Deloris James knew something wasn’t right when she became winded just walking to her mailbox. The active 78-year-old grandmother of four saw her doctor, who ran some tests and realized she needed to see a cardiologist.
Dr. Bhalaghuru Chokkalingam Mani, an interventional cardiologist at Novant Health Heart and Vascular Institute in Matthews, North Carolina, quickly determined that she had two massive blockages in her heart that needed treatment. James was shocked by the news. She’d also recently lost her husband and was afraid of what would come next.
But Mani had good news -- James was an ideal candidate for minimally invasive angioplasty and a newly approved stent that would allow her to forgo a more complicated procedure that carried more risk, more time in the hospital and a longer recovery.
“I was able to go home the same day with no pain and hardly any scarring,” James said. “It’s incredible.”
No. 1 killer
According to the Centers for Disease Control and Prevention, heart disease is the leading cause of death for both men and women in the United States, killing about 610,000 Americans annually. The most common type of heart disease, coronary artery disease, claims more than 370,000 lives each year.
In James’ case the blockage occurred where the artery branches into a wishbone-like formation, called a bifurcation. When fatty material called plaque builds up at these junctions, it becomes difficult to treat one without potentially compromising the other.
The Tryton Side Branch Stent, approved by the Food and Drug Administration in 2017, was designed to address complicated bifurcations that involve a large side branch artery. The procedure, known as angioplasty, or “heart cath” is much less invasive than coronary bypass surgery (open-heart), which is usually recommended for people who have two or more narrowed arteries. For patients with two blockages in this wishbone-like artery, angioplasty requires multiple steps to protect the side branch.
“Tryton, however, simplifies a procedure that used to be much more complicated,” Mani said. “The device allows us to treat both arteries simultaneously without risk of compromising the other at any point during the procedure and restoring blood flow to the heart.”
The procedure is done through a small incision in a patient’s groin or arm. A balloon-tipped tube (catheter) is inserted into a patient’s artery where the blockage is. The balloon inflates and the stent (a tiny mesh tube that holds an artery open) expands, widening the artery and restoring optimal blood flow to the heart.
Once the vessel has been widened, the balloon is deflated and the catheter is removed, leaving the stent in place.
The stent stays in the artery and holds it open to prevent future blockages. This improves blood flow to the heart muscle and relieves a patient’s symptoms -- usually chest pain or shortness of breath.
Recover much faster
According to the American Heart Association, patients who have angioplasty and stents recover from these procedures much faster than patients who have open-heart surgery.
A buildup of plaque over time can cause a person’s arteries to narrow, disrupting blood flow and weakening the heart muscle. Those with coronary artery disease or other risk factors (high blood pressure, high cholesterol, diabetes, etc.) have more plaque in their arteries than those without. A complete blockage can cause a heart attack.
Over time, the reduced blood flow and weakened heart muscle can cause chest discomfort, pain, or shortness of breath.
According to research from the National Institutes of Health and American Family Physician, as many as 40 percent of patients who have angioplasty without a stent will experience restenosis. This means an artery becomes narrowed again after surgery.
That figure drops to about 30 percent when the procedure is performed using a stent. It drops to less than 10 percent when a “drug-eluting” stent is used. Drug-eluting stents are coated with medication that is gradually released to prevent blood vessels from becoming clogged again.
“We are thankful that we can offer a wide variety of treatment options to our community,” Mani said. “Our heart and vascular teams at Novant Health can take care of these complex blockages in a safe and effective way. Without compromise, we deliver the best possible care.”
James is back to spending time with her grandchildren and frequenting craft shows and doesn’t worry about a heart attack any time soon. “I may give my daughter one first!” she laughs.
According to CDC reports, 75 percent of U.S. adults have a “heart age” that is older than their actual age, meaning you may have a higher risk of a heart condition. To find out your heart age, take the quiz at novanthealth.org/heartage.