What is complex coronary intervention?

The name 'complex coronary intervention' sounds pretty intimidating, but this surgery for blocked coronary arteries has advanced from traditional, high-risk open-heart surgery with a long recovery, to an effective operation where patients can go home on the same day and get back to normal life within a week. 

Here to offer an expert look at what's involved in complex coronary intervention is leading consultant cardiologist in London, Dr Ahmed Elghamaz.   

What is complex coronary intervention? 

Complex coronary intervention is essentially, a term recently used by interventional cardiologists to describe the new technology that opens up blocked arteries for patients, and achieve long-term results in ways that were not possible before. 

Simply, because of the lack of technology and the lack of technical ability and training of operators to achieve that. It's a combination of highly-skilled trained operators and using very new technology to open up arteries in ways that hasn't been possible before. 

When is this type of procedure necessary?

It's necessary because in previous years the type of disease and blocked arteries which were impossible to open percutaneously, or by microsurgery. These patients were often referred to open heart surgery. 

Now, patients are getting older and more frail, and many of these patients who have complex coronary disease aren't suitable to have open heart surgery but the new technology has enabled us now to be able achieve good long term successful results in complex coronary disease in patients who were previously not seen as suitable for open heart surgery. 

It's absolutely necessary because it provides excellent results and very good quality of life for patients, in ways which were not possible before.  

How are complex coronary interventions performed?

Complex coronary intervention is performed in the same way as any simple coronary intervention. It's all through a keyhole puncture in the wrist, often. Sometimes we use two punctures, or one depending on the type of procedure we're going to do. 

Then, the techniques used often involve using technology of calcium modification, or wires to open up coronary arteries, and so on, as well as new microcatheters and new techniques. 

However, for the patient the procedure isn't any different from doing any kind of coronary intervention except that it sometimes often takes slightly longer. The procedure itself from a patient perspective is done in the same way as any kind of coronary intervention.  

How long does it take to recover from this type of procedure?

Most patients will recovery from complex coronary intervention in the same day; most of the patients can go home four to six hours after the procedure. So, if we finish early the patient can go home on the same day. 

In certain cases, where it's finished late in the day or it was a long procedure, the patient can stay overnight and go home the next day to resume normal life almost immediately after that. 

How has this type of surgery evolved in recent years?

The world of coronary intervention has evolved incredibly fast in recent years. This is mainly because of the availability of: 

• new wires; 
• microcatheters; 
• calcium modification techniques; 

that weren't available in previous years. 

Also, operators, training and technical skills have improved dramatically in recent years. The technology has allowed operators to improve their training and techniques in ways which have evolved very quickly in recent years. It's a combination of new technology and better-skilled operators. 

If you'd like to arrange an appointment with Dr Elghamaz, you can do so via his Top Doctors profile.