‘In coil embolisation, there is complete control over the amount of infarct

Interventional cardiologist Dr Sudhir Vaishnav and his team has recently pioneered coil embolisation on 51-year-old A J Satpathy suffering from Hypertrophic Obstructive Cardiomyopathy at Asian Heart Institute. Dr Vaisnav spoke to Express Healthcare Management about the procedure.

When would a patient require coil embolisation?

A patient with Hypertrophic Obstructive Cardiomyopathy (HOCM) would require coil embolisation. HOC is a genetic condition in which a part of the partition of the heart (ventricle septum) becomes thickened (hypertrophy), resulting in obstruction to the flow of the blood in the left ventricle and results in disabling symptoms.

What are the conventional methods of treating this heart condition?

In HOCM, one of the treatment options is to inject alcohol into one of the arteries, which supply blood to the septum. However, this has resulted in some patients having significant complications, including a major heart attack. Despite medications, some patients continue with disabling breathlessness.

In what ways does coil embolisation have an edge over conventional method?

In coil embolisation, instead of alcohol, we have used platinum coil to occlude (thrombus) the septal artery. This has resulted in a controlled infarction (heart attack) and the patient’s obstruction after the procedure has gone down dramatically.

Alcohol being a liquid, the movement of alcohol in the artery cannot be controlled. Hence, in some cases, it has been observed that the alcohol damages the main artery, the LAD, resulting large infarct. However, coil being a metal can be precisely deployed at a particular site. The advantage of coil closure over the conventional treatment of alcohol injection is that there is complete control over the amount of infarct.

How did you measure the effectiveness of coil embolisation during and post the surgery?

By measuring the gradient on echo prior to during the procedure.

How many such treatment cases have been reported in the world?

There is only one report available on the Internet.