For one patient, it was a life-saving procedure. For thousands of clinicians across the world, it was a masterclass in advanced cardiac care.
Live cases — surgical intervention procedures that are broadcast in real time and shared on demand — are a critical tool for teaching health care professionals outside of an operating room novel and specialized techniques.
Late last year, Dr. Sanjog Kalra, an interventional cardiologist at UHN's
Peter Munk Cardiac Centre (PMCC), walked viewers through a groundbreaking — and challenging — intravascular imaging procedure as part of the Transcatheter Cardiovascular Therapeutics (TCT) Conference.
A small number of expert physicians are selected to present live case sessions at the conference each year. The sessions turn real-time procedures into powerful educational moments for clinicians.
"My hope is that the audience saw that even though a procedure is really difficult, it has purpose, and that using our best tools and techniques to get the best possible result is how we put the patient first," says Dr. Kalra.
"The conference audience should walk away feeling that they understood both the cognitive and technical aspects of the procedure well, with take-home lessons to apply to their own practice at home."
The TCT conference brings together health professionals from around the world to share knowledge, techniques and research aimed at improving the survival and quality of life for patients with heart and vascular disease. Live case sessions are considered a hallmark feature of the conference.
"Live case sessions are among the most powerful educational formats in cardiovascular medicine, bringing complex decision-making, advanced techniques and real-time problem-solving directly to physicians worldwide," says Dr. Barry Rubin, Medical Director of the PMCC.
"Dr. Kalra's participation reinforces UHN's role as a global educator, demonstrating how Canadian innovation and clinical leadership influence practice well beyond our borders."
Leading in complex and high-risk interventional heart procedures
Dr. Kalra's desire to improve outcomes for patients who are often overlooked is what fueled his interest in complex and high-risk interventional procedures (CHIP).
CHIP is a subspecialty that treats patients with narrowed or blocked heart arteries and serious health issues that make them too high-risk for open heart surgery or too complex for traditional interventional cardiology.
Hard to reach blockages reduce patients' heart function so severely that they often require the use of specialized heart support pumps and skilled intensive care to get through procedures.
In 2015, Dr. Kalra became the world's first CHIP fellow at Columbia University, where he learned how to perform complex and high-risk percutaneous coronary interventions (PCIs) — a minimally invasive procedure where a catheter is used to place small stents in narrowed or blocked heart arteries to hold them open.
With his return to Canada in 2020, Dr. Kalra brought this specialty training and expertise to UHN, leading the charge for PMCC to become an international leader in CHIP.
"This is the dream," says Dr. Kalra. "The difference in a patient's health from when they are at their worst to a life where they feel like themselves again. That difference is our impact. Our dream is to have as big of a positive impact as possible for our patients."
CHIP expertise takes the global stage
During his session at TCT, conference attendees watched as Dr. Kalra and his team performed intravascular imaging in complex PCI.
"While more than a thousand clinicians may be in the live audience, tens of thousands more benefit from on-demand viewing, allowing the learning to extend far beyond the meeting itself," says Dr. Rubin.
The procedure involved treating a man in his early 60s who had three of his four major heart vessels blocked.
"The patient came to the table with a confluence of three things: His heart pumping function was weak, his coronary anatomy was super complicated and he had a bunch of medical problems," says Dr. Kalra.
Throughout the live case session, an oversight panel offered commentary while leading two-way discussions with viewers.
At the end of the procedure, the team successfully restored blood flow to the patient's heart vessels.
"That's one of the things that makes complex and high-risk PCI both interesting and fun as an operator: By opening the patient's native arterial flow, we gave him back his quality of life and arguably his quantity of life," says Dr. Kalra.
UHN continues its commitment to shaping global cardiac care standards
The achievement marks a milestone moment that reinforces UHN's position as a global thought leader, committed to accelerating research, education and innovation.
"By sharing expertise on an international stage, centres like the Peter Munk Cardiac Centre help advance patient care worldwide, while affirming UHN and Canada's leadership in cardiovascular medicine," says
Dr. Rubin.
UHN continues to set global health standards by sharing research and knowledge that redefines best practices and elevates health outcomes for all patients.
Dr. Kalra sees participating in the TCT Conference as both recognition and a responsibility — for himself and UHN.
"The more you work with others, the more you learn each other's way and that increases access to care for patients everywhere," he says.
"It doesn't matter if you're in Ethiopia, Toronto or in Delhi. You're a human being. You should have access to good care. And that's why we do what we do."
