Creating a European standard
Professor Di Mario is the team leader for complex coronary artery disease at the National Institute of Health Research (NIHR) Cardiovascular BRU of the Royal Brompton & Harefield Foundation Trust.
Interventional cardiology is a relatively new field applying percutaneous catheters and other devices to restore blood flow to the heart without major surgery. The field is growing rapidly to include interventions on the heart valves, peripheral vessels and the correction of other structural heart abnormalities.
Professor Di Mario, who is immediate past president of the European Association of Cardiovascular Interventions and councillor on the Board of the European Society of Cardiology, explains: “Increased demand for more interventional procedures has outweighed the number of properly trained new specialists available. Very few countries offer structured training, so it was essential to set up an official programme.”
International training at Royal Brompton
The first European Interventional Cardiology Fellows course was run at Royal Brompton Hospital in November 2006, with successful new editions up to 2012 attended by more than 100 cardiology fellows from all over the world.
Says Professor Di Mario: “The course was an important step in the process towards standardising specialist training throughout Europe. Now the course is run directly by the association, but Royal Brompton continues to attract the best people to study with us,” fellows from Australia, Japan, Greece, Italy, Spain, Turkey and many other countries.”
To share unusual cases, Professor Di Mario has broadcast live transmissions of interventional cardiology procedures to thousands of international colleagues across Europe, Asia and the United States.
At the World Congress of Cardiology, held in Barcelona in 2006, more than 4,000 delegates watched the successful treatment of total occlusions at Royal Brompton. Professor Di Mario used wires passed both from above the occlusion and, via tiny collateral vessels, from below the occlusion, in a new approach called retrograde, which increases the success rate in these complex cases. For 10 years, similar cases have been transmitted at the JIM meeting in Rome, the Transcatheter Therapeutics congress in Washington and many others.
Professor Di Mario trained in Italy, his home country. He then worked in Holland for six years and at the San Raffaele Hospital in Milan, before taking up a specialist post at Royal Brompton & Harefield NHS Foundation Trust. He has authored more than 500 peer-reviewed publications including manuscripts in high impact journals such as the New England Journal of Medicine, The Lancet, Circulation, the Journal of the American College of Cardiology and the European Journal of Cardiology. He is Associate Editor of EuroIntervention, European Heart Journal –Cardiovascular Imaging, the International Journal of Cardiology and member of the editorial board of many prestigious journals.
He has been one of the pioneers of the use of biodegradable stent, with research spanning from a seminal paper in The Lancet in 2006 to a report of the most recent experience published in the Journal of the American College of Cardiology Cardiovascular Interventions. He is also a recognised authority in the field of intravascular imaging, with ultrasound, optical coherence tomography and near-infrared spectroscopy used for research and clinical guidance.
“Our international work makes sure that we offer the best to our patients in terms of what is available in the field. It also keeps us at the forefront of research and scientific developments in specialist areas,” he comments.
Read Professor Di Mario's profile in Circulation (scroll down to view).