Stewart Cardiovascular Imaging and Therapeutic Innovation Laboratory

Innovation Meets Technology

The Stewart Cardiovascular Imaging and Therapeutic Innovation Laboratory is staffed by specially trained investigators including physicians and veterinary staff to provide high quality care and convenience for research studies of heart and vascular diseases. Equipped with the latest technological advancements, not only do you have the most innovative fluoroscopic imaging at your fingertips, you will also have the ability to image three dimensionally without ever moving the subject.

Animal Studies

Animal work is performed in the Animal Care Center (ACC) of McGovern Medical School at UTHealth.  Fully accredited with AAALAC,  the CLAMC animal resources provides professional veterinary, surgical and animal care services, and its staff  includes five veterinarians, seven veterinary technicians, and over thirty animal care and support personnel. The rooms are modern climate controlled with facilities for diagnostic procedures, isolation treatment, and necropsies are available.

History of the Lab

Established in 1980 with conversion to an all digital lab in 1994

Participated in the pioneering and pre-clinical development of Percutaneous and implantable Left-Ventricular Assist  Devices

Pioneered the  development and testing of new interventional cardiac devices including guide wires, guide catheters, balloons, stents, atherectomy systems and intravascular imaging systems

In addition to cardiac device development and testing the lab has also focused on coronary physiological studies, particularly in the area concerning salvage of ischemic myocardium

Over 300 scientific publications have been generated by the research conducted in our laboratory.

Main Angiographic Experimental and Surgical Lab

600 Square Feet of experimental space in an Accredited Facility

5-axis flat panel digital radiographic system w 3D acquisition reconstruction and analysis:

  • 3D acquisition
  • CT-like imaging
  • Rotational DA/DSA
  • Stepping DSA
  • 2D/3D road map
  • Online aortic valve analysis
  • Software for TAVR
  • Fusion fluoroscopic live imaging
  • IVUS system analysis
  • Anesthesia  machine with full availability of medical gasses
  • Advanced surgical instruments
  • Access to 2D/3D TTA Echo Machines

Tissue Analysis Lab

  • Apoptosis Analysis
  • RIA Peptide Assays
  • Radioactive Microsphere Blood Flow Analysis
  • Heart tissue Isolation Techniques
  • Protein Assays
  • Infarct Size Analysis
  • Pathology Core Laboratory Histology
  • Calcium Influx Analysis

Current Projects:

Windmill Cardiovascular Systems Inc.                                             09/01/2013 – Present
HSC-AWC-12-071 (Smalling) NIH 1 R42 HL 117446 – 01 NIH
“Synchronized Pulsatile Valveless Support Device for the Failing Heart”

1 R01 HL096981 (PI: Emelianov, Smalling)                                    07/01/2014- 06/31/2019
Real-time in vivo IVUS/IVPA imaging to detect and characterize vulnerable plaques

Past Projects:

Gilead Inc
Cardioprotective Effects Of An Endothelin Type A Receptor Antagonist, Ambrisentan during Myocardial Ischemia and Reperfusion in a Porcine Model

How can you help support our innovative work:

There are many ways that you can support the work of the Stewart Cardiovascular Imaging and Therapeutic Innovation Lab.  To make a philanthropic donation please visit the following page and one of our professional staff will be happy to assist you.

We honor our donors who are making a difference!


Selected Lab Research Publications:

  1. Sethuraman S, Aglyamov SR, Amirian JH, Smalling RW, Emelianov SY. Development of a combined intravascular ultrasound and photoacoustic imaging system. Proceedings of the SPIE 2006; 6086:108-8.
  2. Sethuraman S,  Amirian J ,  Litovsky S., Smalling R, and  Emelianov S: Ex vivo Characterization of Atherosclerosis using Intravascular Photoacoustic  Imaging, Optics Express, 2007: 15 (25)  16657-16666
  3. Sethuraman S, Amirian JH, Litovsky SH, Smalling RW, Emelianov SY.  Spectroscopic intravascular photoacoustic imaging to differentiate atherosclerotic plaques.  Opt Express 2008; 16(5):3362-67.
  4. LeDoux J, Tamareille S, Felli P, Amirian J, Smalling RW: Left Ventricular Unloading with Intra-aortic Counter Pulsation Prior to Reperfusion Reduces Myocardial Release of Endolethin-1 and Decreases Infarction Size in a Porcine Ischemia-Reperfusion Model. Catheterization and Cardiovascular Interventions. 2008:4:513-52.
  5. Tamareille S, Achour H, Amirian J, Felli P, Bick R, Poindexter B, Geng YJ, Barry W, Smalling RW, MD, PhD, FACCa,*.Left ventricular unloading before  reperfusion reduces endothelin-1 release and calcium overload in porcine  myocardial infarction. J Thoracic Cardiovasc Surg 2008;136:343-351
  6. Wang B, Su J, Amirian J, Litovsky SH, Smalling RW, Emelianov S.  On the possibility to detect lipid in atherosclerotic plaques using intravascular photoacoustic imaging.  Conf Proc IEEE Eng Med Biol Soc 2009; 2009:4767-70.
  7. Wang B, Su J, Karpiouk A, Sokolov K, Smalling R, Emelianov S. Intravascular photoacoustic imaging. IEEE Journal of Selected Topics in Quantum Electronics 2010 May/June; 16(3):588-99
  8. Letsou GV, Pate TD, Gohean JR, Kurusz M, Longoria RG, Kaiser L, Smalling RW.  Improved left ventricular unloading and circulatory support with synchronized pulsatile left ventricular assistance compared to continuous flow left ventricular assistance in an acute porcine LV failure model.  J Thoracic Cardiovasc Surg 2010; 140(5):1181-88.
  9. Wang B,Su J, Amirian J, Litovsky S, Smalling R,  Emelianov S. Detection of lipid in atherosclerotic vessels using ultrasound-guided spectroscopic intravascular photoacoustic imaging. Opt Express,2010. 18(5), 4889-4897.
  10. Tamareille S, Terwelp M, Amirian J, Felli P, Zhang X, Barry W, Smalling R., Endothelin-1 Release during the Early Phase of Reperfusion Is a Mediator of Myocardial Reperfusion Injury. Cardiology 2013;125:242–249
  11. Gohean J,George M, Pate T, Kurusz M, Longoria R, Smalling R.,Verification of a Computational Cardiovascular System Model Comparing the Hemodynamics of a Continuous Flow to a Synchronous Valveless Pulsatile Flow Left Ventricular Assist Device, ASAIO J. 2013 Mar-Apr;  59(2):107-16.

Principal Investigator: Richard Smalling, MD, PhD

Dr. Smalling is a native Texan who received his undergraduate degree in Aerospace Engineering, master’s degree in Bio-Medical Engineering, and Ph.D. from The University of Texas. He is an AOA graduate of The University of Texas Medical School at Houston and completed residency training and cardiology fellowship at University of California San Diego. Dr. Smalling is board certified in internal medicine, cardiovascular medicine, and interventional cardiology

Dr. Smalling specializes in coronary artery angiography and revascularization, treatment of adult congenital heart disease percutaneously, and the treatment of vascular heart disease percutaneously. He has extensive expertise in the treatment of peripheral vascular disease including carotid stenting, percutaneous endovascular repair of abdominal aortic aneurysm, renal, iliac, femoral and below-knee angioplasty and stenting. Additionally, his team is experienced in utilizing left ventricular assist devices to support high risk coronary angioplasty and complicated valve treatment procedures.


Office Phone: 713-500-6559
Fax: 713-500-6560
Assistant: Araceli Rosas