Our approach to chronic total occlusion care
Chronic total occlusion (CTO) is a condition in which at least one major artery supplying blood to the heart is completely blocked for three months or longer. CTO can cause chest pain, shortness of breath, fatigue and other symptoms. In some cases, CTO can lead to a heart attack.
That's why our CTO experts go the extra mile to give your heart the best possible care. We'll perform a comprehensive review of your medical history and previous test results and run additional tests to determine possible treatment options for you.
Signs and symptoms of CTO
When your heart doesn't get the blood it needs, you'll feel it, with or without physical effort. Symptoms of CTO can include:
- chest pain, pressure or tightness
- shortness of breath
- dizziness or fainting
- fatigue
- nausea
- pain in the upper body and arm
- rapid or irregular heartbeat
When to seek care for chronic total occlusion
If you're consistently feeling the symptoms above, it's important to see a doctor right away. These are signals that you could have a serious condition — and time is of the essence.
Our steps to a diagnosis
Diagnosing CTO involves several steps to carefully rule out other heart conditions and find the source of the problem. Our thorough evaluation includes:
- medical history: We'll ask you about your symptoms, risk factors and personal and family medical history.
- physical exam: We'll perform a physical exam to check your vital signs, listen to your heart and lungs and check for any problems.
- electrocardiogram (EKG): An EKG records the electrical activity of your heart. It can show if you have a heart rhythm disorder or other heart problems.
- echocardiogram: Also called a heart ultrasound, an echocardiogram uses sound waves to create images of your heart. It can show how well your heart is pumping and any structural problems.
- cardiac catheterization: In this diagnostic procedure, our heart specialists insert a thin tube into an artery in your arm or leg and thread it to your heart. This test allows us to see the inside of your arteries and check for blockages.
Our treatment options
WellSpan’s heart specialists offer many treatment options for CTO, including medication, minimally invasive procedures and surgery. The best treatment option for you will depend on your individual circumstances. Our highly skilled team will work closely with you and tailor your treatment plan to your unique symptoms and risks.
Common treatment options for CTO include:
- CTO percutaneous coronary intervention (CTO PCI): Our experienced cardiac interventionalists, who have advanced training in treating CTO, perform this minimally invasive procedure. During CTO PCI, they place a small mesh tube (stent) within the blocked artery to widen it and restore blood flow. CTO PCI has a high success rate, with a survival rate of nearly 90 percent.
- Coronary artery bypass grafting (CABG): If you're not a good candidate for CTO PCI, open-heart surgery may be a treatment option for you. The CABG procedure involves sewing (grafting) a healthy blood vessel from another part of your body into your heart. The grafted vessel creates a new route for blood to flow around the blockage.
- Medication therapy: Our heart specialists may prescribe medications to manage symptoms and reduce the risk of complications. These may include anti-anginal medications, beta-blockers, calcium channel blockers and nitrates.
- Lifestyle changes. Adopting heart-healthy lifestyle habits can help improve your overall cardiovascular health and reduce the risk of further blockages. Some healthy habits include regular exercise, a balanced diet, weight management, smoking cessation and stress reduction.
It's important to discuss the risks and benefits of each treatment option with your doctor, so together you can make an informed decision about your care.
Benefits of treating CTO
Treating CTO is important to ensure that we improve lifestyle-limiting symptoms, such as angina (chest pain). Ultimately, our goal is to give you lasting results, reducing your risk of coronary artery disease (CAD) complications in the future.
Tests and treatments
- physical exam
- EKG
- echo
- catheterization
- angioplasty
- CTO PCI
- CABG