Prof Chia Boon Lock receives the SMA Honorary ... - nuhcs

MICA (P) 023/09/2007 Issue No. 11 • January – June 2008
Prof Chia Boon Lock receives the
SMA Honorary Membership Award
– READ MORE ABOUT IT ON PAGE 2

in this issue
02
04
PROF CHIA BOON LOCK
RECEIVED SMA HONORARY
MEMBERSHIP AWARD
UPCOMING PUBLIC SYMPOSIUM
ON SUDDEN CARDIAC DEATH
RECEIVING THE SMA HONORARY
Prof Chia Boon
05
06
07
08
10
MRCP (UK) PREPARATORY
COURSE
CAROTID ARTERY STENTING
INFORMATION TECHNOLOGY @
THE HEART INSTITUTE
NHG HMDP EXPERT VISIT –
A/PROF DAVID CAMPBELL
1 ST SINGAPORE-ASIA CARDIAC
RESYNCHRONISATION THERAPY
COURSE
CARDIAC REHABILITATION
PROGRAMME
16 TH ANNUAL CONGRESS OF THE
ASIAN SOCIETY FOR
CARDIOVASCULAR AND THORACIC
SURGERY
A/Prof Tan Huay Cheem, Chief, Cardiac
11
12
13
14
16
18
20
WET LAB WORKSHOP
16 TH ASCVTS ENDOVASCULAR
AORTIC STENTING COURSE
SINGAPORE CARDIAC SOCIETY
LECTURER AWARD
FIRST PRIZE – YOUNG
INVESTIGATOR’S AWARD
CHICAGO ACC SUCCESS
GIVING THE SICK HEART A BREAK
NMRC GRANT AWARD
COARCTATION STENTING –
PERCUTANEOUS THERAPY FOR A
RARE PROBLEM
CIT BEIJING MEETING
HAPPENINGS
DIRECTORY AND AWARDS
FEEDBACK
Please direct your feedback to
The Editor, PULSE
c/o The Heart Institute
National University Hospital
Cardiac Department
Level 3, Main Building
Singapore 119074
Tel 6772 5565
Fax 6778 6057
Email The_Heart_Institute@nuh.com.sg
EDITOR
Dr Poh Kian Keong
ABSTRACTS, PUBLICATIONS AND
NEW DOCTORS ON BOARD
ADVISOR
A/Prof Tan Huay Cheem
Contents are not to be reproduced without the
permission of The Heart Institute
“The name Prof Chia Boon Lock, immediately conjures up an image
of a superb clinical cardiologist who can interpret any cardiac
murmur accurately, a dedicated educator who enjoys imparting his
knowledge to the medical students and the younger doctors, a clinical
researcher devoted to the pursuit of the intricacies of the
electrocardiogram and above all, a fatherly figure who is always
willing to lend a hearing ear and who is also always unstinting
with his advice.” This is the citation by Assoc Prof Tan Huay Cheem
for Professor Chia Boon Lock, who was conferred honorary
membership of the Singapore Medical Association for the Year 2008
at the recent SMA Dinner.
One of the early pioneers of cardiology in Singapore, Prof
Chia was in charge of cardiology in Medical Unit II (later known
as the University Department of Medicine II) at SGH from 1975
to 1985 and was also Head of this Department from 1981 to 1983.
After moving over to NUH, he became Head of the hospital’s
Division of Cardiology, Department of Medicine, from 1986 to
1989 and Chief of the Cardiac Department from 1996 to 1999.
Amongst his many achievements, he was one of the first two
cardiologists to introduce echocardiography and the first to
introduce ambulatory blood pressure monitoring in Singapore.
Prof Chia is the current Chairman of the Ministry of Health
Workgroup for the Clinical Practice Guidelines on Lipids and a
Member of the Workgroup on Hypertension. He was formerly
President of the Singapore Cardiac Society, Chairman of the
Chapter of Physicians, Academy of Medicine (now the College of
Physicians, Singapore) and a Member of the 17 th and 18 th Council
of the Singapore Medical Association.
An outstanding and inspiring teacher who is a favourite of
the NUS medical students and also registrars training in Cardiology,
Prof Chia has contributed significantly to the training of generations
of doctors and cardiologists in Singapore. For this and other
contributions, the NUS conferred him the title of Emeritus Professor
THI PULSE | 2

AWARD
Lock
Dept
@ NUH
in 2006. Other awards which he has received include the Lee
Foundation-National Healthcare Group Lifetime Achievement Award
and the Dato Paduka Mahkota Brunei.
Remarkably, most of Prof Chia’s achievements have been
attained despite a long battle with advanced nasopharyngeal
carcinoma – initially with the treatment 24 years ago and
subsequently with the late side-effects arising from the radiotherapy
which he had received. This is truly a
testimony of his great courage and his
indomitable spirit.
The award at the dinner was
presented to Prof Chia by the Permanent
Secretary of Health, Miss Yong Ying-I.
THI PULSE | 3

UPCOMING SYMPOSIUM ON
Sudden Cardiac Death
Dr Abdul Razakjr Omar, Cardiac Dept @ NUH
The Singapore Medical
Association will be
organising the 39 th SMA
Annual National Medical
Convention on 5 th July
2008 at the Raffles City
Convention Centre. The
Heart Institute, National
Healthcare Group is privileged to co-host this year’s important
national healthcare convention.
The recent extensive and frequent media coverage of
sudden death among our youth propelled the quest to educate our
society about the issues related to sudden cardiac death. Therefore
this year the theme for the medical convention is “Prevention of
Sudden Cardiac Death: Perception and Reality”. We have the
pleasure of having the senior parliamentary secretary of health,
Mr Hawazi Diapi to grace the occasion as our guest of honour.
Despite a substantial reduction in age-adjusted rates of death
from cardiovascular causes during the past 40 to 50 years,
cardiovascular disease remains the single most common cause of
natural death in developed nations. Sudden cardiac death (SCD) is
estimated to account for approximately 50 percent of all deaths
from cardiovascular causes. In US, it accounted for 20% of all deaths
annually (>300,000 SCD), while in Europe ~100 SCD per 100
000 and in our society ~ 1 per 1000 individuals.
The majority of such sudden deaths are caused by acute
ventricular tachyarrhythmias, often triggered by acute coronary
events (coronary artery disease)
Clinical trials have shown that antiarrhythmic- drug therapy
is not effective in reducing mortality among patients who are
assumed to be at risk for such death, but recent randomized trials
have demonstrated a survival benefit in high-risk patients of therapy
with an implantable cardioverter–defibrillator, compared to
conventional drug therapy.
The Centers for Medicare and Medicaid Services estimate
that as many as 500,000 Medicare beneficiaries might be eligible
to receive a prophylactic ICD in the United States. Given the
substantial cost of the ICD, the economic effect of this strategy
must be considered in future healthcare planning.
The importance of educating all doctors on SCD should be
recognized. The highlights of the Medical Convention will include
a one-day medical symposium and workshop for healthcare
professionals and public forum. The interesting program will be
finalized by Dr Eric Hong & Dr Ong HY (Chairmans for Public
Symposium) and Dr Seow SC (Scientific Chairman for Medical
Symposium) focusing on prevention and latest management of SCD.
MRCP (UK)
Preparatory Course
Dr Eric Hong, Cardiac Dept @ NUH
The Final MMed (Int Med)/MRCP PACES Examination
Preparatory Course was held from 14-19 April in various hospitals
in Singapore under the auspices of the Division of Graduate Medical
Studies, Yong Loo Lin School of Medicine. This was an intensive
programme consisting of practice sessions in all stations of the
examination, culminating in a full
mock examination on the last
2 days of the course.
The Heart Institute is
proud to organize the
examination held in the
National University Hospital.
This demonstrates the
department’s strong
commitment in training
new generation of young
medical specialists.
The examination
was well received by the
participants. Many found
the cases useful in honing
their clinical skills assisted by tutors at hand who critique the
participants’ examination and presentation skills.
THI PULSE | 4

Carotid Artery Stenting
Dr Teo Swee Guan, Cardiac Dept @ NUH
Percutaneous transluminal angioplasty and stenting have become
an established therapeutic modality for coronary and peripheral
arterial diseases, complementing surgical treatment. The
application of this technique in carotid artery stenosis is an
expected progression. The perceived advantages of carotid artery
stenting (CAS) compared to carotid endarterectomy (CEA)
include avoidance of general anesthesia and open surgical incision,
shorter procedural time and hospitalization, and increased
patients’ acceptance.
Since FDA approval of CAS in 2004, it has been increasingly
used for patients considered as high risk for surgery. In contrast to
most endovascular peripheral arterial interventions, CAS
represents a more challenging procedure because it requires the
use of smaller guidewire system (0.014-in vs 0.035-in guidewire
system as in peripheral intervention), distal embolic protection
device and rapid exchange system (vs. over-the-wire system). The
use of long guiding sheath via common femoral artery to perform
balloon angioplasty and stenting also represents new challenge for
physicians with less CAS experience.
CEA has long been the gold standard for the treatment of
carotid artery stenosis. In North American Symptomatic Carotid
Endarterectomy Trial (NASCET), symptomatic patients with
carotid artery stenosis (70-99%) in CEA arm compared to medical
group had higher perioperative stroke/death (5.8% vs 3.3%) but
significantly lower major/fatal ipsilateral stroke at 2 years (2.5%
vs 13.1%, p

SPOTLIGHT
Information Technology
@ The Heart Institute
Dr James Yip & Ms Fauziah Azizi, Cardiac Dept @ NUH
Within the ‘heart’ of operations at the The Heart Institute runs a
unique software that has been storing critical information of our
patients since 1991. This database, the cardiology information
system (CIS) was initially spawned by Professor Maurice Choo,
when he was then chief of the cardiac department in NUH. It was
initially a report generator for our echocardiography, treadmill
and ambulatory blood pressure investigations and networked on a
series of Macintosh computers. In 1998, the system was revamped
to include research data and a new engine which helped
cardiologists track their cases. In 2000, the system was moved to a
Windows platform and the system was exported to Alexandra
Hospital for use. It also boasted of a hospital interface which allowed
its reports to be seen in NUH’s Hospital information system. We
also developed an expert system for our percutaneous interventions
which allowed full text reports to be generated from data captured
during a procedure. We expanded our repertoire of investigations
in the system to include 35 unique cardiology investigations ranging
from Nuclear, CT angiography, Cardio-pulmonary exercise,
Electrophysiology, congenital heart and vascular interventions.
In 2001, we bravely entered the world of real time digital
imaging. We began storing all images from echocardiography,
cardiac catheterization, electrocardiograms and nuclear. One of
our overriding principles, was that all ‘raw’ source data from any
system had to be stored and shared with everyone. In 2003, this
database was installed in Tan Tock Seng Hospital and a National
Heathcare Group (NHG) cardiology network was established. Our
cardiology reports became available to the whole cluster in 2005
on the computerized patient record system (CPRS). In 2003, we
won a grant from The Enterprise Challenge from the Prime
Minister’s office and we became the first medical unit in Singapore
to use tablet personal computers for our daily ward rounds. This
allowed all cardiology reports and images to be disseminated to
the patients bedside. This improved our overall efficiency and
allowed patients to have a shorter length of stay for our inpatients.
In 2004, our CIS won the prestigious National Infocomm Awards
from the Infocomm Development Authority (IDA) for the best
implementation of IT in a public institution. In 2005, our IT
director, Dr James Yip was inducted into the IT Hall of Fame of
the Singapore Computing Society for the Friend of IT award.
On a daily basis, the CIS allows our cardiologists to review
patient information on a timely basis and to complete their
cardiology reports. It has the capacity, for our doctors to work
from home and to store interesting cases for teaching and research.
The CIS contains coded fields which allows directed research to
be conducted by our cardiologists and data to be collected
prospectively. Thanks to this database, our research output each
year grows by leaps and bounds, and doctors are able to submit
numerous abstracts for local and overseas meetings, with some
our young researchers frequently clinching young investigator
awards. Part of the success of our CIS system, is that it is self
developed and self managed. It is an organism which continually
evolves to meet the new challenges, which is what expensive
proprietary systems cannot promise to deliver. In the future
development of the CIS, we hope to increase its connectivity
to other systems and to deliver clinical decision support for
the cardiologists.
THI PULSE | 6

NHG HMDP EXPERT VISIT 26-20 MAY 2008
A/Prof David Campbell
A/Prof Peter Robless & Dr Benjamin Chua, CTVS @ NUH
The Department of Cardiac, Thoracic & Vascular Surgery at NUH
was honoured to host Prof David Campbell from Beth Israel
Deaconess Hospital and Harvard Medical School, Boston, USA
during his visit as NHG HMDP Expert in Vascular Surgery. Prof
Campbell is one of the most well-known figures in the field of limb
salvage bypass surgery for peripheral vascular disease and diabetic
foot preservation. His group in Boston have published extensively
on limb salvage surgical techniques and outcomes for the last 20
years and their results for limb salvage and low perioperative
mortality are the gold standards others aim for.
Prof Campbell’s visit included a mix of lectures and
demonstration surgery, in addition to a vascular anastomosis
masterclass. In his series of lectures, he shared with an extensive
audience of surgeons, physicians and anaesthetists, the experience
and outcomes from his surgical series numbering more than 6000
lower limb bypass surgeries.
Prof Campbell has been instrumental in developing diabetic
limb salvage programmes in the Vietnam and India in the last
decade. He has been traveling to hospitals in Hanoi, Danang and
Ho Chi Minh City for the last ten years to promote limb salvage
and has reported this in the Bulletin of the American College of
Surgeons. It was during one of these trips that he met Prof KO
Lee from the Dept of Endocrinology at NUH and was invited to
visit Singapore to promote diabetic limb salvage.
He was welcomed at NUH by the vascular surgery,
endocrine, renal and diabetic foot teams. Prof Campbell assisted
in two patients undergoing carotid endarterectomies. He also
visited the vascular surgery units at Singapore General Hospital
and Tan Tock Seng Hospital, where he participated in the vascular
radiology meetings. At TTSH, he demonstrated his techniques of
distal bypass surgery. Despite his busy schedule, Prof Campbell
also found time to conduct a masterclass on vascular anastomotic
techniques using animal cadaveric vessels models held in the
SmartLab of the Advanced Surgery Training Centre at NUH.
Supported by Ethicon, J&J and Terumo Vascutek, it was well
attended by an enthusiastic group of 10 surgeons and advanced
surgery trainees. Prof Campbell remarked that, “This is the most
number of surgeons I have trained in one afternoon ever!” Valuable
lessons in surgical technique and a great time by all. He was also
the guest of honour at a dinner hosted by the Vascular Surgical
Society of Singapore held at the Peranakan restaurant,True Blue
in Armenien Street. This was indeed a novel culinary experience
for our visiting New England surgeon.
Prof Campbell delivered his talk on “Infection,
Neuropathy and Arterial Insufficiency in the Diabetic” at the NUH
hospital grand rounds. After that he participated in the Diabetic
Foot Ward Rounds conducted by Prof Aziz Nather and the NUH
diabetic foot team, where he shared his knowledge and experience
in management in diabetic patients with foot wounds. This ward
round was well-received and attended by a large group of surgeons,
nurses and podiatrist.
Prof Campbell’s visit as HMDP Expert was a resounding
success, judging from the number of people who attended his
lectures, ward rounds and masterclass. It was our pleasure to host
his visit and we certainly hope that he too had a great time and will
visit us again soon.
THI PULSE | 7

don’t bypass Cardiac Rehabilitation
Dr Eric Hong, Cardiac Dept @ NUH
Cardiac rehabilitation is increasingly
recognised as an integral component of
the continuum of care for patients with
cardiovascular disease. Its application is a
class I recommendation in most
contemporary cardiovascular clinical
practice guidelines. Despite the
documentation of substantial morbidity
and mortality benefits, cardiac
rehabilitation services are vastly underutilised.
Established in the late 1990s, the Cardiac
Rehabilitation Programme (CRP) at National University
Hospital (NUH) is characterized with a provisional
comprehensive long term services involving medical evaluation,
prescriptive exercise; cardiac risk factor modification, education,
counseling and behavioural interventions.
It is paramount that a good CRP is multifaceted and
multidisciplinary in nature consisting doctors, specialized cardiac
nurses, physiotherapists, dietitians, pharmacists, medical social
workers, occupational therapists, psychologist and psychiatrist. In
NUH, cardiologist Dr. Eric Hong Cho Tek leads this unique
specialised individualised programme. Dr Roger Ho, a psychiatrist,
is also part of this dynamic
multidisciplinary team.
Upon the completion of the
National University Heart Centre for
Cardiovascular Services, a dedicated
cardiac rehabilitation gym with the
state-of-the-art exercise equipment
and facilities will help to meet the
needs of the evolving society.
Numerous studies have demonstrated that cardiac
rehabilitation programmes can reduce the cardiac death rate by as
much as 20 to 25 per cent. It has been shown to be as important as
compliance to prescribed medication and following, of a strict
recommended diet. Despite the presence of cardiac rehabilitation,
only 15 to 20 per cent of appropriate candidates participated in a
formal CRP in Singapore. In our survey, most quoted ignorance
of the existence of a CRP.
In NUH CRP, our goals are manifolds. Besides reducing
morbidity and mortality, improvement of the quality of life,
reduction in subsequent rehospitalization, and getting patient
back to normality, if not better. We provide supervised exercise
training, multidisciplinary education programme to patients
1 st Singapore-Asia Cardiac Resynchronisation
Dr Seow Swee Chong & Dr Abdul Razakjr Omar, Cardiac Dept @ NUH
Heart failure is a major public health issue in developed countries,
exacting a heavy toll on medical resources and more importantly,
a high mortality and morbidity on the patients. Until recently, little
other than medication could be done for patients with chronic heart
failure who are not suitable for coronary revascularization or cardiac
transplant. Patients were forced to restrict their activities often to
minimally functional levels to adapt to their poor heart function
while they lived their lives under the spectre of certain death by
progressive heart failure or sudden cardiac arrest.
The advent of device therapy for chronic heart failure has
literally brought new life and hope for these patients. Individuals
with very poor heart function often have uncoordinated contraction
of their heart walls. By implanting a pacemaker with multiple leads,
these walls can be made to move together again in a coordinated,
synchronized fashion resulting in improved symptoms, cardiac
output and even a reduction in mortality. Aptly termed “cardiac
resynchronization therapy” (CRT), this modality has been shown
in large clinical trials to reverse the process of progressive heart
enlargement seen in chronic heart failure.
Heart failure patients are also at high risk of sudden cardiac
arrest due to life-threatening heart rhythm abnormalities. By
combining a CRT pacemaker with a defibrillator in a single device,
this other major cause of death in heart failure is addressed, and
results in a further reduction in mortality in the COMPANION
and MIRACLE-ICD trials.
THI PULSE | 8

Programme
recovering from cardiac events such as a heart attack,
interventional procedures like angioplasty, heart surgery (bypass,
transplant or valvular) and congestive heart failure. This is to
target the motivated individuals who want to reduce traditional
cardiovascular risk factors. In NUH, we have also developed a
dedicated smoking cessation programme
In our experience, we are aware that many cardiac
patients have high levels of stress and anxiety. Depression is
prevalent after acute cardiac events, with 20 to 45 per cent
of patients having significant depression after acute myocardial
infarction (AMI). Depression is an independent risk factor
for mortality in patients with AMI, or unstable angina. Several
studies suggest improvement with cardiac rehabilitation
intervention. Patients with depressive symptoms have a fivefold
increased risk of non-completion of cardiac rehabilitation
and therefore require enhanced attention and support. We
have also dedicated a team to focus on neuropsychological
aspect of these patients.
A review of 46 randomised trials of secondary
prevention, in 18821 patients with coronary heart disease was
recently conducted by the agency for Health care research and
quality: Secondary prevention programs were demonstrated to
reduce hospitalization, recurrent MI and long term mortality.
Physicians can initiate the referral if their patient is appropriate
for CRP in NUH.
Please visit www.nuh.com.sg/_cardiac/
ourServices_cardiacRehabilitation.htm or contact
the CRP nurses for more information.
Lai Shuet Ming – 67725563 / 95402582
Rachel Chan Wang Hia – 67722436 / 95669078
Ooi Lean See – 67722497 / 98028205
(CRT) Therapy Course
It is little wonder therefore that there is much interest
worldwide in the technique of performing CRT implants, which
is more complex than a routine pacemaker implant. With the
generous support of St Jude Medical, the Cardiac Department at
the National University Hospital was able to conduct the 1 st
Singapore-Asia CRT implant course, which hosted foreign doctors
from South Korea and the Philippines. Over the course of 3 days
from 28 th till 30 th April 2008, live cases of CRT implant were
performed, spaced apart by didactic lectures on the indications
and trial evidence for such therapy as well as methods for
optimization of CRT devices post-implant. Led by course directors
Dr Abdul Razakjr Omar and Dr Seow Swee Chong, the programme
also included a practical session demonstrating optimization of the
devices using echocardiography.
With overwhelmingly positive feedback from course
participants, the Department is geared up to continue conducting
such courses on a regular basis; sharing knowledge and
experiences and fostering friendships with fellow cardiologists
across the region.
THI PULSE | 9

16 th Annual Congress of the Asian Society
for Cardiovascular and Thoracic Surgery
Prof Uwe Klima, CTVS @ NUH
Singapore hosted the 16 th Annual Congress
of the Asian Society for Cardiovascular and
Thoracic Surgery (ASCVTS) held over 13–
16 March 2008 under the Chairmanship of
Professor Lee Chuen-Neng, Chair, University
Surgical Cluster, Head, Department of
Surgery and Department of Cardiac, Thoracic
& Vascular Surgery, National University
Health System. It was attended by over 870 participants from 50
countries.
Since its foundation in 1993, the ASCVTS had become
the largest cardiothoracic Society In Asia. Its goals have been to
promote the study of the art, science and practice of cardiovascular
surgery, hence facilitating the exchange of ideas in the field of
cardiovascular surgery. Journeying into the 21 st century,
advancements in the field of healthcare have been accompanied
by unexpected challenges and greater responsibilities. The theme
this year – “Putting Patients first in the Era of Modern Technology”,
embodies the purpose of this congress, which is to equip healthcare
personnel as well as patients with medical knowledge that is
becoming increasingly relevant in our society.
wet lab workshop
For the first time outside of America, the American
Association for Thoracic Surgery (AATS) held a post-graduate
review course. This was well received.
The congress received over 250 free paper submission, of
which 50% were for oral presentation over 14 sessions and 50%
were for poster presentation. Alongside the main congress, several
workshops namely the Haemodynamic Workshop, Endovascular
Aortic Stenting Course and Minimally Invasive Thoracic
Symposium were conducted at the Advanced Surgery Training
Centre, National University Hospital. All the workshops were
convened by our doctors with international and regional panelists.
The nursing symposium which was attended by more than
200 participants was coordinated by a nursing committee
represented by all the major hospitals in Singapore.
Prof Uwe Klima, CTVS @ NUH
In conjunction with ASCVTS 2008, St. Jude Medical took the
opportunity to run a wet lab workshop on the 12 th March 2008.
A total of 11 doctors, coming from various Asia countries
participated in the workshop which was held at the Advanced
Surgical centre at the National University Hospital of Singapore.
The workshop was conducted by Prof Uwe Klima and A/Prof
Theodoros Kofidis from the National University Hospital and Dr
Chua Yeow Leng from the National Heart Center.
The workshop started with Dr Chua sharing a presentation on
HIFU (High Intensity Focus Ultrasound) technology for open cardiac
ablation for the treatment of Atrial Fibrillation. He shared the
differences between HIFU and other technologies, as well as the
method of performing a procedure using the EPICOR machine. The
main advantage for HIFU is the ability to provide
transmural ablation effectively and safely.
There was also a short hands-on session
where Dr Chua demonstrated an ablation
using EPICOR on a porcine heart.
This was followed by Prof Klima giving a presentation on
the treatment of Valvular Disease using MHV (Mechanical Heart
Valves). Regent TM valve was highlighted as one of the best performing
MHV with outstanding performance for EOAI (Effective Orific Area
Index) and profile. A/Prof Kofidis spoke on Current Trend for Tissue
Heart Valves, the Epic TM Heart Valves was featured for its superb
profile and unique anticalcification technology. The participants
broke out into smaller groups where the trainers gave a detailed
demonstration on the tips and tricks of sewing the Regent TM valve
and Epic TM Supra valve onto a porcine heart. Each participant also
had a chance to assist or replace a valve onto a porcine heart under
the supervision of the trainers.
Overall, the feedback and response towards the workshop
have been positive. All participants mentioned that they found the
session insightful, and the various advice given by the trainers during
the session were invaluable in helping them provide better patient
care through better techniques and skills learn through the workshop.
THI PULSE | 10

16 th ASCVTS Endovascular
Aortic Stenting Course
A/Prof Peter Robless, CTVS @ NUH
The 16 th Annual
Meeting of the
Asian Society for
CardioVascular &
Thoracic Surgery
was held from the
12–16 th March
2008 in Singapore.
As part of the
meeting, the Heart
Institute was pleased
to host the ASCVTS Endovascular Aortic Stenting Course held at
the Tan Sri Khoo Teck Puat Advanced Surgery Training Centre at
the National University Hospital on the 15 th March 2008. The
workshop was fully subscribed with over 60 delegates from
Singapore, Indonesia, Phillipines, India, Taiwan, Thailand, Malaysia
and Japan attending.
We were pleased to bring together an international faculty
of eminent cardiovascular surgeons and interventionists involved
in the training and development of thoracic endovascular aortic
stenting programs. The guest faculty included Drs Roy Greenberg,
Joe Bavaria, John Wolfe, Wei Zhou, Bart Muhs, Hassan Tehrani,
Stephen Cheng, Ian Nixon, Shih Chun Che and Sophia Ang.
This workshop aimed to address the practical aspects of patient
selection, planning, case preparation and stent deployment. The
current evidence base for thoracic aortic endovascular stenting was
also presented and discussed.
The participants were able to have a practical hands on
demonstration of the leading thoracic aortic stentgrafts in clinical
use such as the Gore TAG, Medtronic Valiant, COOK TX2 and
Djumbodis Saint Come Chirurgie. There was intense interaction
with experienced physician proctors and technical product specialists
from the manufacturers.
In addition to didactic presentations and small group handson
demonstration there was also interactive case discussions. In
order to promote participation and discussion, several of the faculty
brought their own teaching cases which were prepared on our 3-D
Dextrobeam workstation for planning and discussion. This was
facilitated by Dr Luis Serra and the team from Volume Interactions.
This unique combination allowed the audience to view cases in the
standard axial, coronal and sagitall planes as well as in 3-D to fully
appreciate the tortousity, landing zones, branching and access issues
in thoracic endografting. Several cases involving thoracic aortic
aneurysms, dissection and traumatic transections were discussed.
Endovascular strategies involving hybrid repair of the thoracic aorta
were also presented.
THI PULSE | 11

Singapore Cardiac Society lecturer award
Associate Professor
Tan Huay Cheem is
honoured as the
Singapore Cardiac
Society Lecturer for
Year 2008 at its
recently held Annual
Scientific Meeting
(ASM). This is an
award bestowed upon member who has contributed significantly
to the Society. A/Prof Tan has served in the Council of the Society
for the last 9 years since 1999, and was the Secretary, Vice
President and eventually President of the Society for two terms
from 2003–2005. He has contributed actively to many of the
Society’s continuing educational activities including helping to
organize the 13 th SCS Annual ASM in Year 2000 and many
international meetings such as the 13th ASEAN Congress of
Cardiology in Year 2000 and 14 th Asian-Pacific Society of
Cardiology in Year 2003. Cited by Dr Richard Ng, President of
the SCS, A/Prof Tan is described as a dynamic and winsome doctor
who is popular with both patients and colleagues locally and abroad
for his enthusiastic and invaluable collaboration and fellowship. In
his lecture, A/Prof Tan gave his insights on the “Management of
Coronary Artery Disease-Diagnostic and Therapeutic Advances” which
was warmly received by the audience.
FIRST PRIZE
Young Investigator’s Award
Dr Chan Wan Xian, Cardiac Dept @ NUH
It started with our department’s research grand round. After
presenting my project entitled “Cardiorespiratory Gas Exchange
Analysis During Dynamic Exercise Predicts Surgical Indications
for Severe Mitral Regurgitation”, fellow colleagues encouraged
the submission to the annual Singapore Cardiac Society meeting.
I started working with my mentor, Prof Ling LH, to beat the
dateline of submission. We went through our data and statistics
many times to draw accurate conclusions from months of hard
work of patient recruitment and data collection. We then
proceeded with the drafting of our abstract and finally submitting
just before the deadline.
After weeks of waiting, I received an e-mail from the
Singapore Cardiac Society notifying us that the abstract has been
selected for presentation at the Young Investigators’ Award session
at the annual Singapore Cardiac Society Meeting. I immediately
started preparing for the presentation.
Our post-graduate education director, Dr Poh KK, arranged
a practice session for us to present our studies to the department
before the actual presentation. I was not fluent in my presentation.
Fortunately, many colleagues from the department gave valuable
comments from presentation style to slides content. That provided
me feedback to reflect and improve.
After that were
sleepless nights to
modify my presentation
contents and to rehearse
my presentation style.
Seniors and secretaries
from the department
lent their help in all ways
they could. Special
acknowledgements to
Dr. James Yip, who lent me his books and articles on CPET and spent
time explaining to me the concepts of CPET; and my mentor, Prof Ling,
who patiently corrected my presentation and gave me invaluable advice.
The presentation itself was an experience which one could
not learn from books. It also provided me an opportunity to
learn from my competitors, research methods and presentation
skills. It widened my exposure to ongoing cardiovascular research
in other instituitions.
I feel most honoured to win the Young Investigator’s Award.
I will continue to put in my best efforts and hope to do well in the
coming Asean’s Young Investigators’ Award presentation in Hanoi.
THI PULSE | 12

Chicago ACC Success
Dr
Eric Chong, Cardiac Dept @ NUH
American College of Cardiology
Annual Scientific Meeting was held at
Chicago this year. We had an
outstanding 8 abstract presentations
during the meeting. Dr Poh KK from
our department was an invited faculty
speaker in the echo seminar (E3:
Essential Echocardiology with Experts)
and A/Prof Tan HC was the only
invited Singaporean faculty member at
the ACC/SCAI (Society of Cardiovascular Angiography &
Intervention) i2 Interventional Cardiology Summit meeting. It was
snowing and freezing in Chicago at the beginning of the meeting.
But the huge attending crowds warmed up the entire conference
hall. Every room was crowded with attendees from all over the
world and it was hard to find oneself a standing place during the
more popular talks. Many world renowned speakers from
institutions like the Cleveland and Mayo clinic gave impressive
lectures. Dr Poh KK spoke on imaging of right heart masses which
was well received by the packed
international audience. In addition, Dr
Abdul Razakrj bin Omar was
conferred the ACC Fellowship at the
meeting. A/Prof Tan HC arranged a
wonderful dinner meeting at a
restaurant called the “Hugo Frogs”.
This restaurant was so named because
of its famous fried frog leg dishes.
However, I think our Singapore styled
frog dishes taste even better. It was a great pleasure to meet up
with all the overseas NUH doctors in training during the dinner.
Mark, Raymond, Chao Yang and Caroline gave speeches about their
training in the States and shared their wonderful experiences. It
was great to learn that NUH has provided us with a solid foundation
in cardiology before the HMDP overseas stint. This was our first
ever alumni gathering overseas. We hope that everyone will meet
again in the next year’s ACC. It’s a truly memorable experience.
FOR THE BETTER
giving the sick heart a break...
Goh Si Guim, CTVS @ NUH
Heart disease is one of the leading causes of death worldwide.
Open-heart surgery is a major operation indicated for
patients to bring about relief of their debilitating symptoms and
cardiac dysfunction.
The surgeon requires a motionless heart and a bloodless
field to do his job. Blood that normally course through the heart
and lungs is diverted to the Heart Lung Machine. This provides
an alternative and artificial means of keeping the blood going,
mimicking the natural organs it replaces. The process is called
cardiopulmonary bypass or more commonly known as Heart
Bypass Surgery. The vital functions of the heart and lungs are
now being performed by a mechanical device that works like the
real organs but look far from it!
Once cardiopulmonary bypass is established, the heart is
paralysed and the lungs shut down. The surgeon then go about
mending the hibernating heart.
To quote one of our surgeons, “these hearts get to rest,
not ours!”
Perfusionist is an alliedhealth
specialty intimately
related to cardiac surgery.
They work alongside the
surgeons, anesthetists and
nurses. They are specially trained professionals who manage the
heart lung machine and provide optimal life support for patients
undergoing heart surgery.
Cardiopulmonary bypass is a form of “insult” to the
integrity of the human body.”
It elicits a host of adverse responses that put patient at
further risks. However, it is a necessary evil, from which, most
patients benefit, coming out of it with a renewed lease of life. It
enables them to get back on with things they would otherwise be
too incapacitated to perform.
Today, some heart surgery procedures can be done without
the need of the heart lung machine, known as beating heart surgery.
Robotics is another exciting advancement that has entered the
realm of heart surgery.
THI PULSE | 13

NMRC Winning Grant
Dr Chen Lin Yee, Cardiac Dept @ NUS, NUH
“Identification of Novel Genetic Determinants
of Atrial Fibrillation in an Asian Population”
is a continuation of my research focus that
started when I was undergoing cardiology and
cardiac electrophysiology training at the Mayo
Clinic College of Medicine, Rochester, MN.
With start-up funds from the Yong Loo Lin
School of Medicine, and the support of the Cardiac Department,
NUH, and Department of Medicine, NUS, I started to lay the
groundwork for this project in August 2006. The process was made
significantly easier through the guidance and mentorship of Prof
Chia Kee Seng, Center for Molecular Epidemiology, and Assoc Prof
Ling Lieng Hsi, Cardiac Department, NUH.
Atrial fibrillation (AF) is the most common sustained arrhythmia,
reaching epidemic proportions in the aging population, and resulting
in significant morbidity, mortality, and socioeconomic burden. In a
subset of younger patients (

1. Identify disease susceptibility polymorphisms for AF using
candidate gene association analysis
2. Define interaction of genetic factors with acquired factors in
modifying AF risk and phenotypic expression
3. Pave the way toward establishing a larger cohort to facilitate
genome-wide association analysis in the future
With preliminary data derived from this cohort of lone AF
patients, I successfully obtained a National Medical Research Council
grant that will support this research effort for the next three years.
Presently, approximately 100 lone AF patients have been enrolled;
I anticipate the enrollment process will be accelerated through
collaboration of colleagues in National Heart Center and Tan Tock
Seng Hospital. In addition, mutation scanning of candidate genes
such as potassium and sodium channel genes is underway.
This project would not have been possible if it was not
for the support of the following: Chief, Cardiac Department,
NUH, Assoc Prof Tan Huay Cheem; Head, Department of
Medicine, NUS, Prof Ho Khek Yu; my mentors, Prof Chia and
Assoc Prof Ling; colleagues in the Cardiac Department, NUH;
research nurses, Ms. Quay Chwee Neo and Ms. Loh Fong Chee;
collaborators in National Heart Center and Tan Tock Seng
Hospital; the Yong Loo Lin School of Medicine and the National
Medical Research Council. Ultimately, the success of this project
will not only advance our understanding of a significant
cardiovascular disease, but also underscore the feasibility and
importance of multi-center collaboration in Singapore.
CIT Beijing meetingDr Adrian
Low, Cardiac Dept @ NUH
CIT Beijing 2008 (China
Interventional Therapeutics,
Beijing) is an annual major
meeting for interventional
cardiologists. It was held this year
from 19 to 23 March at the Beijing
Interventional Convention Center.
We were privileged to be given an
opportunity for live-transmission
to showcase our interventional techniques.
The live-transmission was held on the morning of the 2nd
day (20th March). We had 2 teams on hand: Prof Tan Huay Cheem
and Dr Lim Ing Haan; Dr Adrian Low and Prof Ronald Lee. As was
traditional, there was an introductory segment to Singapore; fusing
a blend of Singapore skyline, cultural activities, and images of our
esteemed interventionists, to a pulsating soundtrack. The montage
was expertly executed, earning praises even from professional media.
Prof Tan started the live-transmission with a case of “instent
restenosis”. This patient had had previous stenting to the heart
artery but returned because of re-narrowing of the same segment.
This was addressed with a novel drug-eluting balloon. This balloon
is coated with a medication that inhibits recurrent renarrowing of
the heart artery and has been shown in a recent published study to
be effective at least in patients with narrowing of the leg arteries.
The blockage was expertly cleared and treated with this new device
with good results. In contrast to the usual placement of another
medicated stent, this approach does away
with deploying an additional metal coat
which may have deleterious consequences.
The second case was an
intervention of a saphenous vein graft.
Traditionally, this is addressed using a distal
protection device, either a filter wire or
balloon occlusion device, to catch the
anticipated downstream flow of clots and
other debritus. We however demonstrated the safety and efficacy of
a new proximal protection device. This was a special catheter with
an inflatable balloon at its tip that can be inflated to seal off the
saphenous vein graft, thereby preventing flushing of debris
downstream. An advantage of this is the virtual protection from all
embolism, even with initial passage of our guide wire across the
blockage. This case was similarly well received. In addition, it was the
first time that a live-transmission of such as device was demonstrated
regionally. The audience’s curiosity was obviously piqued.
As usual, there was the usual banter by the chairperson
and other prominent interventional cardiologists. Our doctors
joined in the spirited exchange and responded well to the variety
of questions fielded. The teams enjoyed themselves doing difficult
cases under the glare of the media, and the live-transmission was
all too soon over. As the day came to a close, Prof Tan made his
sojourn to Beijing, representing our interventional cardiology team
and of course NUH.
THI PULSE | 15

happenings
3D-
TRANSESOPHAGEAL
ECHOCARDIOGRAM
WORKSHOP –
ORGANISED BY
PROF TI LIAN KAH
AND DR SOPHIA
ANG
12 MARCH 2008
CARDIAC DEPT MO FAREWELL DINNER
28 APRIL 2008
SINGAPORE CARDIAC
SOCIETY 20 TH ANNUAL
SCIENTIFIC MEETING
22 MARCH 2008
ACC 2008 PRESENTATIONS
31 MARCH 2008
PCI SIMULATOR COURSE
24 MAY 2008
THI PULSE | 16

GP SYMPOSIUM
BY DR JAMES YIP
AND DR ABDUL
RAZAKJR OMAR
12 APRIL 2008
OVERSEAS FELLOW (INTERVENTIONAL
CARDIOLOGY) FAREWELL DINNER
19 NOVEMBER 2007
OVERSEAS FELLOW (ECHOCARDIOGRAPHY)
FAREWELL DINNER
29 JANUARY 2008
CCU PARTY
14 JANUARY 2008
“WHY THIS HEART SPECIALIST GETTING
BUSY?” NEWSPAPER ARTICLE ON DR ABDUL
RAZAKJR OMAR
1 JUNE 2008
THI PULSE | 17

abstracts
AMERICAN COLLEGE OF CARDIOLOGY
SCIENTIFIC SESSIONS 2008 AND SCAI-ACCI2,
CHICAGO, 29 MARCH–1APRIL 2008
1. The Impact of Gender on the Outcomes of Invasive versus
Conservative Treatment of Patients with Acute Coronary
Syndrome. Lee LC, Leng P, Tang T, Tan YL, Tee HW, Shi L,
Poh KK, Tan HC
2. Myocardial Doppler Imaging Can Detect Subclinical
Cardiac Dysfunction After Anthracycline-Based
Chemotherapy. Wong RC, Gong L, Chan WX, Daw HY,
Goh BC, Lee SC, Lim SE, Soo R, Ling LH
3. Left Ventricular Performance and its Determinants
Immediately Prior to and Post-Marathon Running:
Insights from Two Dimensional Speckle Tracking
Echocardiography and Serum Biomarkers. Poh KK,
Tournoux FB, Picard MH, Wood MJ
4. One -Year Clinical Follow-Up of Endothelial Progenitor
Cell Capture Stent versus Uncoated Stent in Patients
Undergoing Primary Percutaneous Coronary Intervention
for Acute Myocardial Infarction. Lee YP, Tay Edgar, Melissa
Co, Yeo WT, Lee CH, Low A, Teo SG, Lim J, Lim IH, Lim
YT, Tan HC.
5. Risk Scoring System for Prediction of Contrast Induced
Nephropathy In Patients With Preexisting Renal
Impairment Undergoing Percutaneous Coronary
Intervention. Chong E, Shen L, Poh KK, Tan HC
6. Comparison of Eighteen-Month Clinical Outcomes of
Endothelial Progenitor Cell Capture Stent versus
Sirolimus-Eluting Bioabsorbable Polymer-Coated Stent
versus Bare Metal Stents In Patients Undergoing Primary
Percutaneous Coronary Intervention for Acute Myocardial
Infarction. Chong E, Lee CH, Shen L, Low A, Teo SG, Poh
KK, Tan HC
7. Risk and Clinical Predictors for Patients with Unstable
Angina and Non-ST Segment Elevation Myocardial
Infarction Post Early Percutaneous Coronary Intervention.
Chong E, Shen L, Poh KK, Tan HC
8. Comparison of Risk Predictors for Contrast Induced
Nephropathy Post Percutaneous Coronary Intervention
in Patients with Normal versus Impaired Baseline Renal
Function. Chong E, Shen L, Poh KK, Tan HC
9. Relation of ventricular-arterial coupling to exercise
capacity in ischemic cardiomyopathy: a cardiac multimodality
imaging study. Wong R, Dumont C, Austin B,
Kwon D, Flamm S, Thomas J, Starling R, Desai M.
10. Ventricular-vascular stiffening is more strongly associated
with Exercise Capacity compared to left ventricular
outflow tract gradient in Hypertrophic Cardiomyopathy.
Austin B, Kwon D, Dumont C, Wong R, Thamilarasan M,
Flamm S, Lever H, Desai M.
11. Greater degree of LV septal hypertrophy and associated
coronary arteriole dysplasia are significantly associated
with myocardial fibrosis in hypertrophic cardiomyopathy.
Kwon D, Rodriguez E, Wong R, Tan C, Thamilarasan M,
Smedira N, Lytle B, Lever H, Desai M.
19 TH ANNUAL SCIENTIFIC SESSIONS OF THE
AMERICAN SOCIETY OF ECHOCARDIOGRAPHY,
TORONTO, CANADA, 7-11 JUNE 2008
1. Predictors of Pulmonary Artery Systolic Pressure in
Significant Mitral Regurgitation Secondary to Mitral Valve
Prolapse. Zhang J, Lee LC, Tan HC, Yip JWL, Poh KK
2. Progression and Predictors of Left Ventricular Dilation
Secondary to Significant Organic Mitral Regurgitation:
Insights from Tissue Doppler Imaging. Zhang J, Lee LC,
Tan HC, Yip JWL, Yeo TC, Poh KK
3. Reperfusion therapies reduce ischaemic mitral
regurgitation following an inferoposterior ST elevation
myocardial infarction. Lee LC, Poh KK, Tee HW, Tan HC,
Chia BL, Zhang J, Ong HY, Yeo TC
4. Late Diastolic Mitral Annular Velocity in Aortic Stenosis:
Relation to Left Atrial Morphophysiology. Chan WX,
Gong L, Poh KK, Daw HY, Ling LH
HEART RHYTHM 2008, SAN FRANCISCO,
CALIFORNIA, USA, 14-17 MAY 2008
1. Utility of Electrocardiogram and Programmed Ventricular
Stimulation for Risk Stratification in Brugada Syndrome.
Singh D, Chong E, Seow SC, Poh KK, Omar AR
ESC HEART FAILURE CONGRESS 2008, MILAN,
ITALY, 14-17 JUNE 2008
1. An Asian comparison of cardiologist versus noncardiologist
care of heart failure. Ling LF, Shen L, Chai P
THI PULSE | 18

publications
1. European Heart Journal 2008; In Press. Assessing Aortic
Valve Area in Aortic Stenosis by Continuity Equation – A
Novel Approach using Real-time Three Dimensional
Echocardiography. Poh KK, Levine RA, Solis J, Shen L,
Flaherty M, Kang YJ, Guerrero JL, Hung J
2. Circulation 2008; In Press. A Phase 1b Randomized Study
of Antidote-Controlled Modulation of Factor IXa Activity
in Patients with Stable Coronary Artery Disease. Mark Y.
Chan, Mauricio G. Cohen, Christopher K. Dyke, et al.
3. Journal Thromb Haemost 2008 May; 6(5):789-96. A
randomized, repeat-dose, pharmacodynamic and safety
study of an antidote-controlled factor IXa inhibitor. Chan
MY, Rusconi CP, Alexander JH, Tonkens RM, Harrington
RA, Becker RC.
4. Journal Nucl Cardiol 2007 Jul; 14(4):617-20. Hybrid
cardiac imaging: complementary roles of CT angiography
and PET in a patient with a history of radiation therapy.
Hong EC, Kimura-Hayama ET, Di Carli MF.
5. Circulation 2008 Apr 1;117(13):1693-700. Interrelation
of coronary calcification, myocardial ischemia, and
outcomes in patients with intermediate likelihood of
coronary artery disease: a combined positron emission
tomography/computed tomography study. Schenker MP,
Dorbala S, Hong EC, et al.
6. European Journal Neurol 2008; In Press. Takotsubo
cardiomyopathy associated with status epilepticus. Seow
SC, Lee YP, Teo SG, Hong EC, Lee CH.
7. Annals of Academy of Medicine, Singapore 2008 Mar;
37(3):243-2. A Case of Myopericarditis in a Patient with
Methicillin-resistant Staphylococcus aureus (MRSA)
Community-acquired Pneumonia. Lee YP, Hoi WH,
Wong RC.
8. Journal Heart Lung Transplant 2008. Tricuspid
regurgitation after cardiac transplantation: an old problem
revisited. Wong RC, Abrahams Z, Hanna M, et al.
9. Echocardiography 2008; In Press. Echocardiographic Left
Ventricular Mass in a Multi-ethnic Southeast Asian
Population: Proposed New Gender and Age-Specific
Norms, Wong RC, Gupta A, Yip JWL, Yang H, Ling LH.
10. International Journal of Cardiology; In Press. Fulminant
dengue myocarditis masquerading as acute myocardial
infarction. Lee CH, Teo C, Low AF.
11. Annals of Academy of Medicine, Singapore 2008 May; 37
(5):365-7. Risk Factor Profile and Treatment Patterns of
Patients wih Atherothrombosis in Singapore: Insight from
the REACH Registry. Yeo TC, Chan YH, Low LP,
Venketasubramanian N, Lim SC, Tay JC, Tan RS, Eng P,
Lingamanaicker J.
12. European Journal Echocardiology 2008; In Press.
Prognostic value of Left Atrial Size in Chronic Kidney
Disease. Chan MY, Wong HB, Ong HY, Yeo TC.
BOOK CHAPTER
1. Post-operative Management of the Cardiac Transplant
Patient. Immunosuppression and Drug Interaction.
Fink J, Wong RC, Sipahi I, Taylor D.
new doctors
on board
National University Hospital
Dr Benjamin Chua Soo Yeng – Associate Consultant,
Vascular Surgery- CTVS
Dr Sujeeb Rajbhandari – Honorary Fellow, Cardiology
Dr Yeo Wee Tiong promoted to Registrar, Cardiology
THI PULSE | 19

directory
awards
THE HEART INSTITUTE,
NATIONAL HEALTHCARE GROUP
Secretariat Office
c/o Cardiac Department
National University Hospital
5 Lower Kent Ridge Road
Level 3, Main Building
Singapore 119074
Tel 6772 5596
Fax 6778 6057
Website
www.thi.nhg.com.sg
ALEXANDRA HOSPITAL
378 Alexandra Road
Singapore 159964
Tel 6472 2000
Fax 6379 3880
Appointment Line 6476 8828
Fax 6379 3880
Specialist Outpatient Clinic 6379 3190
NATIONAL UNIVERSITY HOSPITAL
5 Lower Kent Ridge Road
Singaore 119074
Tel 6779 5555
Fax 6779 5678
Cardiac Clinic H
Clinic Appointment 6772 5730
Fax 6775 1617
Cardiac Centre
Clinic Appointment 6772 5277/6772 5278
Fax 6772 5279
TAN TOCK SENG HOSPITAL
11 Jalan Tan Tock Seng
Singapore 308433
Tel 6526 6011
Fax 6252 7282
Cardiology Clinic
Central Appointment 6357 7000
Fax 6357 7011
Private Appointment 6357 8000
Fax 6357 7011
Direct Line to Clinic 6357 8011
Fax 6357 8680
GEMS AWARDS MARCH 2008
Go the extra miles, are Exemplary role models who
Made a difference and Spectacular contributions
Dr Chai Ping, Consultant, Cardiac
Dr Low Fatt Hoe Adrian, Consultant, Cardiac
Dr Ooi Oon Cheong, Associate Consultant, CTVS
THORACIC SURGERY FOUNDATION FOR RESEARCH
AND EDUCATION SCHOLARSHIP
The Heller School Executive Leadership Program in
Health Policy and Management – An intesive
program in health policy and management for the
senior level health care providers.
Brandeis University, Walktham, Massachusetts, USA, 2008
Dr Ooi Oon Cheong, Associate Consultant, Cardiothoracic Surgery
NATIONAL RESEARCH FOUNDATION
Ministry of Health Healthcare Research Scholarship
(Master of Clinical Investigation, MCI)
Dr Ooi Oon Cheong
ELECTION AS MEMBER OF THE AMERICAN
ASSOCIATION FOR THORICAC SURGERY
Prof Lee Chuen Neng has been elected as Member of
the American Association for Thoracic Surgery, being
one of the 12 cardiothoracic surgeons to be elected
outside of North America this year. Membership of
AATS is prestigious and Prof Lee is the only one from
Singapore so far. This took place during the recent
88 th Annual Meeting of the AATS in Washington DC,
USA from May 10–14, 2008