In probably a first the world over, cardiologists at the Indira Gandhi Medical College (IGMC), Shimla, performed a rare angioplasty in a patient having a single coronary artery through the trans-radial approach (through arm).
A rare condition, single coronary artery is seen only in around .024% population, and so far has been treated only through the transfemoral access (through groin), according to Dr Rajeev Bhardwaj, Professor at IGMC’s cardiology department.
The patient, Lal Chand, 62, a resident of Shimla district, had suffered a heart attack onSeptember 12 and was admitted to the IGMC. After being treated in the medicine department, he was discharged on September 16. However, he again complained of chest pain and was admitted in the cardiology department’s OPD on October 15.
On conducting an angiography on the patient on October 16, Dr Bhardwaj, assisted by resident Dr Konal Mahajan, could not locate the left coronary artery even after searching for 10-15 minutes.
“Eventually, we discovered, the patient had only a single coronary artery, which was arising from right side of the aorta, and further giving rise to three coronary branches. Normally, a person has three coronary arteries,” Dr Bhardwaj said, adding that of the three coronary branches, the right one was totally blocked, causing chest pain.
“When the artery is single and has abnormal origin, it is difficult to hook with catheter. However, with great difficulty, we managed to hook this artery and cleared the blockage with guide wire, and implanted two stents in the artery,” he said.
As transradial access has lower complication rates and lest post-operative recovery time, the patient diagnosed as fit and discharged October 19. The patient’s surgery was covered under the Rashtriya Swasthya Bima Yojana, and had to pay nothing.
Dr Bhardwaj said only a few cases of angioplasty in single coronary artery were reported world over, and this was probably the first time angioplasty in such a condition was done through the transradial approach.