Medical Breakthrough: First Transcatheter Closures of Ventricular Septal Defect In Children

December 26 2005

[Gleneagles Hospital]

Gleneagles Hospital has successfully completed five cases of transcatheter closure of ventricular septal defect (VSD) in children since March 2004, achieving yet another medical first in Singapore. VSD is the most common type of congenital heart defect, where a hole in the septum exists between the two lower ventricles. The hole allows blood to flow from the left ventricle to the right ventricle. If left untreated, VSD may cause heart failure, produce abnormally, high pressure within the lungs, and even result in death.

The first few cases of transcatheter closure of VSD in the United States were only recently carried out in November 2003: The Singapore VSD team, lead by renowned paediatric cardiologist Prof. William Yip Chin-Ling of, Gleneagles Hospital, performed the first paediatric VSD case in Singapore on March 2, 2004. Since then, Dr. Yip's VSD team has successfully performed five (5) cases of VSD in children born with the congenital malady (photo).

Unlike traditionalopen-heart surgery, VSD closure by Amplatzer Membranous VSD Oecluder is non-invasive and can be preformed in less than three hours. Dr Yip stated that the primary advantages of this newest procedure include the avoidance of a heart-lung bypass machine and blood products, no postoperative pain, minimal surgical scars and other open-heart surgery complications. "The innovative transcatheter VSD procedure offers a viable alternative to traditional open-heart surgery," added Dr Yip.

Transcatheter closure of VSD is currently indicated for patients who have a significantly large VSD that requires surgical closure. Under guidance of ultrasound imaging and angiography, a specialized catheter and guide wire are used to cross the VSD where a unique device is deployed to close the VSD. Essentially, the Amplatzer Membranous VSD Occluder is delivered through a catheter to "plug" the congenital hole between the ventricles.

World's First Interactive Computer-Aided Vision Improvement Centre [SingHealth - Singapore National Eye Centre]

The Singapore National Eye Centre (SNEC) recently launched the world's first interactive, non-surgical, computer-aided; NeuroVisiona treatment centre for amblyopia and myopia. The innovative, groundbreaking technology offers treatment for adults with amblyopia ('lazy eye') which has been considered untreatable until now, as well as individuals with low degrees of myopia ('short-sightedness'). The Neuro Visiona technology improves vision without the need for surgery, contact lenses or medication. It is a series of computer-based programmes that exercise the part of the brain responsible for visual function to improve contrast sensitivity and to sharpen images seen. The patient will look at a sequence of flashing images for about 30 minutes every other day for about two months. It is unique in that the programme is interactive, and tracks the patient's individual progress to customise treatment around the individual's visual needs.

Successful Clinical Trials

The success rate of the NeuroVision® treatment is encouraging, with over 80% of the participants in its clinical trails, conducted in the United States, Singapore, and Israel, showing visual improvement. The technology has minimal risk, and has received regulatory approval from the United States Federal Drug Administration (FDA) and the European Union's CE mark. In achieving the approval of these globally respected regulator bodies, the NeuroVision® treatment has demonstrated safety in treatment, reliability in results, and validity of its technology. Clinical trials have shown that the effects on vision are sometimes after to two years

The Next Step for NeuroVision® Research

Associate Professor Donald Tan, deputy director of SNEC said "We know it works for low degrees of myopia and ambylopia, but there are other conditions where we'd like to test this as well -higher degrees of myopia, astigmatism, or can we enhance normal vision?" Clinical trials are currently underway to examine some of these options.

Unveiling New Skin Treatments - AuroraTM and PolarisTM

[Pacific Healthcare]

Pacific Healthcare Group announced the introduction of AuroraTM Fotofacial Radiofrequency and PolarisTM Skin Rejuvenation treatments in May 2004. These two treatment systems, available for the first time in Singapore, restore and renew skin to a more youthful state in a highly effective and safe manner. The new advanced treatments produce minimal or no side effects, allowing patients to undergo treatment in less than two hours and resume their normal activities with no downtime.

How does it work?

AuroraTM utilises proven technology that combines the optical energy of Intense Pulsed Light (IPL) and the electrical energy or radio frequency (RF) waves simultaneously, coupled with advanced controlled skin cooling techniques, to improve skin's appearance. This treatment is able to gently and quickly correct skin imperfections without damaging surrounding tissue or skin. Regardless of skin type, Aurora can achieve long-lasting results of skin conditions such as pigment imperfections resulting from sun damage and aging, red blotchiness from rosacea or vascular imperfections, and rough skin texture. The state-of-the-art system uses lower levels of each type of energy owing to the synergistic effect of the energies on each other. This approach is highly effective and safe, and yet has lower risk of side effects than conventional IPL treatments.

The PolarisTM skin rejuvenation treatment is an advanced system that maximises the synergy between electrical energy (conducted RF) and non-invasive diode laser energy. The PolarsTM system produces RF energy that is four times stronger than that of Aurora, thus enabling even greater capability for collagen stimulation, while protecting the outermost layers of the skin. It is extremely effective for wrinkle reduction, tightening enlarged pores, smoothening acne scarred skin, and achieving a non-surgical facelift. Polaris TM, however, does not treat pigmentation problems and is recommended as a complimentary treatment to Aurora TM.

Forte

First Adult Congenital Heart Disease Programme in South East Asia

[National Healthcare Group-The Heart Institute]

The Heart Institute, National Healthcare Group officially launched the first regional Adult Congenital Heart Programme in January 2004. The programme is designed to cater to the needs of the growing population of adult congenital heart disease (ACHD) patients. The prevalence of congenital heart disease is approximately 8 cases per 1,000 live births. Over the past two decades, neonatal and paediatric care for patients with congenital heart disease has sufficiently increased whereby 85 per cent of these children now survive into adulthood. Thus, the growing number of adults with congenital heart disease is estimated to be near 12,000 patients in Singapore alone. With continuing improvements in health care technology, allowing more of these individuals to survive into adulthood, the number is projected to increase 30 per cent by the year 2006. Currently, the paediatric doctors or adult cardiologists caring for theses patients may not be well equipped to deal with the complex problems these patients face while growing up. Issues such as pregnancy, arrhythmias and coronary artery disease become greater obstacles for these individuals.

The commencement of the Adult congenital Heart Programme is a first for Singapore and the South East Asian region. The multidisciplinary team comprises of adult and paediatric cardiologists, congenital heat surgeons, obstetricians, radiologist, nurse clinicians, medical social workers, physiotherapists and technologists. The programme offers expertise in heart disease during pregnancy, pulmonary hypertension and palliative care for those with end stage congenital heart disease. The versatile team specialises in non-surgical device intervention for atrial septal defects, surgical correction of heart problems, radiology (Nuclear and MRI), arrhythmia management, and cardiopulmonary exercise testing (photo). Additionally, they offer screening of patients and their family members who are suspected of having Marfan syndrome. A positive diagnosis of Marfan syndrome carries the risk of developing aortic dissection, a life threatening condition that can be prevented.

In July 2004, the implantation of an atrial septal defect (ASD) (photo) device was done with intracardiac echocardiography (ICE) (photo) for the first time in Singapore without the need for general anaesthesia. This equipment allows echocardio-graphy to be conducted from within the heart through a small tube inserted in the leg. This is in contrast to other methods that require entry from the throat. With this new procedure, patients can avoid painful scars on their chest.

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