Dr. Paul Chiam's Publications

Leaky tricuspid valve (tricuspid regurgitation) showing backward blood flow from the right ventricle into the right atrium

Minimally Invasive Treatment Options for Leaky Tricuspid Valve

A leaky tricuspid valve, also known as tricuspid regurgitation, is a heart valve condition that can cause swelling, breathlessness, fatigue, and worsening heart failure if left untreated. While open-heart surgery was once the only definitive treatment, advances in heart valve technology now allow selected patients to be treated using minimally invasive catheter-based procedures, including tricuspid transcatheter edge-to-edge repair, transcatheter tricuspid valve replacement, and caval valve implantation.

Dr Paul Chiam March 2, 2026

Valve-in-valve TAVI illustration showing minimally invasive heart valve replacement procedure

Valve-in-Valve TAVI: Minimally Invasive Replacement of Worn Out Artificial Heart Valves

What if replacing a worn-out heart valve did not require another open-heart surgery? Discover how valve-in-valve TAVI in Singapore makes it possible.

Dr Paul Chiam August 11, 2025

Minimally Invasive Mitral Valve Repair with the PASCAL Device

Treat severe mitral regurgitation without open-heart surgery. Discover the PASCAL Device at The Heart & Vascular Centre — a safer, minimally invasive solution in Singapore.

Dr Paul Chiam April 29, 2025

Stroke Prevention: Carotid Artery Stenting and PFO Closure

Stroke prevention is crucial, and procedures like carotid artery stenting and PFO (patent foramen ovale) closure effectively reduce risk. At The Heart & Vascular Centre, we provide advanced screenings and treatments to protect your heart health and prevent strokes. Early detection is key to a healthier future.

Dr Paul Chiam January 23, 2025

Human heart with clogged arteries. 3d illustration

Advanced Techniques in Complex Coronary Angioplasty for Coronary Artery Disease

Coronary angioplasty is a vital medical procedure used to treat coronary artery disease, a condition characterised by the narrowing of the coronary arteries—the main vessels supplying blood and oxygen to the heart. Typically, coronary angioplasty is followed by the placement of a stent to maintain the artery’s patency, ensuring sustained blood flow and minimising future blockages.

Dr Paul Chiam October 14, 2024

Sentinel dual-filter system to reduce stroke during Transcatheter Aortic Valve Replacement (TAVR or TAVI)

In the realm of cardiovascular medicine, transcatheter aortic valve replacement (TAVR or TAVI) stands as a revolutionary procedure, offering renewed hope to individuals suffering from aortic valve stenosis. This minimally invasive intervention has transformed the landscape of cardiac care, providing an effective alternative for patients with respect to traditional open-heart surgery. At our centre, we also utilise the Sentinel cerebral protection system, which significantly reduces the risk of major stroke that, though uncommon, may occur during TAVI procedures.

Dr Paul Chiam July 18, 2024

Dr. Paul Chiam's Articles

Minimally Invasive Treatment Options for Leaky Tricuspid Valve

Valve-in-Valve TAVI: Minimally Invasive Replacement of Worn Out Artificial Heart Valves

Minimally Invasive Mitral Valve Repair with the PASCAL Device

Stroke Prevention: Carotid Artery Stenting and PFO Closure

Advanced Techniques in Complex Coronary Angioplasty for Coronary Artery Disease

Sentinel dual-filter system to reduce stroke during Transcatheter Aortic Valve Replacement (TAVR or TAVI)

Dr. Paul Chiam's Scientific Publications

Transcatheter Aortic Valve Implantation (TAVI)

Chiam PT, Nair D, Lim YT, Sivathasan C. Optimising percutaneous valve-in-valve TAVI with bioprosthetic valve fracture. Annals, Academy of Medicine, Singapore 2024; 53: 328-330.

Chiam P, Lim Y, Sivathasan C. Transfemoral transcatheter aortic valve implantation facilitated by intravascular ultrasound-guided shockwave lithotripsy. AsiaIntervention 2021 Dec; 7(2): 116-117.

Chiam PT, Ho KW, Keng FY. Transcatheter aortic valve implantation in Singapore: Cost effective after a decade of evolution? Annals Academy of Medicine Singapore 2020; 49: 420-422.

Chiam PT Transcatheter aortic valve implantation in Asia: the first decade. Eurointervention 2018; 14: 35-37.

Chiam PT. Transcatheter aortic valve implantation in rheumatic aortic stenosis. Asiaintervention 2018; 4: 11-13

Chiam PT, Ewe SH, Soon JL et al. Percutaneous transcatheter aortic valve implantation for degenerated surgical bioprostheses: the first case series in Asia with one-year follow-up. Singapore Medical Journal 2016; 57(7): 401-5.

Chiam PT. Ewe SH. The expanding indications of transcatheter aortic valve implantation. Future Cardiology 2016; 12 (2): 209-219

Chiam PT, Ewe SH, Chua YL, Lim YT. First transcatheter aortic valve implantation for severe pure aortic regurgitation in Asia. Singapore Medical Journal 2014; 56: e1-e3.

Ong BH, Chiam PT, Sim DK, Tan TE. Post-implantation transcatheter aortic valve migration in a left ventricular assist device patient with severe aortic insufficiency. European Heart Journal 2014; 35: 1616.

Krupa J, Chiam PT, Chua YL, Ewe SH. Feasibility of transcatheter aortic valve implantation in systemic lupus erythematosus associated non-calcific aortic stenosis. European Heart Journal 2013; 35: 1624.

Chiam PT, Ewe SH. An update on complications associated with Transcatheter Aortic Valve Implantation (TAVI): stroke, paravalvular leak, atrioventricular block and perforation. Future Cardiology 2013; 9 (5): 733-47.

Chiam PT, Chao VT. Percutaneous Transcatheter Aortic Valve Implantation – An update. Asean Heart Journal 2013; 21: 11-14.

Chiam PT, Koh AS, Ewe SH, Sin YK, Chao VT, Ng CK, Lee CY, Lim YP, Su JW, Lim SL, Tan TE, Lim CH, Tan SY, Lim ST, Chua TS, Koh TH, Chua YL. Iliofemoral anatomy among Asians: Implications for transcatheter aortic valve implantation. International Journal of Cardiology 2013; 167: 1373-9

Pang PY, Chiam PT, Chua YL, Sin YK. A survivor of late prosthesis migration and rotation following percutaneous transcatheter aortic valve implantation. European Journal of Cardio-thoracic Surgery 2012; 41: 1195-6.

Chao VT, Chiam PT, Tan SY. Transcatheter aortic valve implantation with preexisting mechanical mitral prosthesis – Use of CT angiography. Journal of Invasive Cardiology 2010; 22: 339-40.

Chiam PT, Chao VT, Tan SY, Koh TH, Lee CY, See Tho VY, Chua YL. Percutaneous transcatheter heart valve implantation in a bicuspid aortic valve. Journal of the American College of Cardiology Interventions 2010; 3: 559-61.

Chao VT, Chua YL, Chiam PT, Lee CY, See Tho VY, Tan SY, Lim ST, Hwang NC, Sin YK, Koh TH. Percutaneous transcatheter aortic valve replacement: First transapical implant in Asia. Singapore Medical Journal 2010; 51: 69-72.

Chiam PT, Koh TH, Chao VT, Lee CY, See Tho VY, Tan SY, Lim ST, Hwang NC, Sin YK, Chua YL. Percutaneous transcatheter aortic valve replacement: First transfemoral implant in Asia. Singapore Medical Journal 2009; 50: 534-37.

Chiam PT, Ruiz CE. Percutaneous transcatheter aortic valve implantation: Evolution of the technology. American Heart Journal 2009; 157: 229-42.

Ruiz CE, Laborde JC, Condado JF, Chiam PT, Condado JA. First percutaneous transcatheter aortic valve-in-valve implant with three year follow up. Catheterization and Cardiovascular Interventions 2008; 72: 143-148.

Chiam PT, del Valle-Fernandez R, Ruiz CE. Percutaneous transcatheter valve therapy. Revista Espanola Cardiologia 2008; 61 (Suppl 2): 10-24.

Chiam PT, Ruiz CE. Percutaneous transcatheter aortic valve implantation – Assessing results, judging outcomes and planning trials: The interventionalist perspective. Journal of the American College of Cardiology Interventions 2008; 1: 341-50.

Carotid, Intracranial and Peripheral Artery Intervention:

Chiam PT, Lim YT, Ong CK, Au Eong KG.Severe carotid stenosis presenting as ipsilateral ocular ischaemic syndrome: successful treatment with carotid artery stenting. Singapore Medical Journal2021; 62(12): 667-669

Chiam PT.Endovascular recanalization of chronic aortoiliac occlusions – will this become the initial treatment of choice? AsiaIntervention 2019; 5: 107-109.

Chiam PT, Roubin GS, Panagopoulos G, Iyer SS, Green RM, Brennan C, Vitek JJ.One-year clinical outcomes, mid-term survival and predictors of mortality after carotid stenting in elderly patients. Circulation 2009; 119: 2343-48.

Chiam PT, Roubin GS.Carotid sheath rescue with a distal filter retrieval catheter. Catheterization and Cardiovascular Interventions 2008; 71: 987-90.

Chiam PT, Roubin GS, Iyer SS, Green RM, Brennan C, Vitek JJ.Carotid artery stenting in elderly patients – Importance of case selection. Catheterization and Cardiovascular Interventions 2008; 72: 318-24.

Chiam PT, Samuelson RM, Mocco J, Hanel RA, Siddiqui AH, Hopkins LN, Levy EI.Navigability trumps all: Stenting of acute middle cerebral artery occlusions with a new self-expandable stent. American Journal of Neuroradiology 2008; 29: 1956-8.

Chiam PT, Mocco J, Samuelson RM, Siddiqui AH, Hopkins LN, Levy EI.Retrograde angioplasty for basilar artery stenosis: Bypassing bilateral vertebral artery occlusions. Journal of Neurosurgery 2008; 110: 427-30.

Chiam P, V. Kwok, BA Johan, C. Chan.A case of major pulmonary embolism treated with a rheolytic thrombectomy catheter. Singapore Medical Journal 2005; 46: 479-82.

Transradial Percutaneous Coronary Artery Intervention

Chiam PT, Chua NHL, Tan HC. Forearm pain after coronary angiography via the distal radial artery. AsiaIntervention. 2023 Mar 15;9 (1): 58-59

Chin CY, Chin CW, Chiam PT, Tan RS. Chest pain with a blue hand: simultaneous coronary and left subclavian artery thrombosis. Asia Intervention 2016; 2: 142.

Chiam PT, Liu B, Wong AS, Wong PE, Lim ST, Koh TH, Lim VY. Comparison of novel 6.5 Fr sheathless guiding catheters versus 5 Fr guiding catheters for transradial coronary intervention. EuroIntervention 2011; 7: 930-5.

Chiam PT, Lim VY. Transulnar artery approach for percutaneous coronary intervention: An alternative route in a patient with challenging transfemoral access and hypoplastic radial artery. Singapore Medical Journal 2010; 51(5): e81-4.

Structural Heart Disease Intervention

Chiam PT, Lim CP, Loh JP, Zee YK. Percutaneous Bicaval Valve (TricValve) Implantation for severe Tricuspid Regurgitation due to Carcinoid Syndrome. Singapore Medical Journal 2024 (In press).

Chiam PT, Lim CP, Hsu LF, Liew R. Iatrogenic atrial septal defect after catheter ablation-to close or not to close? Ann Acad Med Singap. 2022 Jul;51(7): 441-443.

Chiam PTL, Lim CP, Lim YT, Sivathasan C. Percutaneous paravalvular leak repair for severe aortic regurgitation after transcatheter aortic valve implantation (TAVI). Annals Academy of Medicine Singapore 2021 Mar; 50(3): 274-276.

Chiam PT, Lim YT, Lim CP, Wong PS, Chua YL. Transfemoral transcatheter tricuspid valve replacement of a degenerated tricuspid bioprosthesis: Initial experience in Southeast Asia with three-year follow-up. Singapore Medical Journal 2020 Nov; 61(11): 614-616.

Chiam PT, Lim CP, Lim YT, Sivathasan C. Percutaneous transfemoral transcatheter mitral valve replacement of a degenerated mitral bioprosthesis: Initial experience in Southeast Asia with 9- month follow up. Singapore Medical Journal 2020; 61: 445-446.

Chiam PT, Ping-Ping Goh, Yean-Teng Lim. How should I treat a percutaneous posteromedial mitral periprosthetic paravalvular leak closure in a bioprosthesis with no radiopaque ring? AsiaIntervention 2016; 2: 65-72

Soon JL, Chua YL, Chao VT, Chiam PT, Ewe SH, Seetho VY, Lee CY, Tan SY, Koh TH, Sin KY. Asia’s First Successful Minimally Invasive Transapical Transcatheter Mitral Valve-in-Valve Implantation. Annals Academy of Medicine Singapore 2013; 42: 85-87.

Yeo KK, Ding ZP, Chua YL, Lim ST, Sin KY, Tan WC, Chiam PT, Hwang NC, Koh TH. Percutaneous mitral valve repair with MitraClip for severe functional mitral regurgitation. Singapore Medical Journal 2013; 54: e9-e12.

Ruiz CE, Jelnin V, Kronzon I, Dudiy Y, del Valle-Fernandez R, Einhorn BN, Chiam PT, Martinez C, Eiros R, Roubin G, Cohen HA. Clinical outcomes of patients undergoing percutaneous closure of periprosthetic paravalvular leaks. Journal of the American College of Cardiology 2011; 58: 2210-7.

Chiam PT, Ruiz CE. Percutaneous transcatheter mitral valve repair: A classification of the technology. Journal of the American College of Cardiology Interventions 2011; 4: 1-13.

Chiam PT, Ding ZP, Sin YK, See Tho VY, Chua YL, Gunasegaran K, Jelnin V, Ruiz CE. How Should I treat a percutaneous transcatheter mitral paravalcular leak closure? Eurointervention 2010; 6: 653-9.

Chiam PT, CohenHA, Ruiz CE. The parallel wire technique for atrial septal defect closure. Catheterization and Cardiovascular Interventions 2008; 71: 564-7.

Chiam PT, Ruiz CE. Percutaneous Transcatheter Left Atrial Appendage Exclusion in Atrial Fibrillation. Journal of Invasive Cardiology 2008; 20: E109-13.

Ruiz CE, Kipshidze N, Chiam PT, Gogorishvili I. Feasibility of patent foramen ovale closure with no-device left behind: first-in-man percutaneous suture closure. Catheterization and Cardiovascular Interventions 2008; 71: 921-6.

Chiam PT, Ruiz CE, Cohen HA. Placement of a large transseptal cannula through an inferior vena cava filter for Tandem Heart percutaneous left ventricular assist. Journal of Invasive Cardiology 2008; 20: E197-9.

Chiam PT, Schneider LM, Ruiz CE. Cardiac perforation during patent foramen ovale (PFO) closure sealed with an Amplatzer PFO occluder. Journal of Invasive Cardiology 2008; 20: 665-8.

General Cardiology

Lim CP, Chiam PTL, Lai HK, Koh YL.A rare case of isolated atrial myocarditis. Singapore Medical Journal 2021 Nov; 62(11): 610-614

Lee PT, See CK, Chiam PT, Lim ST.Electrographic changes in acute perimyocarditis. Singapore Medical Journal 2015; 56: e1-e3.

Liew RK, Chiam PT.Risk stratification after acute myocardial infarction. Annals Academy of Medicine Singapore 2010; 39: 237-46.

Chiam PT, Liew RK.Adjunctive pharmacologic agents and mechanical devices in primary percutaneous coronary intervention. Annals Academy of Medicine Singapore 2010; 39: 230-6.

Chiam PT, C. Ong, B. Kwok.Widespread ST-segment elevation due to cerebral infarction. HEART 2006; 92: 535.

Chiam PT, S.C. Chuah, P. Wong, W.S. Teo.A lady with chest pain. Singapore Medical Journal 2006; 47: 166-8.

I. Chew, Chiam PTA review of the diagnosis of Marfan’s Syndrome. ASEAN Heart Journal 2002; 9: 52-6.

General Medicine

Poulose, Chiam P, W.T Poh.Kikuchi’s Disease: a Singapore case series. Singapore Medical Journal 2005; 46: 229-32.

Chiam PT, H. Oh, E.E. Ooi.Localised outbreak of Falciparum Malaria in Singapore. Singapore Medical Journal 2003; 44: 357-8.

Chiam PT, V. Poulose, K.P. Hui, K. Narendran.Wheezing. Lancet 2002; 360: 850.

Chiam PT, S. Tavintharan, V. Poulose, K.M. Fock.A case with diarrhoea, hypotension, wasting and weight loss. Journal of Postgraduate Medicine 2002; 48: 304-6.

Book Chapters

Yeo KK, Chiam PT, Tan J, Ding ZP.Atlas of Percutaneous Edge-to-Edge Mitral Valve Repair (2013). Eds: Feldman T, Franzen O, Low R, Rogers J, Yeo KK. Chapter 23: Chiari Network Complicating a Mitraclip Procedure.

Chiam PT, Roubin GS.Cerebral Revascularization: Microsurgical and Endovascular Techniques (2010). Eds: Nussbaum, Mocco. Chapter 11: Carotid Artery Stenting.

Chiam PT, Iyer SS, Roubin GS, Vitek JJ.Interventional Cardiology – Best Practice (2010). Ed: Bernhard Meier. Carotid artery stenting – Current best practice.

Chiam PT, Roubin GS, Iyer SS, Vitek JJ.Hurst’s the Heart Manual of Cardiology 12th edition (2009). Chapter 56: The Nonsurgical Approach to Carotid Disease.

Chiam PT, Lim YT, Ong CK, Au Eong KG.
Severe carotid stenosis presenting as ipsilateral ocular ischaemic syndrome: successful treatment with carotid artery stenting. Singapore Medical Journal2021; 62(12): 667-669

Chiam PT.
Endovascular recanalization of chronic aortoiliac occlusions – will this become the initial treatment of choice? AsiaIntervention 2019; 5: 107-109.

Chiam PT, Roubin GS, Panagopoulos G, Iyer SS, Green RM, Brennan C, Vitek JJ.
One-year clinical outcomes, mid-term survival and predictors of mortality after carotid stenting in elderly patients. Circulation 2009; 119: 2343-48.

Chiam PT, Roubin GS.
Carotid sheath rescue with a distal filter retrieval catheter. Catheterization and Cardiovascular Interventions 2008; 71: 987-90.

Chiam PT, Roubin GS, Iyer SS, Green RM, Brennan C, Vitek JJ.
Carotid artery stenting in elderly patients – Importance of case selection. Catheterization and Cardiovascular Interventions 2008; 72: 318-24.

Chiam PT, Samuelson RM, Mocco J, Hanel RA, Siddiqui AH, Hopkins LN, Levy EI.
Navigability trumps all: Stenting of acute middle cerebral artery occlusions with a new self-expandable stent. American Journal of Neuroradiology 2008; 29: 1956-8.

Chiam PT, Mocco J, Samuelson RM, Siddiqui AH, Hopkins LN, Levy EI.
Retrograde angioplasty for basilar artery stenosis: Bypassing bilateral vertebral artery occlusions. Journal of Neurosurgery 2008; 110: 427-30.

Chiam P, V. Kwok, BA Johan, C. Chan.
A case of major pulmonary embolism treated with a rheolytic thrombectomy catheter. Singapore Medical Journal 2005; 46: 479-82.

Lim CP, Chiam PTL, Lai HK, Koh YL.
A rare case of isolated atrial myocarditis. Singapore Medical Journal 2021 Nov; 62(11): 610-614

Lee PT, See CK, Chiam PT, Lim ST.
Electrographic changes in acute perimyocarditis. Singapore Medical Journal 2015; 56: e1-e3.

Liew RK, Chiam PT.
Risk stratification after acute myocardial infarction. Annals Academy of Medicine Singapore 2010; 39: 237-46.

Chiam PT, Liew RK.
Adjunctive pharmacologic agents and mechanical devices in primary percutaneous coronary intervention. Annals Academy of Medicine Singapore 2010; 39: 230-6.

Chiam PT, C. Ong, B. Kwok.
Widespread ST-segment elevation due to cerebral infarction. HEART 2006; 92: 535.

Chiam PT, S.C. Chuah, P. Wong, W.S. Teo.
A lady with chest pain. Singapore Medical Journal 2006; 47: 166-8.

I. Chew, Chiam PT
A review of the diagnosis of Marfan’s Syndrome. ASEAN Heart Journal 2002; 9: 52-6.

Poulose, Chiam P, W.T Poh.
Kikuchi’s Disease: a Singapore case series. Singapore Medical Journal 2005; 46: 229-32.

Chiam PT, H. Oh, E.E. Ooi.
Localised outbreak of Falciparum Malaria in Singapore. Singapore Medical Journal 2003; 44: 357-8.

Chiam PT, V. Poulose, K.P. Hui, K. Narendran.
Wheezing. Lancet 2002; 360: 850.

Chiam PT, S. Tavintharan, V. Poulose, K.M. Fock.
A case with diarrhoea, hypotension, wasting and weight loss. Journal of Postgraduate Medicine 2002; 48: 304-6.

Yeo KK, Chiam PT, Tan J, Ding ZP.
Atlas of Percutaneous Edge-to-Edge Mitral Valve Repair (2013). Eds: Feldman T, Franzen O, Low R, Rogers J, Yeo KK. Chapter 23: Chiari Network Complicating a Mitraclip Procedure.

Chiam PT, Roubin GS.
Cerebral Revascularization: Microsurgical and Endovascular Techniques (2010). Eds: Nussbaum, Mocco. Chapter 11: Carotid Artery Stenting.

Chiam PT, Iyer SS, Roubin GS, Vitek JJ.
Interventional Cardiology – Best Practice (2010). Ed: Bernhard Meier. Carotid artery stenting – Current best practice.

Chiam PT, Roubin GS, Iyer SS, Vitek JJ.
Hurst’s the Heart Manual of Cardiology 12th edition (2009). Chapter 56: The Nonsurgical Approach to Carotid Disease.