Cardiology took a huge leap forward in the last 40 years; the development of thrombolysis, coronary angioplasty, statins and transcatheter valve replacements have made a huge difference to the treatment we can provide patients. I am predominantly a clinician but try to support the research of others and some of my own work.
CT Coronary Angiography
For my doctorate I undertook research into the use of CT (computed tomography) scanners to assess coronary arteries. In particular I looked at the CT technology, methods of improving image acquisition and the possibility of assessing coronary stents to see if they had patency and the applicability of coronary CT to the assesment of patients with chest pain of recent onset.
CT scanners are X-ray machines that take cross-sectional images through the body. Recent technological developments gave them the speed and resolution to start to be used in assessing the moving coronary arteries. In fact CT scanners are now quite widely used in the assesment of low risk patients with chest pains. The advantage of CT coronary angiography is that it avoids the risk of invasive coronary angiography and when used appropriately can exclude the presence of significant coronary arteries rapidly and safely.
Radial Access for Coronary Agiograms and PCII was lucky to be trained in some of the prominent cardiac centres in the world with enthusiastic proponents of using the radial artery to perform invasive procedures such as angiograms, angioplasty and coronary stent insertion. I have performed a small amount of research on this theme. In particular, in conjunction with the doctors at Sunnybrook hospital in we have investigated the feasibility of undertaking TAVI assesment via the radial access route and this should be published shortly.
Trends in RevascularisationIn the UK, the British Cardiac Interventional Society publishes a great amount of detail exploring the performance of invasive coronary procedures, with a huge amount of work undertaken by Dr Peter Ludman and the UK surgical societies have been publishing similar data for some time for bypass surgery. In British Columbia, I am undertaking some similar work investigating the trends in both bypass surgery and coronary intervention, the changing population and characteristics of patients undergoing these revascularisation procedures and how well they do after teir procedures.
Large Multicenter TrialsThere are many research trials ongoing across the world that recruit patients from multiple centres in an effort to give the most accurate data and avoid the influence of local practice, variations and bias. It is important to try and involve patients appropriately in these studies if they are interested in doing so and I try to facilitate this whenever reasonable. I have been very lucky to work with the Victoria Heart Institute Foundation recruiting and assessing patients for a large range of cardiac research trials.
If you would like to discuss research or trials involvement then please get in touch.