Portrait — Professor Koh Tian Hai

The European Association of Percutaneous Professor Koh Tian Hai is Medical Director of The National Heart Centre (NHC) in Singapore, which employs over 700 staff, including more than 50 medical specialists and around 300 nursing staff

How long have you worked in cardiology?

I've been working in Cardiology for twenty five years in total.

What prompted you to choose cardiology over other areas of medicine?

It was the most interesting internal medicine sub-specialty that I had experienced as a junior doctor. At that time, intracoronary thrombolysis and PTCA was just being established in the Western world. This meant that for the first time as physicians we were able to both diagnose illness and then directly administer appropriate interventional therapy to our patients. This revolution in therapy was tremendously appealing to a young doctor at that time. Of course, we could not have anticipated that interventional cardiology would blossom into such a dominant force in medicine today. During those early days, the surgeon was still the undisputed king.

What area of cardiology is of most interest to you? What's most intriguing for you?

Without a doubt, it is and will remain interventional cardiology. I treasure the learning and use of new devices in complex case scenarios and there is no shortage of new technological developments

What element of your career are you most proud of?

I am proud to be able to treat patients with acute myocardial infarction successfully in the cathlab. Seeing them recover almost miraculously gives me enormous satisfaction. The opportunity to help continue the growth and development of the National Heart Centre in Singapore would be another highlight for me personally.

How has the field of cardiology evolved during your career?

I started in medical school witnessing the enforced six week bed rest after a myocardial infarction, and in an era when the only drugs easily available for angina were nitrates. To see how cardiology has metamorphosed over the past 35 years has been astounding. I would not have thought it possible during my career to be able to witness the treatment of valvular disease by percutaneous aortic valve replacement!

What do you feel are the biggest challenges faced today by experts in your field?

Long term drug eluting stent safety is a major concern for me. Other major challenges include the improvement of left ventricular failure with stem cell based therapy, and the prevention of thromboembolism in atrial fibrillation with interventional devices or techniques.

How do you see your field evolving in five years time?

We should be able to see some breakthroughs in the above areas of DES safety, LVF stem cell therapy and AF thromboembolism prevention. During the next five years percutaneous aortic valve replacement is also likely to become mainstream therapy.