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Cardiologists unblock heart vessels using a diamond drill

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</span><p class="MsoNormal"><span style="font-family: helvetica;">Cardiologists at the Aga Khan University Hospital’s state of
the art Heart and Cancer Centre facility were able to break new ground recently
in heart procedures by using a diamond drill to unblock a major heart artery
which was too hard to open with a balloon treatment alone. An elderly patient
from Uganda became the first patient to undergo this procedure in the region
when it was performed and remains in a good state of health after he received
this treatment.</span></p><p class="MsoNormal"><span style="font-family: helvetica;">Dr Mohamed Jeilan, Cardiologist at Aga Khan University Hospital
said, “Among heart attack patients with blocked coronary arteries, balloon
expansion (or angioplasty) at the site of blockage has been the mainstay of
treatment for more than two decades. The balloon is guided using a special
X-ray facility to the blocked vessel through a tiny catheter introduced via a
very small puncture in the groin or the wrist. When the catheter is in place, a
small amount of dye will be injected into it. X-rays will be taken as the dye
travels through the coronary arteries. After the balloon is removed, the doctor
will usually place a stent (a metallic tube) to ensure that the artery has been
kept open after the balloon has been removed.”</span></p><p class="MsoNormal"><strong style="font-family: helvetica;">Drill</strong></p><p class="MsoNormal"><span style="font-family: helvetica;">“In many patients, the vessel wall is too calcified
(hardened) and the blockages are very long. In these patients, balloon
inflations are unable to relieve the obstruction. Doctors at the Aga Khan
University Hospital delivered a miniature ‘rotablator’ drill (less than 1.5mm
wide) which was small enough to fit into the very small heart vessels to bore
open the artery. The drill is coated with very tiny pieces of diamond crystal
and is used in a catheter based procedure called rotational atherectomy. A
specially designed diamond burr is used to grind away the blockage, rotating at
more than 150 000 times per second.”</span></p><p class="MsoNormal"><span style="font-family: helvetica;">With coronary artery disease continuing to affect more
Kenyans and the tide being on an upward surge, the Hospital continues to foster
new technologies and therapies that have proved successful in other parts of
the world. The Heart and Cancer Centre has pioneered several procedures and
this complex intervention comes in a long line of similar pioneering procedures
opening up treatment options among patients suffering from heart diseases. The
Hospital’s Heart and Cancer Centre is the only one of its kind in East and
Central sub-Saharan Africa and serves as the regional referral heart and cancer
centre.  In addition to providing high
quality tertiary cardiac and cancer care, the centre is a platform for
scientific research and postgraduate sub speciality fellowship training.</span></p><p class="MsoNormal"><span style="font-family: helvetica;">Commenting on the impact of this treatment and its
significance in the region, Dr Anders Barasa, Consultant Cardiologist at the
hospital added “This unique and technically advanced method is safe and
effective and can be performed with little risk in the right hands. It has
already been used in more than 50,000 cases worldwide and will now also benefit
the population here and help define Nairobi as the capital of cardiovascular
care in the region.”</span></p><p class="MsoNormal"><strong style="font-family: helvetica;">Absorb</strong></p><p class="MsoNormal"><span style="font-family: helvetica;">A second introduction in the care of coronary artery disease
includes placement of ‘absorbable stents’. The standard of care has been to use
stents which are made out of precious metals such as platinum. The newest
technology in this field involves the use of dissolvable stents which stay in
place for several months before getting absorbed after the vessel has healed. A
middle aged woman received the first absorbable stent in the region last year
and she remains well one year down the line. The stent technology was
introduced first at the Aga Khan University Hospital’s Heart facility but it is
anticipated that these stents will start to become available at other major
centres in the region in the near future.</span></p><p class="MsoNormal"><span style="font-family: helvetica;">Talking about the absorbable stent, Dr Mohamed Jeilan
explained, “Absorb is a first-of-its-kind device that functions like a metallic
stent by opening a blocked artery in the heart and restoring blood flow.
However, unlike a metallic stent, which cages the vessel, absorbable stent is
more flexible and dissolves over time. 
This leaves behind a treated vessel free of a permanent implant with the
potential to flex, pulse and dilate in response to various demands on the
heart, based on people&#39;s lifestyle and activities including exercise.”</span></p><p class="MsoNormal"><span style="font-family: helvetica;">Other coronary procedures which Aga Khan University Hospital
has been in the forefront include Intravascular Ultrasound (IVUS).  Dr Jeilan further noted that, “After
performing a coronary angiogram, using a key-hole technique, we introduce a
tiny ultrasound probe into the inside of our patient’s coronary artery and
watch the moving images to assess the lining of the artery from the inside.”</span></p><span style="font-family: helvetica;">

</span><span style="font-size: 11pt; line-height: 115%; font-family: helvetica;">“The procedure allows us to decide whether the
inner lining of the artery had been damaged significantly and whether a stent
should be placed in the artery to improve the healing of the artery. This
special catheter enables us to visualise the inside of the heart artery and 
take pictures which doctors can use to analyse the type and mechanism of
narrowing in the artery”.</span>

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