Panchkula June, 7: A day long cardiology workshop on chronic total
occlusion (CTO) was held at Alchemist hospital on Tuesday. The workshop
comprised three CTO cases, was performed by Dr Rohit Parti and Dr Arvind Kaul
Cardiologist Alchemist Hospital along with their team under the supervision of
Dr Gerald Werner from University of Frankfurt / Main & Heidelberg-
Mannheim, Germany.
Angioplasties for chronic total
occlusion were done from both antegrade and retrograde technique
Although the heart is the
strongest muscle of the body, but is highly vulnerable to various unhealthy
lifestyle habits. Many such habits have been the cause of some severe heart ailments resulting in total or
partial occlusion of arteries. Total occlusion of arteries is usually resolved
through a By-Pass surgery. It has been seen that due to the risks associated
with surgery, patients are often reluctant of undergoing a by-pass surgery.
However, with the advancement of
technology, a new procedure, Chronic
Total Occlusion Intervention (CTO Intervention) has been invented which
allows patients even with 100% one artery blockage to undergo angioplasty.
Dr Rhoti Parti said that
Angioplasty for CTO lesions is of immense use when patients cannot be sent for
surgery due to other medical reasons or don’t fulfill the criteria to undergo
CABG.
CTO Intervention is one of the
latest advancements in the field of interventional cardiology and has
experienced significant growth in the last few years. With the adaptation and
refinement of advanced techniques, including retrograde and dissection/re-entry
(Please explain), there has been a significant increase in the attempts of CTO
Intervention in many countries abroad, inspiring many interventional
cardiologists all over the world to explore this cutting-edge field for patient
benefit. With a good success rate in India, this procedure is usually conducted
on patients where only one artery is totally blocked. It is less invasive and
less complicated than a by-pass surgery. The procedure can provide significant
benefits to patients who have no revascularization options (i.e. patients with
previous CABG who present with graft failure) or may be referred for surgery
because PCI is not considered to be feasible (i.e. patients with isolated right
coronary artery CTO and medically refractory angina). However, this procedure
is not advised for patients of kidney failure considering the high quantity of
dye used. Increasing data suggests successful CTO Intervention can alleviate
angina, improve left ventricular systolic function and possibly reduce the
impact of future ACS or even improve survival. Moreover, the procedure can be
accomplished safely with low complication rates.
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