Percutaneous coronary intervention

The first case of percutaneous coronary balloon angioplasty was done in Taiwan in 1983. Since catheter was first inserted in the human heart in 1929, cardiac catheterization became an important examination for evaluation of heart structure and cardiac function. A new era of intervention cardiology is evolving after the first patient with coronary artery disease underwent successfully coronary angioplasty in 1977. The first cardiac catheterization room of Taipei Veterans General Hospital was established in 1964. The first successful percutaneous coronary balloon angioplasty (PTCA) in Taiwan was done by Shih-Pu Wang, Chief, Division of Cardiology, in July 1983. The number of patients who underwent PTCA in Taipei Veterans General Hospital has gradually increased since then. The number of coronary angiography is around 5,000 annually and the number of percutaneous coronary intervention (PCI) is around 2,000 annually in Taipei Veterans General Hospital. Currently, coronary angiography and PCI have become the standard diagnosis and treatment for coronary heart disease. Our PCI team have highly specialized skills for treating complex coronary artery disease, such as chronic total obstructive lesions (CTO), complex bifurcation lesions, and left main coronary artery disease by the using various types of apparatus and techniques including rota-ablation for heavy calcified lesions, intravascular ultrasound (IVUS) assisted stent deployment in left main coronary artery, drug-eluted stent (DES) deployment, bioabsorbable scaffold deployment and drug- eluted balloon (DEB) intervention…etc. Renal artery denervation for treating patients with resistant hypertension is available in our hospital. Furthermore, the outcome including success rate, and complication rate of our transcatheter aortic valve replacement (TAVI) treatment is world-class. Our intervention cardiologists often attend international medical conferences to keep up to date with latest interventional technology.  

Electrophysiological study and catheter ablation

Since 1982, Professor Bining Jiang introduced the technique of electrophysiological study. Through the efforts of Professor Shih-Ann Chen and his team, Taipei Veterans General hospital have made an outstanding academic achievement and have been recognized as an international pioneer and leader in the field of radiofrequency ablation, especially for atrial fibrillation (AF). Up to-date, the team members have achieved over a thousand cases of AF ablations and have discovered numerous novel electrophysiological mechanisms and ablation treatment. The contribution from Professor Chen’s team has indeed led to a new era in the management of atrial fibrillation. In the past decade, the team has performed multiple complex atrial fibrillation ablation procedures more than 50 cases in the international medical centers such as in the USA, Japan and Korea, and moreover the team provides those centers invaluable technological support and advice to help them creating the electrophysiological laboratories. Besides, the team attracts over a hundred international doctors from not only the Asia Pacific region but also USA and Europe being trained by Professor Chen to learn the skills and techniques of radiofrequency catheter ablations. Currently, the electrophysiological team have published extensively in the researches of catheter ablation and the research findings have been consistently ranked among the top three in the world in the recent 5 years.

Cardiac Implantable Electronic Device (CIED)

    The device team at Taipei Veterans General Hospital (Taipei VGH) is one of the pioneers of CIED implantations in Taiwan. The first permanent pacemaker was implanted at Taipei VGH on August 25^th, 1975. Since then, the total number of patients who have received new CIED implants in our hospital has exceeded 5,000 (the oldest patient was 105 years old), and more than 1,500 patients have received generator replacements. Every member of the CIED team at Taipei VGH has received integrated training in electrophysiology and is well experienced. The overall procedural complication rate is less than 1%. Currently, more than 360 patients receive CIED operations every year. The first implantable cardioverter defibrillator (ICD) was implanted in the year 1998, and since then, more than 50 patients per year have received ICD implantations at Taipei VGH. The number of CIED implantations has steadily grown over these last few years, and the CIED team strives to provide the best highly qualified patient care.

Echocardiography

The echocardiography laboratory of cardiology was found at Taipei Veterans General Hospital in 1969. It initiated the era of cardiac imaging. In 1988, transesophageal echocardiography was introduced and it provided a further accurate diagnostic tool in cardiac imaging. Dr. Tsui-Lieh Hsu, the ex-director of the laboratory, pioneered in reconstruction of transesophageal echo images and live-time three-dimensional transthoracic echocardiography since 2002. Under the assistance of live-time three-dimensional transesophageal echocardiography, our cardiology division has successfully performed the first transcatheter aortic valve implantation and the first left atrial appendage occlusion in Taiwan. Dr. Wen-Chung Yu, current director of the laboratory, is devoted to the development of speckle tracking imaging, which could provide more information in early diagnosis of cardiomyopathy and follow-up of treatment. Currently, more than 20,000 transthoracic echo exams and 800 transesophageal echo exams were performed annually. Aside from clinical service, our echo team is keen to research and the academic achievement has been recognized internationally. We have published many images of echocardiography in the leading journals of cardiology including Journal of American College of Cardiology, Circulation and European Heart Journal.

Vascular Biology and Atherosclerosis

To advance the research in the field of vascular medicine and vascular biology, a vascular research laboratory was established in National Yang-Ming University Cardiovascular Research Center under Prof. Shing-Jong Lin and Prof. Jaw-Wen Chen since 1998. Two different models are used in this laboratory: one is the in vivo atherosclerosis model with high cholesterol feeding rabbits, and another is the in vitro atherosclerosis model with cytokine-stimulated endothelial adhesiveness to monocyte/mononuclear cells in cultured human aortic endothelial cells (HAECs). We investigate atherosclerosis using in vivo and in vitro systems, and tested the antioxidant effects of Chinese herbs on in vivo atherosclerosis in the high cholesterol feeding rabbit model and on in vitro atherosclerosis in terms of cytokine-stimulated endothelial adhesiveness to monocytes/mononuclear cells. Recently, we focus on the fields of endothelial progenitor cell and angiogenesis, and created animal models with different cardiovascular diseases including abdominal aortic aneurysm, diabetic nephropathy, hindlimb ischemia, atherosclerosis, and subtotal nephrectomy for basic and clinical translational research. In the past decades, our team has published many outstanding papers in high-ranking journals, such as Circulation, European Heart Journal, Journal of the American College of Cardiology, Diabetes, Chest, ATVB, Atherosclerosis, Journal of Molecular and Cellular Cardiology, Cardiovascular Research, et al.

Hemodynamics

Our cardiovascular hemodynamic laboratory has become an internationally esteemed research team and led plentiful scientific advancement in this area. The principle research aim of our team is to translate our comprehension of the cardiovascular hemodynamics into the better care of the cardiovascular health of the general population and patients with cardiovascular diseases. In the past decade, our main research efforts have been made to comprehend the prognostic roles of various hemodynamic indices for cardiovascular outcomes in epidemiologic studies, to develop noninvasive methods for more conveniently measuring relevant hemodynamic parameters prepared for clinical application, to utilize the comprehensive hemodynamic assessment in the care and research of patients with acute and chronic heart failure. With such efforts, we have successfully procured several multinational patents, which have been subsequently transferred to manufacturers for commercialization. In addition, our research findings have been published in many distinguished cardiology journals including Circulation, J. Am. Coll. Cardiol., Hypertension, Journal of Hypertension, etc. With national and international research cooperation on important research topics including the influence of cardiovascular hemodynamics on other vital organs, we will continue our endeavor to facilitate the research translation to better the clinical practice in the future.

Taipei Veterans General Hospital International Medical Service Center