Heart Disease Patient Treated With Coronary IVL Treatment
A team led by Dr Anup R Taksande, Consultant Interventional Cardiologist, Wockhardt Hospital, Mira Road, performed a procedure on 3 patients suffering from coronary heart disease (CHD). The coronary shockwave Lithotripsy was conducted to open up a calcific blocked coronary artery.
Patient Chaudhary, a 65-year-old banker who was a heavy smoker and had comorbidities like longstanding diabetes, hypertension and coronary heart disease was admitted to Wockhardt Hospital, Mira Road. He complained of chest pain and breathlessness for the last three months and angiography was performed for a minor attack on the day of admission which was revealed in ECG and blood test. The angiography showed single vessel disease (LAD) one of the biggest arteries of the heart. It was with 95 per cent blockage in the entire length of the artery which is calcific. The option of CABG (open heart surgery) v/s angioplasty was explained to the patient. The patient was explained about Intravascular lithotripsy (IVL) for better results especially it is a calcific artery to expand the artery. He agreed to go for that and the procedure was performed on him 2 months ago.
Dr Anup R Taksande, Consultant Interventional Cardiologist, Wockhardt Hospital, Mira Road, said, “Intravascular lithotripsy (IVL) is a novel technique strategy for renal calculi. Now, this procedure is showing promising results in CHD patients. The Intravascular lithotripsy (IVL) balloon was decided best for the patient. The device consists of sonic pulses (high-pressure sound waves) that fracture the calcium at the target site and allow optimized drug-eluting stent implantation aiding the quick recovery of the patient. The procedure was done through the femoral artery which is the leg artery. The patient was in the ICU for a day and then shifted to a normal ward for 2 days for observation. The procedure is safe with minimal hospital stay and was done successfully without any complications. There were no sutures, scars, incisions and the risk of infection was low. The patient was discharged after 2 days of the procedure. The patient is having an uneventful course after that and is taking medication. Now, the patient is asymptomatic, mobile, doing well, and able to carry out all the activities with ease. He has resumed taking lectures too.”
Severe CAC (Coronary Artery Calcification) is a measure of lesion complexity and is strongly associated with procedural complications and PCI failure. Calcification may impact PCI (Coronary Angioplasty) success in a number of ways. As a result of friction between DES (Drug-Eluting Stent) and CAC proximal to the lesion, the polymer may be damaged and hence contribute to target lesion failure. At the lesion itself, drug delivery from polymer to tissue may be impaired in the setting of severe calcification, with the calcification acting as a barrier to diffusion. Moreover, calcification within the lesion physically impairs stent expansion. The single most important predictor of early stent reblockage after PCI. Circumferential coronary calcification is also a predictor of strut malposition which in some studies has been associated with acute stent thrombosis.
Dr Taksande added, “This is the 3rd IVL procedure in our Cath Lab with excellent results, by offering percutaneous revascularisation to patients with severe Calcific CAD to match with international standards. Our endeavour is to build our Cath Lab centre into a world-class IVUS + Rotablation ( ROVUS ) and Rotablation + IVL (Rotatripsy ) Centre. All kinds of high-risk, calcific, longstanding, not willing for CABG or open-heart would be preferably treated with this kind of procedure.”
“When the doctors told me about this procedure, I wasn’t aware of it. But I was thoroughly briefed regarding it, prepared well for the procedure. This procedure was seamless and I didn’t encounter any problem after undergoing it. I am thankful to the doctors for giving me a new lease of life and helping me overcome symptoms like chest pain and breathlessness. I have recovered very well, and have resumed my daily routine,” concluded the patient Chaudhary.
