At 85, Alix, a petite and high-spirited woman, was losing her independence and zest for life. Fortunately, a minimally invasive procedure by Associate Professor Tom Ford provided Alix with a renewed opportunity for a healthy life.
Alix had been suffering from episodes of unstable angina, a condition characterised by chest pain due to insufficient blood flow and oxygen to the heart. The angina was not just an inconvenience; it was a source of distress with bouts of chest pain radiating to her jaw when attempting physical activity. These symptoms were particularly alarming given her history of heart attack 12 years earlier and left her in fear of when the next episode might strike.
Alix knew she needed expert care, so she turned to A/Prof Tom Ford who had successfully treated her husband. “I was delighted to look after her husband Lin, who had a bypass years ago and a more recent heart scare requiring emergency intervention,” said A/Prof Ford.
A/Prof Ford swiftly assessed Alix at Central Heart’s clinic in North Gosford and ordered an urgent outpatient coronary angiogram – an accurate diagnostic test that uses X-rays to look at the heart’s blood vessels. This revealed a calcified complete blockage of the right coronary artery within an old stent. The stent, placed 12 years ago following her heart attack, had failed to fully expand, likely due to calcification.
Stents can be lifesaving devices designed to open narrowed or blocked arteries, but they carry risks of re-narrowing or blocking. Up to two per cent of stents fail each year due to factors like scar tissue, plaque buildup, or calcification. Inadequate plaque/calcium modification before stent deployment is a key factor, along with patient factors such as diabetes, smoking, and kidney disease.
Images from coronary angiography (left) and intravascular ultrasound (IVUS) imaging (right) confirm calcified nodule with an under-expanded stent.
Images from coronary angiography showing restored flow (left) and IVUS imaging (right) confirming safe stent expansion within the stented vessel following shockwave balloon dilation.
Advanced intracoronary imaging technology
To address these challenges, A/Prof Ford has helped establish the widespread use of advanced intracoronary imaging technologies like intravascular ultrasound (IVUS) in both Gosford Public and Private hospitals over the last five years. An IVUS provides detailed images from inside the blood vessels, ensuring optimal stent placement and expansion. This technology has been shown to reduce the risk of stent failure by 50 per cent.
Given Alix’s complex case, A/Prof Ford chose to use the latest technology available – the Boston Scientific Avvigo+ system, the first IVUS imaging system equipped with artificial intelligence software. Additionally, he advocated for her health fund to cover the cost of a specialised Shockwave C2+ Coronary Intravascular Lithotripsy Catheter. This device delivers shockwaves to fracture hardened calcium deposits within the arteries, effectively treating her severely calcified blockage and allowing for better stent expansion.
An Australian-first procedure, here in Gosford
Recognising A/Prof Ford’s expertise and high volume of complex stent procedures, Boston Scientific provided him with the opportunity to introduce this advanced technology in Australia for the first time.
“I’m grateful for this opportunity, which truly reflects the dedication of our entire team to delivering the best possible care for our patients, particularly in managing complex cases locally,” said A/Prof Ford.
The procedure, performed at Gosford Private Hospital with the assistance of Dr Prajith Jeyaprakash, a cardiologist specialising in coronary intervention, was a significant milestone for the Central Coast region. It was the first use of the Boston Scientific Avvigo+ system technology anywhere in Australia.
A remarkable recovery
The procedure was performed from her wrist and took around 90 minutes and Alix’s recovery was remarkably fast. She spent the night in the hospital and returned home the next morning. Today, Alix remains independent, feels positive, and cherishes her time at home with her husband. Reflecting on her journey, she shares, “I’m feeling well, confident, and better than I have felt in years. Thank you to all the team.”
Alix’s journey with A/Prof Ford and his dedicated team shows the positive impact of modern technology using minimally invasive techniques to improve quality of life and patient outcomes.
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