Using latest imaging techniques like Fractional Flow Reserve (FFR) and Optical Coherence Tomography (OCT), the team found that a block in a patient had naturally recanalized and had multiple branches.
The findings that were published in the Journal of American College of Cardiology highlights the case of a middle aged woman in whom the block was shown as mild in a regular angiogram.
FFR helps gauge the intensity of the block and points out accurately if the patient needs a surgery or stent to correct it or not. FFR is calculated by analyzing the pressure of flow above and below a block.
OCT is similar to doing an ultrasound inside a blood vessel but is guided by light instead of sound to detect vulnerable lipid rich plaques. A miniature probe which emits light is passed through the blood vessels and is used to detect clots and nature of calcification inside them.
“She came in with severe chest pain but the angiogram showed only a 50% block which was treatable with drugs. But we had our suspicions and did a FFR only to find that her block was dangerous and there was a significant pressure drop. When we performed an OCT on her, there were multiple micro channels originating from the calcified block,” said Dr G Sengottuvelu, Senior Consultant, Department of Cardiology at Apollo Hospitals, Chennai who led the surgical team.
The woman was treated with two stents and her blocks were removed. The doctors repeated the imaging techniques to ensure that her blood flow was restored to normalcy.
“While technology helps understand heart blocks better, FFR and OCT imaging techniques have completely changed the management scenario,” said Dr N Sathyabhama, Director of Medical Services, Apollo Hospitals,Chennai.