Mongolian banker avoids open-heart operation with minimally invasive PCI
Successfully treated for blocked artery at National Heart Centre Singapore
Bat Battulga, a 54-year old banker from Ulaanbaatar, Mongolia, is a picture of rosy health. He brisk walks a few times a week and eats healthily. It would be hard for anyone to even guess that Mr. Battulga had ischaemic heart disease; a condition where the heart muscles receive reduced blood supply due to blockage in a coronary artery.
He didn’t know it then, but blocked arteries were the reasons for his chest pain every time he brisk walked. In May 2008, Mr. Battulga went for a medical checkup and learnt that he has two blocked heart arteries. He had a successful Percutaneous Coronary Intervention or PCI (balloon angioplasty and stenting) for one of the arteries. Due to the severity of blockage in the other artery, his cardiologist recommended that he go for a heart bypass operation.
Alarmed and hoping to avoid a major heart surgery, he decided to seek a second opinion at the National Heart Centre Singapore (NHCS) where his mother-in-law had undergone a successful treatment for her heart condition by NHCS’s Medical Director, Associate Professor Koh Tian Hai a few years ago.
In July 2008, the couple flew to Singapore and met A/Prof Koh. After reviewing his medical history, A/Prof Koh arranged for a coronary angiogram for Mr. Battulga. A coronary angiogram uses a special dye and x-rays to see how blood flows through the heart. Based on the angiogram result, A/Prof Koh decided to perform PCI on Mr. Battulga’s artery, which is completely blocked.
The success rate of PCI on this type of blockage is about 50 to 60% using the conventional antegrade or front approach. Failures are usually due to unsuccessful crossing of the blockage. However, by using the recently developed retrograde or back approach, A/Prof Koh managed to cross over the blockage and applied stents to unblock Mr. Battulga’s artery. Said A/Prof Koh, “Mr. Battulga recovered quickly from the procedure, and has been well since then.”
A day after his procedure, Mr. Battulga was discharged from the hospital a pleased and relieved man. He said, “I was afraid I had to go for an open-heart surgery. I was so pleased that NHCS could perform PCI on the blocked artery. A/Prof Koh is very professional and the service of NHCS staff, such as the nurses, is very good.”
His wife added, “I’m very glad my husband is now well. As a bonus, after the PCI, my husband snores much less than before!”
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What is Percutaneous Coronary Intervention (PCI)?
As we age, cholesterol, also known as plaque, can build up on the walls of our arteries. This causes narrowing of the arteries, reducing blood flow to a trickle. PCI is one of two procedures used to treat diseased coronary arteries. The other procedure is coronary artery bypass grafting (CABG), or known simply as a heart bypass. CABG is an open-heart surgery.
PCI is a minimally invasive procedure involving threading a slender balloon-tipped catheter from an artery in the groin to the blocked artery of the heart. The balloon is then inflated, compressing the plaque and dilating the narrowed artery so that blood can flow easily.
Often an expandable stent, a wire mesh tube, is placed in the artery after dilation to prop up the artery. The stents are either bare metal or drug eluting (coated with immuno-suppressant, anti-mitotic or anti-inflammatory drugs). Patients are usually given a local anaesthesia at the groin area and a sedative before the procedure. Patients can usually be up on their feet a few hours afterwards, and go home the next day.
PCIs are usually done by experienced cardiologists in a medical facility that performs a high number of such procedures in a year. The National Heart Centre Singapore performs more than 2,000 PCI procedures each year.
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For more information about PCI, other heart treatments and tips for a healthy heart, log on to www.nhcs.com.sg