Volume 50, Number 9
Early reperfusion of ST-segment elevation myocardial infarction (STEMI) leads to better outcomes. Interventions that have resulted in shorter door-to-balloon time include prehospital cardiovascular laboratory activation and prehospital electrocardiogram transmission, which are only available for patients who arrive via emergency ambulances.
A Singapore retrospective study examined data of patients who arrived at the emergency department by emergency ambulances and via their own transport. The findings revealed that arrival via ambulance was associated with a decreased door-to-balloon time for STEMI patients compared to arriving via own transport. In spite of this, only a third of the patient cohort had arrived by ambulance.
Public education can help to increase awareness of STEMI symptoms and the use of emergency transportation when experiencing such symptoms. Findings from the study can guide further investigations and workflow to improve door-to-balloon time.
Editorial
Reducing the total ischaemic time in ST-segment elevation myocardial infarction: Every step matters
Ischaemic heart disease (IHD) is the third leading cause of death in Singapore, accounting for 18.8% of all mortalities in 2019.1 With our ageing population, there is an increased prevalence of cardiovascular risk factors such as hypertension, hyperlipidaemia and diabetes mellitus (affecting 15.6%, 13.6% and 6.9% of the population,...
Editorial
Hepatic artery anastomosis in liver transplantation
Liver transplant is the definitive therapy for end-stage liver failure. The challenges include overcoming technical difficulties of the transplant surgery followed by medical therapy to prevent organ rejection. The most important surgical hurdle is the prevention of hepatic artery thrombosis (HAT) that can occur in up to 9% of...
Editorial
Phenotyping in COVID-19: Making the case for why science needs philosophy
COVID-19 pneumonia is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Among patients with SARS-CoV-2 infection, the most frequent reason for intensive care unit (ICU) admission is the development of acute respiratory distress syndrome (ARDS) and consequent hypoxaemia.1
There has been much academic discourse and debate around clinical...
Original Article
Improved door-to-balloon time for primary percutaneous coronary intervention for patients conveyed via emergency ambulance service
Early reperfusion of ST-segment elevation myocardial infarction (STEMI) has been shown to result in better outcomes,1-3 and guidelines for treatment of STEMI recommend a rapid and coordinated response.4 The American Heart Association guidelines released in 2014 recommend a door-to-balloon (DTB) time of less than 90 minutes,5 and timings of...
Original Article
Strategies for a successful hepatic artery anastomosis in liver transplantation: A review of 51 cases
Liver transplantation is a life-saving procedure for patients with chronic end-stage liver disease, and selected patients with acute liver failure. While 75% of total blood flow into the liver comes from the portal vein, the sole supply of oxygenated blood to the biliary system comes from the hepatic artery.1...
