After 36-year-old Nidhi Surana was diagnosed with a 99 per cent block in the left main coronary artery, doctors told her clearly that she needed early intervention to save her life. But the traumatic memory of a gastro-intestinal surgery in her teens was still fresh and she stubbornly resisted bypass surgery.
A few blocks away, the Das household faced much the same predicament. H.K. Das was diagnosed with a 95 per cent block in the same (left main coronary) artery. But according to doctors, the risk of carrying out a major surgery on the 85-year-old with a history of stroke and diabetes was just too high.
Fortunately, modern medicine had solutions for both. “The large-scale use of the left main coronary stenting method comes as a blessing to numerous such families vexed by a blocked heart vessel,” says Sunil Lhila, consultant interventional cardiologist, Apollo Gleneagles Hospitals.
The multiple-speciality hospital off the Bypass has performed the procedure on a number of such patients, who were either unwilling or unsuitable for surgery. There are many patients who belong to the high-risk category for coronary artery bypass grafting (CABG), due to age or co-existing morbid conditions. But due to the high percentage of blockage of the left main coronary artery feeding the heart, they need early intervention to prevent a heart attack.
“Stenting of the blocked artery is the procedure of choice for most of these patients,” says Aftab Khan, consultant interventional cardiologist at the same hospital. The patients don’t need to be knocked out by general anaesthesia, which is another plus, particularly for those above 60 or those suffering from allied ailments.
For the procedure, that usually takes around 30 minutes, catheters are inserted through the femoral blood vessels and under guided fluoroscopy, they are taken to the site of obstruction. The measured inflation of the balloon does away with the obstruction, and a drug-coated stent — a metallic wire mesh — prevents the artery wall from collapsing and reduces the probability of restenosis.
“The left main coronary artery is the principal vessel feeding the heart muscle, and a recurrent blockage there could be extremely critical,” feels Lhila. “But with drug-eluting stents preventing restenosis, stenting of the left main coronary artery is no more a major concern.”
Leaving the hospital after two days, patients can resume their normal routine, but with the express advice to “walk that extra mile to prevent further deposition of fat and help keep the arteries open”.