Saving Lives in Pakistan

The Peshawar Institute of Cardiology – Medical Teaching Institution (PIC-MTI) is a relatively new heart and vascular hospital in Khyber Pakhtunkhwa, Pakistan. The hospital was established in 2021 to provide high-quality care for patients in the area with cardiac, vascular, and pulmonary conditions. The institute offers a wide range of clinical services, advanced diagnostic and therapeutic options, and state-of-the-art treatment through the use of cutting-edge technology. In addition to providing clinical services, they are also focused on advanced training of healthcare professionals, as well as academic research. VISIONS Special explored how the Institute’s new Alphenix Interventional Cardiology solutions and collaboration with Canon Medical Systems support clinical progress.
Dr. Ali Raza Peshawar Institute of Cardiology, Khyber Pakhtunkhwa, Pakistan

Addressing significant needs

PIC-MTI is the largest healthcare project undertaken by the Health Department of the Government of Khyber Pakhtunkhwa (KPK) in recent times. As the first specialty hospital of its kind, it will not only cater to cardiac patients in KPK but also adjoining Afghanistan.

“All activities are supported by cardiac diagnostic facilities, such as Cardiac MR, and CT Angiographies, Electrophysiological studies, and Nuclear Cardiology,” said Professor Syed Shakar Ahmed Shah, Medical Director at the PIC-MTI. “PIC-MTI aims to provide ethical, evidence-based, and cost-effective treatment for the people of KPK, and the dream has come true.” “Recent studies show that in Pakistan with every passing hour, 46 people are dying of cardiac ailments. One in four in middle aged adults in Pakistan has prevalent coronary artery disease. Annually 250,000 people die due to cardiac diseases in Pakistan, which is an alarming figure in itself and, therefore, the need for a dedicated and specialized cardiac treatment facility in KPK has never been greater before,” said Dr. Nayamat Shah, Hospital Director at the PIC-MTI .“We aim to be the premier center for all sorts of cardiac ailments in adults and children. We are introducing tertiary care cardiac procedures, like ventricular assist devices and percutaneous, minimally invasive valve replacements, and beating-heart coronary bypass surgeries. Our vision is to initiate heart transplant surgeries soon. The hospital aims to make it easy for patients, their families, and medical institutions to use the cardiac care services the PICMTI offers.”

“Alphenix has got a very good resolution and high safety profile. It's very user friendly for staff. It comes with very good integrated systems and software as well, such as Vitrea and others. It can integrate with other machines and imaging systems”

Dr. Ali Raza
Peshawar Institute of Cardiology,
Khyber Pakhtunkhwa, Pakistan

Supporting a high-volume service

Dr. Ali Raza is an Interventional Cardiology Consultant at the PICMTI. He specializes in Structural Heart Disease and complex PCI. Dr. Raza was previously a Consultant at Wythenshawe Hospital, in Manchester, UK – A well-known heart and lung transplant center.
Peshawar Institute of Cardiology
“We started with our Alphenix from Canon Medical Systems from the beginning. We have been using it now for more than three years”, he remarked. “PIC-MTI started initially with low volume services, but now we're becoming one of the highest volume services, with more than 10,000 procedures being performed each year. We are the highest-volume center in Pakistan for performing Coronary Intervention, Structural Heart Disease, and TAVI procedures.”
“When we increased to that volume, we found that the Alphenix system was really beneficial,” he added. “It gives you a wide space, and is very suitable to high-volume centers, such as our own, because it is so easy to use and we could allocate our staff to different positions and utilize them optimally, while still keeping up with our volume. We can operate it with minimum staff with a lot of ease and comfort.”
Peshawar Institute of Cardiology

“We perform different complex procedures, which can last as long as few hours. The tube never heats up during the procedure. Especially in TAVI, which generally takes longer than other treatments, there was no downtime throughout the entire process.”

Dr. Ali Raza
Peshawar Institute of Cardiology,
Khyber Pakhtunkhwa, Pakistan

Ease of use

Dr. Raza had gained experience of the Alphenix system from working in hospitals in the UK and Canada previously. “The Alphenix works very well. It has got a very good resolution and a high safety profile. It's very user friendly for staff. It comes with very good integrated systems and software as well, such as Vitrea and others. It can integrate with other machines and imaging systems,” he said. “We are very happy with its performance.”

“Ease of use was a main factor in choosing the Alphenix,” he continued. “We perform different complex procedures, which can last as long as a few hours. The tube never heats up during the procedure. Especially in TAVI, which generally takes longer than other treatments, there was no downtime throughout the entire process. The safety profile of this machine is excellent. We regularly monitor our radiation dosages, and for that, we have seen that it protects from higher doses of radiation. The resolutions are excellent and achieves high-quality pictures, which improves our patient safety as well.”

In addition to the very high resolution achievable, Dr. Raza finds the Alphenix software sophisticated.
“The paradigm of cardiology is expanding every day and with this machine, we can encompass more,” he said. “Even in a very crowded type of situation, or when we have much volume workload and turnover of patients”.
He also recognizes that the Alphenix can be integrated easily with other systems.

“We use their software which is associated with the Vitrea software as well,“ he explained. “We are about to publish a paper that compares Vitrea with 3mensio and the initial outcomes have shown that even new beginners can do their TAVI analysis very well with the software that is provided with the Alphenix. Alphenix has better integration with the other systems as well, like IVUS, or FFRs.”

“In addition, Alphenix Core +’s 5-axis geometry provides more space for a transesophageal echo machine, anesthesia machines, and the IVUS system. This results in more space with better resolution and less radiation.”
Dr. Ali Raza’s team

Exceeding expectations

Dr. Raza has been pleasantly surprised by the capabilities of the Alphenix. “I have found that it is very user friendly,” he said. “ You can use it even with limited staff and you can still get the same quality of images with it, even with the lower frame rates, whereas you have to increase the frame rate, increase radiation with other machines. You get less dose and great image quality with the Alphenix.”

“We recently completed 7 TAVI procedures over the course of one day in 10 hours. This is a significantly high number of TAVIs to be undertaken in this time period and we used the Alphenix system. We did not encounter any issues with the machine. The machine still delivered a high and safe performance for our patients,” he explained.

The exceptional after sales service offered by Medequips, the local distributor in Pakistan, and Canon has impressed Dr. Raza and his team.

“We get an excellent after sales service for the Alphenix,” he said. ”Considering in Pakistan that we get very high-volume usage and the system is busy most of the time, it really helps that the Alphenix is a system which you can use with so much ease and comfort.”

“Together with the software which comes with the Alphenix, it's integration with other systems. The space that it occupies enabling better usage of the other space in the cath lab resolution, I would recommend it to my colleagues and peers. There will also be the ability to use the system in other places.”

“We recently completed 7 TAVI procedures over the course of one day in 10 hours. This is a significantly high number of TAVIs to be undertaken in this time period and we used the Alphenix system...The machine still delivered a high and safe performance for our patients."

Dr. Ali Raza
Peshawar Institute of Cardiology,
Khyber Pakhtunkhwa, Pakistan
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