Since Interventional cardiology has taken wings as a procedure, CTOs have always been a difficult challenges for Interventional cardiologists. CTOs are heart blocks, which completely block, typically above 99% of the artery space and have been existing for more than three months or years. This complete blockage of the artery results in significant decrease of blood supply, resulting in ischemia or heart attack. According to studies, prevalence of CTOs in patients with Coronary artery disease is as high as 30%.
Conservatively treating such patients through Medical option may not be sufficient to relieve symptoms or to improve long-term outcomes. Conventionally Coronary artery bypass surgery (CABG) has been the only treatment option for CTOs. However performing CABG has not been simple on such patients in addition to various complications associated with a major surgery and the prolonged recouping time. With this new minimally invasive technique called Chronic Total Occlusion Percutaneous Coronary Intervention, an angioplasty is performed using drug eluting stents to treat CTOs, thereby avoiding surgery. CTO PCI can reduce the need for CABG in 50 to 75% of the CTO patients.
According to Dr. R. K. Jain, CTO PCI is the most challenging procedure but it presents several potential benefits for the patients including improvement in symptoms, improvement in left ventricular (LV) function, and improvement in survival rates. However not all patients with CTO may be eligible for CTO PCI and has to be assessed and decided by the Cardiologist on a case to case basis, he adds. The skill and the experience of the interventional cardiologist are of great significance in CTO PCI, says Dr. Jain.
Dr. M. Yamane, Dr. R. K. Jain and his team performed CTO PCIs successfully on two patients at KIMS Hospital, today. The first was a 45 year old male patient presented with calcified legion. The second patient, a very complex case, was of a 65 year old male presented with chest pain with a long diseased segment and total occlusion of Right coronary. Eminent Cardiologists Dr. Padmanabhan, Dr. Jiwani, Dr. Ravikanth, Dr. Dayasagar Rao, Dr. Hygriv Rao, Dr. Srinadh and Dr. Balaji also participated in the workshop.
