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Cardiovascular disease (CVD) is the world’s leading cause of death, claiming 18.6 million lives each year, according to the World Heart Federation.

However, the increasing use of robotics and artificial intelligence (AI) and other advanced technologies backed by big data is helping telecardiology treatment reach the next level, offering precision treatment to patients while saving many precious lives.

“The advancement in technology has revolutionised healthcare. The advent of AI, big data, and robotics has led to a paradigm shift in caregiving. It has introduced sweeping changes,” says Dr Y. A. Nazer, Consultant Cardiac Surgery, Burjeel Hospital, a unit of VPS Healthcare.

Firstly, he explains that the introduction of advanced technology is enabling clinicians to fast track diagnosis and ensure precision treatment for patients.

“Similarly, robotics and AI are influencing treatment protocol to a great extent. The application of AI and robotics in surgery helps and guides a surgeon to perform a complex procedure with utmost precision in less time and reduces the chances of errors to a larger extent,” says Dr Nazer.

From the patient perspective, he expects the increased use of minimally invasive surgeries to reduce the length of stays in hospital. “With the application of AI and robotics, the method of procedure could undergo major changes. This would reduce hospital stay by a considerable margin.”

Senior cardiologists at Aster Hospitals point out that robotic systems are commonly used for single and double vessel coronary artery bypass grafting (CABG) and mitral valve (MV) replacement. The other applications of robotic systems include the resection of left atrial tumours and the repair of atrial septal defect (ASD).

Robotic cardiac surgery is heart surgery done through very small cuts in the chest. The biggest advantage of robotic surgery, explain experts, is that it offers excellent mitral valve (MV) repair rates as there is minimal need for coronary re-intervention.

Dr Ashik Sasidharan, Specialist Cardiologist, Aster Clinic Al Qusais, Damascus Street, says that robotic surgeries have been used for a number of different heart-related procedures, including valve surgery, especially mitral surgery, coronary artery bypass, cardiac tissue ablation, heart defect repair, and tumour removal.

His colleague Dr Naveed Ahmed who is a Cardiology Specialist Interventional, at Aster Hospital, Mankhool, agrees that advanced technology including AI has brought a breakthrough in cardiology.

In terms of ECHO cardiography, he explains, AI has made things simpler with less time and more accurate calculations of ejection fraction, estimation of valvular dysfunction, heart strains, etc.

“In electrophysiology — we have remote monitoring of devices such as pacemakers and ICDs, which are directly linked to our mobile devices where they can be monitored and controlled,” says Dr Ahmed, adding that Apple watches and other wrist devices have come up which help in identifying arrhythmias, without invasive monitoring.

UAE — a destination for advanced cardiac care

Medical experts working in the UAE vouch for the emirate’s strength which they say has adopted AI and various other advanced technologies in a big way. “The UAE is a country which is receptive to recent advances in any field, more so in the medical field. And we do have the infrastructure to implement the most modern technologies at ease,” says Dr Sasidharan.

Hence, he adds, with the skilled and well-trained doctors already at hand, the learning curve of these latest technologies, would not be steep and can expect a giant leap in providing these latest services to the needy, in the near future.

Dr Zuhair Yousif, Consultant Interventional Cardiologist at Mediclinic City Hospital, acknowledges that the UAE health authorities have always encouraged new technology and innovation.

In line with this initiative, he says Mediclinic City Hospital has been one of the leading hospitals in the UAE to adopt robotic surgery and other advanced innovations. “An increasing number of healthcare facilities are currently well equipped with highly skilled trained staff ready to implement the latest advances in diagnostic and therapeutic technologies.”

On the question of whether doctors need special training to use many of these latest technologies, Dr Ahmed points out that the UAE ranks best in terms of quality of life and safety, and “has attracted cardiologists and surgeons from across the globe who are well trained in the most recent technology. “Most of the hospitals in the UAE are now going for new generation equipment including ECHO machines, new robotic Cath lab and robotic surgeries,” he says.

UAE hospitals and doctors say they are constantly upgrading and adopting new technologies to offer advanced cardiac care.

Dr Nazer says at VPS Healthcare, they have always been vigilant to the rapid and daily developments in the industry across the globe.

“AI, robotics, and big data analysis are developing technologies. We are noticing the latest trends and are updating ourselves. We are also fast adopting and adapting to proven technologies that would help us in serving our patients in a better and efficient manner,” he concludes.

Treatment for congenital heart diseases
The number of cases of congenital heart defects including atrial septal defect (ASD), ventricular septal defect (VSD), PDA and complex congenital heart diseases in children and adults is increasing worldwide and it’s not very uncommon in the UAE either.
Dr Y. A. Nazer, Consultant Cardiac Surgery at Burjeel Hospital, explains ASD is a congenital heart problem where there is a hole in the wall that divides the chambers of the heart. VSD surgery is performed in children to correct a hole between the left and right ventricles of the heart. “In PDA device closure, paediatric cardiac interventionists place a small device in the vessel to close the PDA,” he says.
The traditional treatment option for palliation and correction of congenital heart defects in infants and children was surgery, says Dr Ashik Sasidharan, a Specialist Cardiologist working at Aster Clinic Al Qusais, Damascus Street. “However, this is almost completely replaced by developments like transcatheter methods which include transcatheter balloon dilatation procedures, transcatheter closure of ASD, VSD, PDA and percutaneous
valve replacements.”
He points out that the role of robotics in paediatric cardiac surgery ranges from the use of 3D imaging and a robotic wrist for dissection and reconstruction to voice-controlled robotic arm for scope manipulation -- all of which facilitate thoracoscopic procedures such as ligation of PDA and division of vascular rings.
Medical experts point out that ASD, PDA and a few VSD can be managed by devices without the need for surgery.
With the advancement in technology, Dr Naveed Ahmed, Cardiology (Specialist Interventional) at Aster Hospital, Mankhool, says, “minimally invasive robotic-assisted surgeries have improved the morbidity and mortality associated with complex congenital heart disease.”
UAE hospitals such as Aster and Burjeel are well equipped to treat congenital heart diseases using the latest technologies.
“At Burjeel Cardiac Surgery department, we are equipped to perform procedures such as ASD and VSD Device Closure, PDA Device Closure, Coarctation, Stenting and transcatheter minimal invasive surgery,” says Dr Nazer.

Diagnostics in cardiac care

Thumbay Labs is an important player in the diagnostics industry of the UAE, the MENA region and beyond. “Positioning Thumbay Labs as a leading provider of diagnostic services in the region, has been a huge achievement,” says Dr Nasir Parwaiz, Director, Thumbay Labs. “Evidence-based medicine requires the support of good quality labs which offer accurate and reliable diagnostic services, and this is an important area where Thumbay Labs can play a crucial role.” He adds that Thumbay Labs has introduced several screening packages for families to enable them to prevent diseases.

GN Focus report