“Quad” of modern devices helps clear calcified coronary arteries
Ms. NTT (75 years old) was taken to the emergency room at Tam Anh General Hospital in Ho Chi Minh City with chest pain and severe shortness of breath – typical symptoms of myocardial infarction. Ms. T. has had chronic kidney failure for more than 10 years, so the doctor ordered coronary angiography using the Philips Azurion Robotic Ceiling FlexArm digital subtraction angiography system with a 360-degree rotating robotic arm, using a minimal amount of contrast agent (Cardio Swing technique). The results showed that the heart artery (anterior interventricular artery) was 95% narrowed and severely calcified.
The ARTIS Pheno angiography robot combines the optical coherence tomography (OCT) system to provide clear images of the structure of blood vessel layers and lesions on the surface of the vessel, helping doctors place optimal stents, limit complications and reduce the risk of restenosis for patients.
Master-Doctor-CKII Vo Anh Minh, Deputy Head of Interventional Cardiology Department, Cardiovascular Center – Tam Anh General Hospital, Ho Chi Minh City, analyzed the case of Ms. T., who would have had difficulty achieving optimal treatment results if using the conventional balloon angioplasty and stent placement method. “The patient’s blood vessels were severely calcified, there was a risk of the balloon not expanding, the stent slipping off the balloon, the stent expanding in the wrong position or not expanding completely, creating a blood clot blocking the blood vessel. Therefore, the intervention team carefully drilled and cut the atherosclerotic plaque in the lumen of the vessel with a diamond-coated drill (Rotablator) before placing the stent,” said Dr. Minh.
The diamond-coated drill bit with a diameter of 1.5 mm and a rotation speed of up to 180,000 rpm will shred and finely grind the hardened plaque into tiny particles and be removed by macrophages in the blood. Each drilling session lasts from 5 to 10 seconds to ensure that the heart is continuously perfused with blood. Doctors operate under the guidance of the Dynamic Coronary Roadmap (DCR) “compass” and the “magic eye” of intravascular ultrasound (IVUS), which is a combination of 64 platinum alloy elements and electronic chips, helping to clearly display images of the lumen and blood vessel wall. Thanks to that, doctors accurately determine the location where the stent needs to be placed, accurately measure the lumen size, choose the largest and longest diameter stent, and dilate the stent to the maximum, reducing the risk of acute occlusion or restenosis.
Philips Azurion Robotic Ceiling FlexArm digital angiography and intervention system with 360-degree rotating robotic arm, directional “compass” (DCR), “magic eye” (IVUS) combined with AI analysis helps doctors place stents with minimal contrast, preserving kidney function for patients.
The “Quartet” is a set of modern AI-based devices that are being deployed synchronously in cardiovascular interventions at the Cardiovascular Center – Tam Anh General Hospital, bringing outstanding results. “Compared to conventional stent placement techniques, this combination gives better results: reducing acute occlusion – reducing restenosis – reducing mortality – reducing complications. The rate of acute occlusion is only 0.44%, restenosis is 1.6% in the first year and 4.2% in the next 3 years,” said Dr. Minh.
The hospital is also equipped with a Hybrid operating room with the ARTIS Pheno angiography robot combined with an optical coherence tomography (OCT) system for clear images of the vascular lumen even when injecting a minimal amount of contrast agent, and optimal stent placement for patients.
Confidently master advanced techniques for diagnosing cardiovascular diseases
With more than 50 years of experience, Associate Professor, Doctor, Doctor Pham Nguyen Vinh, Director of the Cardiovascular Center – Tam Anh General Hospital, Ho Chi Minh City, said that cardiovascular diseases are very difficult to diagnose. Compared to previous centuries, the integration of AI in the echocardiography system, computed tomography (CT-Scanner) or magnetic resonance imaging (MRI) helps doctors synthesize and analyze data at a very fast speed, optimizing time and diagnostic efficiency. AI also suggests additional diagnoses based on consulting available specialized big data systems, helping many cases detect abnormalities from the smallest signs and treat them promptly.
AI is integrated into the new generation echocardiography system to help screen and detect cardiovascular diseases early in fetuses, newborns, children and adults.
The AI algorithm in the GE Vivid E95 or Voluson E10 echocardiography machine also allows doctors to cut and reconstruct the fetal heart structure (even if the fetus is only as small as a coin) in 4-dimensional space, combined with artificial intelligence to automatically separate each blood vessel in complex blood vessel complexes, easily detecting vascular abnormalities. Many cases of complex congenital heart disease detected from the 16th to 17th week of pregnancy at Tam Anh General Hospital are closely monitored by obstetricians and cardiologists and intervened immediately after birth, increasing the child’s chance of survival.
In addition to the echocardiography system, AI is applied in most imaging diagnostic techniques such as cardiac magnetic resonance imaging, coronary computed tomography (MSCT)… Tam Anh General Hospital System is the first medical unit in Southeast Asia to order and put into use the GE HealthCare genuine synchronous 1975-slice Revolution Apex Elite CT machine, the world’s most modern AI application.
Team of leading experts, experienced doctors, Cardiovascular Center of Tam Anh General Hospital System
The system has a capture speed of 0.23 seconds/time resolution of 19.5 milliseconds, detecting small lesions of only 0.23 mm (previous generations of machines were up to 0.33 mm). From here, atherosclerotic plaques, blood clots, stenosis, aneurysms… can be detected early. In particular, the machine helps evaluate blood perfusion of the entire heart and capture coronary images in just one beat, suitable for cases of tachycardia, arrhythmia, atrial fibrillation. The machine takes pictures quickly with an ultra-low radiation dose, capable of reducing radiation dose by up to 96%, safe for patients.
“Our hospital has invested in a synchronous system of modern equipment, a team of doctors who coordinate closely with other specialties and are regularly updated with techniques with colleagues around the world, so we are confident in mastering advanced techniques, aiming to detect early and promptly treat many complicated heart disease cases in the country with optimal efficiency and cost,” Associate Professor, Doctor, Doctor Pham Nguyen Vinh concluded.
Associate Professor, Doctor, Doctor Nguyen Thi Bach Yen, Head of the Cardiology Department – Tam Anh General Hospital, Hanoi, said that in the past, severe coronary artery stenosis cases almost always required open surgery. However, elderly patients with underlying diseases make the risk of surgery higher. The application of AI is a new step forward in the field of cardiovascular intervention, helping to promptly treat complex cases with minimally invasive methods, prolonging life and improving the quality of life for patients.