Bridge the Communication of International Cardiovascular World- Sino-Thai Cardiovascular Professional Corridor was held successfully

“The symposium served as a great platform for continued learning and education for physicians from both countries, facilitating future clinical practices on both ends.”

On Mar. 19th 2021, Sino-Thai Cardiovascular Professional Corridor commenced online, bringing together King Chulalongkorn Memorial Hospital, Thailand and Nanjing First Hospital of Nanjing Medical University, China. The conference received high recognition from Dr. Wacin Buddhari from King Chulalongkorn Memorial Hospital who expressed his gratitude by pointing out that the symposium further enhanced international communication in cardiovascular medicine between the two countries and forged stronger friendship. He looked forward to meeting overseas cardiovascular peers virtually in similar future events .

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The event invited Dr. Wacin Buddhari, Prof. Wasan Udayachalerm, Associate Prof. Suphot Srimahachota, Dr. Jarkarpun Chaipromprasit, Dr. Siriporn Athisakul, Dr. Vorarit Lertsuwunseri and Dr. Chaisiri Wanlapakorn from King Chulalongkorn Memorial Hospital and Prof. Chen Shaoliang, Dr. Zhang Junjie, Dr. Ye Fei, Dr. Tian Nailiang, Dr. Ge Zhen and Dr. Zhang Juan from Nanjing First Hospital of Nanjing Medical University. Cardiovascular experts conducted profound discussion on complex coronary cases and TAVR.

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Dr. Wacin Buddhari was introducing Cardiac Center of King Chulalongkorn Memorial Hospital

Founded in 1914, King Chulalongkorn Memorial Hospital, as one of the biggest hospitals in Thailand, is a century-old hospital with glorious history. The Cardiac Center operates 3 Cath Labs and multiple specialties, including Cardiology, Cardiothoracic Surgery, Anesthesiology, Cardiac Imaging, Pediatrics and Rehabilitation Center. The Cardiac Center registers growing annual PCI volume, reaching 969 in 2019. Its emergency PCI volume accounted for 20-25% of total PCI volume. The Cardiac Center is active in the treatment of structural heart diseases. Since its first TAVR operation in 2010, the hospital is now the biggest TAVR center in Thailand.

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Introduction of Cardiology Department of Nanjing First Hospital of Nanjing Medical University by Prof. Chen Shaoliang

Cardiology Department of Nanjing First Hospital of Nanjing Medical University operates 4 advanced cath labs, a molecular biology laboratory, a clinical trial center, an echocardiogram and non-invasive diagnosis and treatment clinic and a cardiovascular pharmacology research lab. The department runs close to 300 beds with an international team of 65 cardiologists and was recognized as ‘excellence heart center’ by ESC last year. The department has rich experience in left main bifurcation lesion, pulmonary artery denervation (PDNA) and intervention treatment of structural heart diseases and top-of-the world capability in multiple medical technologies. The DK-Crush technique proposed by Prof. Chen Shaoliang has been proven to be better than Provisional stenting in treating true left main & bifurcation lesion and was written into 2018 ESC Guideline on Myocardial Revascularization.

In the case discussion session, the two hospitals presented a complex bifurcation case respectively.


The Thai Hospital

The choice of technique is very important to long-term prognosis

Dr. Chaisiri Wanlapakorn from King Chulalongkorn Memorial Hospital shared a case of emergency high-risk bifurcation lesion under the title of ‘The Art of PCI.’

Presented with acute chest pain, the patient was admitted to hospital and found to have LAD and LCX proximal bifurcation lesion with an extremely short LM on coronary angiography. The patient developed cardiac arrest the moment we performed wiring. After cardiopulmonary resuscitation, the lesion was treated using SKS technique with IABP support, which successfully treated the lesion. The patient was readmitted after 4 months due to in-stent restenosis and underwent only the balloon dilation from LAD to circumflex under IVUS guidance.

Dr. Chaisiri Wanlapakorn noted that when performing the emergency PCI, patient’s long term prognosis should be considered. 

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Dr. Chaisiri Wanlapakorn on case discussion


The Chinese Hospital

Application of DK-Crush in treating true bifurcation lesion

Prof. Ge Zhen from Nanjing First Hospital of Nanjing Medical University shared a case treating left main distal bifurcation lesion with DK-Crush under IVUS guidance. 

Upon admission, the patient was classified as complex bifurcation lesion based on definition of complex bifurcations. DK-Crush technique was chosen. During the operation, right coronary lesion was first treated before successfully treating true left main distal bifurcation lesion under IVUS guidance.

Prof. Ge Zhen emphasized the importance of balloon sizing for proper Crush. The choice of balloon should be based on vessel diameter. Main branch crushing balloon to proximal main branch vessel diameter ratio is better at 1:1.

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Prof. Ge Zhen on case discussion


Live-streaming TAVR on low risk aortic valve stenosis 

Prof. Zhang Junjie from Nanjing First Hospital of Nanjing Medical University remotely connected with the operating physician of a TAVR operation. The TAVR for rheumatic aortic valve stenosis with severe adhesion was performed  successfully. 

During the operation, physicians from Thailand and China engaged in a heated discussion on whether post-dilation was necessary. Prof. Suphot Srimahachota held that echo showed relieve of stenosis after valve implantation and acceptable pressure gradient, therefore post-dilation was unnecessary. Prof. Zhang Junjie argued that though the self-expandable valve would self-expand without post dilation, yet, he learned from experience that patients with complex anatomy like this one would not have good long-term prognosis without post dilation.

Dr. Wacin Buddhari agreed with the benefit of post-dilation. The technique would significantly reduce regurgitation and was the best choice for this patient. Prof. Chen Shaoliang echoed his support. Clinical result also showed significant reduction in regurgitation, indicating effective post-dilation.

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Prof. Zhang Junjie in the Live-streaming operation

In the 2-hour-long symposium, the Thai and Chinese medical team had a thorough communication on PCI strategy for complex bifurcation lesions and diagnosis and treatment of TAVR. Dr. Wacin Buddhari also shared the development of TAVR in Thailand: the first TAVR operation in Thailand was done in 2009. By 2015, only 3 hospitals in Thailand have conducted TAVR. Now, a total of 12 centers in hospitals in Thailand have completed more than 700 TAVR operations. TAVR is fast developing in Thailand.

“DK-Crush technique proposed by Prof. Chen Shaoliao provides us with new tools in the treatment of bifurcation lesions. We want to keep communicating with cardiovascular experts from all over, join hands in promoting PCI and TAVR development across the world and benefit more cardiovascular patients.”

Dr. Wacin Buddhari made a special remark that this symposium helps us to learn from each other, make the best out of the both centers and motivate all physicians to strive for excellence in intervention treatment. 

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