Tirunelveli , 7th July 2025 : A complex
angioplasty procedure was done in a 58 year old male diabetic person at Kauvery
Hospital, Tirunelveli lead by Senior Interventional Cardiologist, Dr R
Srinivasan.
The said patient was admitted in a very critical state with a massive
heart attack leading to low pulse rate and low blood pressure. Immediately, he
was given a temporary pacemaker and coronary angiogram was done. He had severe
multiple blockages of all the main three arteries supplying the heart. Due to
severe calcium deposits stent could not be implanted at that time.
He was referred to the cardiac surgeon for feasibility of coronary
bypass surgery as multiple stents has to be used in angioplasty. Since, bypass
surgery in this patient carried a high risk and the blood vessels were very
poor, the same was deferred. It was decided to perform a high risk Angioplasty
as his blood pressure and complete heart block did not improve with medical
management.
The patient’s blood vessels had multiple thick calcium deposits and
Stent in such blood vessels should not be implanted unless the calcium is
broken or grinded which would otherwise be life-threatening. Many techniques
are available for the treatment of calcified arteries. Among them the latest
advanced technology of Orbital Atherectomy was chosen. Orbital Atherectomy is
new device to manage calcium, where the diamond coated burr of the device rotates
at a speed of 120,000 times per minute causing grinding of calcium to less than
5 micron particles which are washed away by the blood flow. This therapy
mandates the use of imaging devices like Optical Coherence Tomography (OCT) or
Intra Vascular Ultra Sound (IVUS) unlike the conventional X-Ray alone
angioplasty.
This rarely performed OCT guided high risk angioplasty in three blood
vessels using Orbital Atherectomy which lasted for about 6 hrs. Was
successfully performed by a team led by Senior Interventional Cardiologist, Dr
R Srinivasan. The patient resumed to his normalcy on the next day and was
discharged in the next three days, without any surgical wound and without the
feel of undergoing such a major procedure.
Medical Administrator, Dr Lakshmanan said that the procedure was
meticulously executed by the team, and there is no necessity for patients to
travel to metropolitan cities for such complex cardiac treatments in the coming
days.