Southlake performs advanced PPG coronary analysis

NEWMARKET, Ont. – Southlake Health has achieved another Canadian first in cardiac innovation, becoming the first hospital in the country to perform a Pullback Pressure Gradient (PPG) analysis of a coronary vessel. This advanced predictive procedure helps physicians deliver more precise, personalized care for patients with complex heart disease, and is another way Southlake is delivering leading edge cardiac care, closer to home.

Led by interventional cardiologist Steven Miner (pictured), MD, and a team at Southlake’s Regional Cardiac Program, the procedure uses cutting-edge coronary physiology technology to better understand how blocked arteries impact blood flow and whether a patient is likely to benefit from a stent or another type of cardiac intervention.

“This technology represents a major advancement in how we evaluate and treat coronary artery disease,” said Dr. Miner. “Traditionally, physicians have relied on measurements that tell us whether blood flow is reduced. PPG goes a step further by helping us understand the pattern of disease within the artery and whether intervention is truly the best option for the patient. It helps us make smarter, more informed decisions and ensures we are treating the right problem, in the right way, for the right patient.”

Coronary artery disease (CAD) is the most common form of heart disease in Canada, where heart disease remains the second leading cause of death. CAD occurs when plaque builds up inside the coronary arteries, reducing blood flow to the heart and increasing the risk of chest pain, heart attacks, heart failure, and other serious complications. As populations continue to grow and age, early diagnosis and personalized treatments are more important than ever. Advanced technologies like PPG analysis are helping physicians better understand how CAD affects each patient and how treatment can be tailored to their specific needs.

PPG builds on the concept of Fractional Flow Reserve (FFR), a widely used tool that measures blood flow in coronary arteries. While FFR can identify if blood flow in a vessel is reduced, PPG provides more detailed insight into whether the disease is concentrated in one specific area (focal disease) or spread diffusely throughout the blood vessel.

This distinction is critical to improve patient outcomes and experiences. Patients with a focal blockage often benefit significantly from Percutaneous Coronary Intervention, while patients with diffuse disease may benefit from medical management or surgery. By identifying which patients are most likely to benefit from treatment, and precisely where treatment should occur, PPG allows physicians to deliver more personalized and effective care.

Earlier this year, Dr. Miner and his team performed the first procedure in Canada using the latest PPG innovation, the CoroFlow Cardiovascular System and Abbott’s PressureWire X Guidewire. These technologies are designed to provide highly detailed physiological assessments of coronary arteries.

The wireless guidewire measures pressure and temperature within the vessel, allowing physicians to evaluate blood flow in real time and better understand the severity and pattern of coronary disease. By combining these measurements with PPG analysis, Southlake’s cardiac team can determine whether a patient will benefit from intervention and where treatment should be targeted.

“It’s inspiring to see Canadian clinicians leading the way in adopting advanced coronary physiology techniques,” said Ethan Korngold, MD, chief medical officer at Abbott’s vascular business. “Southlake Health’s first-in-Canada use of PPG analysis underscores how innovation, when paired with clinical expertise, can unlock deeper insights into complex coronary disease and help deliver more precise, personalized patient care.”

As a Level 7 Regional Cardiac Program, Southlake’s contributions to advancing cardiac care extends far beyond the operating and procedure rooms. The highly skilled team of medical staff and staff provide almost every type of cardiac care, except heart transplants, saving patients from travelling into travel to Toronto for world-class care.

As leaders in their fields, the team actively participates in ground-breaking research and are often the first to perform industry-leading procedures in Ontario, Canada and the world. Southlake continues to collaborate with international experts to enhance cardiac care and improve patient outcomes globally.

Southlake’s Level 7 Regional Cardiac Program is the fourth largest comprehensive heart program in Ontario, providing advanced cardiac care close to home to thousands of patients from York Region to Muskoka.

Southlake is known internationally for its research and innovation in cardiac care. Last year, Dr. Miner and his team were selected to perform a live case at the Transcatheter Cardiovascular Therapeutics (TCT) Conference, the world’s largest and most prestigious conference for interventional cardiology.

In 2024, Dr. Miner was named co-chair of the U.S.-based Microvascular Network Physician Education Committee, sharing the Southlake experience to an international audience.