked once again and after 12 years at Presbyterian Intercommunity, my career took a new turn. I was invited to take a position at Columbus Hospital in Milan to work with Dr. Antonio Colombo. Dr. Colombo had just finished a residency and fellowship in the United States and returned to Italy to open a new cardiovascular lab. His vision was to merge some of the technical skills and tools we had in America at that time with his cath lab in Italy. A new language, new culture and new world of change awaited and I moved to Italy. It was during the next few years, while living and working in Italy, that one visionary Italian, Dr. Eugenio Cremascoli, saw value in positioning an American to assist companies in efforts to bring early stage technology and innovation to Europe. With his help, I founded MMC Medical in 1991. This platform has become the springboard for accessing several new technologies and assisting many companies in their early-stage clinical work. In 2005, I received certification with the Society of Clinical Research Associates as a certified clinical research professional. Why did you choose to work in the invasive cardiology field? The field of invasive cardiology was a choice based on timing. Rather than remain in diagnostic radiology when I received my RT registry-level credential, I wanted to seek out other opportunities. I walked into a new cardiovascular lab and was fortunate to be given an invitation to be trained. I knew I had been blessed. Can you describe your role in the cath lab? My role in the lab currently involves exploring, studying, and writing about new technology and devices. I embrace innovation and continue to look for new methods for technologists to approach complex cases. What is the biggest challenge you see regarding your role in the cath lab? The greatest challenge is logistic. It's an unusually long commute to fly to Europe from the west coast. I enjoy the work and life in Italy tremendously, so I try to minimize the inconvenience of travel which is typically every 6 weeks. What motivates you to continue working in the cath lab? My motivation comes from a desire to give patients the most comfortable and professional experience possible. Even if the language is a challenge, I have learned many ways to communicate. Exploring communication has taught me to be a better technologist and journalist. What is the most bizarre case you have ever experienced? There was a patient who presented with angina in the ER. We brought him into the lab and began to run a catheter up the femoral, only to find it veering off to the right side of the chest cavity. It was so unbelievable to see the image of the heart reversed. We questioned what we were looking at as if it was a visual trick. I had read about cases of dextrocardia, but to actually catheterize someone with this anomaly was bizarre. When work gets stressful and you experience low moments (as we all do), what do you do to help keep your morale high? I have worked over the years with a comedic group of people and we always found ways to remind each other that laughter is the best way to de-stress. We have always found humor in each other and it lightens an otherwise heavy load. Are you involved with the Society of Invasive Cardiovascular Professionals (SICP) or other cardiovascular societies? I belong to several European societies and attend EuroPCR every year, a meeting that is the European equivalent of TCT. It has previously been in Paris and now is in Barcelona. I also participate in the Joint Interventional Meeting (JIM) in Rome every February. I am a member of the American Registry of Radiologic Technologists (ARRT), SICP, Radiological Society of North America (RSNA), American College of Cardiology (ACC) and American Heart Association (AHA), and recently accredited with Society of Clinical Research Associates. Are there websites or texts that you would recommend? I recommend reading Euro-Intervention, a journal published through EuroPCR. It provides access to new technologies and publishes smaller cohorts of studies done in Europe. I also recommend the International Journal of Cardiovascular Interventions, Journal of the American College of Cardiology (JACC), Journal of Invasive Cardiology (JIC), Catheterization and Cardiovascular Interventions and the website www.tctmd.com. Do you remember participating in your first invasive procedure? I remember scrubbing for my first procedure. Our lab was situated inside surgery, so we shared scrub area with surgeons. This was a straightforward diagnostic procedure, but for me the excitement and sense of fulfillment couldn't have been more unique. In the late seventies, procedures were typically both right and left heart catheterization. In my first week while panning for a case I had to use the paddles on a patient and remember the feeling when we converted him. I was nervous and empowered at the same time. If you could send a message back to yourself at the beginning of your cath lab career, what advice would you give? The message I would send would be to continue with the educational aspect of the career and prioritize learning as many different skills as possible. It is often easy to become complacent and comfortable. Expanding our knowledge and various technical skills is the key to becoming and remaining a good clinician. Where do you hope to be in your career when it is time to retire? I never would have imagined that I would be working in a cath lab in a European country. I now have the opportunity, through new device support, to work throughout Europe and experience the cultures of many countries. I believe that the best way to immerse in any culture is to work and live amidst its people. I was so fortunate to already feel comfortable with my job and be able to focus on language and lifestyle. I can't imagine retirement yet! Has anyone in particular been helpful to you in your growth as a cardiovascular professional? I would have to say without a doubt that Dr. Antonio Colombo has been not only a great teacher and monumental influence for my own personal growth, but of invaluable importance to the field of interventional cardiology. Having the opportunity to work with a mind that routinely reinvents percutaneous coronary intervention has been a tremendous blessing. He has taught me how to approach a procedure, relying rarely on any assumptions about a particular case. Where do you think the invasive cardiology field is headed in the future? Invasive cardiology has begun a collaboration with surgeons in a hybrid environment where computed tomographic (CT) angiography and other imaging modalities will require both specialties to work together. I believe in the next 10 years, we will image and treat differently if we can reduce radiation exposure levels. We are experiencing the next generation in drug-eluting stent platforms, drug-eluting balloons, percutaneous approaches to valve replacement and repair, and digital magnetic navigation systems, all of which contribute to the changing environment where we image and treat. We are watching a fantastic voyage in a dynamic world of innovation.

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