In 2018, cardiologists at North Shore Hospital were beginning to use a new technique to break up arterial calcium in some of their more seriously compromised heart patients – Shockwave Intravascular Lithotripsy (IVL).
That same year, Dr Bernard Wong began his training to become a cardiologist, a speciality that had always inspired him.
“Cardiology was exciting – with something new always around the corner.”
IVL was new, and Dr Wong published multiple observational studies on the device before designing a pilot IVL randomised controlled trial in 2020 using 60 patients. The trial is presently ongoing at North Shore Hospital.
“We’re testing the device against standard therapy, which is conventional ballooning prior to stent replacement,” says Dr Wong. “The existing evidence doesn’t compare shockwave to anything else, so although t
his device has shown a lot of promise, we still need good quality research to prove it works better than existing options.”
The trial is the basis of a medical doctorate that Dr Wong is working on part-time, under Auckland University supervision. He aims to finish by 2024 and an A H Couch Trust grant is covering his university fees.
Alongside that research, Dr Wong chose in 2021 to advance his practical skills as an Interventional Cardiologist. He won the New Zealand Heart Foundation’s John Ormiston Grant in 2021, to support a fellowship at the Prince of Wales Hospital in Hong Kong, a teaching hospital that uses I
VL, also Rotational Atherectomy – a tiny diamond-tipped drill guided by wire to ablate calcium deposits, usually as a prelude to stenting, also a related but much-newer technique – Orbital Atherectomy.
The Rotational Atherectomy drill has with just one rotational axis, but the newer Orbital Atherectomy, though similarly guided by wire, has an eccentrically-mounted burr that allows the cardiologist to hit arterial calcium from more than one direction.
“I’ve been lucky enough to train in both devices, but I’ve been focussing on Orbital Atherectomy because it’s quite new in New Zealand, and I can bring some of those skills back,” says Dr Wong. “Orbital Atherectomy requires the operator to perform 6 cases supervised by an experienced operator before you get signed off to use it by yourself. So the supervisors are either someone from the company that makes the device or an existing proctor or supervisor, whic
h I will become myself."
“I’m in the process of writing a paper describing the use of combinations of Rotational Atherectomy with Lithotripsy and Orbital Atherectomy with Lithotripsy. This paper, which hopefully will get published, will form part of the doctoral thesis as well.”
When Dr Wong returns to New Zealand at the end of 2022 he’ll be welcomed back by a well-established North Shore family here. His parents emigrated from Hong Kong 26 years ago, when he was seven years old. He’ll return also as a family man himself. He and his wife Zoe, a Taiwanese nurse at Auckland City Hospital, married in 2020, and they now have a nine-month-old-daughter, Olivia.
He’ll take up a cardiology post at North Shore Hospital in January 2023. Alongside his clinical work, and finishing th
e doctorate, he’ll take the lead at North Shore Hospital’s cardiology research unit, working alongside experienced research nurses and a research fellow, to take part in multi-centred trials on both a national and international scale.
“I owe it to my mentors throughout my training journey, in particular the cardiologists at North Shore Hospital who have unreservedly supported my research and welcomed me back to their department.”