INSIDE HARRIS HEALTH
System’s Innovative Treatment for Advanced Heart Disease
February is officially heart health month, but the prevalence of heart disease makes heart health awareness an everyday concern. Heart disease is the leading cause of death in America, with a person dying from heart disease in the U.S. every 34 seconds. Preventing heart disease is top of mind for cardiologists everywhere. Diet and exercise, quitting smoking, limiting alcohol – all these steps can be taken to reduce your risk. But those with high cholesterol and comorbidities like kidney disease or hypertension may have a blockage in their arteries and often require intervention. That’s where doctors like Waleed Kayani, MD, FACC, interventional cardiologist and director, Cardiac Catheterization Laboratories, Harris Health Ben Taub Hospital, step in.
Kayani leads Harris Health System’s intravascular lithotripsy procedures, a revolutionary new treatment for patients with complex and calcified blockages of heart arteries. Lithotripsy uses sound waves to break down resistant calcium deposits in arteries, making way for a stent to be inserted and fully expanded to keep blood flowing well inside the heart arteries. This minimally invasive procedure is safe and highly effective, making it the go-to choice when a patient with calcified arteries needs stenting.
“When blocked arteries harden with calcium deposits, it makes it difficult for a stent to expand,” explains Kayani, also an assistant professor and program director of Interventional Cardiology Training Program, Baylor College of Medicine. “A poor stent result can cause stent failure and even a heart attack. By fracturing calcium build up and improving stent expansion, intravascular lithotripsy prolongs the life of the stent and lowers stent failure. Based on available data in patients with heavily calcified blockages of heart arteries lithotripsy has outperformed regular stenting, providing better stent expansion and has significantly lowered the need for repeat intervention. We are proud to offer it to Harris Health patients and becoming one of the very few public healthcare systems nationwide offering this procedure to its patients.”
Imagine a garden hose hardened from being left out in the sun. High water pressure can cause the hose to leak or even rupture. Calcified arteries operate similarly if someone tries to expand a stent at high pressure without fracturing calcium deposits. A stent can prolong the life of a hardened artery, but only if it can be safely and effectively inserted. Lithotripsy, a procedure in use in Europe in 2017, has repeatedly been shown to do this. Harris Health, despite being a public
healthcare system, has been on the cutting edge of the procedure since it was approved by the Food and Drug Administration (FDA) in 2021.
So, what does a lithotripsy procedure look like? If you have the good fortune of having the procedure at Ben Taub Hospital, you have the advantage of coordinated patient care, a hugely successful patientfocused program headed by Ana Davis, MSN, FNP-C, CCRN, CVRN-BC, NEA-BC, director of nursing, Cardiology, Ben Taub Hospital.
“Coordinated patient care means a patient will have a nurse making sure their care is coordinated and all their questions answered. It’s the peace of mind of knowing someone is advocating for them,” explains Davis, who’s worked for Harris Health for 27 years. “When a patient comes to the catheterization lab, it’s often their first time in the hospital. Having a nurse by your side makes a huge difference.”
Started in 2008, this program has helped thousands of patients in cardiology get the best care possible. Adding the intravascular lithotripsy procedure is the latest expansion of cutting-edge care that Harris Health offers, making Ben Taub Hospital a one-stop for all things heart-related.
Inside an Intravascular Lithotripsy Procedure
Before each procedure, a nurse walks the patient through what to expect, what the procedure will be like, and answers any questions the patient might have. Throughout the procedure, the nurse is there, monitoring the patient, ensuring their comfort and attending to any additional needs.
The lithotripsy procedure itself is exactly like inserting a traditional stent, minimally invasive and incredibly safe, all with no general anesthesia. A catheter is inserted at the wrist followed by a tiny lithotripsy balloon until it reaches the calcified portion of the heart artery. The balloon is connected by a thin cable to a pulse generator, which delivers the sound waves that break down the calcification in the artery. Once accomplished, the stent is then inserted through the catheter and put in place inside the artery.
After the procedure, the patient is moved next door to the critical care unit (CCU), where staff assess them to ensure no complications occur. So far, there have been zero complications and none of the stents placed using intravascular lithotripsy have required re-stenting.
“The experience is no different from a traditional stent,” Kayani says. “In fact, the procedure time is often shorter because of the vessel saturation beforehand.”
Kayani describes a recent patient who had a stent placed with intravascular lithotripsy. She’d visited the hospital multiple times complaining of chest pain, but her arteries were too hardened and tortuous to safely accept a stent. Now, after having the lithotripsy procedure, her stent is in place, and for the past two years has been living pain-free.
“Intravascular lithotripsy is very safe,” Kayani affirms. “We’ve seen over and over again, the procedure is safer and more successful than traditional stenting, and hopefully, we’ll see better long-term outcomes.”
Improving health outcomes is the mission of all healthcare systems. At Harris Health, both technology and people make a difference in improving those outcomes. Intravascular lithotripsy makes it so that a patient’s stent is more effectively placed, often leading to a longer, healthier life. The coordinated care program is designed so each patient is treated as the unique individual they are.
While coordinated care and new technology can’t solve heart disease alone, these interventions are important tools. Kayani encourages all Harris Health patients and the general public to do their best to prevent heart disease with diet and exercise. But if you do need help, don’t ignore symptoms of heart disease—chest pain or tightness, shortness of breath, pain, numbness or weakness in the legs— and visit cardiology professionals like the experts at Ben Taub Hospital.
“Intravascular lithotripsy is very safe ... the procedure is safer and more successful than traditional stenting.”
- Dr. Waleed Kayani