75-year-old man undergoes CTO surgery to remove 100% blockage

A seventy-five-year-old Hyderabad resident who had 100 per cent blockage of coronary artery underwent a successful Chronic Total Occlusion (CTO) intervention -- the Japanese technique of angioplasty -- at Jehangir Hospital on Sunday. The two-and-a-half hour surgery was conducted by Dr J S Dugal, intervention cardiologist and Dr Mandar Deo. According to the doctors, of the total patients having blockages, 13 to 15 per cent of them have 100 per cent blockages. They said that most of the patients opt for bypass surgery, but CTO interventions are the best option for blocks that seem totally beyond repair and are proving to be a lifesaver.

It’s a success: (From left) Nandkishor Lahoti (son), Dr Mandar Deo, Rajkanwar Lahoti (wife), patient Parshuram Lahoti (75), and Dr JS Dugal at Jehangir Hospital. Pic/Krunal Gosavi

No hope
Parshuram Lahoti, a businessman and resident of Warangal in Andhra Pradesh had severe angina pain after which his family admitted him to a hospital at their village. “When we visited the village doctor, he told us that my father had suffered a heart attack. After conducting an angiography test, it was revealed that there was 100 per cent blockage in two arteries. One was in the left anterior descending artery,” said Nandkishor Lahoti, son of Parshuram Lahoti. “The doctor advised us that bypass is the preferred treatment for treating such blocks and there was no other way to save my father,” said Nandkishor.

Ray of sunshine
When Lahoti’s relatives who reside in the city and work in the medical field got to know of Lohati’s condition, they referred him to Dugal and Deo. Around the same time, Dr Dugal was planning to participate in a revolutionary surgery at the first CTO live summit when they came across Lahoti’s case and decided to perform the CTO intervention on him. “ We studied Lahoti’s case and carried out a myocardial perfusion study to ascertain the viability of muscles. This is a necessary test to be carried out because in a 100 per cent blockage, sometimes there are chances of a non-working artery. The test is also called Thallium test. The test was positive and we decided to conduct Lahoti’s surgery during the summit.”

The procedure
“In CTO, we need hard wire to be inserted in the artery as the blockages stiffen after they are formed. With the help of a catheter, we insert a small size wire to prick the blockage and make way for the balloon, which will then place a stent in the artery. If the thin wire does not do the job, we have to use a wire of a higher dimension,” said Dr Deo.

“I was a little shocked when the doctor said nothing can be done after I had the heart attack. The doctors here have removed my blockages. After the surgery, my son called the doctor in Hyderabad and informed about the successful surgery. I will get discharged today,” said Parshuram Lahoti. 

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