Otsuka stent used in St. Luke's Heart Institute procedure

MANILA, Philippines - Cardiovascular disease is the leading cause of death among non-communicable diseases (NCDs) such as cancer, diabetes, and chronic respiratory diseases.

According to the World Health Organization (WHO), at least 48 percent of NCD deaths are due to cardiovascular diseases.

The number of cardiovascular deaths worldwide is projected to rise from 17 million to 25 million annually by 2030.

This class of ailments must be given medical attention as soon as it is recognized to minimize complications resulting in morbidity and mortality.

Percutaneous trans-mitral balloon commissurotomy and coronary angioplasty are treatment options that can be considered in treating cardiovascular conditions involving stenosis or narrowing of coronary arteries or valves that supply blood to the heart.  

In percutaneous trans-mitral balloon commissurotomy (PTMC), a constricted heart valve is widened to improve blood flow to the heart. The procedure most commonly involves the mitral valve, which supports the continuous flow of blood from the lungs, into the left atrium, left ventricle, and the aortic valve.

This procedure is done with the use of a collapsed balloon catheter inserted through the femoral artery until it reaches the mitral valve. Finally, the balloon is inflated inside to widen the constricted valve. 

This is similar to coronary angioplasty, otherwise known as percutaneous coronary intervention (PCI), a non-surgical procedure that relieves narrowing and obstruction of the arteries to the heart.

It is accomplished using a stent mounted in a small balloon catheter inserted into an artery in the groin or arm and advanced to the narrowed coronary artery. The balloon is then inflated, widening the stent which is left inside the artery to serve as a “scaffold.”

During the recently held 26th anniversary celebration of St. Luke’s Medical Center’s Heart Institute in Quezon City, these procedures were successfully demonstrated via a live-stream session as part of the scientific symposium entitled, “Multi-Specialty Concerns in the Management and Prevention of Cardiovascular Disease.”

The percutaneous balloon commissurotomy was done by the team of Dr. Isabelo Ongtengco, former president of the Philippine Heart Association, and Dr. Benedict Lazatin, a renowned interventional cardiologist. The angioplasty procedure was performed by Dr. Rodney Jimenez and Dr. Richard Nicandro Torres.

The St. Luke’s Heart Institute in Quezon City is known for its 99 percent success rate in heart surgeries, including coronary angioplasty and stenting.

Used in one of these procedures was the Firebird, a rapamycin-eluting stent introduced in the Philippines in August 2006. Since then, Firebird has become one of the most widely used stents in many percutaneous interventions in the country. 

The Firebird rapamycin eluting coronary stent delivery system has three layers of coating for optimum effect. At the base coating, the stent is composed of a polymer that keeps the drug attached to the stent during delivery and dilatation. 

The second layer consists of the drug rapamycin and another coating of polymer. Finally, on the top coating is another polymer layer responsible for the controlled release rate of the drug, giving the Firebird an ideal drug release profile.

The Firebird drug eluting stent is marketed by Otsuka, one of the top Japanese pharmaceutical companies in the Philippines.