When the Second-Best Becomes the Best Choice": High-Risk PCI Saves NSTEMI Patient

A Successful Intervention by Dr. Gyana Ranjan Nayak at SUM Hospital, Bhubaneswar
 
BHUBANESWAR, India - Aug. 25, 2025 - PRLog -- A 75-year-old male with NSTEMI and ongoing chest pain has been steered to recovery thanks to a carefully executed high-risk Percutaneous Coronary Intervention (PCI), led by Dr. Gyana Ranjan Nayak, Interventional Cardiologist at SUM Hospital, Bhubaneswar.

The patient presented with ECG showing triple-vessel disease (TVD pattern) and significantly elevated Troponin T (>10).

Coronary angiography revealed:
  • Diffuse disease in the Right Coronary Artery (RCA) with up to 99% stenosis,
  • Critical narrowing of the Distal Left Main Coronary Artery (LMCA),
  • Tight lesions at the ostio-proximal LAD and LCX,
  • Left Ventricular Ejection Fraction (LVEF) at 35%, indicating compromised cardiac function.

While Coronary Artery Bypass Grafting (CABG) remains the gold standard and is a Class I recommendation for this anatomy, Dr. Nayak noted that in this case, CABG carried a prohibitive surgical risk due to age and reduced EF, making it unfeasible despite being the ideal guideline-based option.

After discussing risks and alternatives, the decision was made to proceed with bifurcation PCI using the mini-crush technique. This strategy allowed revascularization of both LAD and LCX with excellent angiographic results (TIMI 3 flow) and no complications.

"Nothing rivals a LIMA-LAD bypass, but when surgery isn't an option, expertly performed PCI can become the best—and sometimes life-saving—choice," said Dr. Gyana Ranjan Nayak.

About Dr. Gyana Ranjan Nayak
  • Consultant Interventional Cardiologist at SUM Hospital, Bhubaneswar.
  • Gold Medalist in MBBS (SCB Medical College, Cuttack) and MD (KGMU, Lucknow); completed DM in Cardiology and Post-Doctoral Fellowship in Interventional Cardiology and Structural Interventions.
  • Expert in Preventive Cardiology, Heart Failure, Coronary & Structural Interventions, Pediatric Interventions, and advanced diagnostics including TEE and stress echocardiography.
  • Served as faculty at national and international cardiology symposia, with multiple peer-reviewed publications in coronary intervention and valvular research.
  • Known as one of the best cardiologists in Bhubaneswar, practicing a patient-centric, empathetic approach to high-quality cardiac care.
  • Contact and appointment details available via website and WhatsApp: +91 6371307504.

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