Woman talking with a cardiologist at an Ascension site of care.

CTO care in Tulsa and Bartlesville

Heart specialists at Ascension St. John Heart and Vascular Center provide advanced care for chronic total occlusion (CTO).
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Experienced heart specialists at Ascension St. John Heart and Vascular Center deliver advanced care for chronic total occlusion (CTO). As leaders in heart and vascular care, your team of specialists collaborate to deliver a personalized care plan that’s right for you. Our cardiologists are part of a national team of doctors, sharing best practices and advanced treatment options for CTO. 

What is CTO?

CTO is a complex heart condition that occurs when there is a total blockage in one or more coronary arteries. CTO is a common heart disorder – occurring in 20 to 25 percent of patients with coronary artery disease (CAD). This blockage prevents blood containing oxygen and nutrients from flowing to your heart.

CTO is different from a heart attack because the blockage develops over time and symptoms can worsen as the blockage increases. This may cause your heart to grow new blood vessels that will reroute blood around the blockage. These new vessels help supply some of the blood your heart needs and may prevent a heart attack.

Understanding your risk for CTO

Risk factors for CTO include:

  • Known coronary artery disease or history of heart attack
  • Excessive tobacco use
  • High LDL cholesterol or low HDL cholesterol
  • Diabetes
  • Sedentary lifestyle
  • High blood pressure
  • Family history of premature cardiovascular disease
  • End-stage kidney disease
  • Obesity
  • Postmenopausal women

Diagnosing CTO

Common symptoms of blocked arteries can include:

  • Chest pain, pressure or tightness
  • Fatigue
  • Nausea
  • dizziness
  • Rapid or irregular heartbeat
  • Pain in the upper body and arm
  • Shortness of breath, trouble breathing

Diagnosis of CTO is based on your medical history, a physical exam, diagnostic testing and a coronary angiogram procedure often known as a heart catheterization. During the catheterization procedure, dye is injected into the coronary arteries and images are taken. The images can reveal blockages and show how the heart muscle and valves are functioning.

Advanced treatment options for CTO

Your doctor will work with you to find the right treatment for you. Your care team personalizes your care plan and works with you to improve your quality of life. Treatment options may include: 

  • Medication

    Your doctor may prescribe medication that prevents plaque building up, eases the stress on your heart and reduces symptoms. These medications may include: antiplatelets, beta-blockers, angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), and other medications.

  • Percutaneous coronary intervention (PCI)

    Your doctor may recommend PCI, commonly known as coronary angioplasty. In the past, CTO was treated with open heart surgery. Now, it can be treated using PCI, which is less invasive and may lead to a faster recovery.

    During PCI, an interventional cardiologist inserts a very thin wire into an artery in your wrist or groin. Using imaging, your doctor will guide the wire to your heart and the blockage. Your doctor will inflate a small balloon against the blockage and a mesh tube, called a stent, is inserted in the narrowed portion of your artery to re-open it and restore normal blood flow. 

    Most patients go home the same day as the treatment. Many patients report feeling relief from their symptoms right after the procedure is performed. For others, it may take days to weeks.

  • Coronary artery bypass (CABG) surgery 

    In the past, CABG surgery was used to help restore proper blood circulation to the heart by rerouting blood flow around blocked or narrowed arteries. During this procedure, a heart surgeon removes part of a healthy vein or artery from another part of the body and attaches it to your heart above or below the CTO. This allows blood to flow around the blockage. This procedure helps improve the oxygen supply to your heart and can help reduce or eliminate symptoms, such as chest pain and shortness of breath.

Get a second opinion on your heart diagnosis or care plan

Get the confidence and peace of mind that your doctor and care plan are right for you. It's easy to get a second opinion at Ascension St. John Heart and Vascular Center. We can review your medical records and healthcare history to answer your questions and discuss options. Talk with one of our doctors about a personalized care plan.

Whether you are experiencing new symptoms or have a new diagnosis and are considering treatment options, our specialists can provide a second opinion, based on our experience and as part of a national team of heart specialists.

CALL – 918-332-3600 – BARTLESVILLE

CALL – 918-748-7650 – TULSA

What is CTO?

Michael Megaly, MD, explains symptoms and how CTO is treated at Ascension St. John with state-of-the art technology.