NEW DELHI: A 70-year-old man, who had multiple calcified blockages in all three arteries of his heart and was suffering from multiple comorbidities including diabetes, hypothyroidism, and dyslipidemia, was given a new lease of life after doctors at Max hospital in Delhi’s Shalimar Bagh used world’s smallest heart pump, an Impella device, to help maintain his blood flow during a high-risk protected angioplasty performed on him.
After six hours and stabilisation of the patient, the Impella device which is used to support the heart’s function during the critical procedures, was removed and the functioning of all his vital organs was normal. The patient was discharged after four days.
He has now recovered completely and is leading a normal life, with his heart functioning at 40 per cent, the doctors said.
“We did angioplasty even when all his three blood vessels were blocked and the heart functioning was at just 10 percent. Bypass surgeons had denied him surgery in 2022. The patient landed up with a blood pressure of just 80 systolic along with severe breathlessness and chest pain,” Dr. Naveen Bhamri, Director and HOD- Cardiology, Max Shalimar Bagh, said, adding that two complex angioplasty were performed within a span of 40 minutes only.
The uniqueness of this case was that four stents were implanted in the bifurcation region and it raised the patient’s heart function to 40 per cent.
“It reflects that his heart had a viable myocardium (heart muscles were alive) but his heart function dropped to 10 percent due to inadequate blood supply,” Dr Bhamri, explained, adding that Impella helped them in giving hemodynamic support (to maintain mean arterial pressure to ensure end-organ perfusion and decrease myocardial oxygen demand while maintaining or increasing the cardiac output) to do such a complex angioplasty.
According to doctors, Delhi-based Rajendra Kumar Basoya came to the hospital in a state of shock with complaints of shortness of breath along with chest pain from almost 10 days and was also underweight around 48kg.
“Upon investigation, we found that the patient had triple vessel disease with left main disease and calcified LAD diagonal and a heart function of 10% only,” the doctor said.
In such cases, CABG OR Bypass surgery (very high risk due to poor heart function and frail elderly) or Multi-vessel angioplasty with mechanical circulatory support is effective therapy as an alternative to surgical revascularization in selected patients with triple-vessel coronary artery disease.