NE HEALTH BUREAU
VADODARA, MAR 26
In a first of its kind in Gujarat, the procedure to remove calcium from heart blood vessels was performed at a private hospital in the city using a new technology of Orbital Atherectomy recently. The Orbital Atherectomy is a new procedure that has been introduced in the country and Dr Mahesh Basarge, leading interventional cardiologist at Baroda Heart Institute and Research Centre and his team performed the first case of novel orbital atherectomy procedures in patient with heavily calcified coronary arteries.
One woman was an elderly patient, 72, who had undergone treatment for breast cancer and was having chest pain at rest and had severely calcified tortuous left anterior descending artery. The patient was at high risk for redo coronary artery bypass surgery and anatomy of her vessels was unsuitable for bypass surgery. She underwent successful ablation of calcium using diamond back orbital atherectomy device with slow and at high speeds.
- Orbital atherectomy is a novel therapy used for opening up calcified blocks before stentingand its its success rate is 98 perecent
- It operates by creating micro fractures in the calcium and breaking it down further through the device, that can be operated at low and high speeds and is decided based on the anatomy of the patient
- The patient was turned down for coronary artery bypass surgery as she was post-radiotherapy
- According to a study published in The Lancet, 2.8 million Indians die from Cardiovascular Disease (CVD) per year, with the majority of deaths due to CAD
“Calcified lesions are difficult, challenging subsets to treat as they are hard and conventional balloon angioplasty do not work. The patient was turned down for coronary artery bypass surgery as she was post-radiotherapy. And hence, angioplasty was done using this new procedure. In addition, coronary imaging using OCT was also performed, in which a microcamera sensitive to light was introduced inside the artery to look at the calcium. The final result of the procedure was excellent,” explained Dr Mahesh Basarge.
“Orbital atherectomy is a procedure which enables stenting for complex, calcified coronary lesions. Utilizing a unique mechanism of action incorporating centrifugal forces, a standard 1.25 mm eccentrically mounted and diamond-coated burr orbits bi-directionally to ablate calcified plaque. In a normal angioplasty, a balloon is inflated to push aside the plaque, and the stent is deployed. However, in a heavily calcified plaque, this simple PCI procedure may not be sufficient. Patients with calcified arteries are advised to have an orbital atherectomy, a minimally invasive therapeutic technique that uses a small-sized burr to remove the calcific coronary obstruction and ablate the calcium. The burr is rotated at a speed of 85,000 & 125,000 revolutions per minute and cuts the calcium just like a diamond cuts through glass. Once the calcium is removed, the stenting is performed with excellent results. Orbital atherectomy is a safe and newer technique for the treatment of CAD,” Dr Parvinder Singh said.
Answering the queries, Dr Mahesh Basarge said that the success rate of OA was 98 percent and cost was Rs 2.25 lakh.
The cardiology team at Baroda Heart, consisting of Dr Parvinder Singh, Dr Mahesh Basarge, Dr Falgun Panchal, Dr Husain Bhatia, Dr Sagar Shah, and Dr Sheshrao Pawar, performed this complex angioplasty by using OA in a patient having heavily calcified coronary arteries.
While informing about Coronary artery disease the expert team of Cardiologists, shared, “Coronary Artery Disease (CAD) is caused by plaque build-up in the walls of the arteries that supply blood to the heart. According to a study published in The Lancet, 2.8 million Indians die from Cardiovascular Disease (CVD) per year, with the majority of deaths due to CAD. One-third of the total CAD cases show a high incidence of coronary artery calcification (CAC).”
“Calcium is often a part of the plaque build-up in the arteries. If the calcium breaks off, a blood clot may form, blocking the blood flow and oxygen supply to the heart. When a plaque becomes significant, it can end up blocking the blood flow and oxygen supply to the heart. This can damage the heart muscles and be fatal. Calcium deposits in the arteries form because the muscle cells in the blood vessels start to become hard when they are old or diseased. People with co-morbidities like high blood pressure, high cholesterol, diabetes, or kidney failure are prone to plaque and calcium build-up in the arteries. If left unattended, CAD and related clinical conditions like CAC can impose serious problems with blood circulation in the heart,” shared the expert cardiologists further.
The availability of this device adds another option to treat these calcified blocks. It is particularly helpful in large vessels with long calcified eccentric lesions. The device has a learning curve and operator needs to be trained. The patient recovered well and is being followed up.
