5th December, 2024: A 72-year-old gentleman from Delhi NCR had been living with debilitating chest pain and heaviness for several years. He had previously undergone bypass surgery 10 years ago for angina and chest discomfort. Despite following a strict medication regimen, his symptoms persisted and worsened over time, severely limiting his daily activities. He could barely walk 50 steps without experiencing intense chest pain, and in recent weeks, his condition had worsened to the point where even sleep became difficult, as he had to rest in a sitting position to relieve the pain.
Mr. Jain’s ongoing chest pain and discomfort were attributed to a recurrence of blockages in his coronary arteries despite his previous bypass surgery. After consultation with his family, he decided to seek help from Dr. Ravinder Singh Rao, a leading interventional cardiologist. Dr. Rao recommended an angiography to assess the cause of his persistent symptoms.
The angiography revealed a 90% blockage in one of his bypass grafts, which was identified as the primary source of his symptoms. This blockage had caused reduced blood flow, resulting in chest pain and fatigue.
Dr. Ravinder Singh Rao, who specialises in complex angioplasty and high-risk cardiac procedures, recommended a complex angioplasty to address the 90% blockage in the bypass graft. The procedure was scheduled to use advanced imaging techniques, including intravascular ultrasound (IVUS) and optical coherence tomography (OCT), to precisely identify the composition of the blockage and guide the angioplasty.
The complex angioplasty procedure, which lasted about an hour, was performed successfully under local anaesthesia. Dr Rao used advanced imaging to guide the stent placement, ensuring the blockage was opened without complications.
The results of the procedure were immediate and dramatic. That very night, Mr. Jain was able to sleep peacefully without experiencing chest pain for the first time in over 30 days. The following day, he was able to walk for 30 minutes and climb two storeys without any discomfort.
Mr. Jain’s daughter expressed her joy and relief, saying, “It’s overwhelming to see my father walking independently after so many years of struggle. He has truly been given a new lease on life.”
Dr. Ravinder Singh Rao, who performed the complex angioplasty, emphasised that imaging-guided procedures like IVUS and OCT help improve the precision of the treatment and reduce complication rates. He also noted, “Studies have shown that imaging guidance reduces complication rates by over 30% compared to procedures done without it.”
Mr. Jain’s case serves as an inspiring example of how complex angioplasty, when performed with advanced techniques and precision, can significantly improve the quality of life for patients suffering from chronic coronary artery disease, even after previous bypass surgery. The success of the procedure highlights the importance of specialised expertise and the role of imaging in ensuring positive outcomes in high-risk cardiac procedures.
Dr. Rao also emphasized the significance of Complex High-Risk Indicated Procedures (CHIP) in managing challenging cases like Mr. Jain’s, where blockages in main arteries, bifurcations, and bypass grafts are involved. The use of advanced techniques and appropriate imaging can lead to excellent outcomes, even in high-risk cases.