News
Sri Lankan interventional cardiologists showcase prowess at international session
View(s):- A first at ‘Singapore Live’
By Kumudini Hettiarachchi
Many eyes not only from Singapore but also the region were riveted on a Catheterization Laboratory in Sri Lanka, in a first for our country when two well-known Cardiologists performed a live coronary (heart) intervention on Friday (January 26).
In the Cath Lab of the Asiri Central Private Hospital was a 45-year-old man from Anuradhapura, who had suffered a heart attack. He was under local anaesthesia.
Having evaluated his case, Senior Consultant Cardiologist Dr. Vajira Senaratne and Consultant Cardiologist Dr. Tanya Pereira had discussed the pros and cons and what was best for him. The decision was clear – the better option was Percutaneous Transluminal Coronary Angioplasty (PTCA) for the Left Main Stem (LMS) vessel and Left Anterior Descending (LAD) artery providing blood to his heart, but were blocked. This would be the better and minimally invasive option rather than Coronary Artery Bypass Graft (CABG) surgery which entails open heart surgery.
The procedure being performed by Dr. Vajira Senaratne and Dr. Tanya Pereira in Sri Lanka as a Live Transmission Centre
And so, this patient was the ‘chosen one’ for the live procedure viewed not only by senior colleagues but also juniors in training who were participating in the prestigious ‘Singapore Live’ (SingLIVE 2024) from January 25-27, an Asia-Pacific pre-eminent annual live course in cardiac interventions. It had been launched back in 1989 by the National Heart Centre Singapore (NHCS).
This 33rd annual live interventions in vascular endotherapy session covering coronary interventions; structural heart interventions; imaging and physiology; and practical tips and tricks was held at the Raffles City Convention Centre in Singapore.
Sri Lanka was among the ‘Live Transmission Centres’ including Singapore’s National Heart Centre, National University Heart Centre & Tan Tock Seng Hospital; India’s Apollo Hospitals – Chennai, Apollo CVHF Heart Institute – Gujarat, Meditrina Hospital, Medanta The Medicity & Metromed International Cardiac Centre (MICC) – Kerala; Hong Kong’s Queen Elizabeth Hospital & Tuen Mun Hospital; Thailand’s Central Chest Institute; Vietnam’s National Heart Institute; and Belgium’s Brussels University Hospital – Uz.
Explaining why this is a unique event, Dr. Senaratne said that it is the first time Sri Lanka had been invited to showcase its expertise, skills and technology at ‘Singapore Live’ to share knowledge with peers and juniors even though Sri Lankans had been participating over the years. 
“The complex procedure we performed was revascularization the diseased Left Main Coronary Artery (LMCA) through Percutaneous Coronary Intervention (PCI). Even though for several decades, CABG has been regarded as the standard choice, with our experience in angioplasty we are now performing PCI on suitable cases,” he said.
Dr. Senaratne explains how they used Intravascular Ultrasound (IVUS) to get real-time visualization of the right gauge of the block, its length etc to get accurate measurements for stenting and identify any procedural complications. They also utilized the rotablator to trim the calcium deposits to make the insertion of the stent smoother.
Dr. Pereira who is President of the Sri Lanka College of Cardiologists said that the procedure was performed through a small artery in the wrist.
The Sunday Times learns that under this procedure, the interventional cardiologist inserts a small tube called a sheath (similar to an IV) into a blood vessel in the wrist. Then a catheter (a smaller tube) is placed within the sheath and guided through it to the heart. Live X-ray images help guide the catheter through blood vessels until it reaches the affected coronary artery.
Once the catheter is in place, a contrast liquid is injected into the artery to determine where the coronary artery is narrowed or blocked. Thereafter, a thin guide-wire is sent through the catheter and across the narrowed or blocked section of the artery.
This is followed by balloon angioplasty, where a second, smaller catheter – equipped with a balloon – is inserted and tracked over the wire to the coronary artery. It is positioned within the narrowed or blocked section of the artery and inflated, opening the artery and allowing the blood flow.
Next a stent – a tube made of mesh wire – is inserted into the reopened section of the artery. The stent is coated with a slow-release medication (drug-eluting) to help prevent a recurrence of the block.
The ‘live case’ was followed by a panel discussion in which Cardiologists Dr. Stanley Amarasekera, Dr. Sreenivas Kumar Arramaraju, Dr. Choo Gim Hooi, Dr. Nimali Fernando, Dr. Billal Patel, Dr. Mohan Rajakaruna, Dr. Gotabhaya Ranasinghe and Dr. Alan Cy Yeung participated. It was chaired by Dr. Koh Tian Hai and Dr. Wijeyasingam Shantharaj.
The procedure being watched closely at the Raffles City Convention Centre, Singapore.
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