Proceedings of TRICO 2012 from desk of Tejas Patel


TRICO 2012, the Eighth International Transradial Intervention Course was held on November 3rd and 4th, 2012.This time, the venue was Nirma University Auditorium and the live transmission was from Apex Heart Institute, Ahmedabad.

Apex Heart Institute is state of the art cardiac institute having 85 beds, 3 medical ICUs, 2 surgical ICUs, 1 high dependency unit and rooms of different categories. It has 2 ultra modern GE cathlabs (Innova Image Guided System 520) and 2 ultra modern cardiac surgical theaters. It is a unit of TCVS Private Limited, the company owned by us. We had gone through a tough time during the making of this institute for almost last 18 months. However, we started the preparation for TRICO 2012 in the beginning of this year, and our old friends including Samir Pancholy, John Coppola, Tak Kwan, Mitchell Krukoff, Sunil Rao, Thomas Comberg, Josef Ludwig, Christoph Naber, Tejan Patel, Kimberly Skelding, Ian Gilchrist and Kintur Sanghavi agreed to be on international guest faculty. Unfortunately, Tak Kwan, John Coppola and Sunil Rao could not make it this time. The new faces who could make it were Oliver Bertrand and David Kandzari. Because of the busy schedule, Shigeru Saito could not join us since last three years. It was an honor for us to having this time as Course Director alongwith me and Sanjay. On August 15, 2012, we started functioning at Apex Heart Institute and tried to address most of the teething issues of a new institute in shortest possible time. It was too much of mental and physical stress on me particularly, in month of October because I had to travel twice to U.S.A. (First for Dukes Master Course and then for TCT). However, we were able to accumulate 22 very complex cases of coronary interventions and all of them got admitted on 2nd November, 2012 at Apex. The response of participants for registration was overwhelming and before we realized, 565 participants were registered and we had to stop registering new participants almost a week before TRICO 2012. To our surprise, last moment dropout rate was only 10%. Most participants and international guests arrived on 2nd November, 2012. We were all set for the power packed course.

On 3rd November, 2012 at 9.00 a.m., we started live demo of the first case. It was a complex LAD-D1 bifurcation stenosis and a complex long RCA stenosis. Sanjay was assisting me and we had good discussion during the case. In this case, we showed utility of both IVUS and OCT. It ended well. The next case was a CTO of LCX and LCX was arising from RCC. Again, there was a struggle crossing the lesion, but, end result was optimal. The case was done by me and Sanjay. During these cases, there was a penal consisting of International and National Guest Faculties, who participated from the venue and on site commentators in the cathlab were Mitchell Krukoff and Ian Gilchrist. The discussion was very candid at both the ends and I am sure that the audience enjoyed it. Dr. Saito arrived at 11 a.m. and we kept a decade old CTO of RCA for him and as usual, he performed it in an elegant fashion. Everybody enjoyed his way of performing the case and interacting with the audience. The fourth case was done by Samir Pancholy, who was assisted by Rajni. It was a critical LAD stenosis in an extremely ectatic artery. He generated a great discussion on pre and post stent IVUS observations. There was a lunch break at 1.30 before that there were two extremely important talks delivered by Oliver Bertrand and David Kandzari. The talks were very well received.

After lunch, the first case was done by Tejan Patel and was assisted by Chirayu. It was a complex bifurcation LCX and CTO. He showed different techniques to overcome the problems. He is a very experienced interventionalist. Next case was a complex loop in right radial artery and we were supposed to fix an RCA lesion. Oliver Bertrand and David Kandzari were the on site moderators. We showed different techniques to negotiate the loop and successfully performed the intervention. I am sure that it was a very good learning and teaching session. The next case was again an in stent CTO in RCA and was performed so well by Dr. Saito. There was an exhaustive lecture session then, which was conducted so well. Ian Gilchrist, Josef Ludwig, Christoph Naber, Mitchell Krukoff and Samir Pancholy did excellent job. It was an end of the first day and we had a great gala dinner at Karnavati Club.

On 4th November, 2012, the first case was done by Mitchell Krukoff, who was assisted by Surendra. It was a tortuous LAD having multiple lesions. He gave an excellent demonstration of IVUS and FFR technology. I am sure it was extremely useful to the young cardiologists in the audience. The next case was a complex LAD-D1 bifurcation and CTO. Sanjay helped me in the case. We showed the successful use of rotational atherectomy. There was a great discussion. Then Dr. Saito did a very complex LCX OM bifurcation and LAD CTO case. He received a lot of applause from the audience. Following that I and Sanjay performed a complex and long RCA CTO case. Again in this case, after successful completion with multiple stents, we demonstrated use of both IVUS and OCT. Different pros and cons of both the technologies were discussed and crowd enjoyed it. This was the end of live demonstration. Except for 30 minutes on first day, throughout the course, the quality of fibre optic transmission was appreciated. Before lunch, there were two very important talks from Thomas Comberg and Kimberly Skelding. After lunch, we assembled at auditorium and talks were delivered by Kintur Sanghavi, Sanjay Chugh and Denise Rhodes (a Senior Nurse practitioner from Ian Gilchrists Hospital). Mitchell Krukoff delivered an extra curricular talk on Mantra Study, which was very well received. Following that, it was an angio presentation session and young cardiologists very enthusiastically presented their cases. The course ended at 5 p.m. It was a matter of great satisfaction for me, Sanjay and the Apex team. I announced the dates for TRICO 2013 i.e. 18th and 19th October, 2013.

I am grateful to all my international friends, national guest faculties and participants for making this course a grand success.

Tejas Patel,
Course Director,
TRICO 2012.



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