To maintain high standards of clinical quality and improved patient care through the latest pathbreaking innovations for those with heart conditions, a team led by Dr. Anup Taksande, Consultant Interventional Cardiologist at Wockhardt Hospitals, Mira Road, carried out a pioneering high-risk Cardiac Intervention (CHIP) PCI to address complex heart blockages, saving the life of a 69-year-old frail elderly lady and ensuring she gains a new lease on life.

Tracilla Alphonso, a 69-year-old resident of Vasai with comorbidities like hypertension experienced pain and discomfort in the chest and around her neck in mid-September, the patient got her ECG done from the local hospital, and her ECG revealed Ischemic changes and urgent angiography was performed. Angiography revealed critical Calcific Left Main narrowing and near total occlusion of the Right Coronary Artery, urgent Coronary Artery Bypass Grafting (CABG) was advised given the Angiography picture. The option of extremely complex high-risk angioplasty to the Left Main & Right Coronary Artery (RCA) with imaging guidance and Rotablation for cutting the calcium was discussed when the patient came for a consultation with Dr. Anup Taksande, Consultant Interventional Cardiologist at Wockhardt Hospital, Mira Road

Dr. Anup Taksande, said, “On arrival in an emergency at Wockhardt Hospitals, Mira Road, this patient had severe discomfort for 2-3 days before coming to the hospital. This was a truly complex case, with the left main coronary artery being more than 90% blocked and the right coronary artery being over 99% occluded. The cardiovascular disease burden in our country is increasing because of factors such as sedentary lifestyle choices, stress, and genetic predispositions. The patient was initially recommended for an urgent coronary artery bypass graft (CABG) surgery due to the critical nature of her condition. However, the patient and her family were reluctant to undergo open-heart surgery due to her advanced age and frail health. We decided to proceed with a high-risk, unprotected Left main pioneering cardiac intervention (PCI), a procedure that is typically considered extremely complex. We utilized advanced imaging techniques and specialized tools, including Rotablation and high-pressure balloons, to meticulously navigate the severely calcified and narrowed coronary arteries.”

Dr. Taksande added, “Performing a successful PCI in such a scenario requires exceptional skill, advanced technology, and a well-equipped medical setup, all of which were available at our Hospital.  The procedure was carried out step-by-step, with the team first addressing the right coronary artery blockage and then moving on to the left main artery. Imaging catheters and precise stent placement allowed us to achieve results comparable to those of bypass surgery, all while ensuring the patient’s hemodynamic stability throughout the procedure. We started with the right coronary artery which we stented after lot of pre-dilatation with balloons and making adequate lumen, we did two stents again, added at very high pressures which showed a satisfactory result. After the right coronary artery was fixed properly, we started working on the left main coronary artery. The Left main was extremely severely narrowed and calcific, and since 60 to 70% of the circulation depended on the Left main, any small mistake would mean that the patient would crash on the table. After doing the wiring Rotablation (Diamond Drill) was used to cut and polish the calcium on the Left Main and LAD. Subsequently using high pressure (OPN-NC) Balloon, we were able to achieve a satisfactory flow. The iOS imaging catheter helped us understand the length of the stents, the size of the stents, and the number of stents that we would use. In this case, we used two, overlapping stents in the LAD and the Left main, which were of different sizes and diameters, and they were optimized at high pressures to different diameters, which confirmed the vessel wall sizing. The patient tolerated the procedure well. The entire procedure lasted for approx. 90 mins– 110 mins. The patient had an uneventful recovery and was discharged in 2 days. After 2 months of follow-ups, she is fine, and independent with normal heart pumping.

This case highlights the importance of having a Comprehensive, Tertiary-level Cardiac Care Facility that can offer cutting-edge treatments for even the most complex and high-risk cases. “The successful outcome of this procedure underscores the advancements in Interventional Cardiology and the dedication of the medical team to provide exceptional, life-saving care to their patients. Wockhardt Hospital, Mira Road is a leading tertiary care hospital known for its excellence in cardiac care. Our Hospital is well-equipped with state-of-the-art facilities and a team of highly skilled and experienced cardiologists, who are committed to providing innovative and comprehensive treatment options to their patients,” highlighted Dr. Taksande.

“After struggling with chest pain and discomfort that suggested a heart attack, I was hesitant about having a CABG. Dr. Anup Taksande and his team carried out the essential minimally invasive angioplasty that greatly enhanced my quality of life. I felt elated as I returned to my daily activities without any difficulties. I am grateful to Dr. Taksande and his team for providing me with another chance at life,” concluded the patient, Tracilla Alphonso.