Apollo Hospitals, Greams Road, Chennai has successfully performed two novel cardiac procedures on a dialysis patient from Thoothukudi district. The procedure called Orbital Atherectomy (OA) is a calcium modification technique for large coronary arteries with severe calcification to crack the calcium and deploy the stents. A 75-year-old man from Thoothukudi had been on regular dialysis for a long-time. Patient had chest pain and underwent a coronary angiogram in Thoothukudi. The angiogram test showed severe calcified blockages in 2 blood vessels in the heart. He also had irregular heartbeat which was going down mostly at the time of dialysis. This was a major concern for the nephrologist during the time of dialysis in Thoothukudi.
Patient was referred to Apollo Hospitals, Greams Road, Chennai for further treatment. At Apollo Hospitals, Chennai, the patient was examined by Dr Refai Showkathali, Senior Consultant – Interventional Cardiologist and Dr Raja Mahesh, Senior Consultant – Nephrologist.
Post evaluation, the family was explained about the patient’s condition and the challenges involved in treating him, as he was overweight and not well mobilized. It was decided to use two newer technological advances for treating his complex cardiac issue. For the blockage in the blood vessel, he required complex angioplasty because of the calcium deposit. The newer drilling technique, Orbital Atherectomy was used which breaks the calcium by rotating in an orbital fashion- approximately 80,000 to 1.2 Lakh rpm inside the blood vessel. By doing this it helped open the blockage and deliver the stent at the level of blockages.
At present this technology is available only in few centres in India and should be done by highly-skilled doctor. For his heart beat problems (low pulse rate), the doctors decided to place a permanent pacemaker. But considering his age and the risk of infection (as his immune system had weakened being a dialysis patient), a special kind of pacemaker called Micra was used.
“Micra is a leadless pacemaker i.e. it does not need any wire or battery to create a pocket like the normal pacemaker. This is done via a pinhole in the groin and a small device (which is smaller than a “AAA” battery) weighing less than 2 gm is inserted directly into the heart and placed in position.” said Dr Refai Showkathali.
Patient underwent both these procedures successfully in April 2023 at Apollo Hospitals, Greams Road, Chennai and was discharged within few days. Since then he is doing well and visiting for regular follow ups.
This is the first time that these two novel cardiac procedure were performed on the same patient and the patient is back to Thoothukudi. It is an example of a great teamwork and effort put in by the staff at Apollo Hospitals to achieve this feat.
