Mrs. Shalini is 82 years old female from Gadchiroli presented with chest pain and shortness of breath. On further examination, she had heart attack on ECG, she underwent angiography which showed 90% blockages with calcification. Her angioplasty was attempted but was unsuccessful. Hence referred to higher centre. She reached rhythm heart hospital in serious condition as blockages were hard and difficult. Newer technology of rotaablation was used for this difficult situation. Patient underwent angioplasty and discharged after 5 days and her life was saved.
In the fast pacing world we need advance technologies to improve outcomes in the field of cardiology. Newer advancements and innovative approaches not only simplify the complex procedures but also improve long term results. At Rhythm Heart and Critical care, we are using such technologies for patients in complex cases. The top of the list in the innovation is Rota-ablation. In Rota-ablation a diamond coated burr drills through calcified blockages. As a result, very critical calcified and impossible to treat hard blockages can be easily treated and managed in catherisation lab. Rhythm Heart and critical care is a comprehensive and advanced hospital where all the innovative and new cutting edge technologies are being used and adapted for the betterment and improved health care facilities for our beloved patients.
Apart from the Rota-ablation, Technologies like Intra-vessel Ultrasound Sonography (IVUS), Fractional Flow Reserve (FFS), Transcatheter Aortic Valve Implant (TAVI) are newer technologies available at Rhythm Heart and critical care. Team of Dr. Manish Juneja and Dr. Pankaj Raut, work seamlessly and are quick to respond to respond to emergencies, making it one of the few institutes in Nagpur to have such high skilled and fast acting team. Rhythm Heart and critical care believes in patient centric approach with time bound treatment and team work. And the lead doctors, Dr Pankaj Raut and Dr Manish Juneja are eminent cardiologist of Maharashtra to be known for complex angioplasties and difficult cardiac cases.
Another technology worth mentioning is intravascular imaging (IVUS and OCT), where a camera is placed in the vessel to determine the actual severity of the blockage, which is sometimes difficulty to access on routine angiography. A 42 year old male patient was referred from Jabalpur to Rhythm Heart and Critical Care with the complaints of acute chest pain. A Coronary Angiography done at Jabalpur revealed blockage in the major vessel of heart and was advised urgent angioplasty for rescue of the patient. As the angiographic picture did not appear convincing, IVUS was used in this case, which revealed non-significant blockage hence managed with medicines only. Patient responded well to the given treatment and remains asymptomatic till date.
Not every case or patient is affording for invasive treatments. So, providing the best quality care at affordable cost is our motto. The next case demonstrates the same scenario. A 48 year old patient from Amravati was advised for Coronary Artery Bypass graft (CABG) due to blockage at a very critical position, where putting a stent is not advisable. Patient relatives considering his age were not willing to perform CABG. Hence, he was referred to our hospital for a second opinion. Patient was counselled properly regarding the new technology of Drug Eluting Balloon (DEB). DEBs are medical devices used in a procedure called angioplasty. They’re like balloons that are filled with air to open up blocked or narrow blood vessels, but they have a special coating on them that releases medicine as soon as the balloon touches the blood vessel wall. This medicine helps prevent the blood vessel from becoming narrow again after the procedure. The goal is to both open up the vessel and keep it open without leaving any lasting materials inside the body, unlike stents. So this technology of DEB helped this patient.
Not only younger patients but also sometimes patients with old age, patients with comorbidities, do also need a smart solution to get their health on track. And when the risk of heart in such age is considered, it comes with major life-threatening situation. In order to avoid the risk of such comorbidities, especially, when the patient require urgent valve replacement. Transcatheter Aortic Valve Implantation (TAVI) plays a major role. TAVI stands for Transcatheter Aortic Valve Implantation, which is a type of minimally invasive heart procedure. It is used to treat patients with aortic stenosis, a condition where the aortic valve in the heart becomes narrow and doesn’t open properly, which can lead to decreased blood flow and increased pressure in the heart. In TAVI, a replacement valve is delivered to the heart through a catheter, a thin tube that is inserted into the body through a small incision, usually in the groin. The new valve is then positioned inside the old, damaged valve and expanded, effectively taking over the function of the original valve. TAVI is an alternative to traditional open-heart surgery and is often used for patients who are too sick or have other health conditions that make traditional surgery too risky. This reduces the need for a large open chest incision and leads to a quicker recovery period with low mortality rates compared to traditional surgery. A 86 year old male patient from United Kingdom, while in India, visited our hospital with having severe valvular disease (Aortic stenosis) with multiple comorbidities. He was taken up for TAVI, which significantly helped him to improve quality of life and patient still remains asymptomatic.
FFR stands for Fractional Flow Reserve. It’s a medical test used to determine the pressure inside coronary arteries. In simple terms, the test measures the amount of blood that can flow through a particular part of the coronary artery. The test results can help the doctor determine if there is enough blood flow to the heart and if any treatment, such as angioplasty or bypass surgery, is necessary to improve the blood flow and prevent a heart attack. This technology is available at a very few centers in Nagpur.
To conclude, all the technologies mentioned have helped significantly make progress in complex angioplasties. All the rare cases that are mentioned have been earlier either presented at national and international conferences from the desk of Rhythm Heart and critical Care
Our research wing has also published articles in Indexed Journals marking the substantial growth in research division of Rhythm Heart and Critical Care. At Rhythm Heart and Critical Care, not only are patients provided with state-of-the-art treatments, but the facility also takes advantage of opportunities to advance the field of cardiology through conducting phase 3 clinical trials and extensive research work. The department is led by Dr Harshawardhan Dhanraj Ramteke, who works for innovation and integration of technology in the cardiology field. Furthermore, research department at Rhythm heart and critical care has published 14 papers and many more are lined up for publishing to improve for the future of health care and better quality of treatment for patients.
