INSUBCONTINENT EXCLUSIVE:
MUMBAI: Heart attack at 23 years of age seems so improbable that Rakesh (name changed), who works with a cost accounting firm in Goregaon,
didn't consider it as a cause for the tightness he felt in his chest on waking up on July 4.It was while walking out of Nesco Goregaon Metro
stop a few hours later that the Kandivli youngster suffered an "unbearable pain" and slumped to the floor.In a city where roughly 30 people
die every day due to heart attack, Rakesh's heart attack has, however, had a happy ending: He is among the 100-odd patients in the city to
have got access to laser to "vaporise" the blockage in his artery
"The blood vessel that was completely blocked seems as good as new," said cardiologist Dr Ganesh Kumar who performed the laser angioplasty
on Rakesh at L H Hiranandani Hospital, Powai.Rakesh not only smokes, which is a risk factor for heart attack, but he has a strong family
history as well; his father got a fatal attack when he was 38 in 2008.The main medical benefit of the laser angioplasty for Rakesh is that
he didn't need a stent as most patients with heart problems or heart attack would do
"We avoided a stent as he is young
Moreover, the plaque that led to the clot in his case was most possibly very new and small, unlike in older patients,'' said Dr Kumar, who
has used it on 10 patients since the hospital bought the laser machine less than two months ago.Laser angioplasty made a quiet entry into
Mumbai in February 2021 in the midst of the Covid pandemic
Breach Candy Hospital bought the machine and has already used it on over 100 patients
Cardiologist Dr Kirti Punamiya, who has just submitted a medical research paper on the outcome of laser angioplasty on 90 lesions in 75
patients, calls laser a facilitator."It burns the clot and makes angioplasty easier for the patient
A stent can be easily placed in the affected portion of the artery after a part of the plaque or clot is ablated,'' said Dr Punamiya
While cardiologists have other methods of removing deposits from arteries, he said the laser way seems the easiest for the patient.However,
Dr Punamiya said lasers are not a substitute for balloons or stents (tiny, drug-coated metal scaffolding) that are the standard way of
"Laser helps doctors when they have to perform a complex angioplasty or a patient has developed restenosis (narrowing of the artery
previously treated with a stent)," he said.Dr Praveen Chandra from Medanta Hospital Gurugram, said the laser also helps patients needing a
long portion to be stented or having a narrow blood vessel
"Laser is at present only meant for a subgroup of patients with complicated blockages and not for every patient,'' said Dr Chandra, who said
he had led the first trial in laser angioplasty in India over five years.Laser treatment for the heart is available at 19 hospitals across
the country, but only half a dozen centres in Mumbai, Delhi and Chennai use it actively, said the doctors.While it has been around for a
couple of decades, there have been phases of high interest
At present, there is renewed interest in it in India because of the increase in the incidence of heart attack among people under 40 years of
In Rakesh's case, Dr Kumar said the clot was too thick for the guidewires to penetrate
"We then told Rakesh's family and office administrators that we could try the laser to break the clot, but it is an expensive procedure
The office agreed and we used four bursts of the laser to vaporise the clot," he said
Rakesh is now on blood thinners and medications to keep his heart disease in check.The laser component can add Rs 1.5 to 2.5 lakh to the
"But with a growing number of youngsters below 30 years getting heart attacks, the laser offers an alternative,'' said Dr Kumar
For older patients, however, laser alone is unlikely to suffice.Rakesh, who was taken to the Powai hospital because its outreach centre is
next to the metro station where he collapsed, now has a new mission: to not smoke again.
