Orbital Atherectomy was performed on a 70-year-old male patient by Dr. Naveed Ahmed, Interventional Cardiology Specialist, Aster Hospital, Mankhool
Aster Hospital, Mankhool is the first in Dubai to successfully execute a new form of rotational atherectomy-a procedure that relies on removing plaque and calcified blockages in the heart by pulverizing the deposits using an instrument
‘Orbital Atherectomy’ is a medical procedure introduced by Cardiovascular Systems, Inc. The new procedure is safer and easier to use, with reduced likelihood of complications including heart rupture. In Dubai, Aster Hospital is the first to successful attempt and complete this procedure and the third within the UAE. The patient was 70-year old Abdul Kader, hailing from India, with a long history of diabetes and hypertension, and had undergone an angioplasty nearly 10 years ago. The surgery was extremely successful with the patient being discharged within 24-hrs post-operation.
Dr. Sherbaz Bichu, CEO- Aster Hospitals UAE said, “This is a huge milestone for Aster Hospitals and has the potential to revolutionize the department of interventional cardiology especially in a region that has very few doctors trained in rotational atherectomy. Having received his training in Canada, Dr. Naveed Ahmed is well-versed with the procedure, its potential complications and management. The referrals within the Aster DM Healthcare group is an ode to our ever expanding presence and shows that we are dedicated to ensuring the same amount of quality healthcare no matter who you consult. It also stands as a testament to the UAE’s growing role as a centre of medical excellence.”
Dr. Naveed Ahmed said that the patient was followed up with a cardiologist for chest pain on walking a few yards for which medical treatment was optimized. The new form of surgery simplifies interventional cardiology procedure for the best patient outcomes and enables fast recovery. “Despite medication, he persisted to have severe angina on exertion and was referred to me for further angiogram and treatment with angioplasty if required”, said Dr. Naveed. He further asserted, “I worked with the patient to outline the risks and possible complications associated with the procedure and other necessary details. Due to high creatinine presence, specialist opinion from a Nephrologist was considered at all stages (before and after angiogram, before and after angioplasty). The patient is now extremely happy with the post-operative results.”
In older patients, blockages in the heart tend to get calcified. Coronary artery calcification2 (CAC) is highly prevalent in patients with coronary heart disease (CHD) and is associated with major adverse cardiovascular events. The prevalence of CAC is age- and gender-dependent, occurring in over 90% of men and 67% of women older than 70 years of age.
When the calcium levels in the arteries are too high, it is difficult to open the artery with only balloon dilation and a stent. Prior to the procedure, the patient was put on medication to alleviate angina and was referred for an angiogram. The angiogram revealed that the previous stent in one of the heart vessels was clear. Moreover, the angina was attributed to an artery which was heavily calcified. Four weeks following the angiogram, the orbital atherectomy was performed. The artery which grew from less than 1mm to nearly 3-3.5mm was de-calcified (I.e. parts of the calcium was broken down) and three stents were inserted.
In atherectomy, a device is introduced into the heart to remove a part of the calcium from the blocked artery, after which the balloon is introduced and an angioplasty is performed. The rotational atherectomy procedure is considered rather complex and of high-risk as its complications include artery rupture, often resulting in mortality. Orbital atherectomy, on the other hand, is a refined and modified version of this technique with reduced risk of complications.
Dr. Naveed Ahmed has a Fellowship in Interventional Cardiology and Structural Heart Interventions from St Michael’s Hospital, University of Toronto, Canada. He obtained his DM (Cardiology) in King George’s Medical University, Lucknow, MD (Medicine) from Government Medical College, Nagpur and MBBS: JJM Medical College, Davangere, Karnataka.
Prior to joining Aster, he was a Clinical fellow in structural heart disease intervention, St. Michael’s Hospital, University of Toronto, Canada. He brings to the team extensive clinical expertise within coronary and peripheral angiography, angioplasty, pacemaker implantation and structural heart intervention.
News Link: Zawya