Chronic total occlusion

Heart specialists at Ascension St. John Heart and Vascular Center provide advanced care for chronic total occlusion (CTO).

Chronic total occlusion in Oklahoma

Heart specialists at Ascension St. John Heart and Vascular Center provide advanced care for chronic total occlusion (CTO).

Why choose us

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.

Understand chronic total occlusion (CTO)

Cardiologists at Ascension St. John are part of a national team of doctors, sharing best practices and advanced treatment options for chronic total occlusion (CTO). This heart condition occurs when there is a total blockage in one or more coronary arteries, and prevents blood containing oxygen and nutrients from flowing to your heart. CTO is a common heart disorder that occurs in 20 to 25 percent of patients with coronary artery disease (CAD). The condition is different from a heart attack because the blockage develops over a three month period of time and symptoms can worsen as the blockage increases.

Symptoms of CTO

Common symptoms of CTO include:

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

CTO risk factors

Common risk factors for CTO include:

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

How we diagnose CTO

Diagnosis of CTO is based on your medical history, a physical exam and diagnostic tests and procedures, such as:

This test is done during a cardiac catheterization. For this test, your doctor guides a small catheter (hollow tube) through the large artery in your upper leg, or sometimes your wrist or arm, into your heart. Dye is given through the catheter, and moving X-ray pictures are taken as the dye travels through your heart arteries and heart chambers. This comprehensive test shows narrowing in the arteries, heart chamber size, how well your heart pumps, and how well the valves open and close. It also measures the pressures within the heart chambers, arteries, and veins.

Echocardiography (Echo) detailed text

Our cardiology team uses advanced diagnostic tools and expertise to accurately identify a wide range of cardiac issues, ensuring you receive the right care as early as possible.

Your heart specialist uses cardiac MRI to provide detailed images of your heart's structure and function without using radiation. A cardiac MRI uses powerful magnets and radio waves to create 3D images of your heart. It shows how your heart muscle, valves and blood vessels are working in real time. This test is often used when other imaging tests like echocardiograms or CT scans don't provide enough information.

How we treat CTO

Treatment for CTO may include:

A minimally invasive procedure that opens blocked coronary arteries to restore blood flow to the heart. A catheter is used to thread through a blood vessel to the blockage to navigate the occlusion. A balloon is then inflated to displace the plaque, and a stent is placed to keep the artery open.

Your cardiologist might suggest CABG to treat blocked or narrowed coronary arteries.

CABG is a surgical technique used to restore healthy blood flow to the heart, improve heart function and reduce symptoms. Our experienced cardiac surgeons perform both on-pump CABG and off-pump CABG, but the procedure is chosen based on the severity of the blockage in the coronary arteries.

On-pump CABG treatment is performed using a heart-lung machine to take over heart function during surgery temporarily. Cardiac surgeons will stop the heart and use the machine to circulate and oxygenate blood while performing complex bypass surgery.

Off-pump CABG, also known as "beating heart surgery," is performed without stopping the heart. This method keeps the heart beating while holding specific parts of the heart still, allowing your surgeon to complete a bypass.

Your cardiologist may recommend medications to help manage your heart condition. Mediation may be used to lower blood pressure, prevent blood clots, lower cholesterol and more.

This procedure encompasses several types of procedures that are designed to improve blood flow through the coronary arteries, including:

Balloon angioplasty: This is also called PTCA (percutaneous transluminal coronary angioplasty). A small balloon is inflated inside a narrowed or blocked artery to re-establish blood flow. This is often done together with a tiny mesh coil (stent) placement.
Coronary artery stent: A tiny wire mesh coil is expanded inside the narrowed or blocked artery to open the blocked area. It's left in place to keep the artery open.
Atherectomy: The narrowed or blocked area inside the artery is shaved away by a tiny device on the end of a catheter.
Laser angioplasty: A laser is used to help open a blocked artery.

How to get care

emergency

To make an appointment, a referral should be made by your primary care doctor or another specialist. Once the referral is received and reviewed, you will be contacted to schedule an appointment with a cardiologist.

If you are experiencing a life-threatening emergency, go directly to the ER or call 911.