[Sportschosun, Jang Jong-ho] Myocardial infarction and cardiac arrest are representative emergency conditions that do not give patients enough time to travel to a distant hospital of their choice. In addition, cardiovascular diseases such as acute aortic disease, severe heart failure, and life-threatening arrhythmias can significantly reduce a patient’s chances of survival and recovery when treatment is delayed.
In practice, domestic and international treatment guidelines recommend opening the blocked vessel within 90 minutes of arrival at the emergency room for myocardial infarction. For acute type A aortic dissection, the risk of death rises by approximately 1% per hour as surgery is delayed. In cases of worsening acute heart failure or life-threatening arrhythmias, the speed at which treatment begins also determines the prognosis. Thus, emergency cardiac conditions share the common feature that “time” is directly linked to life.
For severe cardiovascular diseases, it is therefore important to have a medical system that can provide rapid diagnosis and emergency treatment nearby, followed by advanced interventions or surgery, intensive care, mechanical circulatory support, and even heart transplantation as needed according to the patient’s condition.
The Cardiovascular Center at Hallym University Dongtan Sacred Heart Hospital, led by hospital director Han Sung-woo, has established this “comprehensive regional cardiovascular care system.” It provides patients in South Gyeonggi with everything from emergency treatment and advanced care to long-term management.
◇ Approximately 700 PCI procedures annually ... Selecting the optimal treatment for each patient
The Cardiovascular Center performed approximately 700 percutaneous coronary intervention (PCI) procedures in 2025. PCI widens narrowed or blocked coronary arteries in patients with angina or myocardial infarction. For complex coronary artery diseases, including left main coronary artery lesions, severely calcified lesions, and chronic total occlusion (CTO), the center determines treatment plans after comprehensively evaluating each patient’s clinical condition and anatomical characteristics.
For left main coronary artery disease and complex multivessel disease, both PCI and coronary artery bypass grafting can be important treatment options. Cardiologists and cardiovascular surgeons jointly determine the optimal treatment after considering the patient’s age, comorbidities, cardiac function, the location and complexity of the lesions, and surgical risk.
Interventional treatment can be an important alternative for elderly patients or those for whom surgery poses a substantial burden because of multiple comorbidities. Conversely, when surgery is considered anatomically more beneficial for long-term outcomes, patients are promptly referred to cardiovascular surgeons for surgical treatment.
◇ Strengthening advanced PCI capabilities, including treatment for severely calcified lesions and chronic total occlusion (CTO)
As the elderly population grows, the number of complex lesions involving hard calcification of the coronary artery walls is also increasing. Severe calcification can make it difficult to expand a vessel sufficiently with conventional balloon dilation alone and may prevent a stent from expanding properly, requiring various additional measures.
The center treats severely calcified lesions using Rotational Atherectomy. This treatment uses a rapidly rotating, diamond-coated burr to finely ablate hard calcified tissue, facilitating subsequent balloon dilation and stent placement.
The center also treats chronic total occlusion (CTO), in which a blood vessel has remained completely blocked for an extended period. Because CTO intervention requires greater experience and technical expertise than conventional PCI, the center actively uses imaging equipment such as Intravascular Ultrasound (IVUS) to precisely assess the structure of lesions and the results of stent placement.
Going forward, the center plans to further expand treatment options for complex coronary artery disease by introducing new technologies, including Intravascular Lithotripsy (IVL), which uses shock waves to modify calcified lesions inside the coronary arteries.
◇ Strength of a multidisciplinary Heart Team involving 20 medical professionals
One of the Cardiovascular Center’s key strengths is its multidisciplinary care system, in which cardiology and cardiovascular surgery departments work closely together.
Through regular Heart Team meetings, the center discusses treatment plans for patients with complex coronary artery disease, valvular disease, and severe heart failure. Approximately 20 medical professionals participate, including cardiology and cardiovascular surgery professors, residents, dedicated nurses, echocardiography staff, and perfusionists.
The key treatment principle is not to determine whether surgery or an intervention is superior, but to select the method best suited to the patient’s condition. The Heart Team considers the patient’s age, comorbidities, anatomical characteristics, surgical risk, life expectancy, and expected quality of life after treatment before choosing the best option between intervention and surgery.
◇ From TAVI and LVAD to heart transplantation ... Completing treatment for severe heart disease within the region
Hallym University Dongtan Sacred Heart Hospital provides Transcatheter Aortic Valve Implantation (TAVI), Left Ventricular Assist Device (LVAD) treatment, and heart transplantation for patients with severe valvular disease and end-stage heart failure.
If aortic stenosis progresses to a severe stage and remains untreated, half of patients die within two years, and the five-year survival rate is only around 20%. In such cases, the Heart Team determines whether surgical aortic valve replacement (SAVR) or TAVI is more appropriate. TAVI involves inserting an artificial valve through a blood vessel without opening the chest. It has become an important treatment option not only for elderly patients and those at high surgical risk, but also for a broader range of patients in recent years.
TAVI can be performed only at institutions that meet all requirements, including facilities capable of cardiac surgery; equipment such as extracorporeal membrane oxygenation (ECMO); cardiology and cardiovascular surgery specialists with the required level of experience; and annual volumes of aortic valve replacement and PCI procedures.
Since introducing TAVI in 2023, Hallym University Dongtan Sacred Heart Hospital has performed more than 50 procedures and continues to expand treatment. In 2024, it successfully performed TAVI through a prosthetic-vessel access route for a patient whose conventional vascular access was difficult, applying treatment tailored to the patient’s anatomical condition. The hospital also has a system that allows treatment to continue through LVAD and heart transplantation for patients with severe heart failure who do not recover despite medication and device therapy.
Hallym University Dongtan Sacred Heart Hospital achieved the first heart transplant in South Gyeonggi in 2017 and the first LVAD surgery in Gyeonggi Province in 2018.
Park Myung-soo, a professor of cardiology, said, “The Cardiovascular Center operates customized treatment programs continuously for the long-term care of patients with severe heart failure. The important point is not whether an individual procedure or surgery is performed, but whether treatment that begins in an emergency can continue without interruption through intensive care and mechanical circulatory support and, when necessary, proceed to LVAD or heart transplantation.”
◇ ECMO treatment for patients with cardiogenic shock ... Operating a 24-hour response system
For some patients who develop cardiogenic shock because of myocardial infarction or severe heart failure, or whose spontaneous circulation does not return after cardiac arrest, extracorporeal membrane oxygenation (ECMO) becomes an important means of sustaining life.
The center operates a 24-hour response system linking on-call physicians, dedicated nurses, and perfusionists, allowing ECMO to be applied promptly in the emergency room or cardiovascular catheterization laboratory when necessary.
ECMO is not a definitive treatment in itself; it serves as “bridge therapy” while clinicians wait for recovery or prepare for the next stage of treatment. Depending on the patient’s condition, the medical team may wait for cardiac function to recover or proceed to the next stage, such as LVAD implantation or heart transplantation.
For cardiovascular emergencies such as myocardial infarction, cardiac arrest, and acute aortic disease, delays in treatment can reduce the likelihood of survival and worsen long-term outcomes. A medical system that enables patients to receive specialized treatment quickly in the area where the emergency occurs is therefore an important part of the community safety net.
The center regards protecting this “golden hour” as an important role of a regional medical institution and operates a 24-hour emergency cardiovascular care system.
◇ Maintaining emergency care despite the healthcare vacuum ... Continuing treatment for patients with severe cardiovascular disease
Even during the period after 2024 when several medical institutions reduced the scope of emergency care or struggled to accept critically ill patients from outside amid the healthcare vacuum, Hallym University Dongtan Sacred Heart Hospital continued operating its emergency room and treating patients with severe emergencies, including myocardial infarction and cardiac arrest.
Emergency medicine, cardiology, cardiovascular surgery, and critical care staff worked together to accept patients with severe cardiovascular disease. For myocardial infarction patients, the hospital maintained a 24-hour on-call system so that rapid diagnosis after arrival at the emergency room could be followed by PCI.
This response has continued beyond that particular period. When a cardiovascular emergency occurs, the patient is evaluated in the emergency room and immediately connected with cardiology. If necessary, treatment proceeds continuously through the cardiovascular catheterization laboratory, intensive care unit, and operating room.
◇ Bridging gaps in cardiovascular care with regional medical institutions in Seosan, Anseong, and Icheon
Hallym University Dongtan Sacred Heart Hospital is also working to reduce gaps in cardiovascular care by cooperating with regional medical institutions that have difficulty securing cardiology specialists.
The hospital has established a care system in cooperation with Chungcheongnam-do Seosan Medical Center, Gyeonggi Provincial Medical Center Icheon Hospital, and Gyeonggi Provincial Medical Center Anseong Hospital. Under the system, university hospital cardiologists regularly provide clinical support, while patients requiring advanced tests or procedures are referred to Hallym University Dongtan Sacred Heart Hospital.
When patients require urgent treatment, such as for acute myocardial infarction, they are promptly transferred to a hospital capable of providing advanced care. After treatment, they can receive follow-up care again at regional medical institutions, with the goal of preventing unnecessary repeated long-distance travel for medical care.
◇ Providing rapid treatment for regional patients through teleconsultation
Since participating in the Ministry of Health and Welfare (MOHW)’s “5G-based Teleconsultation Pilot Project” in 2020, Hallym University Dongtan Sacred Heart Hospital has carried out various teleconsultation projects and developed its collaborative care model with regional medical institutions.
The hospital shared electrocardiograms, echocardiograms, and test results from regional medical institutions with university hospital specialists, provided advice on treatment direction, and supported rapid decisions on patient transfers or additional tests when necessary.
It has also established a consultation and referral-return system linked to hospital information systems, using it to improve continuity of care with regional medical institutions. Teleconsultation is meaningful not because university hospitals replace the role of regional hospitals, but because it is a cooperative model in which specialists share their expertise so regional medical staff can treat patients more safely and connect them promptly to appropriate care when necessary.
◇ Cardiovascular disease prevention begins before treatment
The Cardiovascular Center at Hallym University Dongtan Sacred Heart Hospital is focusing not only on emergency treatment for severe cardiovascular disease, but also on primary prevention and early diagnosis to manage risk factors before disease develops.
Hypertension, diabetes, dyslipidemia, smoking, and obesity are major risk factors for cardiovascular and cerebrovascular diseases, including myocardial infarction and stroke. Because atherosclerosis can progress for a long time without symptoms, it is important to manage blood pressure, blood sugar, and cholesterol appropriately in daily life.
As a regional hub hospital, Hallym University Dongtan Sacred Heart Hospital regularly provides local residents with health lectures on cardiovascular disease prevention and early diagnosis. It is also strengthening communication with regional medical professionals through continuing education programs for local physicians and collaborative echocardiography services.
◇ Assessing cardiovascular risk is important for high-risk groups even without symptoms
Cardiovascular testing is not uniformly necessary for everyone. It is important to select tests based on an individual’s risk, taking into account age, hypertension, diabetes, dyslipidemia, smoking history, and family history.
When necessary, carotid ultrasonography can assess the degree of atherosclerosis in the carotid arteries, while an Ankle-Brachial Index (ABI) test can assess atherosclerosis in the peripheral arteries. Coronary artery calcium CT can also be used to assess the calcification burden in the coronary arteries. Rather than interpreting test results in isolation, clinicians evaluate them together with the patient’s overall cardiovascular risk and use them to determine the intensity of preventive treatment going forward.
Hospital director Han Sung-woo said, “Severe cardiovascular diseases such as myocardial infarction and cardiac arrest do not give patients enough time to deliberate over which hospital to go to. It is important to establish a system that enables rapid emergency treatment within the region and allows care to continue without interruption, according to the patient’s condition, through interventions and surgery, intensive care, mechanical circulatory support, and heart transplantation.”
He added, “Hallym University Dongtan Sacred Heart Hospital will fulfill its role so that residents of South Gyeonggi can receive cardiovascular care with confidence close to home. Multiple specialties, including cardiology and cardiovascular surgery, work closely together to select the treatment method best suited to each patient, while cooperation with regional medical institutions and prevention activities further support this goal.”
Jang Jong-ho, Reporter
bellho@sportschosun.com
This article has been translated by GripLabs Mingo AI.
