Taking Interactive Conferencing to a New Level

04/09/2013

Imagine a conference where delegates roll their sleeves up and get involved in a life- saving heart procedure. That’s exactly what happened at the annual European Society of Cardiology meeting in Amsterdam this week.

Cardiologists from around the world watched as they evaluated imaging data and interacted with the team in Belfast as they performed a keyhole heart valve replacement procedure via satellite link to the conference hall.

The European Society of Cardiology annual congress is considered the largest congress in the world with over 29,000 delegates and prides itself on updating delegates on access to current and new technology which could revolutionise treatment and care. This year the focus was on Northern Ireland where teams from two local HSC Trusts are doing ground breaking work.

Traditionally, older patients with a severe narrowing of the aortic valve may not be strong enough to undergo open heart surgery, and management options are often limited. Now Cardiologists from both the Royal Victoria Hospital and Ulster Hospital can assess patients for their suitability of a pioneering new technique. If a patient is considered suitable a valve can be passed through blood vessels into the heart without the need for major surgery and subsequent recovery in cardiac intensive care. A patient can go home in just a few days.

Success is dependent on a thorough imaging work-up and a key step in this process is the use of specialised CT imaging. The Ulster Hospital has pioneered work in Cardiac CT since 2003 and is now once again at the forefront of a new application. In less than 20 seconds the team at the Ulster can acquire images from the head to top of the legs. This allows them to see the arteries and determine their suitability for this new procedure. Finally, they help the team in the Royal Victoria Hospital to accurately size the valve for implantation.

Dr Patrick Donnelly, Consultant Cardiologist (Ulster Hospital) said: “The emerging role of Cardiac CT imaging in this arena has revolutionised our understanding of the challenges doctors face with vascular access and valve sizing. We can now anticipate some of these challenges before we bring them to theatre thanks to the high quality 3D imaging of CT”.  Recent medical reports have demonstrated that the role of CT has made a real difference to patient outcomes and I am delighted that we can provide this cutting edge technology for patients in Northern Ireland”.

The heart team in the Royal Victoria Hospital, Belfast have a five year pedigree in this new technique and are at the forefront of novel valve designs and implant techniques.

Dr Mark Spence, Consultant Interventional Cardiologist and co-founder of the Belfast Transcatheter Aortic Valve Implantation (TAVI) Programme who led the Belfast heart team for the conference said “We feel privileged to have been invited by our European peers to host this interactive session. TAVI procedures are performed in elderly patients with complex health problems and require a collaborative approach for their success. We, in Belfast, have been early to adopt a minimally invasive approach with this new technology. This allows us to implant a new heart valve with our patients awake and we demonstrated this technique to the conference in Amsterdam. I am also delighted to report that our patient was well enough to return home the day following the procedure”.

Dr Patrick Donnelly who chaired the session in Amsterdam said “This was a wonderful opportunity to showcase the work that we do in Northern Ireland and a privilege to share our experience to the wider cardiology community. At the conference we had the opportunity to emphasise the importance of the Heart Team. By bringing together a number of doctors with different specialist skills who review the patient’s symptoms and imaging test results together creates a collective forum to air best practice, and drive up quality outcomes”.

Dr Donna Fitzsimons, Senior Lecturer, University of Ulster said "This was an innovative and interactive presentation from a multidisciplinary team of experts in the field of TAVI implementation. Hundreds of delegates packed a session in the midst of the European Society of Cardiology congress that saw a live TAVI implantation demonstration live from Belfast with feedback, questions and evaluation from the delegates in Amsterdam. Definitely one of the most informative sessions I have attended at this congress - delighted that the patient is now discharged and congratulations to Dr Donnelly, Dr Spence, Dr Manoharan, Dr Johnston and each of the nurses and Allied Healthcare Professionals that transmitted such sound educational material internationally".

L/R: Operating team at RVH, Sandra Gowdy (Staff Nurse); Dr Ganesh Manoharan (Consultant Cardiologist) & Dr Mark Spence (Consultant Interventional Cardiologist)

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