Kauvery Hospital Tirunelveli done a Complex High-risk Indicated PCI (CHIP) procedure

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.