Dr. Suasit Acharji
Blockage in arteries supplying the heart muscle causes disabling chest discomfort, difficulty breathing and unduly tiredness with activity or a life-threatening heart attack, heart failure and death. These blockages can be treated either by open heart coronary artery bypass surgery or can be opened using minimally invasive procedure called percutaneous coronary intervention, which involves different techniques using a catheter through the blood vessels by insertion through the wrist or groin. Usually, PCI is used to treat simple and a few blockages in the heart arteries, and CABG is reserved for more complicated blockages.
With scientific advancements and improvements in techniques over the past decade, PCI has been an effective alternative to CABG in a vast majority of patients with blockages in heart arteries. Recently inspired by this trend in a few advanced centers around the nation, specialists have started treating the most complicated of the blockages in the sickest of patients; called complex high risk indicated patients PCI. Besides having the most complex blockages, these patients are typically much sicker and have higher risk of complications. However, these are also the patients who benefit most and have improvement in quality of life.
Improving quality of life for patients necessitates specialists to be proficient in specific advanced techniques, and specialized advanced set up and equipment such as using minimally invasive artificial heart pump (Impella device), specific techniques of scraping the plaque in the heart arteries, opening long and complete blockages and obstructions in the difficult to treat locations of the heart arteries. CHIP PCI also is used to treat patients with high risk of complications, including those with very weak heart muscle, multiple coexisting illnesses or those who present with cardiac arrest. Since these patients have a much lower margin for less-than-perfect results, optimal outcomes involve systems, protocols and processes in place, besides advanced trained physicians, personnel and equipment.
Since CHIP PCI has become available, patients with heart artery blockages who earlier could only be treated with CABG or those who were refused for CABG now have the option of living longer, healthier and a more productive life.
In spite of the advances in treatment, prevention is better than cure. Quitting smoking, maintaining healthy body weight, controlling blood pressure, diabetes and cholesterol help prevent blockages in heart arteries in the first place, and after the blockages have been fixed. Avoiding sugar and high starch containing bread, potatoes or pasta, eating lots of fresh vegetables and fruits and portion control are the nutritional recommendations to avoid heart disease. Moderate intensity exercise, such as brisk walking for 30 minutes every day helps prevent the development and progression of heart blockages, as well as feel more energetic and young!