Dr Suhaimi Osman

Dr Suhaimi Osman Dr Suhaimi Osman is an Interventional Cardiologist based in Pantai Hospital Klang and Thomson Hospital Kota Damansara.

Unprotected left main angioplasty can be daunting. Sometimes one has to consider whether to refer a patient for a CABG i...
15/06/2022

Unprotected left main angioplasty can be daunting. Sometimes one has to consider whether to refer a patient for a CABG instead of performing angioplasty. We have decision making tools to guide us in deciding. It’s also very useful to have an IVUS or intravascular ultrasound to guide the procedure. If it is an obviously doable case like this one and you have the skills and tools to proceed, it can be a very safe and succesful procedure. As this case in particular was a heart attack the decision was very easy to make. The results were more than satisfactory.

03/12/2021

Luckily was an easy case to do with drug coated balloons. Two DCBs were used to treat the lesion. Immediate improvement noted in his haemodynamics. Hope he will do well long term.

03/12/2021

This was due to Covid and MCOs. Patient stopped taking his cardiac drugs as he was afraid to venture out. Resulted in a stent thrombosis.

Sometimes when treating a heart attack, we find a huge blood clot in the artery. This makes it difficult to reestablish ...
28/01/2021

Sometimes when treating a heart attack, we find a huge blood clot in the artery. This makes it difficult to reestablish good flow in the culprit vessel. In this particular case, we managed to aspirate the clot with a device called a thrombuster. After thrombectomy, the artery was stented with good results. The patient went home after a few days in ICU almost fully recovered. Another happy outcome.

Been a while since I did angioplasty on a chronic total occlusion. CTO for short. Good final results with minimal use of...
01/12/2020

Been a while since I did angioplasty on a chronic total occlusion. CTO for short. Good final results with minimal use of devices. Just one fielder XTA and fine cross plus a few CTO balloons.

Yesterday I talked about how a stroke can be caused by a blood clot travelling to the brain from the heart. Two possible...
18/09/2020

Yesterday I talked about how a stroke can be caused by a blood clot travelling to the brain from the heart.

Two possible causes were Atrial Fibrillation (AF) and Mural Thrombus embolisation.

In AF the blood clot is formed in the fibrillating left atrium and can embolise to the brain via the left ventricle.

In the past the only way of preventing this was, apart from reverting the patient to sinus rhythm and maintaining it with drugs or surgically (another topic for another day..😅) was to prescribe Warfarin, an anticoagulant, or blood thinner, in layman’s terms.

Warfarin had it’s own risks, the most obvious being bleeding.

A patient could bleed from the stomach or also into the brain. Both are serious side effects.

The activity of the drug also needs to be monitored periodically with a blood test called INR.

This is in fact, very tedious.

Warfarin is still the drug of choice for mural thrombi and as an anticoagulant for prosthetic valves.

However for non valvular AF there is a newer class of drugs called DOACs or NOACs.

Don’t ask me why they keep changing the abbreviations.

Long story short, they are not affected by your diet and also do not require monitoring your blood tests so often.

So, for clots arising from the left ventricle of the heart due to muscle damage from a heart atttack the drug of choice is still warfarin.

For Non Valvular AF the ideal choice should now be NOACs pr DOACs.

NOAC stands for novel oral anticoagulant whereas DOAC stands for Direct...you can guess the rest. 😂

17/09/2020

Heart disease and strokes

Many people do not realise there is a connection between heart disease and strokes.

It is in fact quite common.

What forms of heart disease can be associated with strokes?

Most commonly, atrial fibrillation.

Also not uncommon, a heart attack may cause a stroke.

This can happen in a few ways.

The drop in blood pressure during a heart attack may cause some vulnerable patients to have a stroke if their brain circulation has already been compromised by atherosclerosis.

A patient who has had a heart attack may also develop a stroke due to a blood clot from the heart travelling to the brain.

We call this phenomenon thromboembolism. The blood clot develops in an area of the heart which has been damaged by the heart attack and is no longer moving well.

Then, for whatever reason, this blood clot breaks off and travels to the brain and occludes a main vessel causing a stroke.

These strokes are usually massive and quite devastating.

Of course, prevention is better than cure.

If your doctor is aware of your risk of these conditions it is eminently preventable.

Anticoagulatiom therapy has improved the prognosis of these froms of stroke by leaps amd bounds.

I shall discuss that another day.

This is a very nice example of a coronary ct scan. As you can see there is a lesion in the proximal LAD. The patient pre...
15/06/2020

This is a very nice example of a coronary ct scan. As you can see there is a lesion in the proximal LAD. The patient presented with severe chest pain and tachycardia. There were no ischaemic changes on her ecg and serial cardiac enzymes and troponin were not raised. After treating her medically and slowing her heart rate with B blockers this is the nice image we obtained from CT. She was subsequently angiogrammed and angioplastied and will go home tomorrow.

Haven’t posted here in a while. Hope everyone is keeping well during the MCO. And hope everyone is extra cautious especi...
03/05/2020

Haven’t posted here in a while. Hope everyone is keeping well during the MCO. And hope everyone is extra cautious especially as we are enterring the next phase. I hope my patients do take good care of themselves and do not skip their medication. Today’s case was in fact probably due to skimping on medication and follow up. Patient presented with a new heart attack. His first one was 5 years ago and a very massive one to boot. Lucky he survived that time due to prompt angioplasty that I performed. The patient had been exemplary coming for follow up regularly. I guess he grew complacent as I always found he was doing very well. I lost him for a while and he had not been to see me for a year or so. Anyway, long story short, he had another attack. I managed to stent him within an hour of the onset and he is doing well. The first image is before angioplasty today and the second is after. The initial stent had become restenosed a phenomenon we call instent restenosis. From what I gather he had stopped his statins, ace inhibitor and beta blockers. Oh well. Hope this does not happen again.

01/10/2019

Patient with an ST elevation myocardial infarction after succesful LAD angioplasty.

Timi 3 flow and myocardial contractility has been restored.

01/10/2019

Patient with an ST elevation myocardial infarction presented with chest pain and in heart failure. Decided to thrombolyse and perform delayed PCI. Thrombolysis was successful and PCI was very uneventful. Good outcome.

CTO after angioplasty. 3 wires, 4 balloons and 3 stents later. This is the result.
09/08/2019

CTO after angioplasty. 3 wires, 4 balloons and 3 stents later. This is the result.

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Jalan Raja Musa Musa
Klang
41200

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Monday 09:00 - 17:00
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