Heart ailments are increasingly common in this era of fast life due to various emerging risk factors like sedentary lifestyle, stress apart from the traditional ones. Heart attack due to block in the heart blood vessels is the commonest cardiac issue we encounter in day-to-day practice and it’s not a disease of elderly anymore. The prevalence of heart attack among the young (<55y) is also increasing. With advancing technology, the treatment modalities for heart ailments have become quiet cosmetic and can be dealt through a pinhole from wrist/groin which is nearly scar proof.
Thanks to the technology, even complex heart problems (Left main stenting, devices for valve leaks/narrowing, congenital heart disease) can be treated this way, which were once considered to be treated only with open heart surgery. Also with this technique, the need for minimally invasive surgery which also needs a definitive incision on the chest like open heart surgery can be overcome. Irrespective of the age group, these procedures can be performed successfully in all and patients can be discharged early usually within a day or two from hospital. One of the latest technologies in this regard is the treatment of calcium in the heart.
With ageing, calcium starts to deposit in various parts of the body. Deposition of calcium in the blood vessels of the heart known as coronary calcification is associated with damage to the blood vessels that can result in heart attack. Coronary calcification is seen in 97% of men and 67% of women above the age of 70 yrs. The other common place in heart for the calcium to deposit is the valves, particularly aortic valve. This leads to narrowing of the aortic valve, called as degenerative/calcific aortic stenosis, which happens mostly in older age group.
There is a wrong perception that patients with significant coronary calcification with narrowing should only undergo bypass surgery. This does not apply anymore. Though treatment of coronary calcium with angioplasty remains challenging even now, lot of innovative techniques have evolved to treat it without needing open heart surgery. This includes use of various types of balloons such as cutting balloon, high pressure OPN balloons, atherectomy procedures such as rotational atherectomy or rotablation (small diamond tipped burr used to drill the calcium), Laser atherectomy, Orbital atherectomy and Intravascular lithotripsy (through sonic waves creates cracks in the calcium). All these techniques safely and selectively break the calcium deposits with minimal damage and ease the stent delivery and expansion. With these techniques, even calcification in large coronary arteries such as Left main artery can be treated successfully with stent angioplasty. They are performed routinely these days across all age groups with high success rate by experienced interventional cardiologists in specialized centres.
Similarly, in calcific aortic stenosis (narrowing), a procedure called TAVI (Transcatheter aortic valve implantation) can be performed via a pinhole procedure thereby avoiding opening the chest for valve replacement and the patient can be discharged within a day or two. In this era of modern medicine, the three important factors most patients prefer are early mobilization, early discharge, and quick recovery. Patients would like to go back to their normal life as soon as possible after any treatment and by doing treatment through this highly cosmetic pin-hole procedures for heart ailment, this can be achieved.