Cardiac catheterization, used to open blocked arteries using balloon angioplasty and stenting is generally considered to be the first line treatment for chest pain and other symptoms of heart disease, replacing bypass surgery as an automatic first option. But until recently, about a third of patients with heart disease symptoms didn’t have that option. These are patients with one or more arteries completely blocked for more than three months. Sometimes these patients also can’t have cardiac bypass surgery due to age or other health issues.
Now Brian Strunk, MD, chief of cardiology at Marin General Hospital wants to do something about that. “We call this type of blockage chronic total occlusion,” he says. “The material in the arteries – plaque and fatty deposits – has become almost like cement. When arteries are completely blocked, the heart cannot get enough blood to keep it healthy and functioning properly. Patients commonly suffer from angina or chest pain and are at an increased risk of complications from heart attack.
Traditional catheter-based procedures such as balloon angioplasty to try to open these completely blocked arteries have had little success in the past. Until now, bypass surgery or medical management of heart disease have been the best options for chronic total occlusion. But new devices and new strategic approaches to chronic total occlusion are changing that. According to Dr. Strunk, new catheter-based technology allows cardiologists to guide wires around the blockage in the artery by making slits into the artery wall itself, and then use devices to move the plaque and create new channels for blood flow to the heart.
Marin General Hospital is now capable of performing this minimally invasive procedure with leading edge technology offered in a limited number of hospitals in the country, Dr. Strunk says. “We have been very aggressive in getting the training and the technology to be able to offer this option to our community,” he says. “The procedure is difficult and time consuming, but we are committed to make it more widely available to those patients whose conditions warrant it and whose quality of life will greatly benefit.”
In the past three months, 10 procedures to unblock chronic total occlusions have been performed at the hospital’s cardiac catherization lab, with a 90% success rate. The national average success rate is 75%, according to Dr. Strunk.
“Marin General Hospital offers the county’s only comprehensive heart and vascular care through the Haynes Cardiovascular Institute,” he adds. “Our cardiac catheterization lab is one of the top in the entire region. Patients with heart disease in Marin are fortunate to now have this sophisticated, life saving option to treat blocked arteries.”
For more information or a physician referral, please visit www.maringeneral.org or call the Marin General Health Line at 1-888-99-MY-MGH (1-888-996-9644).