Thai Patient Receives Life-Saving Heart Procedure at Beijing Fuwai Hospital
"I thought I’d just see the doctor and go back home, but the doctor said, 'You can't leave; your coronary artery is severely narrowed!'” recalls 58-year-old Mr. Prasap Chaisang from Chiang Mai, Thailand, still shaken by his diagnosis.
Mr. Chaisang had been experiencing chest tightness and shortness of breath, which led him to seek treatment at Beijing Fuwai Hospital. After further examination, he was diagnosed with acute coronary syndrome, and the condition turned out to be more complex than initially expected. Fortunately, Dr. Liu Hongzhi and his team used the advanced dual-lumen microcatheter and reverse guidewire technique to successfully resolve his heart crisis and restore normal heart function.
Mr. Chaisang’s heart problems had been developing for nearly 20 days. He would experience chest tightness and shortness of breath after any physical activity, which would only subside after resting. Initially, he dismissed the symptoms, thinking they were due to fatigue. However, as his symptoms worsened and even affected his ability to walk, he was persuaded by his family to seek treatment at Beijing Fuwai Hospital.
Upon reviewing his case, Dr. Liu Hongzhi, the Deputy Director of the Heart Failure Department, suspected that Mr. Chaisang’s condition was related to coronary artery disease. He immediately ordered further tests.
Coronary angiography confirmed Dr. Liu’s suspicions: Mr. Chaisang was suffering from acute coronary syndrome, with more complex coronary artery issues than initially expected. The right coronary artery showed a 50% blockage, while the left anterior descending artery had a 95% blockage at the bifurcation.
The real challenge, however, came from a large diagonal branch that stemmed from the left anterior descending artery. Not only was the angle of the branch unusually sharp, but the opening also showed 90% stenosis. "This bifurcation lesion is already considered a high-difficulty case, but the added complication of the reverse-angled diagonal branch and severe stenosis at the opening made it incredibly difficult to enter the affected vessel with the guidewire. If the procedure was not performed correctly, it could lead to acute vessel occlusion, perforation, dissection, or even a heart attack," explained Dr. Liu, which was why he immediately decided against letting Mr. Chaisang "just go after the check-up."
To address the complex coronary lesion, Dr. Liu’s team carefully planned the procedure. They decided to use the "dual-lumen microcatheter-assisted reverse guidewire technique." During the surgery, they first inserted a guidewire into the distal segment of the left anterior descending artery. After balloon dilation to address the severe stenosis of the main artery, they used the microcatheter for guidance and support to carefully maneuver the pre-shaped goose-neck guidewire into the bifurcation of the left anterior descending artery.
When it came to the challenging diagonal branch, the team performed delicate maneuvers, including withdrawing, reversing, rotating, and advancing the guidewire with precision. Successfully, they advanced the guidewire to the distal lesion of the diagonal branch. They then used a cutting balloon to pre-treat the stenosed segment and perform angioplasty. An intravascular ultrasound confirmed that the opening of the diagonal branch was sufficiently wide, with no significant dissection. The team then proceeded with "main stem stenting and branch drug-coated balloon dilation," deploying a stent in the left anterior descending artery and performing balloon angioplasty on the diagonal branch to restore normal blood flow.
The surgery went smoothly, and the results were immediate. Post-surgery follow-up showed that Mr. Chaisang’s coronary blood flow was restored, significantly reducing his risk of a heart attack and improving his heart function. His quality of life improved drastically. "I’m so grateful to Dr. Liu and the team! I was in such bad shape when I came here, I could barely get up, and now I feel no symptoms at all. I feel so much lighter!" Mr. Chaisang said, filled with emotion.
The successful application of the dual-lumen microcatheter and reverse guidewire technique not only saved Mr. Chaisang’s life but also demonstrated Beijing Fuwai Hospital’s technical expertise in treating complex coronary artery lesions. Dr. Liu Hongzhi reminded patients that chest pain, tightness, and shortness of breath after physical activity could be signs of coronary artery disease, especially in middle-aged and older adults or those with underlying conditions such as high blood pressure, high cholesterol, or diabetes. If any of these symptoms appear, seeking medical attention immediately is crucial to avoid serious consequences.