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Clinical trial procedure at Piedmont Heart offers alternative to open heart surgery

Posted on 2/20/2013
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Atlanta, Ga. (February 20, 2013) – Famed art director Tony Seiniger, best known for his movie poster designs for JAWS, One Flew Over the Cuckoo’s Nest and The Last Emperor, recently became one of several Piedmont Heart Institute patients to participate in a national clinical trial designed to treat chronic total occlusions (CTO), or a complete or near-to-complete blockage in the heart artery present for longer than three months.

Seiniger first discovered he had heart disease when his family doctor suggested he get a cardiac calcium scoring test a few months ago due to his age and family history of the disease. Seiniger’s brother had a history of heart disease and his father had congestive heart failure, which eventually led him to require quadruple bypass surgery.

The results of the calcium scoring test showed Seiniger had extensive coronary calcification, indicating the presence of heart disease. Seiniger then had a CT scan done that showed 100 percent blockage in all three coronary arteries.

“My doctor looked at me and said, ‘If you don’t take care of this, you’re going to die,’” said Seiniger. “When you’re young, you think you’re invincible and can get away with anything, but as you get older, you become more susceptible to things and your body can’t handle the same things it once could.”

Seiniger had two of his coronary arteries fixed with an angioplasty procedure. The third artery, where the CTO was located, would be fixed two months later as part of the EXPERT CTO trial, which investigates the combined use of a stent, a guide wire and a catheter to unblock clogged arteries in patients who have CTO.

“We often discover a CTO in heart disease patients during an angiography, the initial X-ray to detect blockages in blood vessels,” said Anna Kalynych, M.D., the Piedmont Heart cardiologist who performed Seiniger’s CTO procedure as part of the trial. “Typically, these patients are recommended to have bypass surgery - a more invasive approach than angioplasty and stenting - which requires a patient to be opened up as opposed to having the procedure done via catheter.”

And a less invasive procedure leads to quicker recovery times, said Dr. Kalynych, who is one of five doctors at Piedmont Heart who perform procedures with CTOs. Using a guide wire to pass into the narrowed area of the heart artery, doctors performing a procedure with a CTO then follow the wire with a catheter which has a deflated balloon mounted on its tip. Guided by X-ray, doctors inflate the balloon to open the artery. Once the balloon is deflated and taken out, it is replaced with a permanent stent.

“Essentially, with this trial procedure, we’ve introduced expanded treatment options for patients who are often limited in terms of therapeutic alternatives,” said David Kandzari, M.D., interventional cardiologist at Piedmont Heart and the national principal investigator and designer for the EXPERT CTO trial. “Formerly, the presence of a CTO is the most common reason for recommendation of bypass surgery, or in many instances, patients continue with symptoms despite medications. This procedure offers a less invasive, effective and durable alternative.”

Currently, Piedmont Heart is one of the two leading enrolling centers in the nation for this study, according to Dimitrios Karmpaliotis, M.D., principal investigator for the EXPERT CTO trial at Piedmont Heart. For more information about heart disease and the clinical research at Piedmont Heart, visit piedmontheart.org