BLESSING FOR THE ELDERLY

BLESSING FOR THE ELDERLY 

Old age is accompanied by the increasing threat of heart attack. But this can now be considerably minimized with a device called Rotablator
By Dr. Purshotam Lal

P-lal

Aging is considered a major risk factor for coronary artery disease which cannot be modified unlike other risk factors such as hypertension, diabetes, smoking etc. The depressing part is that majority of the elderly patients, suffering from coronary artery disease after the age of 80, are having calcified coronary artery blocks.
It is owing to the intractable angina which becomes unresponsive to medical treatment that the disease pattern starts imposing functional limitations in several patients thus affecting their quality of lives. Many such patients have already undergone bypass surgery; however those suffering from other body ailments such as bad lungs are even unfit for the surgery.

Rotablator – A boon!
It is seen quite often that balloon angioplasty and stenting are not possible due to the excess of calcium and under such conditions the patients are left with no other option but to keep on suffering from angina or heart attack. Then it is for such peoplethat the Rotablator often called as diamond drilling proves to be no less than a blessing. This device consists of a burr that is embedded with millions of diamond crystals. The burr rotates at a speed of 150,000 to 200,000 revolutions per minute and cuts the calcium just like diamond cuts the glass. Once the calcium is removed the stenting is performed with excellent results.
The Rotablator was introduced for the first time in India by me. I performed the first procedure on a patient called Surinder Jindal from Punjab while he was at Apollo, Chennai. An authentic scientific paper pertaining to the use of this machine was presented by Dr. Lal at the Annual Conference of Cardiological Society of India held at Hyderabad in December 1991. Later on, the paper got published in Indian Heart Journal.
Approximately 10-12% of our total patients are almost 80 years of age out of which more than 50% require diamond drilling. Even though the number of cases of elderly patients requiring diamond drilling is very high, but the case of 88-year-old Mehbood Singh Kohli,was very challenging. He underwent diamond drilling with stenting of the main artery for multiple calcified blocks on January 07, 2016. The diamond drilling did wonder and the patient’s life got saved. “Dr. Lal treats the elderly patient like flower and we have great faith in Dr. Lal. We are very happy that he saved the life of our father”, said A.S. Kohli, his son.
This surgery was followed by another major heart surgery of the patient called Tejinder Singh. He had critical calcified blocks of the Left Main and both of the other arteries, which was a life threatening emergency. Since the patient was unfit for bypass and balloon angioplasty with stenting, the diamond drilling followed by stenting was done on January 08, 2016 and Tejinder Singh went home after a few days happily.
“I know about Metro Hospital for long time. I appreciate Dr. P.Lal for his successful treatment and his care given to me,” Tejinder Singh said. The 88-year-old, Harbhajan Singh Chhabra, who earlier had bypass surgery and was unable to walk underwent diamond drilling of the Left Main artery and another major artery circumflex successfully on January 09, 2016. And, just after three days he could go back to his home.
Harjeet Kaur Chhabra, wife of the patient, said, “Dr. Lal explained us everything very nicely and we are grateful to him for opening the critical calcified blocks and saving the life of my husband.”
There is no dearth of patients who have received benefits from Rotablator. This technology has not only been able to give a new life to them, but has also made their lives worth living.

(The author is Padma Bhushan, Padma Vibhushan and Dr. B.C. Roy National Awardee and CMD Metro Group of Heart Hospital)

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