Canon / Erbis had invited Dr Kenya Nasu, Director, Department of Cardiovascular Medicine, Toyohashi Heart Center, Japan to share his knowledge and expertise with Indian interventional cardiologists
With the rising incidence of CVDs in India, the cardiology community is set to witness a paradigm shift in treatment mechanisms, technologies, complexities of cases etc., that will enable the community to expand the canvas of research. Cases such as chronic total occlusion, resistant lesions, calcification, bifurcation, and multi-vessel disease will be on a rise. And so a constant update and innovation in surgical treatment sciences, technologies that will allow experts to better their approach to complex lesions will become a growing need. In keeping with this, recently, Canon Medical System conducted workshops on Complex PCIs at Mumbai’s Thunga Hospital and Apollo Hospital. The workshop focussed on discussing complex cardiac interventions, technological innovations and areas still needing improvement.
Canon / Erbis had invited Dr Kenya Nasu, Director, Department of Cardiovascular Medicine, Toyohashi Heart Center, Japan to share his knowledge and expertise with Indian interventional cardiologists. Dr Nasu has been proficient in dealing with chronic total occlusions and other complex lesions. In these workshops, Dr Nasu explained some interesting approaches that interventional cardiologists can take in order to treat complex lesions.
Canon’s vision behind this initiative is to develop a knowledge sharing platform for experts in the field of cardiac sciences to meet and discuss advancements and complexities associated with PCIs. Strategically this initiative will also help the company establish a strong presence in the cardiology business segment. (Read more: Canon Medical System’s to go market strategy).
The two day workshop began on September 24, 2019 at Thunga Hospital, Mumbai with an inauguration meeting where Dr Nasu; N Sotomatsu, Executive Director, Erbis Engineering; Tomoko Kamijima, Senior Manager, Global Strategic Marketing, Canon Medical Systems; MS Menon, Projects Director, S Kumaran, Business Head – Cardiology Solutions, Erbis Engineering; Dr Satish Shetty, CMD, Thunga Hospitals; Rajesh Shetty, CFO, Thunga Hospital and Umesh Shetty – CEO, Thunga Hospital explaining the vision and purpose of the workshops.
Dr Satish Shetty, CMD, Thunga Hospital said that he was extremely delighted to be part of such a knowledgeable workshop at his hospital. At Thunga, they strive to provide the best quality care to patient and this association with Canon is a step in this direction, he acknowledged. Dr Nasu addressed the audience saying, “I am here to share my knowledge and experience in complex PCIs and to help improve cardiac care in India.” Menon spoke on the vision for conducting the first workshop at Thunga Hospital. “We have a relationship with Thunga Hospital for more than 10 years. We choose this cath lab for our workshop because of the highest quality standards that this hospital follows. This hospital has an eye for detail, when it comes to hygiene standards and we feel this is the right place to begin our initiative,” he mentioned.
N Sotomatsu, Executive Director, EBRIS ENGG said, “We want to create more opportunities for collaborations between Japan and India and this workshop is a step towards it.”
The day one workshop began with two complex PCIs conducted by a team of interventional cardiologists Dr Harminder Singh, Interventional Cardiologist, Medways Cardiac Clinic; Dr Surinder Hansra, Interventional Cardiologist and Fellow of European Society of Cardiology and Dr Ryan D’souza, Fellow, Invasive Cardiology, University Hospital, Bern, Switzerland. The first case was of a 65 year old man having three vessel blockages and the second patient was in his late 50s having two blockages but with a heart function rate of only 25 per cent. According to the doctors, the second case was more complex and Dr Nasu’s intervention was really crucial to this procedure.
Dr Singh mentioned, “Japan has a very large geriatric population and so the doctors there are exposed to many complex cases. Dr Nasu’s insights in the cases we worked together were really valuable. Moreover, we got to work on some really high-end image-guided machine that provided us superior quality imaging to manoeuvre around the clogged arteries. The knowledge acquired during the session on complex PCIs with information on the latest developments in hardware and instruments that are used in these procedures can now be passed on to our other colleagues. We can now create a community of well-informed cardio-vascular experts. With all this knowledge we can be sure of increasing the success rate of very complex PCI as well. ”
Dr D’souza chipped in saying. “Dr Nasu updated us on an interesting technique called Plasma-mediated ablation (PMA)that makes use of high energy laser pulses to ionise molecules within the first few femtoseconds of the pulse. According to Dr Nasu, this process leads to a submicrometer-sized bubble of plasma that can ablate tissue with negligible heat transfer and collateral damage to neighbouring tissue. The use of PMA provides a unique means to study regrowth of the damaged axon as well as recovery of physiological behaviour. This also indicates that several types of neurons can regenerate rapidly following a single cut in the axon. This technique is being research further in Japan. Dr Nasu’s insights are greatly appreciated.”
Similarly, Dr Hansra also appreciated the wisdom shared by Dr Nasu and said that we should have more such workshops and knowledge sharing opportunities to improve our healthcare delivery system in India. On the second day, the workshop was conducted at Apollo Hospitals, Navi Mumbai. Dr Nasu also shared his expertise during a couple of procedures done at Apollo’s cath lab. Dr Sanjeev Kumar Kalakekar, Cardiologist, Apollo Hospitals, Navi Mumbai talked about the reasons behind the high incidence of heart diseases among Indians and the importance of PCI to deal with it. He said, “In India awareness on CVDs is growing in urban areas. However, awareness levels are low in rural areas when compared to urban population.” Dr Kalakekar also mentioned that India is the diabetes capital and Indians are genetically prone to heart diseases where there are patients in the age group of 25-30 as well. Cost of procedures is a major concern, but govt schemes are now helping people.”
Additionally Dr Kalakekar said, one should follow newer innovations, doctors should welcome ideas that reduce risk of radiation to patients. This also helps doctors to ensure accuracy. Moreover, Dr Nasu also gave a presentation that explained Canon’s cath lab system and the practices in Japan. He explained that the system is designed to provide high quality images by using a high dynamic range system. The cath lab also has after image correction system and a radiation dose monitor. (See box: Angiography system by Canon) Giving a comparison of the healthcare system in Japan and India, Dr Nasu said that primary care is very important when it comes to management of CVDs in a country like India. In Japan, patients with Myocardial infarction (MI) get immediate care even at a primary health centre in a rural village. Whereas in India, especially in the rural areas, people do not get the necessary care for such illnesses. The insurance system in India is also very different when compared to Japan, therefore, it becomes a little difficult to provide specialised cardiac care in villages. Also, cases of myocardial infraction in Japan is far lesser than India.
He further spoke about the approach that India should take in order to curb the rising incidence of CVDs. He mentioned that a primary preventive care approach is a must. Management of diabetes, hypertension is also very crucial. While talking about the technology and technique utilised during these procedures, Dr Nasu informed that PMA is a highly innovative mechanism to treat chronic total occlusions. It has a high success rate, with high precision and reduces procedure time as well. It also ensures low radiation dose as well.
Speaking about the technology, N Sotomatsu informed that Canon’s cath lab system has a X-Ray radiation dose tracking system that can identify and indicate to the doctor the exact amount of radiation a patient is exposed to during the procedure. This is done in real time and the information is also communicated on a monitor as well as audio in order to ensure that patients aren’t exposed to extra radiation. He also informed on the carbon footprint aspect and power (electricity) requirement of the system. “Our system saves around 15-17 per cent of energy without compromising on the image quality and system performance. We believe in developing products that are eco-friendly and reduce carbon footprint.”
At the end, Dr Nasu said that innovation is very important, it will help to maximise the impact of treatment and we are looking forward for better strategies for patient care.