Dr Ganesh Kumar, chief interventional cardiologist at Dr LH Hiranandani hospital does the largest number of primary angioplasties in this part of the country. The term coronary angioplasty is used to describe a technique wherein a balloon is used to crush blockages in the blood vessels (coronary arteries) supplying the heart, thereby restoring good flow of blood. These procedures are invariably followed by insertion of a metal scaffolding called a stent which prevents recoil and reduces re-blockage at the ballooned site, which is called a stenting procedure.

Balloon angioplasties and stenting techniques have become a very routine day to day procedure performed in most tertiary care hospital across the country. PRIMARY angioplasty, however, is a term used to describe an angioplasty done as a life saving emergency procedure in a patient with an on-going heart attack. Heart attacks occur due to sudden total occlusion of a preexisting partial block, thereby completely cutting off the blood supply to a portion of a heart muscle. These 100% blockages need to be removed within 3-6 hours from the onset of heart attack; else the muscle of the heart gets damaged permanently. Doing angioplasty in a critical patient of heart attack is in itself challenging and doing so in the critical window period of this 3-6 hours further adds to the challenge.

The only other option available for the treatment of heart attack other than the primary angioplasty is use of specific intravenous medications called “thrombolytic agents”. These agents are thrombus (clot) busting medications, and when administered in patients, dissolve the clot in 60-65% of cases. The remaining 35-40% of cases either die due to failed thrombolysis (failure of drug to lyse the clot), or even if they survive the attack, go home with a very weak heart due to a large portion of the heart muscle being permanently damaged. These patients who do survive with weak hearts go on to live with either heart failure, valve leaks, ruptures in the portion of the heart or rhythm problems (electrical disturbances) & have a very morbid and unproductive life, with abundant economical, social and psychological burden. We have millions of such patients in our country with this morbidity, which ultimately is a large burden to the state. On the other hand, success rate of primary angioplasty is more than 95% when performed in experienced hands. This requires not only specialized training in interventional cardiology, more importantly a dedicated team of nurses, and cath lab technician who can react quickly to an emergency call. Dr Ganesh Kumar, chief of interventional cardiology, at Dr LH Hiranandani hospital is amongst few operators in the whole country who is geared up for these types of procedures; with his round the clock primary angioplasty team available 24 x 7.