Monday, March 02, 2009


I spend the weekend in Singapore, joining my colleagues as part of the faculty for this annual interventional cardiology live demo course. This interventional cardiology course is probably the oldest interventional cardiology course around the world. It was started in the early 90s because of a need to teach the interventional cardiology technique to cardiologist in the ASEAN region. I have been part of the faculty from the beginning. The first course was actually organised by Dr Richard Ng ( probably the most senior Interventionist in the ASEAN region ) as part of his tenure as the first President of the ASIAN PACIFIC SOCIETY of INTERVENTIONAL CARDIOLOGY. Later on, the organisation for this meeting pass on to Dr Arthur Tan of Singapore General Hospital Heart Center, and now the organising Chairman is Dr Koh Tian Hai, the Director of the Singapore Heart Center. We are all good friends and have seen the discipline of Interventional Cardiology frow from strength to strength.
The good thing is that many have passed through this meeting encouraged and empowered with more knowledge and information as to how better take care of their patients. Many have come to share ideas, discuss complications and how to deal with them, be updated on the latest data on interventional trials and their application. The course does serve some benefit, over these many years.
The downside is that, it cost alot to run these large interventional meetings. Bringing 1,000 doctors, techs, and nurses out for three days in Singapore cost money. Live transmission from all over the world, cost money, renting the Suntec City complex cost money, having an event organiser cost money. The organisers must decide whether the meeting has met the objectives and whether the cost is worth it, in the 21st Century when interventional cardiology techniques are so established.
Well, I spend Friday-Sunday with the meeting, moderating at three of the sessions. It was nice, to see old friends and also new, young and eager interventionist, some presenting their cases for us to comment. It was interesting to see the differrent approaches to interventional cardiology from all over Asia, India, China, Japan and Singapore mainly.
I was commenting to one of my fellow faculty, that each year that I come, I will see fewere and fewer of our contemporaries. We hear of the sad demise of my friend and coleague Dr Tamai, a pioneer in interventional cardiology in Japan. He was a very good worker and innovator, working with bioabsorbable stents, in the early days, and also working to perfect the teachnique to do CTOs ( chronic total occlusions ). My condolences to his family and loved ones.
Of course the present economic downturn has affected the meeting. In my observations, I think that the meeting is quieter and the vendors' support, somewhat scaled down. I saw and appreciated the work of Dr Ochai and the Japanese who patiently work on complex CTOs, spending hours to open chronically occluded, collaterised coronary arteries. I must say that I do not have their skill and patience. Not to mention that my patients may not be able to afford the cost. It also reminds me that there are still limitations to this field of interventional cardiology, and that keeps me humble and my cardiac surgical colleagues, with work.
Needless to say, Drug-Eluting Stents are used all over the place. Although I personally think that the Endeavor ( and Endeavor Resolute ) and Xience V stents are probably the best around, I can see that the Drug Eluting Balloon and also the Biomatrix DES is being greatly promoted at this meeting. Personally ( as I mention to the manufacturers ) we need more data. I understand that the Drug Eluting Balloon should receive their CE mark soon and that we should soon see more data from the Leaders ( Biomatrix ) Trial. Until then we should keep on to the approved and proven stents, for the safety and benefit of our patients.
Overall, SingLive was an eye-opener. Syabas to Tian Hai and team for putting on a trremendous show.

No comments: