Day 2 :
Cardiologist, Zulekha Hospitals
Time : 10:00 AM
Fekry El Deeb is one of the first interventional Cardiologists in the Middle East. He started practicing Coronary Angioplasty at the Catharina Hospital, The Netherlands in 1986.He has worked in major hospitals such as the King Faisal Specialist Hospital and Research Center and the King Fahad National Guard hospital, Riyadh, Saudi Arabia as a Consultant and Director of the Cardiac Catheterization Laboratory.With interventional experience of more than 25 years, Dr. Fekry has performed over 15,000 different coronary, peripheral and valvular procedures
Atherosclerosis is a progressive disease which affect several vascular structures in the body. It is not uncommon to find patients with advanced atherosclerosis involving several vascular beds at the same time (coronary, carotid and other peripheral arteries). In this presentation, we reviewed the role of percutaneous vasculat intervention as an attractive model of therapy for such advanced cases The first case was for a 72 years old male patient with severe diffuse calcified three coronary vessels disease which was not operable. He had CCC class III-IV angina on mild effort and at rest. This was treated successfuly with Rotablator angioplasty and stenting.The second case was for a 65 years old patient with advanced severe atherosclerosis of both legs arteries as well to both renal arteries.The patient had intermittent claudication on walking for 50 meters. Percutaneous intervention to all lesions was done successfuly.The third case was for a 60 years old male patient with severe three coronay vessel disease and significant right carotid artery stenosis with aneurysm. The patient was elected for Coronary Artery Bypass Surgery. The Carotid artery stenosis and aneurysm was treated with Carotid angioplasy and stent using a filter device successfuly before cardiac surgery.Conclusion:Accumulative experience over years made it possible to treat several vascular atherosclerotic lesions all over the body using the technique of percutaneous vascular angioplasty and stenting. It is a very plausible and attractive method of treatment with relatively low risk and fast recovery.The cost of the procedures continue to decrease with the availability of supplies from several vendors and the increase number of cases.
The BM Birla Heart Research Centre, India
Keynote: Current status of intervention in Aortoarteritis in India, The largest experience of the world
Time : 11:00 AM
Manotosh Panja is the chief adviser in Medical Education and Senior Interventional Cardiology in B.M.Birla Heart Research Centre. He is the Director of Interventional Cardiology, Belle Vue Clinic. Formerly he was Director professor & Head of Cardiology Division at S.S.K.M Hospital & Institute of Post Graduate Medicine Education & Research. He was the Dean of Indian College of Physician (2012-2013). He was also The President of Cardiology Society of India(1995-1996) and Association of Physician of India.(2003-2004). He is a Fellow of American College of Cardiology. He has Published 270 paper. He is also a recipient of Dr.B.C.RAY National Award by Medical Council of India , presented by President of India. He is the Examiner of DM (Cardiology) and D.N.B Cardiology. AIMS (Delhi) ,PGI(Chandigarh) and all other Universities of India for 20 years.
To demonstrate that Angioplasty with or without stenting is the only sort of treatment which can save the life of the patients in addition to medical therapy with the largest experience of the world.
METHODS AND RESULTS
Aortoretritis is a chronic inflamtory disease in aorta and its branches which is prevelent worldwide. Its a single center study conducted from the year 1978 to 2012 from IPGME&R, Kolkata, West Bengal. India. We have reported the largest series of around 750 cases of non specific Aortorteritis. The male female ration was 1:6.4, and the pattern of involvement were like Type I 16%, type II 8%, type III 76%, type iv 36%, type V 10%. Angioplasty done in these cases showed involvement of aortic arch, thorasic and abdominal aorta, renal artery, carotid artery, pulmonary artery, coronary artery, aortic valve (regargitation). 274 angioplasty were done in these cases. Carotid angioplasty was attempted in 40 lesions in 36 patients with 705 success rate. 1 patient had major embolic event, 3 patient had TIA. Angiographic restenosis of carotid was seen in 7 cases (17.5%). Subclavian angioplasty was attempted in 64 lesions in 58 patients. Stenting was done in 14 cases, Aortic balloon angioplasty was done in 58 patients in 52 patients with stenting in 12 lesions. Success rate was 58% restenosis rate is following: thoracic aorta 25%, abdominal aorta 38%, 120 renal angioplasty with stenting in 96 lesions was done. Restenosis rate was 18%. Incidence of coronary artery involvement is 10% in our series. Ostial and Proximal Left main Stem as well as RCA involevement ware onserved. PTCA with cutting balloon followed by DES (LMCA and Proximal LAD 10 cases, RCA 5 cases) were done. Restenosis happened in 3 cases in 5 years.
Aortoarteritis carries substential morbidity and mortality. Medical therapy is not very effective. Angioplasty procedure symptometic improvement and prevent complications, failed angioplasty implicated high mortality.