Beyond the Rounds

For patient referrals: call 602-521-3550How do neurosurgeons decide between open brain surgery, minimally invasive endovascular treatment and careful monitoring? In this episode of Beyond the Rounds, Dr. Daniel Cavalcanti joins Dr. Nolan Fisher to explore the rapidly evolving field of cerebrovascular and endovascular neurosurgery—and how advances in technology are expanding treatment options for patients with complex neurovascular conditions.From brain aneurysms and arteriovenous malformations (AVMs) to chronic subdural hematomas and stroke, Dr. Cavalcanti discusses how neurosurgeons evaluate risk, determine when intervention is appropriate and select an approach based on each patient's condition. He explains how open microsurgery and catheter-based endovascular techniques can complement one another, allowing treatment decisions to be guided by the individual patient rather than a single surgical approach.The conversation also explores advances including flow-diverting stents, middle meningeal artery embolization, minimally invasive surgical techniques and emerging technologies in stroke care. Dr. Cavalcanti shares how multidisciplinary collaboration, research and artificial intelligence are continuing to shape the future of neurovascular care.What We Cover• How cerebrovascular and endovascular neurosurgery work together• Evaluating incidentally discovered brain aneurysms• Determining when an aneurysm requires treatment or monitoring• Choosing between open surgery and endovascular treatment• Flow diverters, aneurysm clips and other treatment technologies• Diagnosis and treatment of arteriovenous malformations (AVMs)• Middle meningeal artery embolization for chronic subdural hematomas• The role of multidisciplinary care in managing complex neurovascular conditions• Emerging technologies and research in stroke care• How artificial intelligence is influencing neurovascular imaging and clinical careKey Topics for Clinicians• Cerebrovascular neurosurgery• Endovascular neurosurgery• Brain aneurysms• Arteriovenous malformations• Stroke• Subdural hematoma• Flow diversion• Aneurysm clipping• Middle meningeal artery embolization• Neurointerventional procedures• Minimally invasive neurosurgery• Neurovascular imaging• Multidisciplinary care• Artificial intelligence in medicineAbout Our GuestDr. Daniel Cavalcanti is a board-certified neurosurgeon specializing in complex cerebrovascular and endovascular neurosurgery. Fellowship-trained in neurointerventional radiology and endovascular neurosurgery, he treats brain aneurysms, stroke, vascular malformations and other complex brain and spinal vascular disorders.How to Refer a PatientBanner Health providers: Use Cerner’s Ambulatory Referral Management (ARM) tool. Community providers: Fax referrals to 602-635-6572 or call 602-521-3550 to schedule a patient for evaluation.DisclaimerThis podcast is intended for educational purposes only and is designed for a clinical audience. Any patient scenarios discussed are modified and de-identified to protect privacy. No protected health information (PHI) is disclosed. The information presented should not replace independent medical judgment or individualized patient care decisions.Subscribe to Beyond the Rounds for physician-focused conversations on clinical innovation, specialty collaboration and evolving standards of care.

For patient referrals: call 970-810-0255How has joint replacement evolved from a multi-day hospital stay to a procedure that can often have patients recovering at home the same day? In this episode of Beyond the Rounds, Dr. Kirk Kindsfater and physician assistant Nate Hawkins, PA-C, join Dr. Nolan Fisher to discuss the evolution of hip and knee replacement—from advances in implant materials and surgical techniques to rapid-recovery protocols and the role of an experienced, highly coordinated care team.Drawing on more than three decades of experience and more than 33,000 joint replacements, Dr. Kindsfater shares how advances in implant technology, alignment tools and surgical techniques have changed arthroplasty while emphasizing the importance of experience, physical examination and foundational surgical skills. Hawkins offers the perspective of a longtime physician assistant, exploring how patient education, expectation setting and a team-based approach contribute to care before, during and after surgery.The conversation also examines how modern pain management and mobilization protocols are helping appropriate patients return home sooner, how surgeons evaluate new technologies such as robotics, and why choosing the right approach for each patient remains more important than following the latest trend.What We Cover• How hip and knee replacement has evolved over the past 30 years• Advances in implant materials and longevity• Rapid-recovery protocols and outpatient joint replacement• Patient selection and setting realistic expectations before surgery• The role of physician assistants in pre- and postoperative care• How an experienced surgical team supports efficiency and consistent outcomes• Technology, alignment and robotics in joint replacement• Why soft-tissue balancing remains critical in knee replacement• Anterior versus posterior approaches to hip replacement• Returning active patients to walking, hiking, golf, tennis and other activities• Evaluating new techniques while maintaining strong surgical fundamentals• The evolving role of physician assistants in improving access to orthopedic careKey Topics for Clinicians• Total joint replacement• Hip replacement• Knee replacement• Arthroplasty• Osteoarthritis• Rapid recovery• Outpatient joint replacement• Implant technology• Surgical alignment• Robotics in orthopedic surgery• Soft-tissue balancing• Anterior hip replacement• Posterior hip replacement• Multimodal pain management• Patient selection• Patient education• Physician assistants• Orthopedic care teamsAbout Our GuestsDr. Kirk Kindsfater is an internationally recognized orthopedic surgeon with more than 30 years of experience in hip and knee replacement. With a background in mechanical engineering, he brings an engineering perspective to joint mechanics, implant design and surgical technique and has performed more than 33,000 joint replacements during his career.Nate Hawkins, PA-C, is a physician assistant with more than 20 years of experience and a background in athletic training. He has worked alongside Dr. Kindsfater for approximately a decade, helping manage patients throughout the joint replacement journey, from evaluation and preoperative education through postoperative recovery.How to Refer a PatientFor patient referrals or to schedule an evaluation, call 970-810-0255.DisclaimerThis podcast is intended for educational purposes only and is designed for a clinical audience. Any patient scenarios discussed are modified and de-identified to protect privacy. No protected health information (PHI) is disclosed. The information presented should not replace independent medical judgment or individualized patient care decisions.Subscribe to Beyond the Rounds for physician-focused conversations on clinical innovation, specialty collaboration and evolving standards of care.

For patient referrals: call 602-521-3550What if the next era of spine surgery isn’t about replacing surgeons—but giving them better tools? In this episode of Beyond the Rounds, we explore how robotics, artificial intelligence and advanced surgical techniques are shaping the future of spine care. Dr. Nicholas Theodore joins Dr. Nolan Fisher to discuss innovation in spine surgery, the role of technology in improving precision and how multidisciplinary expertise continues to drive better outcomes for patients.From complex spinal disorders to emerging technologies, Dr. Theodore shares insights into how robotics and AI are being integrated into clinical practice, where these tools add value and why the surgeon’s judgment remains central to delivering high-quality care.The conversation also explores the evolving approach to spine surgery—from improving surgical planning and precision to advancing treatment options for patients with complex conditions. As technology continues to evolve, the future of spine care will depend on combining innovation with experience, collaboration and evidence-based practice.What We Cover• How robotics is changing the landscape of spine surgery• The role of technology in improving surgical precision and planning• Artificial intelligence and its potential applications in spine care• How advanced tools support—not replace—clinical expertise• The evolution of minimally invasive spine surgery• Treating complex spinal conditions with a multidisciplinary approach• The importance of innovation in improving patient outcomes• What the future of spine surgery may look likeKey Topics for Clinicians• Spine surgery• Neurosurgery• Orthopedic spine care• Surgical robotics• Artificial intelligence in medicine• Minimally invasive spine surgery• Advanced imaging• Surgical navigation• Spinal disorders• Complex spine care• Clinical innovation• Multidisciplinary careAbout Our GuestDr. Nicholas Theodore is a nationally recognized neurosurgeon specializing in complex spine surgery, spinal cord injury and advanced surgical techniques. He is known for his work in developing innovative approaches to spine care and advancing the use of technology in neurosurgical practice.How to Refer a PatientBanner Health providers: Use Cerner’s Ambulatory Referral Management (ARM) tool. Community providers: Fax referrals to 602-635-6572 or call 602-521-3550 to schedule a patient for evaluation.DisclaimerThis podcast is intended for educational purposes only and is designed for a clinical audience. Any patient scenarios discussed are modified and de-identified to protect privacy. No protected health information (PHI) is disclosed. The information presented should not replace independent medical judgment or individualized patient care decisions.Subscribe to Beyond the Rounds for physician-focused conversations on clinical innovation, specialty collaboration and evolving standards of care.

For patient referrals: call 480-733-7400What if one of the most common sports-related injuries was still being treated with outdated advice? In this episode of Beyond the Rounds, we explore two rapidly evolving areas of sports medicine: concussion management and orthobiologic therapies. Dr. Nolan Fisher sits down with sports medicine physician Dr. Evan Werk to discuss why strict rest is no longer considered best practice for concussion recovery, how multidisciplinary treatment is improving outcomes and where therapies such as platelet-rich plasma (PRP) fit into modern musculoskeletal care.For years, concussion management centered on prolonged rest and symptom avoidance. Today, evidence supports earlier return to activity, targeted rehabilitation and individualized treatment plans based on specific symptom patterns. Dr. Werk explains how clinicians can identify concussion subtypes, guide safe return-to-play decisions and address persistent symptoms through coordinated care.The conversation also examines the growing role of orthobiologics, including PRP and bone marrow aspirate therapies. As interest in regenerative medicine continues to grow, understanding what the evidence supports—and where limitations remain—is critical for helping patients make informed treatment decisions.This episode is designed for physicians, advanced practice providers and clinicians seeking practical insights into concussion care, sports medicine and evidence-based approaches to musculoskeletal treatment.What We Cover• Why the "dark room" approach to concussion recovery is outdated• The role of early activity and active rehabilitation after concussion• How concussion subtypes guide treatment decisions• Return-to-play protocols and objective concussion assessment• Persistent post-concussion symptoms and multidisciplinary management• Common misconceptions about regenerative medicine• What PRP is and when it may be appropriate for tendinopathy and osteoarthritis• Bone marrow aspirate therapy and current evidence• The risks of overpromising results from orthobiologic treatments• How sports medicine bridges primary care, rehabilitation and orthopedic surgeryKey Topics for Clinicians• Sports medicine• Concussion management• Return-to-play protocols• Vestibular rehabilitation• Post-concussion syndrome• Platelet-rich plasma (PRP)• Orthobiologics• Bone marrow aspirate therapy• Tendinopathy• Osteoarthritis• Musculoskeletal ultrasound• Exercise medicine• Active aging• Evidence-based sports medicineAbout Our GuestDr. Evan Werk is a board-certified sports medicine physician with Banner – University Medical Group. Trained in both family medicine and sports medicine, he specializes in concussion care, musculoskeletal injuries, ultrasound-guided procedures and orthobiologic therapies. His clinical practice focuses on helping athletes and active individuals safely return to the activities that matter most to them through evidence-based, patient-centered care.He sees patients at: Banner Sports Medicine Scottsdale 7400 N. Dobson Rd., Ste. 201, Scottsdale, AZ 85256Phone: 480-733-7400Fax: 480-207-2118How to Refer a Patient Banner Health providers: Use Cerner’s Ambulatory Referral Management (ARM) tool. Community providers: Fax referrals to 480-207-2118 or call 480-733-7400 to schedule a patient for evaluation. Disclaimer This podcast is intended for educational purposes only and is designed for a clinical audience. Any patient scenarios discussed are modified and de-identified to protect privacy. No protected health information (PHI) is disclosed. The information presented should not replace independent medical judgment or individualized patient care decisions. Subscribe to Beyond the Rounds for physician-focused conversations on clinical innovation, specialty collaboration and evolving standards of care.

What happens when the heart’s electrical system spirals into a life-threatening rhythm disorder? In this episode of Beyond the Rounds, we explore ventricular arrhythmias — dangerous heart rhythm disturbances that can lead to sudden cardiac death, repeated ICD shocks and severe heart failure complications. Dr. Nolan Fisher sits down with cardiac electrophysiologist Dr. Peter Weiss to break down how these arrhythmias develop, why they are so difficult to treat and how new ablation technologies are changing outcomes for patients with complex ventricular tachycardia (VT).Dr. Weiss, Director of the Center for Ventricular Arrhythmias and Robotics at Banner – University Medical Center Phoenix, shares how advanced mapping systems, catheter ablation and emerging technologies like ultra-cold cryoablation, AI-guided mapping and robotic magnetic navigation are helping physicians target dangerous electrical circuits deep within the heart muscle. The discussion also explores how Banner Health is building a multidisciplinary referral center capable of rapidly managing critically ill patients experiencing VT storm and recurrent ICD shocks.This episode is designed for physicians, advanced practice providers and clinicians seeking a practical understanding of ventricular arrhythmias, advanced electrophysiology procedures and the evolving role of catheter ablation in complex cardiac care.What We Cover• The difference between ventricular arrhythmias and atrial fibrillation (AFib)• Why ventricular tachycardia (VT) can become life-threatening• How scar tissue and cardiomyopathy create electrical “short circuits”• Understanding PVCs (premature ventricular contractions) and when they should be treated• How electrophysiologists map the heart’s electrical system in real time• What catheter ablation actually does during a VT procedure• The role of ICDs (implantable cardioverter defibrillators)• Why antiarrhythmic medications like amiodarone can be difficult long term• How robotic magnetic navigation improves catheter stability and maneuverability• AI-assisted mapping and machine learning in electrophysiology• New technologies including ultra-cold cryoablation and pulsed field ablation• The importance of multidisciplinary VT storm programs and rapid referral pathwaysKey Topics for Clinicians• Ventricular tachycardia (VT)• Ventricular arrhythmias• VT storm• Cardiac electrophysiology• Catheter ablation• Robotic catheter navigation• Premature ventricular contractions (PVCs)• Implantable cardioverter defibrillators (ICDs)• Pulsed field ablation• Cryoablation• AI-guided electrophysiology mapping• Ischemic cardiomyopathy• Advanced heart failure• Electrophysiology mapping systems• Structural heart disease• Sudden cardiac death preventionAbout Our GuestDr. Peter Weiss is a cardiac electrophysiologist and Director of the Center for Ventricular Arrhythmias and Robotics at Banner – University Medical Center Phoenix and the University of Arizona College of Medicine – Phoenix. He specializes in complex ventricular arrhythmia management, robotic catheter ablation and advanced electrophysiology procedures. Dr. Weiss trained at Stanford University and has performed more than 1,400 robotic ablation procedures. Prior to joining Banner Health, he spent 14 years building a regional ventricular arrhythmia referral program at Intermountain Health.How to Refer a PatientBanner Health providers: Use Cerner’s Ambulatory Referral Management (ARM) tool.Community providers: Please call 602-521-3090 for referral information and scheduling assistance.DisclaimerThis podcast is intended for educational purposes only and is designed for a clinical audience. Any patient scenarios discussed are modified and de-identified to protect privacy. No protected health information (PHI) is disclosed. The information presented should not replace independent medical judgment or individualized patient care decisions.

For patient referrals: call 602-521-3661What happens when the heart’s electrical system spirals into a life-threatening rhythm disorder? In this episode of Beyond the Rounds, we explore ventricular arrhythmias — dangerous heart rhythm disturbances that can lead to sudden cardiac death, repeated ICD shocks and severe heart failure complications. Dr. Nolan Fisher sits down with cardiac electrophysiologist Dr. Peter Weiss to break down how these arrhythmias develop, why they are so difficult to treat and how new ablation technologies are changing outcomes for patients with complex ventricular tachycardia (VT).Dr. Weiss, Director of the Center for Ventricular Arrhythmias and Robotics at Banner – University Medical Center Phoenix, shares how advanced mapping systems, catheter ablation and emerging technologies like ultra-cold cryoablation and pulsed field ablation are helping physicians target dangerous electrical circuits deep within the heart muscle. The discussion also explores how Banner Health is building a multidisciplinary referral center capable of rapidly managing critically ill patients experiencing VT storm and recurrent ICD shocks.This episode is designed for physicians, advanced practice providers and clinicians seeking a practical understanding of ventricular arrhythmias, advanced electrophysiology procedures and the evolving role of catheter ablation in complex cardiac care.What We Cover• The difference between ventricular arrhythmias and atrial fibrillation (AFib)• Why ventricular tachycardia (VT) can become life-threatening• How scar tissue and cardiomyopathy create electrical “short circuits”• Understanding PVCs (premature ventricular contractions) and when they should be treated• How electrophysiologists map the heart’s electrical system in real time• What catheter ablation actually does during a VT procedure• The role of ICDs (implantable cardioverter defibrillators)• Why antiarrhythmic medications like amiodarone can be difficult long term• New technologies including ultra-cold cryoablation and pulsed field ablation• The importance of multidisciplinary VT storm programs and rapid referral pathwaysKey Topics for Clinicians• Ventricular tachycardia (VT)• Ventricular arrhythmias• VT storm• Cardiac electrophysiology• Catheter ablation• Premature ventricular contractions (PVCs)• Implantable cardioverter defibrillators (ICDs)• Pulsed field ablation• Cryoablation• Ischemic cardiomyopathy• Advanced heart failure• Electrophysiology mapping systems• Structural heart disease• Sudden cardiac death preventionAbout Our GuestDr. Peter Weiss is a cardiac electrophysiologist and Director of the Center for Ventricular Arrhythmias and Robotics at Banner – University Medical Center Phoenix and the University of Arizona College of Medicine – Phoenix. He specializes in complex ventricular arrhythmia management, robotic catheter ablation and advanced electrophysiology procedures. Dr. Weiss trained at Stanford University and completed additional advanced electrophysiology training at the University of Pennsylvania. Prior to joining Banner Health, he spent 14 years building a regional ventricular arrhythmia referral program at Intermountain Health.How to Refer a PatientBanner Health providers: Use Cerner’s Ambulatory Referral Management (ARM) tool.Community providers: Please call 602-521-3661 for referral information and scheduling assistance.DisclaimerThis podcast is intended for educational purposes only and is designed for a clinical audience. Any patient scenarios discussed are modified and de-identified to protect privacy. No protected health information (PHI) is disclosed. The information presented should not replace independent medical judgment or individualized patient care decisions.Subscribe to Beyond the Rounds for physician-focused conversations on clinical innovation, specialty collaboration and evolving standards of care.

For patient referrals: call 602-521-5700What if one of the most common yet misunderstood gynecologic conditions could be diagnosed earlier—without surgery? In this episode of Beyond the Rounds, we explore endometriosis, a condition affecting nearly 190 million people worldwide that still takes an average of 7-10 years to diagnose. Dr. Nolan Fisher sits down with gynecologic surgeon and endometriosis specialist Dr. Rosanne Kho to discuss how advances in imaging, multidisciplinary care and minimally invasive surgery are reshaping the diagnostic and treatment paradigm.Endometriosis is often dismissed or normalized, leaving patients to navigate years of pain, infertility and missed diagnoses. But the field is evolving. With targeted ultrasound, MRI and a shift away from diagnostic laparoscopy as the first step, clinicians now have more effective tools to identify disease earlier and guide treatment based on symptoms, not just surgical findings.This episode explores how endometriosis presents, why it’s so frequently missed, and what clinicians can do to improve outcomes through earlier recognition, appropriate imaging and thoughtful referral.This episode is designed for physicians, advanced practice providers and clinicians seeking a practical understanding of endometriosis diagnosis, treatment pathways and multidisciplinary care.What We Cover• Why endometriosis is frequently underdiagnosed or misdiagnosed• The shift from surgical diagnosis to imaging-first approaches• How advanced ultrasound and MRI improve detection• Common symptoms, including pelvic pain, GI and urinary involvement• When to treat—and when not to intervene• Medical vs. surgical management strategies• Fertility considerations and treatment planning• The role of minimally invasive and robotic-assisted surgery• Multidisciplinary care, including pain management and specialty referral• How to identify patients who need earlier referralKey Topics for Clinicians• Endometriosis• Chronic pelvic pain• Minimally invasive gynecologic surgery (MIGS)• Diagnostic imaging in gynecology• Transvaginal ultrasound (sliding sign)• Pelvic MRI• Fertility and reproductive health• Multidisciplinary care models• Women’s health disparities• Early referral strategiesAbout Our GuestDr. Kho is a gynecologic surgeon and endometriosis specialist at Banner - University Medicine Phoenix, with extensive experience in minimally invasive gynecologic surgery and a national reputation for advancing endometriosis diagnosis and care. She previously led programs at both Mayo Clinic and Cleveland Clinic and has published more than 90 peer-reviewed papers focused on improving outcomes for patients with endometriosis. Her work has helped shift the field toward imaging-based diagnosis and multidisciplinary treatment models.She sees patients at:Banner - University Medicine Women's Institute1441 North 12th Street, Floor 3, Phoenix, AZ 85006Phone: 602-521-5700Fax: 602-521-5701How to Refer a PatientBanner Health providers: Use Cerner’s Ambulatory Referral Management (ARM) tool.Community providers: Fax referrals to 602-521-5701 or call 602-521-5700 to schedule a patient for evaluation.DisclaimerThis podcast is intended for educational purposes only and is designed for a clinical audience. Any patient scenarios discussed are modified and de-identified to protect privacy. No protected health information (PHI) is disclosed. The information presented should not replace independent medical judgment or individualized patient care decisions.Subscribe to Beyond the Rounds for physician-focused conversations on clinical innovation, specialty collaboration and evolving standards of care.

For patient referrals: Call 602-521-5969 or 602-839-4242What if restoring a patient’s core function required more than just closing a defect? In this episode of Beyond the Rounds, we explore complex abdominal wall reconstruction—one of the most technically demanding areas in surgery—and why a multidisciplinary approach is essential for achieving optimal outcomes. Dr. Nolan Fisher sits down with plastic and reconstructive surgeon Dr. Jimmy Chim and general surgeon Dr. Priya Rajdev to discuss how collaboration, surgical innovation and thoughtful pre-operative planning are redefining what’s possible for patients with complex hernias and abdominal wall defects.Far beyond a “simple hernia repair,” these cases often involve loss of domain, prior surgical complications or missing abdominal wall components that significantly impact a patient’s function and quality of life. From minimally invasive techniques to advanced reconstructive procedures, today’s surgical approaches are focused not just on repair, but on restoring strength, stability and independence.This episode explores how these procedures work, which patients may benefit and why optimizing health before surgery is often just as important as the operation itself.This episode is designed for physicians, advanced practice providers and clinicians seeking a practical understanding of complex hernia repair, abdominal wall reconstruction and multidisciplinary surgical care.What We Cover-Why not all hernia repairs are the same—and when cases become “complex”-The concept of loss of domain and its impact on surgical planning-Differences between minimally invasive and open reconstruction techniques-How component separation restores abdominal wall function-The role of mesh—synthetic, biologic and bio-resorbable options-When and why plastic surgery and general surgery collaborate-Prehabilitation: weight loss, diabetes control and smoking cessation-Managing recurrence and why the first repair matters most-Surgical staging vs. single-stage reconstruction-Real-world cases highlighting decision-making and techniqueKey Topics for Clinicians-Complex abdominal wall reconstruction-Ventral and incisional hernias-Loss of domain-Component separation techniques-Minimally invasive hernia repair-Surgical mesh selection-Preoperative optimization (prehab)-Multidisciplinary surgical care-Plastic and reconstructive surgery collaboration-Hernia recurrence preventionAbout Our Guests-Dr. Jimmy Chim is a plastic and reconstructive surgeon specializing in complex abdominal wall reconstruction and advanced soft tissue reconstruction. His work focuses on restoring both form and function for patients with significant surgical defects, trauma or prior complications.-Dr. Priya Rajdev is a general surgeon specializing in minimally invasive foregut and complex abdominal wall surgery. She brings expertise in laparoscopic and robotic techniques to treat hernias and abdominal wall defects through smaller incisions while maintaining strong clinical outcomes.How to Refer a PatientBanner Health providers: Use Cerner’s Ambulatory Referral Management (ARM) tool.Community providers: Call 602-521-5969 or 602-839-4242 to schedule a patient for evaluation.DisclaimerThis podcast is intended for educational purposes only and is designed for a clinical audience. Any patient scenarios discussed are modified and de-identified to protect privacy. No protected health information (PHI) is disclosed. The information presented should not replace independent medical judgment or individualized patient care decisions.Subscribe to Beyond the Rounds for physician-focused conversations on clinical innovation, specialty collaboration and evolving standards of care.

For patient referrals: call 602-521-3090What if one of the most overlooked heart valve conditions finally had a minimally invasive solution? In this episode of Beyond the Rounds, we explore tricuspid valve disease — often underdiagnosed and undertreated — and the emerging transcatheter therapies that are transforming care. Dr. Nolan Fisher sits down with interventional cardiologist Dr. Paul Sorajja to discuss how innovations like the TriClip procedure are improving quality of life for patients who previously had limited or high-risk treatment options.Often referred to as the “forgotten valve,” the tricuspid valve can quietly lead to significant symptoms, including fatigue, edema and organ dysfunction. With advances in catheter-based repair techniques, clinicians now have new tools to treat tricuspid regurgitation without open-heart surgery — offering meaningful symptom relief with low procedural risk.This episode explores how these therapies work, which patients may benefit, and how evolving data is shaping the future of valvular heart disease treatment.This episode is designed for physicians, advanced practice providers and clinicians seeking a practical understanding of transcatheter valve therapies and the management of tricuspid disease.What We Cover• Why tricuspid valve disease is frequently missed or undertreated• The difference between valve repair vs. replacement• How transcatheter therapies (like TriClip) work• Patient selection and when intervention is appropriate• The role of imaging and echocardiography in diagnosis• Understanding symptoms of tricuspid regurgitation• Cardiorenal syndrome and systemic effects of valve disease• Clinical trial insights, including the TRILUMINATE study• Why quality-of-life improvements matter — even without mortality benefit• The importance of a multidisciplinary “heart team” approachKey Topics for CliniciansTricuspid regurgitation (TR)Valvular heart diseaseStructural heart interventionsTranscatheter valve repairTriClip procedureCardiorenal syndromeRight-sided heart failureEchocardiography in valve diseaseInterventional cardiology innovationMultidisciplinary heart team careAbout Our GuestDr. Paul Sorajja is an interventional cardiologist and Director of Interventional Cardiology at Banner - University Medicine Heart Institute. He is a nationally recognized leader in structural heart disease and has been at the forefront of developing transcatheter valve therapies, including early work in tricuspid valve repair. Dr. Sorajja trained at Mayo Clinic, where he spent two decades advancing minimally invasive cardiovascular treatments and leading clinical research.He sees patients at:Banner - University Medicine Heart Institute755 East McDowell Road, Floor 4Phoenix, AZ 85006Banner Health Center plus at Arcadia4200 East Camelback Road, Suite 202Phoenix, AZ 85018Phone: 602-521-3090Fax: 602-521-3661How to Refer a PatientBanner Health providers: Use Cerner’s Ambulatory Referral Management (ARM) tool.Community providers:Fax referrals to 602-521-3661 or call 602-521-3090 to schedule a patient for evaluation.DisclaimerThis podcast is intended for educational purposes only and is designed for a clinical audience. Any patient scenarios discussed are modified and de-identified to protect privacy. No protected health information (PHI) is disclosed. The information presented should not replace independent medical judgment or individualized patient care decisions.Subscribe to Beyond the Rounds for physician-focused conversations on clinical innovation, specialty collaboration and evolving standards of care.

For patient referrals: call 480-256-6444Can ultrasound liquefy tumors? In this episode of Beyond the Rounds, we explore histotripsy — a novel, non-thermal ultrasound therapy that can destroy tumors without surgery, heat, or radiation. Dr. Nolan Fisher sits down with surgical oncologist Dr. Michael Choti, Chief of Surgery at Banner MD Anderson Cancer Center, to discuss how this emerging technology may change the way liver tumors are treated.Using focused ultrasound energy to create microscopic cavitation bubbles, histotripsy mechanically breaks down tumor tissue while sparing critical structures like blood vessels and bile ducts. The result: precise tumor destruction in locations that may be difficult or impossible to treat with traditional surgery or thermal ablation.This episode explores how histotripsy works, where it fits in today’s treatment landscape, and why clinicians should remain both excited and cautious as the technology evolves.This episode is designed for physicians, advanced practice providers, and clinicians who want a practical understanding of emerging technologies in surgical oncology and liver tumor management.What We Cover• What histotripsy is and how cavitation-based ultrasound destroys tumors• Why histotripsy differs from thermal ablation techniques• The “heat sink effect” and why tumors near blood vessels are difficult to treat• How histotripsy may expand treatment options for liver tumors• Using histotripsy as a bridge to liver transplant• The potential immune effects of tumor liquefaction (abscopal effect)• When histotripsy is appropriate — and when it’s not• Current FDA approvals and ongoing research• Why careful patient selection and multidisciplinary evaluation matterKey Topics for CliniciansLiver tumorsColorectal liver metastasesHepatocellular carcinoma (HCC)Liver transplant bridging therapyImage-guided tumor ablationHistotripsy technologySurgical oncology innovationMultidisciplinary cancer careAbout Our GuestDr. Michael Choti is Chief of Surgery at Banner MD Anderson Cancer Center and a nationally recognized surgical oncologist specializing in gastrointestinal and hepatobiliary cancers. His career has focused on liver tumors, colorectal cancer metastases, and advancing surgical and minimally invasive treatments for complex cancers. He previously served as Chair of the Department of Surgery at UT Southwestern and trained at Yale, the University of Pennsylvania, and Memorial Sloan Kettering Cancer Center.How to Refer a PatientIf you believe a patient may benefit from evaluation at Banner MD Anderson Cancer Center:Banner Health providers: Use Cerner’s Ambulatory Referral Management (ARM) tool.Community providers:Fax referrals to 480-256-4607or call 480-256-6444 to schedule a patient for evaluation.DisclaimerThis podcast is intended for educational purposes only and is designed for a clinical audience. Any patient scenarios discussed are modified and de-identified to protect privacy. No protected health information (PHI) is disclosed. The information presented should not replace independent medical judgment or individualized patient care decisions.Subscribe to Beyond the Rounds for physician-focused conversations on clinical innovation, specialty collaboration, and evolving standards of care.