Oman Health: Soluble stents may offer alternative to bypass surgery, says expert

Muscat: Soluble stents may offer an alternative to bypass surgery, a medical expert said on Tuesday. A 65-year-old Omani, who was admitted to a Mumbai hospital after his heart and leg arteries were blocked more than 95 per cent, underwent a procedure for getting a soluble stent in January 2016. Expert opinion is that soluble stent is beneficial for heart patients as it dissolves in the body within one year, unlike the conventional metal stent. “Besides that, the patient will not have to undergo surgery and can walk out from the hospital within 48 hours,” said Dr S A Merchant, who has over 25 years of experience in the field of cardiology. Merchant, who was on a private visit to the Sultanate, said he started researching non-surgical techniques used in French and American laboratories in the late 1990s. After researching for more than a decade, he started experimenting on animals. “For 25 years, I have been working on research on how to treat heart disease without doing an open heart surgery,” he said. The stent melts after a year, Merchant said, adding that the success rate for soluble stents has been 99 per cent. “Till now I have used it on more than 500 people from all over the globe and everybody is fine including the one from Oman,” he said. Merchant uses an IVUS system— a catheter with a camera—to check inside a patient’s heart before inserting the stents. “What I realised then is that heart disease is a very big problem in Oman because of the sedentary lifestyle and lack of exercise,” he told the Times of Oman, adding that he has plans to set up a hospital here. “But nothing is concrete now,” he added. In Oman, people develop cardiac blockages for a variety of reasons: heart attacks, high cholesterol, high blood pressure or diabetes. “Heart failure is a scary word...sounds like the heart has failed to work and can result in death. Actually heart failure means the heart is pumping and the ejection fraction is less than 40 per cent, which means the heart is ejecting 40 per cent of blood to the body, compared with the normal 60 per cent. If one has symptoms of shortness of breath, tiredness, ankle swelling, dry cough or breathlessness, especially while lying down one has to do an echo EF and BNP test to rule out heart failure,” he stated. Spelling out the causes for heart failure, Merchant pointed to hypertension, diabetes, obesity, smoking, a dilated heart and rheumatic heart disease. “Early diagnosis and treatment with lifestyle changes, medicine and salt and water restriction, risk factor control will solve 90 per cent of the cases of heart failure,” he added. If left untreated, heart failure increases eight times the risk of sudden death and the mortality rate by 30 per cent in one year. “Usually, blockages below 70 per cent are treated with medication and lifestyle changes; while more severe cases can be treated mechanically, by non-surgical techniques, such as angioplasty, or by insertion of metal stents, which remain in the body. The only issue with metal stents is that they stay in your body all your life, but for soluble stents there are no incisions and no need for general anaesthesia or blood transfusions. Only a 48-hour stay in the hospital is required,” he added. Merchant has participated and presented papers at various international conferences, and also conducts live angioplasty workshops and lectures in Interventional Cardiology around the world. He has also been awarded a prestigious fellowship by the American Society of Cardiac Angiography and Intervention.