Montreal hospital advances interventional cardiology

MONTREAL – A cardiologist at the Sacre-Coeur Hospital has become the first in Canada to use a new microcatheter, called Mamba, that improves the removal of plaques from coronary arteries.

Boston Scientific, the producer of the device, approached Montreal cardiologist Raja Hatem (pictured) to perform this Canadian first. Dr. Hatem has a subspecialty in high-risk procedures and has already worked with the Mamba tools in Texas.

For its part, the Canadian Press reported, the Sacre-Coeur hospital intends to be a centre of excellence for interventional cardiology, which gives it first tries when new technological tools are launched.

The Mamba line of micro-catheters is already in use in the United States and Europe, but it was in Montreal that the equipment was first used on a patient in Canada.

Dr. Hatem explained that on a regular basis, the coronary arteries become blocked by a build-up of cholesterol plaques, which leads to an acute infarction. Cholesterol is usually a malleable and easy to cleanse material inside the artery once the patient is in the operating room.

However, some patients develop chronic coronary occlusion over many years, and the material then tends to calcify inside the artery. This is what greatly complicates the work of cardiologists, and it is precisely in these complex cases that Dr. Hatem specializes. He has studied this problem at Columbia University in New York.

If a patient’s arteries are heavily calcified, regular microcatheters have difficulty resisting material and breaking through the occlusion.

According to Dr. Hatem, it is also not uncommon for the tip of the microcatheter to break during the operation, which forces the cardiologist to have to interrupt the procedure to retrieve the tool before inserting a new device and to continue the work.

“As far as the Mamba goes, what is quite unique is that the end is much stronger. In addition, thanks to the very tapered profile of the microcatheter, its ability to pass through a severe blockage is excellent,” said Dr. Hatem.

Post-operation, it seems the Mamba answered the call and lived up to his expectations. “It did exactly what it was supposed to do in theory. That is, giving me the most support I needed to get through the occlusion and its narrower profile allowed me to get through the occlusion,” he said. The Mamba will now be part of his toolbox.