Intracoronary Physiology

1. Rota?onal Atherectomy Rota?onal Atherectomy, also known as Rotabla?on, is an advanced minimally invasive procedure used to treat heavily calcified and stenosed (narrowed) coronary arteries. This technique involves using a high-speed rota?ng diamond- coated burr to modify and remove rigid plaque, restoring normal blood flow to the heart. In Chennai, this procedure is commonly performed alongside balloon angioplasty and sten?ng, par?cularly for pa?ents with complex coronary artery disease who may not be ideal candidates for conven?onal angioplasty. The procedure is generally conducted through a catheter inserted into the femoral artery in the leg or, in some cases, via the radial artery in the wrist. Why is Rota?onal Atherectomy Needed? Coronary artery calcifica?on poses a significant challenge in trea?ng cardiovascular disease. Tradi?onal methods like balloon angioplasty and sten?ng may not effec?vely break down rigid calcium deposits, leading to unsuccessful outcomes or restenosis (re-narrowing of the artery). Rota?onal atherectomy provides an effec?ve solu?on by modifying and clearing these hardened plaques, enabling be?er stent placement and improved long-term pa?ent outcomes.

2. Causes of Coronary Artery Calcifica?on Coronary artery calcifica?on occurs due to the gradual accumula?on of plaque, which consists of cholesterol, fa?y substances, calcium, and other deposits. Over ?me, this build-up hardens and restricts blood flow, increasing the risk of severe cardiac events such as heart a?acks, angina (chest pain), and other cardiovascular complica?ons. Common factors contribu?ng to plaque forma?on include: High cholesterol levels Hypertension (high blood pressure) Diabetes Smoking Obesity

3. Sedentary lifestyle Gene?c predisposi?on Who Should Consider Rota?onal Atherectomy? Pa?ents with severely calcified coronary arteries that cannot be effec?vely treated with standard angioplasty are ideal candidates for rota?onal atherectomy. This procedure is recommended for individuals experiencing: Severe chest pain (angina) Symptoms of coronary artery disease despite medica?on Previous unsuccessful angioplasty procedures High-risk coronary artery blockages Leading Expert in Rota?onal Atherectomy in Chennai Dr. M. Kathiresan, a renowned cardiologist specializing in complex coronary interven?ons, is a leading expert in rota?onal atherectomy treatment in Chennai. With extensive experience and exper?se in performing this advanced procedure, he ensures precise diagnosis and op?mal treatment planning for pa?ents with severe coronary artery disease. Diagnosis and Evalua?on To determine the necessity of rota?onal atherectomy, doctors perform a series of diagnos?c tests, including:

4. Coronary Angiography: A specialized imaging test that helps visualize blockages in the coronary arteries. Intravascular Ultrasound (IVUS): Provides detailed images of the artery’s interior, assessing the severity of calcifica?on. Computed Tomography (CT) Angiogram: Offers a non- invasive evalua?on of coronary artery disease. Stress Test: Assesses heart func?on and blood flow under exer?on. Based on these test results, the cardiologist can determine whether rota?onal atherectomy is the best treatment approach. The Rota?onal Atherectomy Procedure Rota?onal atherectomy is performed in a catheteriza?on lab by an interven?onal cardiologist and typically takes 1–2 hours. The step-by-step process includes: 1.Local Anesthesia: The procedure site (groin or wrist) is numbed to ensure pa?ent comfort. 2.Guidewire Placement: A thin wire is carefully threaded through the artery to reach the blockage. 3.Rotabla?on Device Ac?va?on: A catheter-mounted diamond-?pped burr rotates at high speeds (140,000– 200,000 rpm), grinding the plaque into microscopic par?cles that are naturally expelled by the bloodstream.

5. 4.Balloon Angioplasty and Stent Placement: A?er the plaque is modified, a balloon catheter is used to widen the artery, followed by stent placement to keep the vessel open. 5.Monitoring and Closure: The catheter is removed, and the incision is closed. Pa?ents are monitored for any complica?ons before discharge. Success Rate and Benefits of Rota?onal Atherectomy Rota?onal atherectomy has a high success rate when performed by skilled interven?onal cardiologists. The benefits include: Effec?ve Treatment for Calcified Lesions: Successfully removes rigid plaque that cannot be treated with conven?onal angioplasty. Improved Stent Placement: Creates a smooth arterial surface, allowing for be?er stent posi?oning. Minimally Invasive: Faster recovery, smaller incisions, and reduced hospital stays compared to open-heart surgery. Enhanced Long-Term Outcomes: Lower risk of restenosis and improved overall heart health. Poten?al Risks and Complica?ons While rota?onal atherectomy is a safe and effec?ve procedure, poten?al risks include:

6. Arterial dissec?on or perfora?on Arrhythmias (irregular heartbeats) Temporary blood vessel spasm Risk of heart a?ack or stroke (rare but possible) Allergic reac?ons to contrast dye Comparing Rota?onal and Orbital Atherectomy Both rota?onal and orbital atherectomy are used to treat calcified coronary arteries, but they differ in technique: Rota?onal Atherectomy: U?lizes a high-speed rota?ng burr, offering precise plaque removal. Orbital Atherectomy: Uses a diamond-coated crown with an orbital mo?on, ideal for certain plaque forma?ons. A cardiologist will determine the most suitable method based on the pa?ent’s condi?on and plaque characteris?cs. Cost of Rota?onal Atherectomy Treatment in Chennai The cost of rota?onal atherectomy in Chennai varies depending on several factors: Hospital Choice: Advanced cardiac centers may have higher fees. Doctor’s Exper?se: Highly experienced specialists may charge more.

7. Procedure Complexity: The severity of arterial blockages affects the cost. Post-Procedure Care: Hospital stay, medica?ons, and follow-ups contribute to expenses. Despite being more expensive than tradi?onal angioplasty, the long-term benefits make it a cost-effec?ve solu?on. Pa?ents are encouraged to check with their insurance providers regarding coverage op?ons. Advanced Facili?es for Rota?onal Atherectomy in Chennai Chennai boasts some of India’s top cardiac care centers, equipped with: State-of-the-art catheteriza?on laboratories Intravascular imaging technologies (IVUS, Op?cal Coherence Tomography - OCT) Real-?me monitoring systems for pa?ent safety Expert interven?onal cardiologists specialized in complex procedures Conclusion Rota?onal Atherectomy is a game-changing procedure for pa?ents suffering from heavily calcified coronary artery disease. Under the expert care of Dr. M. Kathiresan, pa?ents in Chennai can access cu?ng-edge treatment that significantly improves their heart health and overall quality of

8. life. By leveraging the latest technology and medical exper?se, this minimally invasive approach ensures excellent clinical outcomes, allowing pa?ents to lead healthier, more ac?ve lives. For more details or to book a consulta?on with Dr. Kathiresan, reach out to a reputed cardiac center in Chennai today. Read Also: h?ps://drkathiresan.com/treatments/best-transcatheter- mitral-valve-replacement-in-chennai/