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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 26, No 3, May/June 2015
146
AFRICA
Drug Trends in Cardiology
AfricaPCR 2015, a brief report back
It is difficult to be a dispassionate
observer at a PCR course organised by
the Europa Organisation. Sessions are
designed to stimulate audience participa-
tion and dialogue, and AfricaPCR 2015
exemplified that approach.
Held from the 26–28 March at the
Forum, the Campus, in Bryanston,
Johannesburg, the 2015 course had an
audible buzz, with delegates being as
interactive as the presenters, making
for highly stimulating and informative
sessions, with much take-home value.
Case studies were particularly
interesting because they were not
presented as ‘show and tell’ exercises.
Speakers presented the images pertaining
to their respective cases, identified the
challenges, but did not disclose how
they had handled them. Instead, they
invited the delegates to comment and
debate how they would have treated
the patient. Audience consensus or
divergence regarding recommended
strategies inevitably led to lively
discussion, resulting in a ‘yes’ or ‘no’ vote
for specific procedures. Case studies were
rounded off by the speakers disclosing
how they actually treated their respective
patients, with the chairman of the session
summarising the learning points.
One of the course highlights was a
special focus on radial PCI, with two
workshops each day being dedicated to
how to start a radial programme, and
the tips and tricks needed to succeed
with radial PCI. The workshops were
sponsored by Terumo, who complemented
them with a model of radial access and a
radial simulator which proved to be an
irresistible key attraction.
Another highlight was a special focus
on setting up a new catheterisation
laboratory. Discussion centred on what
the basic requirements were for paediatric
and adult cardiology diagnostic and
interventional procedures in the cath lab.
When it came to tackling complications
in the cath lab, Dr Otieno from Kenya
aptly noted that if delegates hadn’t
experienced complications yet, then they
hadn’t used their cath labs sufficiently!
•
Fluoroscopic guidance was recom-
mended in order to reduce the femoral
access site complication rate.
•
Prof Jean Marco said that coronary
perforation and pericardial tampon-
ade were rare, with a frequency of
less than 0.2% in PCI. He noted that
51% of perforations were guide wire
related, making it vital to image the
position of the guide wire.
•
The success rate in retrieving wander-
ing stents and foreign bodies was
approximately 70–90% when snares
were used.
•
In the case of STEMI or cardiogenic
shock, delegates were advised to call
for assistance from cardiothoracic
colleagues.
•
They were also encouraged to initiate
a quality improvement programme by
keeping records of complications that
occurred in the cath lab and how they
were resolved.
A few major challenges were identified
with regard to establishing more cath labs,
or better functioning cath labs, in Africa.
A shortage of equipment, or inadequate
maintenance of equipment, appeared to
be a common problem in some countries.
There are currently 14 cath labs in Sudan,
for example, but none with the equipment
needed to do FFR.
Angola has four cath labs, with only
two being functional. The reason is that
the equipment suppliers and technicians
are based in another country. Therefore
it is clearly imperative to secure the
servicing and maintenance of equipment
as a contractual obligation when signing
a deal with an industry partner based
elsewhere.
Securing the funding to establish
additional cath labs was clearly a
challenge throughout the continent.
Prof Mpiko Ntsekhe.
Medtronic and Biotronik stands.
Sajidah Khan, course co-director.