DRILLING AT 200,000 ROTATIONS PER MIN INSIDE THE HEART ARTERIES!
WHAT TO DO IF THE BLOCKS ARE HARD AS A ROCK?

Normally the blocks in the arteries are made of soft cholesterol and these can be easily opened with a balloon inflation. But this is not the case if these blocks are filled with CALCIUM deposits. With calcium deposits these blocks become as hard as ROCK/STONE and cannot be opened with regular balloons. The blocks will remain tight or the balloon may burst! Then what do we do? Just like holes are drilled in walls with drills, drills are available for the arteries of the heart, called ROTA-BURRS, lined with diamonds, which can drill at speeds of 200,000 rotations per minute inside the 2.5 to 3.0 mm arteries of the heart and can drill and open up the calcified blocks, which can then be balloon dilated and stented. This procedure is called ROTABLATION-ANGIOPLASTY! However, this is a complex procedure with certain risks like the burr may pass through and through the artery and produce bleeding out of the heart and can be risky to life. But with good experience these can be done safely.
This is one of the challenging rotablations which I performed in a 67 year old man 4 months ago, with extensive calcium and 2 blocks. I used a 1.25 mm Burr and 2 stents to get a good result as can be seen in the images. He is on follow up with a negative treadmill and doing great by God's grace.

NB: Rotablation angioplasty is a procedure associated with risks in contrast to conventional angioplasties and needs extensive skill and expertise.

DR BINOY JOHN MD DM FCSI FACC FESC FSCAI FAPSIC
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