Paul Hunt’s wake-up call came when his physician told him, “You’re going into surgery tomorrow.” Testing at Renown Regional Medical Center’s Chest Pain Center revealed that the 69-year-old
Coleville, Calif., resident had coronary artery disease (CAD), also known as coronary heart disease. He would need triple bypass surgery.
“I had shortness of breath, but no pain,” Paul says, so the diagnosis came as a surprise. However, he did have risk factors for the disease, including high blood pressure and high cholesterol that were being managed.
Paul was undergoing bypass surgery when the surgeon discovered that his arteries were so hard that only one of the bypass grafts could be attached. A subsequent attempt to open up the arteries using balloons and stents (tiny tubes used to open arteries) was also unsuccessful because the arteries were extremely narrow from calcium and plaque buildup.
With treatment options dwindling, Devang Desai, M.D., interventional cardiologist with Sierra Nevada Cardiology Associates and director of the Chest Pain Center, turned to a special tool in his arsenal—a tool that turned out to be a lifesaver.
Inside coronary artery disease
Paul’s CAD diagnosis made him one of the more than 17.5 million Americans who have the disease. It’s the most common type of heart disease and the leading cause of death in the United States in both men and women.
CAD occurs when the arteries that supply blood to the heart become hardened and narrowed from plaque—a substance containing fat and cholesterol. This narrowing blocks blood flow through the arteries and to the heart, which can lead to chest pain or, in Paul’s case, shortness of breath. It can also result in a heart attack, heart failure and irregular heartbeats called arrhythmias.
Some risk factors for CAD, such as age and race, can’t be changed. But others, like smoking and high blood pressure, can. “The best treatment for coronary artery disease is still prevention,” Dr. Desai says.
The plaque attack
Careful consideration was given to Paul’s treatment. Trying to inflate balloons again in his narrowed arteries could tear the arteries, and placing stents into the arteries in such a fragile condition would put Paul at high risk for later stent failure, Dr. Desai explains. That’s when he turned to the excimer laser ablation system, which was already being used at Renown to treat blockages in leg arteries. Dr. Desai is the only physician outside of Las Vegas in the state of Nevada who’s certified to use the laser for heart patients.
Like in most interventional heart procedures, the laser is threaded up from the groin to the heart using tiny tubing called a catheter. “The laser pulses at a very high frequency, creating a mini-earthquake inside the artery, which causes cracks in the plaque. Quick and very effective, it takes only one to two minutes,” he says. With the plaque weakened, the balloons and stents were tried again and, this time, easily placed. With that, Paul became the first patient to receive coronary laser treatment in northern Nevada and the only one in the state outside of Las Vegas.
“Most heart patients don’t require the laser, but in Paul’s case it made all the difference,” Dr. Desai says. He adds that this technology and a well-trained staff make Renown’s cardiac catheterization lab, where the procedure was performed, the most comprehensive in the area. “Paul Hunt was out of options. This saved his life.”
On the road to recovery
Paul is back at work at his job as a heavy equipment mechanic, and says he now feels younger than his 69 years. He’s completed cardiac rehabilitation and has made lifestyle changes, like following a diet lower in sodium.
His wife, Susie, says she’s grateful to have her husband back in good health and credits Renown for helping them get through this scare. “I’ve been in a lot of hospitals, and the doctors at Renown were great. Everyone made us feel really comfortable,” she says. “We were so lucky that Paul was able to have this procedure done there.”
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