MICA (P) 023/09/2007
Issue No. 10 • July – December 2007
Dr Poh Kian Keong:
Cardiovascular Research
at The Heart Institute
NEW
CARDIOVASCULAR
CENTRE
–
ON PAGE
4
–
READ MORE ON PAGE
2
in this issue
Cardiovascular
02
C ARDIOVASCULAR RESEARCH AT
THE HEART I NSTITUTE, NUH
NHG OUTSTANDING CITIZENSHIP
AWARDS
04
AT THE
NEW CARDIOVASCULAR CENTRE
05
HEART
C ARDIAC ELECTROPHYSIOLOGY
AT NUH
06
BRINGING SPECIALIST CARE TO
THE COMMUNITY
NATIONAL H EART WEEK
07
OPENING OF NUH
ANGIOGRAPHY CENTRE
ADDITION OF
08
2ND NUCLEAR LAB
NUH WINNING CPIP PROJECT
09
NUH 3RD SIMULATOR C OURSE
C ONFERMENT OF VISITING
P ROFESSORSHIP BY BEIJING
AEROSPACE CLINICAL INSTITUTE
10
3RD AICT MEETING
SINGAPORE V ENOUS FORUM
11
ECHO SINGAPORE 2007
12
LOST IN T RANSLATION IN
DURHAM, NORTH CAROLINA
13
THI AT EUROPEAN SOCIETY OF
CARDIOLOGY CONGRESS
Research at NUH Cardiac Dept has come a long way. Here,
the strength lies in clinical research as this is coupled with strong
clinical service and a large clinical database/digital archive, although
there is increasing activity and focus on bench research. The
research culture is pervasive at all levels, including doctors, nursing
staff and technologists. Research begins early in the career of
cardiology trainees at NUH and is pegged to training. Registrars
in their first years, are exposed and involved in research with their
respective mentors. It is a department policy for each of the junior
trainees to be mentored by a senior in their first year so that they
may be closely guided and stay focused. Often these registrars
continued on their projects with the same mentor, though in their
second year onwards, they can develop their own interest and
potentially move to work on their subspeciality of choice. Our
registrars usually become highly productive from their second year
of research. For example in the year 2007, they have abstracts
accepted for presentations in highly competitive international
conferences such as the annual scientific sessions of the American
MY EXPERIENCE IN NUH
14
A CASE OF MYOPERCARDITIS
IN A PATIENT WITH AN
AXILLARY ABSCESS
15
ADVANCED PRACTICE NURSES
AHA ANNUAL SCIENTIFIC
SESSION 2007
16
HAPPENINGS, ABSTRACTS,
P UBLICATIONS, COMPLIMENTS
20
DIRECTORY, AWARDS
FEEDBACK
Please direct your feedback to
The Editor, PULSE
c/o The Heart Institute
National University Hospital
Department of Cardiac,
Thoracic & Vasular Surgery
Level 2, Main Building Singapore 119074
Tel
6772 5565
Fax
6778 6057
Email
The_Heart_Institute@nuh.com.sg
EDITOR
Dr Poh Kian Keong
ADVISOR
A/Prof Tan Huay Cheem
Contents are not to be reproduced without the
permission of The Heart Institute
NHG Outstanding
In this year’s NHG Annual Scientific Congress Dinner on
10 Nov 2007, two doctors from the NUH’s Cardiac department
were awarded NHG Outstanding Citizenship Award. They are
A/Prof Tan Huay Cheem, Co-Director of The Heart Institute,
Senior Consultant & Chief of Cardiac Department NUH; and
Dr James Yip, Consultant and Clinical Director, Adult Congenital
Heart Disease, Cardiac Department, and Deputy Chief Medical
Information Officer, NUH.The award is given to staff in the cluster
who have gone beyond their area of expertise to help NHG achieve
its strategic organisational goals in improving healthcare delivery.
A/Prof Tan was instrumental in assisting TTSH and AH
build their Cardiology capabilities through the training of
manpower. He is also the deputy chairman of one of NHG’s
Institutional Research Boards. As Director of the Clinical Trials
Unit in NUH, he is a member of the committee that were
instrumental in securing funding from EDB and NUS to set up the
THI PULSE | 2
Research
INSTITUTE, NATIONAL UNIVERSITY HOSPITAL
Dr Poh Kian Keong,THI@NUH
Heart Association, the American College of Cardiology, the
European Society of Cardiology and sub-specialist conferences such
as the Transcatheter Cardiovascular Therapeutics and the American
Society of Echocardiography. This has helped to put Singapore
Cardiology research on the world map. In addition, our doctors
have consistently made their presence felt in local and regional
events such as the Singapore Cardiac Society, National Healthcare
Group and the Asia Pacific Congress of Cardiology scientific
meetings. Besides presenting their research findings, they were
also mentored to achieve Young Investigator Awards.
The mentors in the department are our own associate
consultants, consultants and senior consultants. Several collaborate
extensively outside the department as well, with NUS/NUH, other
hospital and research institutes within Singapore and
internationally. The entire culture of research has been healthy.
Most of the staff is involved in their own PI-initiated projects. These
encompass subspeciality research including interventional,
electrophysiology, cardiac imaging and cross-speciality projects.
In the year 2007, we have published in numerous peerreviewed journals: nine Tier-1 papers (eg Circulation, European
Heart Journal), three Tier-2 papers (eg American Heart Journal),
four Tier-3 papers (eg International Journal of Cardiology), five
Tier-4 papers (eg Journal of American Society of Echocardiography,
Annals Academy of Medicine, Singapore) and six other peerreviewed papers (eg Singapore Medical Journal).
Year 2007 also saw Prof Lee Chuen Nien and A/Prof Tan
Huay Cheem co-organizing a successful research retreat with active
participation from many bench and clinician scientists interested
in cardiovascular research.
Grant support came from multiple sources including
competitive medical research councils, institutional grant calls,
pharmaceutical company related clinical trials and from wellmeaning donors.
In this new year, we look forward to consistency, novel
discovery and research outcomes which will hopefully result in
clinically useful insights for our patients.
Citizenship Awards
Assoc Professor Tan Huay Cheem,THI@NUH
first General Clinical Research Centre (GCRC) in NHG that can
be used by any researchers within the cluster for clinical trials. As
the clinical champion for the NHG-Group Purchasing Office
Cardiac workgroup, he has also helped save significant expenses in
consumables and coronary stents.
Dr James Yip has been the brain behind the department
and hospital’s Medical Information Technology (IT) system. With
his unique knowhow and expertise in computer IT, Dr Yip
contributed immensely in helping NHG harness the application of
IT systems to enhance the efficiency of healthcare delivery.
He was instrumental in developing Aurora, the Clinician
Order Entry system – a system that will reduce errors in order
entries. He also single-handedly mapped the 25,000 ICD-9 codes
into the Aurora system for laboratory and radiology order entry.
The codes are now in an easily searchable format that facilitates
clinicians’ work, as well as able to capture data that will form the
Dr James Yip & his wife (on left) and A/Prof Tan Huay Cheem and his wife (right)
backbone of future decision support and audit systems.
Dr James Yip was previously conferred the Singapore Computing
Society Hall of Fame – Friend of IT award in 2005.
THI PULSE | 3
new cardiovascular centre
Assoc Professor Tan Huay Cheem ,THI@NUH
In Oct 2007, the Minister of Health, Mr Khaw Boon Wan,
announced the setting up of a second national cardiovascular and
cancer centres at the National University Hospital (NUH). With
increasing service demand on cardiovascular care because of the
ageing population and the high healthcare burden of this disease,
the Ministry of Health has viewed it necessary to establish a second
national cardiovascular subspecialty centre at the Kent Ridge
campus. National University Hospital is chosen because of the
substantial strength and expertise that she already possesses.
What is distinctive of this new cardiovascular centre is that
it is under a new governance structure of a joint operating entity
of NUH, NUS School of Medicine (NUS-SoM) and Faculty of
Dentistry. This new Board with comprise members from the
National Healthcare group (NHG), NUS, Ministry of Health and
Ministry of Education. NUH will remain a member of the National
Healthcare Group, and continue to benefit from collaborations,
patient referrals and shared central and support services.The SoM
will remain a part of NUS. The new governance structure will
allow doctors, faculty and staff to work even more effectively
together and to achieve greater synergies, in clinical care delivery,
medical training and research. In particular, the Board and the Chief
Executive of the joint NUH-SoM entity will oversee a common
budget and resource allocation system, as well as a common human
resource framework for all staff.
Lim Yong Wah, non-Executive Chairman of Inter-Roller
Engineering and former Director of NUH Board has been
appointed Chairman of the Board of Governors, which will oversee
the joint operating entity. Professor Tan Chorh Chuan, the Senior
Deputy President at the NUS, will be appointed the Chief Executive
to lead the operations of the new joint entity. A cardiovascular
planning committee, chaired by Associate Professor Tan Huay
Cheem, will chart vision, strategies and action plans and timelines
for the planning of the new cardiovascular centre. It is envisaged
that the new centre will ride on its unique strengths in areas of
clinical service, research and education in developing itself to be a
leading centre in the world. With its close proximity to the
University and medical school, the new centre is positioned to
conduct more cross-disciplinary vascular biological scientific
researches, clinical and epidemiological studies with the relevant
partners in the campus. The centre will also seek to collaborate
with The Heart Institute of NHG, National Heart Centre, DukeNUS Graduate Medical School Singapore and the rest of the
Singapore Heathcare system in pushing cardiovascular care in
Singapore to the next level. The planning and development of the
new cardiovascular centre, which seek to provide a new paradigm
of integrated and multidisciplinary care, is assisted by an
International Advisory Board chaired by the renowned Professor
Judith Swain, executive director of Singapore Institute for Clinical
Sciences (A*STAR), Dr Elizabeth Nabel, Director, National Heart,
Lung and Blood Institute; and Professor Bruce Reitz, Department
of Cardiothoracic Surgery, Stanford University, USA.
THI PULSE | 4
CARDIAC ELECTROPHYSIOLOGY AT THE
National University Hospital
Dr Abdul Razakjr, Dr Seow Swee Chong & Dr Chen LinYee,
THI@NUH
bradyarrhythmias is also performed in
Cardiac Electrophysiology is a
the electrophysiology laboratory.
subspecialty of cardiovascular
Our center also offers
medicine that addresses an
dedicated Arrhythmia Clinics and
increasingly important area:
Implantable Devices (Pacemakers and
arrhythmias or heart rhythm
Defibrillators) Clinics every week.
disorders.
The
effective
These provide outpatient support and
management of coronary artery
follow-up for patients with heart
disease over the past two decades has
rhythm disorders and intra-cardiac
led to improved patient survival.
devices, respectively. In affiliation with
This has in turn resulted in a
the NUS, the Heart Rhythm Service
worldwide increase in the
has on-going research projects aimed
prevalence of congestive heart
From left to right Dr Chen Lin Yee, Dr Abdul Razakjr Bin Omar,
at understanding fundamental
failure and heart rhythm disorders Dr Seow Swee Chong.
arrhythmia mechanisms and ultimately,
in the survivors.
The once-considered esoteric field of electrophysiology has improving patient care.
The Director of Cardiac Electrophysiology and Pacing
undergone revolutional changes in recent years. With advances in
technology enabling accurate 3-dimensional visualization of service, Dr. Abdul Razakjr Omar, is an alumnus of the NUS. After
internal cardiac anatomy and localization of electroanatomical obtaining his MRCP (UK), he completed his specialist training in
targets, catheter ablation therapy for cardiac arrhythmias has cardiology at NUH and his fellowship in Electrophysiology and
emerged as the treatment of choice in developed countries. This, Cardiac Pacing at Toronto General Hospital, Canada. He is a Fellow
coupled with improvements in catheter and other hardware design, of the American College of Cardiology (FACC) and of the Academy
has made catheter ablation a safe, effective and curative option in of Medicine, Singapore (FAMS). He is also a council member of
the Singapore Medical Association.
the treatment of heart rhythm disorders.
Dr. Seow Swee Chong graduated with MBBS from the NUS
Evidence accrued from multiple trials have demonstrated
significant mortality benefit from implantable cardioverter and went on to obtain MRCP (UK) and completed his fellowship
defibrillators (ICD) and biventricular pacemakers in patients with in Clinical Cardiac Electrophysiology and Pacing at Westmead
impaired cardiac function; and this has led to an increase in the Hospital, Australia. He is accredited in Invasive Electrophysiology
and Cardiac Pacing under the European Society of Cardiology. Dr.
number of such specialized procedures being performed.
This trend of burgeoning arrhythmia cases in Singapore Seow is a Fellow of the European Society of Cardiology (FESC) as
creates a demand for electrophysiologists. The Heart Institute at well as FAMS. He is also a Member of the European Heart Rhythm
the NUH is fortunate to have three heart rhythm specialists who Association (EHRA).
After graduating with the MBBS (Hon) from the NUS,
have been trained in cutting-edge techniques to manage complex
heart rhythm problems.These include ablation for atrial fibrillation Dr. Chen Lin Yee pursued further training at the Mayo Clinic,
and ventricular tachycardia, in addition to the more common Rochester, USA, where he completed training and is board certified
supraventricular tachycardias. These complex procedures are in internal medicine, cardiology, and cardiac electrophysiology.
performed safely and effectively under the guidance of advanced As Assistant Professor in the Department of Medicine, NUSe, Dr.
3-dimensional mapping systems (CARTO MERGE) and imaging Chen is also keenly involved in medical research especially in the
modalities (intracardiac echocardiogram and Cardiac CT scan) in genetic basis of heart rhythm disorders.
Led by a well-trained team of doctors with a broad global
a sophisticated, state-of-the-art cardiac electrophysiology
laboratory. Implantation of devices to improve the functional status perspective of various different techniques and cutting edge
of heart failure patients (biventricular pacemakers) and to prevent technology, the EP team at NUH is well poised to meet the
sudden cardiac death (ICDs), as well as for the treatment of challenges posed by the current era of cardiac patient care.
THI PULSE
PULSE || 55
THI
CARDIAC SERVICES AT JURONG
MEDICAL CENTRE
bringing specialist care
to the community
Dr Ong HeanYee,THI@AH
We celebrated our first birthday on
the 18th October 2007 at the Jurong Medical
Centre (JMC). JMC is located at “The
Frontier Community Place” next to the
Jurong West Library. Easily accessible via
Boon Lay MRT and the Boon Lay Bus
Interchange, it is in the heart of a dense and
vibrant community in the western aspect
of Singapore.
A significant percentage of referrals
from Primary care physicians were for assessment of minor
abnormal signs and symptoms picked up during routine review.
While many of these were unlikely to represent significant
pathology, they nonetheless require further investigation to clarify
and reassure. The usual work flow would require a referral to a
specialist, ordering the relevant tests by the specialist and a review
prior to discharge back to the primary physician. We hope to
bypass a few of these steps and empower the GPs to order these
tests directly and hence reduce the cost in
terms of time and money to the patient.
While there is concern that inappropriate
tests may be ordered by a non-specialist,
we will form close partnerships and opened
lines of communication to optimize the
utility of these services.
We will be offering several basic
cardiac investigations such as exercise stress
treadmill, 24 hour ambulatory ECG, 24
hour blood pressure monitoring and echocardiography. Through
the availability of exercise stress treadmills may be limited initially,
the other services have been running since August 2007. Also, in
the initial phase, we have a direct number to call and a form to fax
to us, we will be developing a paperless system in our next phase
– our working philosophy is “results when and where you need it”
and the results will be delivered to you wherever you are and before
you see your patient again.
National Heart Week
The Heart Institute at National University Hospital
participated actively in this year’s National Heart Week organized
by the Singapore Heart Foundation.This is an annual event held to
increase public awareness of cardiovascular disease and to promote
preventive measures to reduce its occurrence. It is held worldwide
and supported by the World Heart Federation. Associate Professor
Tan Huay Cheem and Dr Poh Kian Keong from the NUH Cardiac
Department, was the chairman and deputy chairman of this year’s
organising committee. The theme for the year is “Team Up for
Healthy Heart”. Among the many fun-filled and educational
activities was a mass walk across the
Sentosa bridge by 3000 walkers
from the SouthWest Community
Development Council. The
occasion was gracedby Ms Grace
Fu, Minister of State for National
Development.
THI PULSE | 6
Assoc Professor Tan Huay Cheem,THI@NUH
OPENING OF
NUH Angiography Centre
Assoc Professor Tan Huay Cheem,
THI@NUH
The opening of the
and patent foramen ovale. As
Angiography Centre on the
the volume of patients
11 Nov 2007 marked an
requiring minimally invasive
important milestone in the
diagnostic and interventional
development of interventional
procedures is expected to rise
cardiology programme at NUH.
with the ageing population and
From a small set-up of one
the influx of foreign patients,
cardiac catheterization laboratory From left A/Prof Wang Shih Chang and A/Prof Benjamin Ong
the centre is poised to handle
11 years ago performing only From right A/Prof Tan Huay Cheem and CEO Chua Song Khim
the additional workload in the
about 300 percutaneous coronary
coming years.
interventional (PCI) procedures a year, the new centre has now 3
The latest acquisition in the Angiography centre is a Siemens
out of its four catheterization laboratories equipped with cardiac Artis flat-panel system armed with the latest state-of-the-art
imaging capabilities. Last year, NUH performed more than 1500 software capable of providing superb quality images which enable
PCI procedures, 2300 coronary angiography and many other operators to perform highly complex procedures.The Centre was
procedures such as electrophysiologic studies and ablation officially opened by Mr Chua Song Khim, CEO NUH, witnessed
procedures, pacemakers implantation and treatment of structural by about 100 guests from the hospital management, medical staff
heart disease such as percutaneous closure of atrial septal defect and industry representatives.
ADDITION OF
nd
2 nuclear lab
THI PULSE | 7
NUH winning
CPIP project
Assoc Professor Tan Huay Cheem,THI@NUH
As the adage goes in the cardiology community for
patients with acute myocardial infarction, ‘time is muscle’,
the survival of these patients is intimately dependent on the time
taken for reperfusion therapy to be instituted. At National
University Hospital, the standard reperfusion therapy is the
mechanical revascularization of the occluded coronary artery in
the form of primary percutaneous coronary intervention (PCI).
One of the important quality measure indicator by which the
efficacy of this treatment is assessed is the door-to-balloon time
(the time by which a patient present at Emergency Room to the
time he received balloon dilation across his artery). It is a core
quality measure collected, recommended and reported by the
American College of Cardiology/American Heart Association, the
Centers for Medicare and Medicaid Services (CMS) and the Joint
Commission on Accreditation of Healthcare Organizations
(JCAHO). Studies have shown that every 30-minute delay in the
door-to-balloon time results in relative increase of 7.5% mortality
at 1 year. The recommended median door-to-balloon time is less
than 90 minutes for centres providing this service.
At NUH, the median door-to-balloon time between Jan
and Oct 2006 was 103 minutes. We therefore sought to identify
operational and clinical processes that may shorten the door-toballoon time in a Clinical Practice Improvement Project (CPIP)
headed by Associate Professor Tan Huay Cheem, Chief of the
department. The team comprises interventional cardiologists; Dr
Shirley Ooi, Chief of Emergency department (ER), cardiac
registrar, nursing staff of the coronary care unit and cardiac
catheterization laboratory, technologists and radiographers.Three
significant changes were instituted: (1) ER doctors are allowed to
activate the interventional team directly, (2) Patients with STEMI
CPIP PROJECT ON REDUCING ‘DOOR-TOBALLOON TIME’ IN PRIMARY PCI
are immediately transferred to the catheterization laboratory from
the ER after informed consent is obtained and (3) all members of
the interventional team will carry handphones instead of pagers.
The results of our project are shown in the figure below.
Between March and August 2007 (6 months), a total of 124
myocardial infarction patients were admitted though the ER
department at NUH. After adoption of the new strategies, the
median door-to-balloon time during the 6-month study period
was 70 minutes and > 73% of patients achieved the ‘below 90
minutes’ objective. In fact in the month of August, a spectacular
result was obtained. The median door-to-balloon time was 65
minutes and more than 90% of the patients achieved the target.
This is in sharp contrast to the period prior to the commencement
of the CPIP project when the median door-to-balloon time was
103 minutes. For the minority of the patients who exceeded 90
minutes of door-to-balloon time, the common reasons were:
hemodynamic instability requiring prolonged resuscitation in the
ER department and indecisiveness of the patients in giving consent
for the procedure.
In successfully shortening the median door-to-balloon time
for our patients with AMI undergoing primary PCI at NUH, we
have shown that innovative changes in work processes can bring
about significant transformation in outcomes for our patients.
The changes adopted in this project are proving to be
sustainable ones and have now become our routine practice.
For that, this project was awarded the best CPIP project at
the National HealthCare Group (NHG) Annual Scientific
Meeting held in November 2007.
From left: A/Prof Tan Huay Cheem & Dr Hou Xi Min
THI PULSE | 8
rd
NUH 3 simulator course
Assoc Professor Tan Huay Cheem,THI@NUH
National University Hospital successfully organized its 3rd
introductory course in interventional cardiology with hands on
training on vascular models and virtual-reality simulator in
November 2007. Started inYear 2006, NUH is the first South East
Asia center to organize this event on a regular basis. Originally coorganised with interventional cardiologists from University of
Wurzburg, Germany, this is the first time that the course is run
entirely by interventional cardiologists from NUH and TTSH.The
course is well received with participation by delegates from
countries such as Oman, India, Taiwan, Indonesia, Vietnam,
Myanmar etc. NUH aims to move on to organize the first Chinese
simulator course for doctors from mainland China, outside their
own country.
conferment of visiting professorship
BY
BEIJING AEROSPACE CLINICAL INSTITUTE
Assoc Professor Tan Huay Cheem,THI@NUH
Following closely his recent Visiting Professorship
conferment by China Shanghai Chest Hospital in June 2007,
Assoc Professor Tan Huay Cheem was awarded Lifetime Honorary
Professorship by the University of Beijing affiliated Beijing
Aerospace Clinical Institute in Sep 2007. In the citation, Assoc
Professor Tan was acknowledged for his professional knowledge
and influence in the field of cardiovascular medicine in the
international arena. The appointment certificate was presented to
Assoc Prof Tan by Professor Li Xiao Yu, administrative vice
president of the hospital.
THI PULSE | 9
rd
3 AICT Meeting
Dr Adrian Low,THI@NUH
The ‘Asian Interventional Cardiovascular Therapeutics
(AICT)’ is a unique forum representing the best of Interventional
Cardiology in Asia Pacific through the collaboration of Cardiac
Institutes of Excellence and National Interventional Cardiology
Societies in participating countries of the region. The inaugural
1st AICT Meeting held in Singapore in August 2005 was a
resounding success. This was followed by the 2nd AICT Meeting
in New Delhi, India last October which was also met with much
approval from the general interventional cardiology community.
This year, the 3rd AICT Meeting was held in Kuala Lumpur,
Malaysia from 11 to 14 July 2007 in combination with MY LIVE
2007, the Malaysian live-intervention demonstration course. The
meeting is a close partnership with the following societies: Asian
Pacific Society of Interventional Cardiology (APSIC), Society for
Cardiovascular Angiography and Interventions (SCAI),
Interventional Cardiovascular Society of Malaysia (ICSM) and
National Heart Association of Malaysia (NHAM)and brings East
and West together for Live Case demonstrations from seven
countries across the world, state of the art lectures, SCAI and APSIC
monitored training modules, Simulation Workshops and Fellowship
programmes. At the 3rd AICT, The second convocation of
Cardiology Fellows for the Asian Pacific Society of Interventional
Cardiology was held.
Singapore transmitted 2 live cases on the second day of the
conference.The focus was on bifurcation lesions and both complex
cases were carried out without complications.The operators were
Prof Tan Huay Cheem/Dr Lim Ing Haan and Prof Ronald Lee/Dr
Adrian Low. After completion of the demonstration, the doctors,
nurses, and technicians made their way to the airport and were
soon in Kuala Lumpur to join in the rest of the meeting.
Our doctors were faculty and given a broad range of roles
including moderator, speaker and instructor. Our group left on
Saturday exhausted but with many pleasant memories of a good
trip.
Singapore Venous Forum
A/Prof Peter Robless (CTVS) and Prof Lenny Tan (DDI),THI@NUH
embolism accounts for 25,000 deaths per
The inaugural Singapore Venous
annum and 100,000 people die annually
Forum jointly organized by the Heart
of VTE in the US, more than Breast
Institute and theYLL SoM was held from
Cancer, road traffic accident fatalities and
20-22nd Sept at the CRC. This meeting
AIDS combined. Yet it still remains a
brought together internationally
highly preventable cause of death in many
recognized experts on all aspects of
instances. The low use of
venous thromboembolic (VTE) disease
thromboprophlaxis may be due to an
from diagnosis and pathophysiology to
apparent lack of awareness and lack of
the current consensus on treatment.The
understanding of VTE and appropriate
meeting was well received and attended
treatment within the medical profession.
by over 140 delegates and speakers from
There is a perception that VTE is a rare
14 countries.
From left Prof Lenny Tan and A/Prof Peter Robless
and uncommon condition in Asia.This has
Venous thomboembolism
remains a major public health problem in most countries but there been the impetus for bringing together leaders in the field and
remains a lack of awareness about it. In the UK, pulmonary opinion leaders from the various specialties to address this issue in
THI PULSE | 10
16 - 18 AUGUST 2007
Echo Singapore 2007
A/Prof Ling Lieng Hsi,THI@ NUH
World experts in cardiovascular ultrasound and imaging
were brought together again for two-and-a-half days during Echo
Singapore 2007. The meeting, now a biennial event, was jointly
organized by The Heart Institute and National Heart Centre,
Singapore, and held under the aegis of the Singapore Cardiac
Society. Program directors were Dr Lieng H. Ling and Dr Bijoy
Khandheria and overseas experts included Dr Dae-Won Sohn,
Itzhak Kronzon, Jeroen J Bax, Rahal Yusoff, Smadar Kort, Steven
J. Lester and Thomas H. Marwick. The venue this time was the
Clinical Research Centre at theYong Loo Lin School of Medicine,
National University of Singapore.
In line with the theme “Cardiovascular Ultrasound in
Practice”, the 2007 program highlighted the use of
echocardiography and complementary imaging techniques in
clinical practice. The role of multimodality imaging in current
clinical practice, state-of-the-art ultrasound techniques for
quantitation of cardiac function and risk prognostication, diagnostic
and management dilemmas in valvular heart disease, and recent
advances in stress imaging were among the topics discussed.These
generated considerable interest and exchange between the faculty
and a packed audience. Live case demonstrations, clinically-biased
scenarios and use of
an
audience
response system
further enhanced
this interaction.
Feedbac k
from
the
participants was
uniformly good.
Undoubtedly, this
was due in large part
to the excellence of
our guest faculty
and the expert
contributions of our local faculty, comprising eminent cardiologists
from National University Hospital, National Heart Centre, Tan
Tock Seng Hospital, Changi General Hospital and Alexandra
Hospital. For their sterling contributions and that of the meeting
organizers, nurses and sonographers who worked tirelessly behind
the scenes, we owe a debt of gratitude!
an Asian context. The inaugural Singapore Venous forum has
brought together the most up to date work from the region and
the international collaborative effort. It has raised awareness on
the current thinking in the effective clinical management of venous
and lymphatic diseases.
Future plans for the Singapore venous forum include a
bi annual symposium for regional participants on the
management of venous disease and will include mini workshops
on vascular ultrasound and venous ulcer management. For
further details please visit www.sgvenousforum.com
THI
THI PULSE
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11
lost in translation in
Durham, North Carolina
Dr Mark Chan,THI@NUH
I still recall my anxiety at not having enough work to do when
I first arrived at Duke eighteen months ago. I had come with great
ambitions to write manuscript after manuscript, not knowing my
actual scope of daily work or the intensity of the Masters of Health
Science degree that I had signed up for. I clearly recall my frustration
at being asked to write review paper after review paper, write
proposal after proposal and adjudicate clinical event after clinical
event during my first few months at the Duke Clinical Research
Institute. And just when I though I was getting the hang of it, the
onslaught of biostatistics, molecular biology, followed by advanced
biostatistics and more advanced molecular biology. For close to
three months, I felt like a fish out of water. Because the Duke
curriculum stipulates a 2 year research fellowship for all their
cardiology fellows, many of the homegrown research fellows had
already organized several original research projects well in advance
and were able to hit the ground running. Fortunately for me, my
designated mentor, Rick Becker, recognized my enthusiasm and
helped me organize a research portfolio that was aligned with my
needs and his expertise.
So over a period of 12 months, he tutored me, weekly and
often more frequently, in the fine art of thrombocardiology, his
main area of research. Being the director of the Duke
Cardiovascular Thrombosis Center, he was able to provide a large
number of training resources, including opportunities to work on
animal models of device thrombosis, understand the molecular
and cellular basis of thrombosis, and even to try out optical
coherence tomography in pigs! He also got me interested in the
burgeoning field of molecular cardiology, using blood as a reporter
tissue to study thrombotic disorders.When he felt that I was ready,
he put me in charge of 2 phase 1 clinical trials studying a state-of-
the-art oligonucleotide factor IXa inhibitor that had its own
customized complementary antidote, saying that this should help
me close the translational research loop. That was followed by
months of hotline calls, site audits, data cleaning, and complex
pharmacodynamic modeling. But all this was worthwhile when he
put me as first author of both primary manuscripts. Not that life
was subsequently easygoing – we went through a total of 6 detailed
revisions for one manuscript and 9 revisions for the other before
submission. And this is in addition to the stacks of reading
assignments, homework, mid-terms and finals from the Masters
course. If not for a group of close-knit international comrades, I
would have burned out long ago!
Time does fly. In six months time, I will be moving over to
the catheterization laboratory at the Montreal Heart Institute. I
must say that my experience at Duke has really opened my eyes to
both the excitement and harsh realities of doing translational
research. Reflecting on my own hits and misses, I would offer this
advice to those eager to embark on a similar career path: 1. apply
for a grant that will get you sufficient training time in the best
possible environment under the best possible mentor; 2. draw up
clear objectives with your future mentor or supervisor well in
advance; 3. never neglect your clinical training as it will only serve
to enhance your research capabilities; 4. let me say it again – get a
good mentor, the best possible. My mentor recently spent an hour
on the phone, from 8 to 9 pm, with Ed Liu from the Genome
Institute of Singapore.When Ed asked him what the call was about,
Rick said bluntly that it was to help make sure I was not out of a
job if I were to return to Singapore. Make sure your mentor does
the same for you!
THI PULSE | 12
European Society of
Cardiology Congress
THI AT
Dr Lee Li Ching,THI @NUH
We arrived in Vienna, the city where
Mozart, Beethoven and the other great
composers used to live, on 31 August. This
year the European Society of Cardiology
(ESC) Congress was held in this city of
music from 1 to 5 September 2007.
We were totally amazed by the city’s
marvellous architecture; it has the exciting
blend of the royal-imperial flair of the past
with modern trends. Vienna has been the
centre of Habsburg Empire for centuries till
World War I. Today, grandiose palaces,
museums, gothic cathedrals, and historical monuments adorn the
inner city. It was not hard to get around the city and the people
were generally friendly and helpful. However, communicating with
the locals can be both challenging and fun. Every so often, we
ended up practising sign language.
The following few days were essentially packed with
scientific programs at MesseWien (Vienna Congress Centre). Chief
and Edgar presented their study on Genous stent, while Swee
Chong presented his research on atrial ablation. Both Eric Chong
and I shared our studies on contrast
induced nephropathy and vortex
formation index.To our surprise, we
found out that reporters from Strait
Times were there too. In fact, Eric’s
research was published in ST before
we were back.
It was a fulfilling opportunity
for us to attend a variety of lectures
and forums at the conference. We
particularly enjoyed the Meet the
Experts’ sessions where interesting
cases were discussed. The resulta ADVANCE study, which
represented the largest ever study in the treatment of diabetes
was released at the conference. It showed the importance of
lowering blood pressure for all diabetic patients, regardless of
whether they were hypertensive or not.
We finally departed Vienna on the rainy afternoon of 6
September after 5 days of enriching stay at Vienna. Putting the
conference aside, perhaps, we missed the best ofVienna:TheVienna
Boys’ Choir!
my experience in NUH
Dr. Hou Xu Min, Honorary Fellow of Cardiac Department,THI@NUH
How time flies! I
remembered clearly that one
year before when I arrived to
NUH from China, everything
was strange to me. This was
the first time I travelled
abroad alone. I was not sure
if I could adjust myself well.
However, after the first day
in NUH, I realized that I had
worried too much. The
Cardiac department in NUH
is a big family where everyone is a member, irregardless of the
language or nationality you are. Everyone treat me kindly and try
their best to help me settle down. That’s why I could concentrate
on learning so quickly, never lose weight
and never felt stressed.
The electronic data system in NUH
amazed me. I could find all the medical
detail that I need quickly before I started
coronary interventional procedure.
Everyday is busy. I became better bit by bit
and accumulated knowledge on optimizing
therapy for patients. I also become more
confident in performing the procedures.
Having completing my fellowship in
NUH, I feel so grateful to Prof Tan Huay
Cheem, Prof Lim Yean Teng, Dr Adrian Low, Dr Ronald Lee,
Dr Teo Swee Guan, sister Irene and all the people in cardiac
department. I look forward in applying what I learnt in NUH.
THI PULSE | 13
a case of
Myopericarditis
in
a
patient with an
Axillary Abscess
Dr LeeYian-Ping,THI@NUH.
We described a healthy
and physically active
50-year-old man who
presented to a private
practitioner with cough,
fever, chest pain and right
axillary pain. Physical
examination revealed a
right axillary fluctuant
lump consistent with an
abscess which was
subsequently drained by
the doctor. He was
prescribed a course of
amoxicillin/clavulanate.
However, the patient Figure 2 ECG showed saddle shaped ST segment elevations in the precordial and limb leads with PR segment depression, consistent with pericarditis.
continued to be febrile and
developed worsening right-sided pleuritic chest pain for the next m y o c a r d i t i s /
3 days. He presented to the Emergency department and was found pericarditis occur
to have a right lower lobe consolidation on chest radiograph (Figure mostly in association
1). His ECG (Figure 2) showed generalized saddle shaped ST with a pneumonia
segment elevations in the precordial and limb leads with PR or enteritis with
segment depression, consistent with pericarditis. The cardiac Mycoplasma and
enzymes were elevated (CKMB 45ug/L, Troponin T 0.75 ug/L) C a m p y l o b a c t e r
indicating myocyte injury.The white cell count was 26.3 x 109/L. being
the
Echocardiogram showed severely impaired left ventricular systolic commoner causes.
Our case
dysfunction (LVEF=30%) with global hypokinesia. There was no
pericardial fluid seen. A diagnosis of severe community-acquired illustrates how a
Figure 1 Presenting chest X-ray showed right lower lobe
pneumonia with resultant myopericarditis was made. The right seemingly benign consolidation and cardiomegaly
lower lobe pneumonia was likely caused by infection originating axillary abscess can
from the axillary abscess that tracked via a fistula from the axilla complicate to involve the pleural cavity, resulting in a pneumonia
to the pleural cavity. The microbiology yielded staphylococcus and subsequently myopericarditis. This highlights the importance
of increased alertness to the diagnosis of myopericarditis and the
aureus and he responded well to intravenous antibiotics.
Infective myocarditis is overwhelmingly reported to be viral uncommon association.
in etiology, with bacterial causes rarely described. Bacterial
THI PULSE | 14
Advanced Practice Nurses
Karen Koh,THI@NUH
The appointment role of
Advanced Practice Nurse
(APN) in Singapore marks the
beginning of an exciting milestone
in nursing history. The aim is to
provide a clinical track for nurses to
progress in their career should they
be interested in remaining in direct
patient care. Otherwise, good
clinical nurses would be ironically
moving further away from patient
care as they are promoted to either
administrative or teaching roles as
nurse managers or nurse educators respectively.
An APN is a master’s prepared nurse practicing at an
advanced level in direct patient care. She improves standards of
care, facilitates patient, nursing, and family education, and
develops nursing leadership with a clinical focus (International
Council of Nursing, 2002). The APN should have expert
knowledge base, complex clinical decision-making skills, and
clinical competencies for expanded practice under a collaborative
agreement with a physician.
In 2003, MoH and NUS collaborated to offer the Masters
of Nursing to prepare for APNs. The Nurses and Midwives
(Amendment) Act was passed in Parliament on 21 April 2005.
The key amendments were to allow for the setting up of an APN
Register and to regulate advanced practice nursing. To date, we
have eight nurses on the APN register out of which two are from
NUH.
Currently, cardiac department has one APN (Karen Koh
whose primary collaborating physician is Dr Chai Ping) and an APN
intern (Emily Gan whose clinical supervisor is Dr Abdul Razak). At
this moment, my focus are in cardiac rehabilitation and in the
coronary care unit while Emily’s focus includes electrophysiology
study and coronary monitoring unit. Both of us are privileged that
cardiac department has been supportive in the history making of
this professional role development. Physicians, at all levels, have
taken interest in teaching and guiding us. Moving forward, we hope
that leveraging on this unique symbiotic position would allow
Singapore’s healthcare system to effectively meet our evolving
healthcare needs.
annual scientific session 2007
AHA
Dr Eric Chong,THI@NUH
AHA annual scientific session 2007 was held at the Orange
County Convention Center, Orlando, Florida, US in November
2007. Several NUH cardiology registrars and consultants attended
the meeting.We had several oral abstract presentations and poster
exhibition. Many world renowned scientists and cardiologists
attended the meeting. The plenary session Hall was packed with
attendees. It was a great learning experience. We witnessed the
release of major breaking trials and attended lectures from
distinguished speakers in the field. It was an unforgettable
experience. I hope we can continue to participate in this meeting
and present our own research in the plenary clinical trial breaking
session in the near future.
THI PULSE | 15
happenings
NHG ANNUAL SCIENTIFIC CONGRESS
11 NOVEMBER 2007
MO’S FAREWELL DINNER
30 OCTOBER 2007
CARDIAC FAMILY DAY
12 AUGUST 2007
THI PULSE | 16
HEART WEEK
29-30 SEPTEMBER
AT VIVO
2007
CITY
ECHO
SINGAPORE
16-18 AUGUST 2007
SINGAPORE VENOUS FORUM
20-22 SEPTEMBER 2007
ASIA PACIFIC CONGRESS OF CARDIOLOGY
YOUNG INVESTIGATOR AWARD –
1ST PRIZE, CLINICAL
13-16 DECEMBER 2007
DR ERIC CHONG, REGISTRAR, NUH CARDIAC DEPT.
(THIS IS THE FIRST TIME A SINGAPORE DOCTOR WON THIS AWARD)
NUH-RESEARCH BIOLABS
CONTRAST ECHO WORKSHOP
6 OCTOBER 2007
THI PULSE | 17
abstracts
2ND ANNUAL SCIENTIFIC MEETING OF THE
SOCIETY OF CARDIOVASCULAR COMPUTED
TOMOGRAPHY 2007, WASHINGTON DC, USA,
5 TO 8 JULY 2007
1.
Detection of Noncalcified Coronary Plaques by 64-slice
Cardiac Computed Tomography in Patients with Suspected
Coronary Artery Disease. Chia PL, Lee R, Ho KT
2.
The 64-Slice Multidetector-Row Computed Tomography
is an accurate tool for the Non-invasive Evaluation of
Coronary Artery Bypass Graft Patency. Lee R, Lim J, Kaw
G, Wan G, Ng K, Ho KT
11TH ANNUAL SCIENTIFIC SESSION OF THE HEART
FAILURE SOCIETY OF AMERICA 2007,
WASHINGTON DC, USA, 16-19 SEP 2007
1.
Risk factors and Clinical Outcomes for Contrast Induced
Nephropathy Post Percutaneous Coronary Intervention
in Patients with Normal baseline Renal Function. Chong
E, Shen L, Tan HC
2.
Comparison of 6-Month Clinical Outcomes of Four
Second Generation Drug-Eluting Stents in Complex
Coronary Stenoses. Chong E, Shen L, Tan HC
3.
Comparison of One-Year Clinical Outcomes of
Endothelial Progenitor Cell Capture Stent and SirolimusEluting Bioabsorbable Polymer-Coated Stent In Patients
Undergoing Primary Percutaneous Coronary Intervention
for Acute Myocardial Infarction. Chong E, Shen L, Co M,
Lee CH, Tan HC
4.
5.
6.
Hyperacute Reduction and Absence of Subsequent
Elevation in Circulating Endothelial Progenitor Cells
during Percutaneous Coronary Intervention in Diabetics.
Lee LC, Choong PF, Hay E L T, Hou XM, Low A, Lee CH,
Omar AR, Chia BL, Tan HC, Chen CS, Poh KK
8.
Safety and efficacy of primary percutaneous coronary
intervention for acute myocardial infarction complicated
by cardiogenic shock in an institution without on-site
cardiothoracic support. Ooi YW, Khoo CH, Chia PL,
Chan SP, Nair D, Lim IH, Lim J
AMERICAN HEART ASSOCIATION SCIENTIFIC
SESSIONS 2007, ORLANDO, FLORIDA,
4-7 NOV 2007
1.
Risk factors and Clinical Outcomes for contrast Induced
Nephropathy post Percutaneous Coronary Intervention
in patients with normal baseline renal function. Chong E,
Tan HC, L Shen, Chan YH
2.
Comparison of Endothelial Progenitor Cell Capture Stent
with Bare Metal Stent in patients undergoing Primary
Percutaneous Coronary Intervention for Acute Myocardial
Infarction. Tay E, Co M, Lee CH, Low A, Lim J, Lim IH,
Teo SG, Tan HC
3.
Natural History and Predictors of Improvement of Mitral
Regurgitation After Percutaneous Aortic Valve
Replacement. Durst R, Friera LF, Avelar E, Poh KK, Llano
M, Chu J, Rodriguez L, Mack MJ, Hanzel G, Kodali SK,
Hung J, Picard MH
4.
Vortex Formation Index in Heart Failure: Novel
Noninvasive Assessment of Fluid Dynamics using
Transthoracic Echocardiography. Lee LC,TanYL ,Tan HC,
Omar AR, Chai P, Yeo TC, Low A, Yip JWL, Chia BL,
Poh KK
5.
Transcription factor E2F2 regulates Vessel Contractile
function and Blood Pressure vis Isoform-specific
Expressions of Endothelin Converting Enzyme-1. Qin
GQ, Zhu Y, Kishore R, Dinesh D, Thorne T, Poh KK,
Losordo DW
6.
Catheterization without In-hospital Revascularization in
Patients with Non-ST Elevation Myocardial Infarction.
Chan MY, Mahaffey KW, Sun LJ, Pieper KS White HD,
Aylward PE, Ferguson JJ, Califf RM, Roe MT
7.
Antidote-Controlled Modulation of Factor IXa Activity
with a First-in-Class Oligonucleotide Drug-Antidote Pair.
Chan MY, Rusconi CP, Alexander JH, Tonkens RM,
Harrington RA, Becker RC
8.
A First-in-Class Oligonucleotide Drug-Antidote Pair
Efficiently Modulates Factor IXa Activity in Human
Subjects. Chan MY, Cohen MG, Rusconi CP, Alexander
JH, Myles SK, Aberle LG, Lin M, Melloni C , Tonkens
RM, Harrington RA, Becker RC
Attenuation of Left Ventricular Vortex Formation Ability
in Heart Failure. Lee LC, Tan YL, Chia BL, Poh KK
TRANSCATHETER CARDIOVASCULAR
THERAPEUTICS 2007, WASHINGTON CONVENTION
CENTER, WASHINGTON DC, 20-25 OCT 2007
1.
7.
Two-Year Outcome after Implantation of a Novel DrugEluting Stent using Bioabsorbable-Polymer Technology in
Myocardial Infarction. Hou XM, Lim J, Low A, Loke C,
Tan HC, Lee CH
Relation Between Late Instent Neointimal Proliferation
and amount of Residual Plaque outside the Drug-Eluting
Stents: An Intravascular Ultrasound Study on Cypher and
Taxus Stents. Lee CH, Zhang JJ, Kailasam A, Tai BC,Ye F,
Low A, Chen SL, Tan HC
Clinical Predictors of Stent Thrombosis in the “RealWorld”
Drug-Eluting Stent Era. Hay ELT, Low A, Lee CH, Teo
SG, Lim J, Lim IH, Tan HC, Lim YT
THI PULSE | 18
publications in press
1.
New England Journal of Medicine 2007; 357(21): 21672178. A 31-Year-Old Woman with Rash, Fever and
Hypotension. Sabatine MS, Poh KK, Mega JL, Shepard
JA, Stone JR, Frosch MP
2.
Journal of the American Society of Echocardiography; 2007,
In Press. Prognostication of Valvular Aortic Stenosis Using
Tissue Doppler Echocardiography: Underappreciated
Importance of Late Diastolic Mitral AnnularVelocity. Poh KK,
Chan MYY,Yang H,Yong QW, ChanYH, Ling LH
3.
Journal of the American Society of Echocardiography;
2007, In Press.The Mitral Annular Mid-Diastolic Velocity
Curve (L’): Functional Correlates and Clinical Significance
in Patients with Left Ventricular Hypertrophy. Lam CSP,
Han L, Oh JK,Yang H, LH Ling
4.
Annals of Academy Medicine, Singapore; 2007; 36(8): 66271. Clinically Compressed Digitally Echocardiography: A
Patient-Safe Alternative to Videotape Review. Poh KK,Yang
H, Omar AR,Yip JWL, ChanYH, Ling LH
12. Int J Cardiol. 2007; 10;119(2): 168-75. The 6-Minute
Walk Test is a Powerful Predictor of both Morbidity and
Mortality in Asian Patients with Congestive Heart Failure
on Contemporary MedicalTherapy. Lee R, ChanYH,Wong
J, Lau D, Ng K
13. Eur J Echocardiogr 2007; 8(3): 175-84. Assessment of
Subclinical Left Ventricular Dysfunction in Asymptomatic
Mitral Regurgitation. Lee R, Marwick TH
14. Singapore Medical Journal 2008; In Press. Isolated high
lateral acute myocardial infarction with superior injury
current axis. Lee LC, Tan HC, Poh KK
15. Acute Coronary Syndromes 2007; 8: 114. P2Y 12
Inhibitors in the Management of Acute Coronary
Syndromes. Chan MY, Becker RC, Mahaffey KW, MD,
Harrington RA, Roe MT
16. Current Treatment Options in Cardiovascular Medicine
2008; In Press. Identification and Treatment of Arterial
Thrombophilia. Chan MY, Becker RC
17. American Heart Journal 2007; In Press. Non-Invasive,
Medical Management for Non-ST-Elevation. Chan MY,
Becker RC, Harrington RA, Peterson ED, Armstrong PW
18. Journal of Cardiovascular Electrophysiology, 2008; In Press.
Lone Atrial Fibrillation: Influence of Famillial Disease on
Gender Predilection. Chen LY, Lin, Olson,Timothy
5.
Journal of Invasive Cardiology; 2007, In Press. Lethal
presentation of coronary artery spasm after an event-free
period of six years following initial diagnosis. Lee CH,
Seow SC, Lim YT
19. International Journal of Angiology, 2008; In Press.
Complete Fracture of an Ikari Guiding Catheter in Axillary
Artery During Transradial Coronary Intervention. LeeYP,
Tan HC, Lee CH
6.
American Journal of Geriatric Cardiology 2007; In Press.
Impact of combination evidence-based medical therapy
on mortality following myocardial infarction in elderly
patients.Tay LW, Chan MY,Tan WD, Sim LL,Tan HC,Yeo TC
BOOK
7.
International Journal of Cardiology; 2008,In Press. Diverse
Clinical Spectrum of Stress-induced Cardiomyopathy. LeeYP,
Poh KK, Omar AR, Lee CH, Low AF,Tan HC, Chia BL
8.
Annals of Academy of Medicine; 2007, In Press.
Noncompaction Cardiomyopathy Presenting with Classical
Angina Pectoris. LeeYP, Ling LH, Low AF
9.
Singapore Medical Journal 2007; 48(6): 528-3. Efficacy of
community-based multidisciplinary disease management of
chronic heart failure. Omar AR, Suppiah N, Chai P, ChanYH,
SeowYH, Quek LL, Poh KK,Tan HC
10. American Heart Journal 2007; In Press. Use of Endothelial
Progenitor Cell Capture Stent (Genous Bio-Engineered
R Stent) During Primary Percutaneous Coronary
Intervention in Acute Myocardial Infarction: Intermediate
to Long Term Clinical Follow–Up. Co M, Tay–E, Lee CH,
Poh KK, Low A, Lim J, Lim IH, Lim YT, Tan HC
11. Clin Chim Acta 2007; 377(1-2): 276-8. B-type Natriuretic
Peptide Testing is Associated with Reduced Cost in Patients
with Secondary Diagnosis of Heart Failure. Hawkins RC,
Chung KN
1.
CHAPTERS
Novel Markers in Patients with Suspected ACS.
Biomarkers in Heart Disease edited by James A. De Lemos,
American Heart Association 2008; In Press. Lopes RD,
Chan MY, Newby LK
compliments
Compliment on ST for Dr James Yip and
Cardiac Staff – Mr Danny Chua
new doctors on board
National University Hospital
Dr Darren HL Lee – CTVS Registrar
Dr Graeme Maclaren – Cardiac Intensivist
Dr Joshua Loh – Registrar
Dr James Smitt – Registrar
Dr Ngo Minh Hung – Honorary Fellow
(Interventional Cardiology)
Tan Tock Seng Hospital
Dr Prabath Joseph Francis - Service Registrar
THI PULSE
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19
THI
directory
THE HEART INSTITUTE,
NATIONAL HEALTHCARE GROUP
Secretariat Office
c/o Department of Cardiac, Thoracic & Vascular Surgery
National University Hospital
Level 2, Main Building
Singapore 119074
Tel
6772 5565
Fax
6778 6057
Website
www.thi.nhg.com.sg
ALEXANDRA HOSPITAL
6472 2000
6379 3880
Appointment Line
Fax
Specialist Outpatient Clinic
6476 8828
6379 3880
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NATIONAL UNIVERSITY HOSPITAL
6779 5555
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Clinic Appointment
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6772 5730
6775 1617
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Clinic Appointment 6772 5277/6772 5278
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Singapore 308433
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Central Appointment
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Private Appointment
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Direct Line to Clinic
Fax
ASIAN CHAPTER CONGRESS
UNION OF ANGIOLOGY
OF THE
INTERNATIONAL
Acknowledgement of Contribution, Dr Rajesh Babu Our
initial experience with Fenestrated branched Endovascular Stent
Grafts for Complex Aortic Aneurysms, Our Experience with
hybrid Endovascular Procedures for Complex Aortic Patholoy
and Endovenous Laser Therapy for Chronic Venous Insufficiency
EUROPEAN SOCIETY
FOR
VASCULAR SURGERY
Poster prize Dr Darren HL Lee
16TH ASIAN PACIFIC CONGRESS
OF
CARDIOLOGY
Young Investigator’s Award (First prize, Clinical)
Dr Eric Chong
NATIONAL HEALTHCARE GROUP ANNUAL SCIENTIFIC
CONGRESS
378 Alexandra Road
Singapore 159964
Tel
Fax
5 Lower Kent Ridge Road
Singaore 119074
Tel
Fax
Awards
6357 7000
6357 7011
6357 8000
6357 7011
6357 8011
6357 8680
Best Poster Award Dr Lee Li Ching
Clinical Practice Improvement Programme (CPIP) Project Award
A/Prof Tan Huay Cheem, To achieve median door-to-balloon
time to <90 minutes; and for 100% patients with ST-elevation
myocardial infarction (STEMI) to receive primary percutaneous
coronary interventions within 6 months.
Sustainability Award 2007 Dr Chai Ping, Reduce Femoral Artery
Complication Following Cardiac Catheterization
Merit Award for FY2007 NUH WAY Quest project Calvin Lim,
Nancy Yong, Nur Ainsyah, Esther, Cardiac PSA Team,
To review patient experience process in Clinic H’s Anti
Coagulation Clinics (ACC) to reduce waiting time.
NATIONAL EXCELLENT SERVICE AWARD (EXSA) 2007
Star Awards Wong Ching Chiew Raymond – Associate Consultant,
Cardiac • Yip Wei Luen James – Consultant, Cardiac • Tan Huay
Cheem – Sr Consultant, Cardiac • Tan Poh Tin – Staff Nurse I,
Cardiac Clinic • Michael George Caleb – Sr Consultant Cardiothoracic
Surgery • Peter Ashley Robless – Consultant Cardiothoracic
Surgery Gold Awards Abdul Razakjr Bin Omar – Consultant,
Cardiac Hong Cho Tek Eric – Associate Consultant, Cardiac •
Azean Binte Ahmad Usari – Patient Service Associate, Cardiac
Clinic • Songco Geronica Gorospe – Medical Technologist,
Diagnostic Cardio • Yang Yumin – Jr Medical Technologist,
Inasive Cardio Lab • Jeevaratnam D/O Sinnappan – Medical Lab
Technician, Nuclear Cardiology • Tan Tiong Tee Christie – Sr
Consultant Cardiothoracic Surgery Silver Awards Seow Swee
Chong – Associate Consultant, Cardiac • Nur Azidah Bte Hussin
– Snr Asst Nurse, Cardiac Clinic • Mary Joyce Yu Galupo – Jr
Medical Technologist, Invasive Cardio Lab • Ee Seow Choon –
Medical Lab Technician, Diagnostic Cardio • Chow Choy Chun –
Sr Patient Service Associate, Diagnostic Cardio • Ooi Oon
Cheong – Associate Consultant Cardiothoracic Surgery
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