Meet Abdul Ihdayhid, Cardiologist and Interventional Structural Heart Disease Fellow at Monash Health.
What is your role at Monash Health and what does it entail?
I’m currently the Interventional Structural Heart Disease Fellow, and also a PhD candidate at Monash University.
I work with an excellent team of structural heart disease specialists including A/Prof Robert Gooley, Dr Liam McCormick, Dr Siobhan Lockwood and our program coordinator Maree Lawrence.
Our team treats patients with severe valvular heart disease using minimally invasive techniques. Traditionally, these patients were treated with open heart surgery and required a long period of recovery. Over the past decade, MonashHeart has been at the forefront of clinical research and innovation in managing valvular heart disease. One of the most common procedures we perform is replacing the aortic valve. We can now do this safely under local anaesthetic and mild sedation with patients often able return home within a few days.
I’m also on call to treat patients with acute myocardial infarction (heart attack). We are one of the busiest centers in Australia, treating over 400 cases of acute myocardial infarction each year. We provide a 24-hour service and I work with a team of highly skilled cardiologists, nurses, technicians and radiographers to perform minimally invasive coronary intervention to urgently treat these patients and unblock their arteries. These are some of the sickest and most challenging patients that we treat and the ability to provide patients with immediate and substantial clinical improvement is an aspect of my work that I find considerably rewarding.
You recently won the Best Moderated Poster Award for Cardiac CT for your abstract titled ‘‘Prognostic value and incremental benefit of ischaemic myocardial burden subtended by non-invasive fractional flow reserve (FFRCT) significant stenoses’ at the 2019 European Society of Cardiology. Tell us more about this work and the impact it will have on cardiac patients?
MoanshHeart is recognised as a world leader in research and innovation in the field of cardiac CT. We perform nearly 4000 cardiac CT scans a year investigating patients for coronary artery disease. Cardiac CT is an excellent tool to identify the presence and severity of a coronary artery disease. However, what’s more important than the severity of the plaque narrowing is the degree of impairment to coronary blood flow. Typically, the measurement of coronary blood flow is performed during an invasive coronary angiogram and requires the placement of a specialized wire down the artery. This is associated with potential side effects, discomfort to the patient and cost to the health system.
MonashHeart has been leading the development of methods to measure coronary blood flow non-invasively using cardiac CT. This technique is called CT Fractional Flow Reserve and works by using the patient’s original CT scan to generate a 3D model of the heart and then using computer analysis and applying complex engineering principles to simulate blood flow through the arteries. By using cardiac CT to assess the degree of plaque narrowing in addition to its effect on blood flow, we hope to reduce the need for further stress testing and in some cases unnecessary invasive procedures.
I recently presented my research at the European Society of Cardiology Congress in Paris. This project forms part of my PhD which is under the supervision of A/Prof Brian Ko. The research was an international collaboration led by MonashHeart and involved centers in North America, Europe and Japan. We reported for the first time a novel method to quantify the amount of heart muscle supplied by a coronary artery on cardiac CT. When we combined this technique with a measurement of coronary blood flow, we were able to improve the accuracy of cardiac CT in identifying patients at high risk of future adverse cardiac events.
This research has generated significant interest and provides the foundation for future studies to refine the technique and investigate its application in clinical practice.
What makes Monash Heart a leading cardiac service in Australia and worldwide?
MonashHeart is one of the largest providers of cardiac services in Australia with a complex and a diverse case-mix. There is a significant focus on teaching and education for all levels of staff and this translates to a commitment to provide the highest standard of patient care across all disciplines of cardiology. MonashHeart is also a national and international leader in cardiovascular research. Despite a heavy clinical load, there is a commitment and support across the department for clinical research as we recognise its importance both to our patients and the broader medical community.
Monash Health with MonashHeart and Monash University are also leading the development of the Victorian Heart Hospital. This will be Australia’s first purpose built specialist cardiac hospital and will create an exciting opportunity to have an integrated center of excellence focusing on all aspects of clinical cardiology, research and education.
What is the most rewarding part of your role?
One of the great privileges of working as a Cardiologist is the ability to alter the course of disease and make a tangible impact on the quality of life of our patients. Many patients with aortic stenosis are debilitated by their symptoms and are too high risk for open heart surgery. To see these patients a few weeks after a minimally invasive valve replacement enjoying their new lease on life and being able perform the activities they love is certainly one of the most rewarding aspects of my job.