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Straits Times
a day ago
- Health
- Straits Times
Innovative customised procedure can help to prevent aortic aneurysms
Sign up now: Get ST's newsletters delivered to your inbox Adjunct Associate Professor Vitaly A. Sorokin (left) and Adjunct Associate Professor Low Ting Ting with Mr Long Foo Pieng, who was among the first few patients to undergo the procedure. SINGAPORE - Aortic aneurysms – where the aorta, the largest artery in the human body, swells to more than 1½ times its normal size – is estimated to result in up to 200,000 deaths worldwide annually. In cases of aortic rupture, when all the layers of the aorta wall tear, there is an 80 per cent mortality rate. An innovative surgical procedure , now available in Singapore, can stop an aneurysm from growing and prevent an aortic rupture from happening. Originating from the heart's left ventricle, the aorta is the body's main artery, directing oxygenated blood from the heart to the rest of the body. An aortic aneurysm can be caused by many factors, such as high blood pressure, genetic conditions or aortic valve issues. The condition is often under-diagnosed, thus increasing the risk that the bulge in the aorta continues to grow and eventually ruptures along the elastic wall, resulting in rapid, life-threatening blood loss. To reduce the risk of such an occurrence, the National University Heart Centre, Singapore (NUHCS) has introduced a procedure called the Personalised External Aortic Root Support (Pears), which uses a custom-made, open mesh support sleeve to reinforce a weakened aorta. Top stories Swipe. Select. Stay informed. 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'The open-mesh sleeve used to support the weakened aorta in Pears is custom-shaped to a 3D-printed model of a patient's aorta from their CT scan,' said Adjunct Associate Professor Vitaly A. Sorokin, who heads the adult cardiac surgery division at NUHCS' cardiac, thoracic and vascular surgery department. 'Due to the customised nature of this sleeve, it provides personalised long-term structural support to the heart vessel, which is crucial in stopping the aneurysm from growing larger,' he added. Pears is developed by British medical manufacturing firm Exstent, whose founder, Mr Tal Golesworthy, has Marfan syndrome – a genetic disorder that affects the body's connective tissue and can weaken the aorta's walls. An engineer by training, Mr Golesworthy designed Pears as a solution to treat his own aorta, becoming the first person to have the device implanted in 2004. Though the procedure has been around for more than two decades, it has only become more widely adopted internationally over the past 10 years, amid advancements in CT scanning and 3D printing, said Prof Vitaly. NUHCS is believed to be the first centre to introduce Pears in South-east Asia, first performing the procedure in November 2024. Six patients, aged between 40 and 55, have undergone the procedure since it was introduced, all of whom are faring well. Among the first few patients to undergo the procedure was 56-year-old Long Foo Pieng, who in 2004 was diagnosed with congenital bicuspid aortic valve – a heart defect present at birth, where the aortic valve has only two leaflets instead of three. This can result in aortic stenosis, where the valve narrows, or aortic regurgitation, where the blood flows backwards from the aorta into the left ventricle. These conditions can be fatal if severe and left untreated. The retired company director initially managed the condition using medication and lifestyle adjustments, as surgery would require that the valve be replaced with a prosthetic substitute, which would require significant changes to his lifestyle, said Adjunct Associate Professor Low Ting Ting, a senior consultant with the cardiology department. However, his condition eventually led to aortic dilation, requiring surgery. 'When this Pears procedure came along, it allows us to manage to constrict the size of his aorta without replacing the aortic valve,' said Prof Low. After undergoing Pears, Mr Long was discharged from the hospital within a week. He recovered well and in six months was able to resume his normal day-to-day activities. 'I was very happy back at the golf course again, going to the driving range almost two to three times a week,' he said.
CNA
a day ago
- Health
- CNA
Health Matters - Heart concerns when you turn SG60
Guest: Dr Yeo Tee Joo, Director of Cardiac Rehabilitation Unit, National University Heart Centre, Singapore (NUHCS).
Straits Times
22-05-2025
- Health
- Straits Times
Unsedated patients on life support have lower risk of heart complications, muscle shrinkage: NUH
A patient in intensive care is undergoing awake Ecmo, where she is kept awake and breathing on her own, without the need for total sedation. PHOTO: NUHS SINGAPORE – Critically ill patients in intensive care will now have the option of staying awake and breathing on their own while on life support, without the need for total sedation. This will also give them a chance to interact with the healthcare team, reduce the chances of muscle shrinkage and for early rehabilitation. Patients are often placed in a medically induced coma when undergoing extracorporeal membrane oxygenation (Ecmo), a treatment for those with life-threatening heart and lung failure that keeps the blood pumping and oxygenated outside the body. An alternative treatment, called awake Ecmo, has been performed successfully on three patients at the National University Hospital since 2023. 'These patients are equally sick, but they are strong enough to get the Ecmo process started while they are conscious,' said Adjunct Associate Professor K.R. Ramanathan, a senior consultant in the Cardiothoracic ICU at the National University Heart Centre, Singapore (NUHCS). 'Most of them are young and they have a single organ failure, such as the heart or lungs.' On the advancements made in managing patients on Ecmo, he said: 'Now we have come to a stage where we do not use sedation at a ll. This helps the patients and caregivers in a big way.' When the patients know what is happening, they are able to communicate better with the medical staff for more favourable outcomes. He added: 'They are able to partake in the rehabilitation process within a few days. It enhances their recovery, and they leave the ICU much earlier.' Avoiding sedation while Ecmo is being initiated also reduces the risk of the patient's heart stopping, he said. However, not all patients are suitable for awake Ecmo. Doctors have to assess the severity of the illness, as well as the patient's ability to maintain a clear airway and tolerate life support while conscious, Prof Ramanathan said. One of the three patients who underwent awake Ecmo was nursing student Gwendolyn Lye, after she developed a high fever and shortness of breath in late January 2024. 'I felt something was truly wrong when I started to feel short of breath, not being able to lie flat to sleep and even sitting up, I would wake up gasping for air. My fever was also not improving despite taking medication,' she said. She was referred to National University Hospital (NUH) on Jan 30 after blood tests showed that she was infected by enterovirus, which is a common virus that usually causes cold-like symptoms, but 'it had somehow managed to get into my bloodstream and got to my heart'. This caused myocarditis, or inflammation of the heart muscle, which led to fluid build-up in her lungs. 'Prior to being placed on awake Ecmo, I only remember feeling super unwell, constantly vomiting and being unable to eat,' Ms Lye said. Her heart was too weak for her to be anaesthetised for traditional Ecmo. 'I was mainly concerned about how much pain I was going to feel,' she said. 'But in the end, I felt completely comfortable and having been able to be awake to see the preparation process – it was interesting.' Nurses and physiotherapists on her care team also initiated gentle exercise sessions, such as stretching and mobility drills, to prevent rapid loss of muscle mass. 'I am thankful that the medical team decided on awake Ecmo as I knew how intubation could possibly lead to a longer recovery process instead,' added Ms Lye. She recovered enough to stop Ecmo on Feb 4 and was discharged on Feb 15, and has returned to doing everything that she used to before hospitalisation, such as hiking and going for clinical attachments for nursing. Prof Ramanathan said that for patients who require sedation during Ecmo treatment, the team aims to wake them after 14 to 21 days to begin rehabilitation and prevent muscle wastage. Thirty-year-old Nathan Tan checked himself into the emergency department in March 2023 after he felt pain in his back and was taking shallow breaths. Despite losing his fingers, toes and his left leg below the knee after a bout of pneumonia in 2023, Mr Nathan Tan, 30, has learnt to dance again after undergoing rehabilitation. PHOTO: LIANHE ZAOBAO He was diagnosed with pneumonia. 'That was when everything went downhill,' he said . Mr Tan remained sedated while on Ecmo for 38 days, but was awakened for rehabilitation as his care team did not want the young man's muscles to atrophy. Unfortunately, in his third month in hospital, the virus that caused his pneumonia entered his bloodstream, causing sepsis. He ended up requiring amputation of his fingers and toes and his left leg below the knee, as they had turned gangrenous. Despite that, Mr Tan continues to live his dream of being a dancer, citing non-traditional dance companies in the US that feature dancers with disabilities, as a source of inspiration. 'My physiotherapists got creative and worked in dance moves for my therapy, helping me to continue to feel that I am worthy. I regained my confidence and I even went to the Lady Gaga concert on May 21 and danced my heart out,' he said. Join ST's WhatsApp Channel and get the latest news and must-reads.
Korea Herald
14-05-2025
- Health
- Korea Herald
A NEW HOPE FOR PATIENTS SUFFERING FROM POTENTIALLY FATAL RARE HEART DISEASE: NUHCS IS FIRST IN ASIA TO RECRUIT PATIENTS FOR LANDMARK GENE EDITING CLINICAL TRIAL
The international study explores gene editing therapy to stop the production of proteins causing the disease in ATTR-CM patients SINGAPORE, May 14, 2025 /PRNewswire/ -- While receiving treatment for a car accident ten years ago, Mr Chua learnt that he had an abnormal build-up of protein in his heart vessels. This discovery led to the diagnosis of a condition known as transthyretin amyloid cardiomyopathy (ATTR-CM), a rare disease currently affecting approximately 150 patients in Singapore. ATTR-CM is caused by the build-up of misfolded, deformed transthyretin proteins in the heart, nerves and other organs due to genetic mutation or ageing. Symptoms of this potentially fatal rare disease are often vague and may include numbness in the hands and feet, lethargy and dizziness. If not diagnosed and treated promptly, ATTR-CM can lead to heart failure. Over time, Mr Chua's hands and legs became stiff, and the once active 62-year-old could no longer walk. The subsequent years following his diagnosis were riddled with frequent visits to the hospital due to episodes of heart failure and multiple injuries from falls resulting from nerve issues caused by the disease. Despite being on years of medication, Mr Chua's condition had continued to decline, and his growing need for assistance with simple everyday tasks had greatly affected his spirit. There is currently no cure for this debilitating illness. A new international clinical trial may be set to change the trajectory of this disease for patients suffering from ATTR-CM – including Mr Chua. The MAGNITUDE study involves a single-dose gene editing therapy administered intravenously that will alter the patient's DNA, slowing down the production of the abnormal protein that causes the disease. Novel treatment offers new hope for patients Assistant Professor Lin Weiqin, Clinical Director of the Heart Failure and Cardiomyopathy Programme at the National University Heart Centre, Singapore (NUHCS), is leading the Singapore arm of this trial. He shared that the double-blind study will investigate the impact of the gene editing research medicine Nexiguran Ziclumeran (nex-z, also known as NTLA-2001) on ATTR-CM. "Gene editing therapy has been approved in other countries, for use in some neuro-muscular conditions, cancers and inherited blood disorders. If this trial is successful, it will be the first DNA altering treatment used in the field of adult cardiology and offers new hope to patients living with ATTR-CM," explained Asst Prof Lin, who is also a Senior Consultant at NUHCS. In Asia, the first patient of the double-blind clinical trial was recruited in Singapore and received his infusion in September 2024 at NUHCS. Since then, four more patients have been involved in the study, including Mr Chua, who was the fifth and most recent participant. The gene editing therapy is administered alongside the standard treatment for ATTR-CM as part of the study. While it may take another two to three years to see the outcomes of this study, early results of the trial medication in early phase clinical trials have shown promising results, with "consistent, rapid, and durable reductions" in the abnormal protein that causes ATTR-CM, and minimal side effects. [1] The patients in Singapore have also not reported any side effects thus far. NUHCS is the coordinating site for the Singapore trial. The heart centre is still recruiting patients, who must fulfil the following criteria: About the National University Heart Centre, Singapore (NUHCS) The National University Heart Centre, Singapore (NUHCS) is an academic, national specialist centre under the National University Health System (NUHS). NUHCS brings together the resources, expertise and capabilities in the areas of Cardiology, Cardiothoracic and Vascular Surgery to better meet the needs of the growing number of patients with heart disease and raise the future generation of medical professionals. As one of two national heart centres in Singapore for the treatment and management of complex cardiovascular diseases, NUHCS offers six core clinical programmes including Heart Failure & Cardiomyopathy, Structural Heart Disease, Acute Coronary Syndrome, Heart Rhythm, Congenital & Structural Heart Disease and Women's Heart Health. The centre has been awarded two institutional Peaks of Excellence for its Minimally-invasive Cardiothoracic Surgery and Aortic Centre Programme, and has been ranked top in Singapore for three consecutive years in 2022, 2023 and 2024 for the specialty of Cardiac Surgery in Newsweek's "World's Best Hospital" Award. Comprising a team of internationally-recognised cardiologists and surgeons from the cardiothoracic and vascular specialties, NUHCS serves as a referral national centre for cardiothoracic and vascular conditions and provides a comprehensive approach to the treatment of these patients. The holistic patient-care approach is backed by leading translational research at the Cardiovascular Research Institute (CVRI) and Cardiovascular Metabolic Translational Program, all of which complements these advanced quaternary clinical services to deliver state-of-the-art treatment solutions to the most challenging heart, lung and circulatory diseases.
The Print
14-05-2025
- Health
- The Print
A new hope for patients suffering from potentially fatal rare heart disease: NUHCS is first in Asia to recruit patients for landmark gene editing clinical trial
Singapore, May 14: While receiving treatment for a car accident ten years ago, Mr Chua learnt that he had an abnormal build-up of protein in his heart vessels. This discovery led to the diagnosis of a condition known as transthyretin amyloid cardiomyopathy (ATTR-CM), a rare disease currently affecting approximately 150 patients in Singapore. The international study explores gene editing therapy to stop the production of proteins causing the disease in ATTR-CM patients. ATTR-CM is caused by the build-up of misfolded, deformed transthyretin proteins in the heart, nerves and other organs due to genetic mutation or ageing. Symptoms of this potentially fatal rare disease are often vague and may include numbness in the hands and feet, lethargy and dizziness. If not diagnosed and treated promptly, ATTR-CM can lead to heart failure. Over time, Mr Chua's hands and legs became stiff, and the once active 62-year-old could no longer walk. The subsequent years following his diagnosis were riddled with frequent visits to the hospital due to episodes of heart failure and multiple injuries from falls resulting from nerve issues caused by the disease. Despite being on years of medication, Mr Chua's condition had continued to decline, and his growing need for assistance with simple everyday tasks had greatly affected his spirit. There is currently no cure for this debilitating illness. A new international clinical trial may be set to change the trajectory of this disease for patients suffering from ATTR-CM – including Mr Chua. The MAGNITUDE study involves a single-dose gene editing therapy administered intravenously that will alter the patient's DNA, slowing down the production of the abnormal protein that causes the disease. Novel treatment offers new hope for patients Assistant Professor Lin Weiqin, Clinical Director of the Heart Failure and Cardiomyopathy Programme at the National University Heart Centre, Singapore (NUHCS), is leading the Singapore arm of this trial. He shared that the double-blind study will investigate the impact of the gene editing research medicine Nexiguran Ziclumeran (nex-z, also known as NTLA-2001) on ATTR-CM. 'Gene editing therapy has been approved in other countries, for use in some neuro-muscular conditions, cancers and inherited blood disorders. If this trial is successful, it will be the first DNA altering treatment used in the field of adult cardiology and offers new hope to patients living with ATTR-CM,' explained Asst Prof Lin, who is also a Senior Consultant at NUHCS. In Asia, the first patient of the double-blind clinical trial was recruited in Singapore and received his infusion in September 2024 at NUHCS. Since then, four more patients have been involved in the study, including Mr Chua, who was the fifth and most recent participant. The gene editing therapy is administered alongside the standard treatment for ATTR-CM as part of the study. While it may take another two to three years to see the outcomes of this study, early results of the trial medication in early phase clinical trials have shown promising results, with 'consistent, rapid, and durable reductions' in the abnormal protein that causes ATTR-CM, and minimal side effects.[1] The patients in Singapore have also not reported any side effects thus far. NUHCS is the coordinating site for the Singapore trial. The heart centre is still recruiting patients, who must fulfil the following criteria: * Between 18 to 90 years old * Diagnosed with heart failure due to ATTR * On medication for heart failure and have experienced heart failure in the past year * For females, they are only eligible if they can no longer have children. About the National University Heart Centre, Singapore (NUHCS) The National University Heart Centre, Singapore (NUHCS) is an academic, national specialist centre under the National University Health System (NUHS). NUHCS brings together the resources, expertise and capabilities in the areas of Cardiology, Cardiothoracic and Vascular Surgery to better meet the needs of the growing number of patients with heart disease and raise the future generation of medical professionals. As one of two national heart centres in Singapore for the treatment and management of complex cardiovascular diseases, NUHCS offers six core clinical programmes including Heart Failure & Cardiomyopathy, Structural Heart Disease, Acute Coronary Syndrome, Heart Rhythm, Congenital & Structural Heart Disease and Women's Heart Health. The centre has been awarded two institutional Peaks of Excellence for its Minimally-invasive Cardiothoracic Surgery and Aortic Centre Programme, and has been ranked top in Singapore for three consecutive years in 2022, 2023 and 2024 for the specialty of Cardiac Surgery in Newsweek's 'World's Best Hospital' Award. Comprising a team of internationally-recognised cardiologists and surgeons from the cardiothoracic and vascular specialties, NUHCS serves as a referral national centre for cardiothoracic and vascular conditions and provides a comprehensive approach to the treatment of these patients. The holistic patient-care approach is backed by leading translational research at the Cardiovascular Research Institute (CVRI) and Cardiovascular Metabolic Translational Program, all of which complements these advanced quaternary clinical services to deliver state-of-the-art treatment solutions to the most challenging heart, lung and circulatory diseases. NUHCS services span across four locations to serve the western and central locations in Singapore: * NUHCS at National University Hospital (NUH), Kent Ridge – Main Operations * NUHCS Heart Clinic @ Ng Teng Fong General Hospital (NTFGH) * NUHCS Heart Clinic @ Jurong Medical Centre (JMC) * NUHCS Heart Clinic @ Alexandra Hospital (AH) For more information, visit: [1] Fontana M, Solomon SD, Kachadourian J, Walsh L, Rocha R, Lebwohl D, Smith D, Taubel J, Gane EJ, Pilebro B, Adams D, Razvi Y, Olbertz J, Haagensen A, Zhu P, Xu Y, Leung A, Sonderfan A, Gutstein DE, Gillmore JD. CRISPR-Cas9 Gene Editing with Nexiguran Ziclumeran for ATTR Cardiomyopathy. N Engl J Med. 2024 Dec 12;391(23):2231-2241. doi: 10.1056/NEJMoa2412309. Epub 2024 Nov 16. PMID: 39555828. (ADVERTORIAL DISCLAIMER: The above press release has been provided by PRNewswire. ANI will not be responsible in any way for the content of the same) This story is auto-generated from a syndicated feed. ThePrint holds no responsibility for its content.
