Heart Sapling Blossoms | Myanmar Trainee Publishes Rare Case in Top International Cardiology Journal European Heart Journal

On June 24, the European Heart Journal—the official journal of the European Society of Cardiology (ESC)—published online a case report titled “Aortic perforation following percutaneous coronary intervention in a patient with permanent pacemaker: a case report” by Professor Wang Yan’s team from Xiamen Cardiovascular Hospital Xiamen University (XMCH). The report documents the successful treatment of an extremely rare complication: aortic perforation caused by a pacemaker lead.

Particularly noteworthy is that the first author of this article is Dr. Toe Wai Wai Naing, a young physician from Myanmar and a graduate of XMCH’s Heart Sapling Visiting Scholar Program. The corresponding author is her mentor at XMCH, Director Cheng Ye. This achievement highlights the depth and effectiveness of the Heart Sapling Program in cultivating international cardiovascular talent.

Case Review: Precise Treatment of a Rare Complication

The patient was a 70-year-old male admitted for intermittent chest pain lasting three weeks. He was diagnosed with chronic coronary syndrome and underwent percutaneous coronary intervention (PCI). On the second day post-PCI, he developed cardiac tamponade and cardiogenic shock. An urgent repeat coronary angiography showed no abnormalities. The true cause was identified during emergency thoracotomy: a dual-chamber pacemaker's right atrial lead implanted six weeks earlier had perforated the aortic wall—a complication rarely reported in existing literature. The team promptly and successfully performed aortic perforation repair, and the patient was discharged 20 days after the procedure.

Chinese Expertise: Heart Sapling Growth from Case to Publication

During her training at XMCH, Dr. Toe participated in the diagnosis and treatment of this case, systematically learning how to rapidly identify high-risk complications, engage in multidisciplinary decision-making, and master complex surgical techniques. She reflected, “Rare cases involving pacemaker implantation, PCI, and emergency surgery helped me deeply appreciate XMCH's meticulous attention to detail and the efficiency of its critical care system.”

Under her mentor's guidance, Dr. Toe documented and published the case, emphasizing clinical insights such as the need to monitor nonspecific chest pain, remain alert to delayed complications following multiple cardiac procedures, and be cautious of strong support catheters potentially damaging pacemaker leads. Her report offers highly valuable Chinese experience for clinicians worldwide.

Heart Sapling Blossoms: Sowing Seeds of Cardiovascular Health Globally

In March 2024, Dr. Toe was selected for the Heart Sapling Visiting Scholar Program at XMCH and completed a one-year specialized training in coronary intervention. Under the mentorship of President Wang Yan and Director Cheng Ye, she received systematic training through theoretical learning, surgical shadowing, case discussions, and teaching ward rounds, gaining rich experience in managing complex and critical cases.

To date, the Heart Sapling Program has hosted 26 visiting scholars from 12 countries, with 14 of them having successfully completed training and returned home. Armed with advanced techniques and clinical concepts from XMCH, these trainees are becoming seeds of hope in improving cardiovascular care in their respective countries. As Dr. Toe put it, “What XMCH taught me goes beyond surgical skills—it’s the rigorous clinical thinking when confronting challenging cases. That’s the most valuable gift I can take back with me.”

From a rare complication to a paper in a top-tier international journal—and to a cohort of young physicians changing the world—the Heart Sapling Program at XMCH is building a bridge that extends China’s cardiovascular expertise and human touch to a wider world.