FV Hospital has recently implemented the latest-generation ROTAPRO technology, featuring a diamond-tipped drill capable of spinning at an impressive 160,000 revolutions per minute. This state-of-the-art tool enables doctors to break down calcified plaques in coronary arteries, restoring blood flow and placing stents without the need for open-heart surgery.
Emergency Treatment for Severe Shortness of Breath Caused by Critically Calcified Coronary Arteries
One morning in November 2024, while shopping at the market, Mrs D.N.C received an urgent call from her husband, Mr L.P.E., a 69-year-old Canadian. He described feeling dizzy, short of breath, and experiencing chest pain. Alarmed by his symptoms, Mrs C. rushed home to find her husband in a critical state, with a dangerously low heart rate of only about 40 bpm. Acting swiftly, she arranged for an ambulance to transport him from their home in Vung Tau directly to FV Hospital for emergency care.
After comprehensive testing, FV doctors identified severe narrowing in three of Mr E.’s coronary branches, caused by heavily calcified atherosclerotic plaques. These blockages were obstructing blood flow, leading to his shortness of breath.
Mr L.P.E., a long-term resident of Vietnam with his wife, had sought treatment for his breathing difficulties at multiple hospitals. Each facility recommended open-heart surgery for coronary bypass. However, Mr E. was reluctant, concerned that his health might not withstand such an invasive procedure. He delayed treatment, even traveling back to Canada for further medical advice, where doctors similarly advised a surgical approach. Faced with long wait times for consultations, the couple decided to return to Vietnam to explore other options.
Ho Minh Tuan, MD, PhD, Head of Cardiology and Interventional Cardiology at FV Hospital, highlighted the challenges of treating Mr L.P.E’s case due to his advanced age and pre-existing conditions including diabetes, hypertension, and high cholesterol. These factors significantly increased the risks associated with open-heart surgery, such as elevated mortality and stroke rates. “The patient was fortunate to have been brought to the hospital promptly,” Dr Tuan explained. “Any further delay could have led to myocardial infarction or heart failure,”
Breaking Atherosclerotic Plaques with a Diamond Drill and Successfully Placing Three Stents Without Open-Heart Surgery
Based on the examination results, Ho Minh Tuan, MD, PhD, determined that the most effective treatment for Mr. E. was coronary balloon angioplasty followed by stent placement. However, the presence of severe calcified atherosclerotic plaques made it impossible for the doctors to advance the balloon or stent through the blocked areas.
“In this case, it was crucial to pinpoint the areas of severe narrowing and calcification using the Optical Coherence Tomography (OCT) system. Following this, the ROTAPRO system was used to mill away the calcified plaques. With a rotational speed of 160,000 RPM, the calcifications were ground down into particles measuring just a few micrometres, comparable in size to a speck of dust. These tiny particles are then naturally carried away by the bloodstream, eliminating the need for removal,” explained Dr Tuan.
Dr Tuan further emphasised that because Mr E. had severe arterial narrowing and calcified plaques at multiple sites, the use of the ROTAPRO system was indispensable. Conventional balloon angioplasty and stenting would have carried a high risk of failure and re-narrowing.
Illustration showing the operation of the ROTAPRO machine with a diamond drill bit breaking down calcified plaque causing artery blockage
Ho Minh Tuan, MD, PhD, and his team perform a coronary intervention procedure using ROTAPRO and OCT in FV Hospital’s Cathlab
After the calcified plaque was sufficiently shaved down using the ROTAPRO machine to allow the stent to pass through, Dr Tuan proceeded with balloon angioplasty and placed coronary stents, guided by a digital subtraction angiography (DSA) machine. This widened the artery, restored blood flow, and alleviated the shortness of breath caused by the obstruction and myocardial ischemia. The patient successfully had three stents placed while fully awake, and with good vital signs. Two days later, Mr E. was discharged in good health.
“After unsuccessful treatments at several places, I researched FV Hospital and found that the doctors here are very skilled, and the equipment is state-of-the-art. After experiencing it myself, I can say that not only are the medical staff highly skilled, but they are also very professional, speak good English, and take great care of the patient, from imaging, testing, result interpretation, treatment, all the way until discharge. Both my husband and I are completely satisfied with all the services and feel fortunate to have chosen FV,” Mrs C. shared.
Ho Minh Tuan, MD, PhD, visits patient L.P.E. before his day of discharge
Before his discharge, Mr E. expressed his happiness and relief at receiving successful treatment at FV without needing a high-risk major surgery with numerous risks. He praised the service and quality of care he received as exceptional. “FV is as good as the best hospitals in Canada, my home country,” Mr E. affirmed.
The ROTAPRO technology plays a crucial role in the treatment of severely calcified coronary artery disease
“The cause of arterial calcification is primarily due to advanced age, underlying conditions such as diabetes, and other vascular diseases, which lead to a higher accumulation of calcium deposits compared to the general population. Statistics show that among patients requiring coronary stent placement, 3–5% need the ROTAPRO system because conventional balloon angioplasty is not viable,” explained Dr Tuan.
The ROTAPRO system consists of a machine and a compressed gas cylinder containing NO at extremely high pressure, allowing the physician to precisely control the desired force. During the calcified plaque removal process, the diamond-coated burr, integrated with AI technology, quickly detects abnormalities and alerts the operator immediately, minimizing the risk of complications. Notably, the diamond-coated burr is single-use and is not reused for other patients.
The ROTAPRO machine introduced at FV Hospital is the latest-generation from the U.S., featuring integrated AI technology. Its compact design and easy manoeuvrability make it highly efficient for use within the Cathlab.
The Next-Generation ROTAPRO Plaque Removal System
Using the ROTAPRO system to break down calcium deposits in arteries is regarded as a highly advanced technique in coronary intervention. It demands extensive expertise, requiring the interventional cardiologist to have years of experience in coronary stent placement to achieve optimal results while minimizing complications.
For more information about coronary intervention procedures using the ROTAPRO system or to schedule an appointment for cardiovascular treatment, please contact FV Hospital’s Cardiology and Interventional Cardiology Department: (028) 54 11 33 33.
