Prashanth Hospitals Performs Twin Advanced Heart Procedures To Save 62-Year-Old Diabetic Man With Very Minimal Heart Function
A severe heart attack, fluid-filled lungs and a failing heart successfully treated using the combined use of Impella-supported Protected PCI and Excimer Laser Coronary Atherectomy (ELCA).
● The successful outcome marks the first time in Chennai that both advanced technologies have been used together in a single patient, highlighting a new treatment approach for carefully selected high-risk cardiac cases.
A 62-year-old man who was admitted with underlying comorbidities, who was admitted with a severe heart attack, acute pulmonary oedema and a heart functioning at just 30% of its normal pumping capacity, was successfully treated by Dr. Aravind Duruvasal, Senior Consultant – Interventional Cardiologist, and his team at Prashanth Hospitals, one of South India’s leading super-speciality healthcare providers. The team performed Chennai’s First combined Impella-supported Protected Percutaneous Coronary Intervention (PCI) and Excimer Laser Coronary Atherectomy (ELCA) in the patient, enabling the successful treatment of an otherwise extremely high-risk coronary blockage and the patient’s subsequent recovery.
The patient was brought to the emergency department with severe breathlessness caused by acute pulmonary oedema, a life-threatening condition in which fluid rapidly accumulated in the lungs, requiring immediate ventilator support. Further evaluation revealed that he had suffered a previous silent heart attack without being aware of it, leaving his heart severely weakened with an ejection fraction (EF) of just 30%, compared to the normal 55–65%. Given the high risk of conventional angioplasty, doctors first implanted an Impella, a miniature temporary heart pump that supported blood circulation and reduced the heart’s workload throughout the procedure, enabling a safer Protected PCI.
Once the patient’s condition was stabilised, the team identified that the blocked artery contained a complex mix of fresh blood clot, hardened plaque and scar tissue, preventing conventional balloons from crossing the blockage. Doctors then used Excimer Laser Coronary Atherectomy (ELCA) to precisely clear the obstruction, creating a pathway for balloon angioplasty and successful stent placement. The three-hour procedure, including the stent placement and removal of the Impella device, was completed successfully. The patient recovered well, was discharged in a stable condition.
Speaking about the case, Dr. Aravind Duruvasal, Senior Consultant – Interventional Cardiologist, Prashanth Hospitals, said, “The patient was diabetic and was found to have suffered a previous silent heart attack without being aware of it, making the case even more complex. In such critically ill patients,
performing a conventional angioplasty can be extremely risky, as the heart may not tolerate temporary interruptions in blood flow during the procedure. His heart was functioning at only 30%, leaving virtually no margin for error during angioplasty. Using Impella allowed us to safely support his circulation while we performed the intervention. However, the blockage itself was extremely complex and could not be crossed using conventional balloons. ELCA enabled us to precisely remove the obstruction and successfully complete the angioplasty. Combining these two advanced technologies allowed us to safely treat a patient who would otherwise have faced a significantly higher risk.”
Patients with severely weakened heart function and complex coronary artery disease often require more than conventional angioplasty. While this approach is not a replacement for bypass surgery, it enables doctors to perform high-risk angioplasty more safely in carefully selected patients. Prashanth Hospitals continues to strengthen its advanced interventional cardiology programme with state-of-the-art Cath Labs, experienced specialists and advanced technologies to provide comprehensive cardiac care for patients across the region