St. Luke's offers alternative to heart transplant

MANILA, Philippines – Extracorporeal Shockwave Myocardial Revascularization (ESMR) therapy is a non-invasive, painless, outpatient procedure that helps stimulate the growth of new blood vessels that supply the heart with oxygen and improve blood flow.

This new technology, the first of its kind in the Philippines, can now be found at St. Luke’s Medical Center, the country’s premier healthcare institution.

ESMR helps patients who suffer from heart problems such as myocardial ischemia (shortage of blood and oxygen supply to the heart muscles) and refractory angina pectoris (severe chest pains that result from myocardial ischemia) that cannot be resolved by standard treatments.

“Myocardial ischemia and refractory angina pectoris usually result from coronary artery disease (CAD),” said Dr. Edward-Bengie Magsombol, head of the Nuclear Cardiology Department. “CAD is usually caused by atherosclerosis (obstruction and hardening) of the coronary arteries (the heart’s blood vessels). 

“The traditional method of treatment for these conditions is undergoing either a cardiac bypass or angioplasty. While utilizing different means for relieving blockage to the heart and allowing for proper oxygen flow, both methods are invasive. Bypass surgery treats blocked heart arteries by creating new passages for blood to flow to the heart muscle,” said Magsombol.

The good news is ESMR can now help Filipinos who suffer from these conditions.

Magsombol said, “When all other treatment options have been or cannot be used, the last resort for patients is usually a heart transplant, but now we have ESMR therapy as an option.”

“The treatment is performed by using a special generator that produces low-intensity shockwaves, a form of soundwaves similar to those generated by ultrasound machines, targeted at the ischemic myocardial tissue in order to stimulate the growth of new blood vessels,” he said.

“The new growth helps supply additional blood and oxygen to the heart muscles, thereby alleviating the pain,” he added.

Patients will first have to undergo cardiac SPECT (single photon emission computed tomography) testing to identify the ischemic areas.

Afterwards, standard echocardiography equipment (using ultrasound technology) is used to locate the treatment area and to map the exact position and extent of the ischemic area. 

“A handheld device called a transducer is placed over the skin where the ischemic area is found and shockwaves will then be delivered to the area. One session lasts approximately 45 minutes,” Magsombol said. “A total of nine sessions are required to obtain optimal results.”

Magsombol, together with Dr. Rodney Jimenez, an interventional cardiologist, and Dr. Sue Ann Locnen, an echocardiographer, recently received hands-on training on performing ESMR therapy from Dr. Raimund Erbel at the prestigious West German Heart Center Essen in Germany and Dr. Jindrich Vainer at the University Hospital Maastricht of the Maastricht University Medical Center in the Netherlands.

St. Luke’s Heart Institute is ably directed by top cardiologists, interventionalists and surgeons who are supported by highly trained paramedical staffers who use the country’s most advanced medical equipment.

With a 99-percent success rate in open-heart surgeries and coronary angioplasties and stenting, St. Luke’s Heart Institute is comparable with the best medical centers in the world.

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For inquiries or appointments, call St. Luke’s Cardiac Catheterization Laboratory at (632) 723-0101/0301 extension 5401 or 4704.