World-class procedure at the Cardiology and Heart Surgery Clinic

The first two orbital atherectomies in severe calcified coronary artery stenosis have been performed at the Department of Cardiology and Cardiac Surgery of the Clinical Center of the University of Debrecen. Using the procedure, the hard calcareous deposit formed in the coronary artery can be effectively removed, the narrowing can be successfully dilated and stented. In Hungary, the method is considered a novelty at this point.

In addition to rotablation and ultrasound balloon, orbital atherectomy is also available in Hungary for the treatment of rough, hard, calcareous plaques. The procedure, which has been used for a couple of years worldwide, was recently used for the first time in our country, among others at the Cardiology and Cardiac Surgery Clinic of the Clinical Center of the University of Debrecen. The device can be used to remove a larger amount of hard, calcareous plaque from the narrowed coronary artery.

- One of the most difficult coronary artery stenoses to treat is calcified stenosis, where the calcified, very hard plaque is already visible on the X-ray. If we do not remove the hard calcified plaque, we cannot expand the vein, since neither the balloon nor the stent will open. Using this device, we can remove the plaque very efficiently, almost completely, and then we can carry out a successful dilation, Assistant professor Tibor Szűk, specialist in the Department of Cardiology and Cardiac Surgery at UD, Clinical Center explained.

So far, the procedure has been used in two patients at the Cardiology and Heart Surgery Clinic. In both cases, a perfect result was achieved, most of the calcification was removed, the patients did not develop any complications, and the artery was widened by implanting stents. The interventions were performed by Tibor Szűk and Ferenc Győry, the clinic's specialists.
The device consists of an electrically driven operating unit and a drilling tool moving on an orbital path, on which is located the grinding head covered with diamond grains, the so-called crown. The crown is delivered via a wire to the section of the vessel containing the narrowing via a wire. With rapid orbital movement, the crown gradually grinds away the calcareous build-up of the vessel wall.

- The plaque breaks up into small particles that are washed out of the vessel with the blood stream. 5-8 percent of coronary artery narrowings develop such severe calcified plaque that only this device can effectively remove it. There is no other way to achieve such a significant reduction in plaque mass in the case of narrowing of large-diameter coronary arteries - associate professor Judit Barta , specialist of the Department of Cardiology and Cardiac Surgery of the DE Clinical Center, head of the Cardiac  Catheter Laboratory, told .

In addition to teamwork, so-called proctoring, i.e., when a specialist trained in the procedure helps the work, is of particular importance in this intervention. During the operations performed at the Clinic of Cardiology and Cardiac Surgery, Zaid Ammari, an expert from the United States, monitored and advised the operating team online.

Press center - CzA