At 87, he’s the oldest from Kolkata to have angioplasty

KOLKATA: An 87-year-old man underwent a successful angioplasty at a city hospital last week, making him probably the oldest Kolkata resident to go through the procedure that involved a fair amount of risk because of his age and vulnerable cardiac condition.
Bhowanipore resident Chiranjilal Tiwari has also probably become the second-oldest person to undergo the process in the city. That record still belonged to a 94-year-old patient from the Northeast, who underwent an angioplasty in the city 15 years ago, experts said.

Tiwari had a complete blockage in one of his cardiac arteries and was admitted to the BM Birla Heart Research Centre eight hours after a heart attack. The time lapse had considerably damaged the heart muscles, affecting chances of survival, but doctors chose to go ahead with the procedure as using blood-thinning medicines as an alternative might have been riskier.
The retired businessman is now back home and stable.
It was not easy, though, according to cardiac surgeon Tarun Praharaj, who conducted the procedure. “I was in two minds about doing the procedure on him since he is in his late eighties, which raises the chances of complications considerably. He was extremely frail, apart from being hypertensive, and still in pain. He was also brought to hospital eight hours after the heart attack, which raised chances of mortality to 15%, and his cardiac muscles had been damaged. But we chose to go ahead with the procedure since using blood-thinning medicines might have led to bleeding and death,” Praharaj said, adding: “Around 40% of those suffering a heart attack die if they receive treatment after more than an hour.”
Angioplasty involves threading a thin tube into a heart blood vessel and insertion of a tiny mesh scaffold (called a stent) to keep the vessel open and restore blood flow. This can often reduce chest pain or angina. Using medication involves high risk of bleeding in cases of acute heart attack, say doctors.
But stent angiography of coronary arteries in patients above 80 may result in more acute cardiac and non-cardiac complications like renal failure, bleeding and in-hospital mortality. Some doctors, however, say angioplasty on an octogenarian is not more risky than on one in his/her sixties. “If other factors remain equal — if the patient does not have any other serious complication that may worsen during the procedure — age hardly makes a difference. The extent of risk would be the same for any patient,” cardiac surgeon Kunal Sarkar felt.
Tiwari’s family had mistaken his chest pain to have been triggered by gastritis, which led to the delay in hospitalisation. “We explained to his family that, even though risky, a primary angioplasty was the best option to get his blocked artery opened and improve the blood flow. Fortunately, they were ready to go for it,” Praharaj said.
Tiwari’s son, Ashok Kumar, told TOI that the 87-year-old had recovered. “He is now moving around freely within the house and has no complaint,” he said.