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Chronic Total Occlusions (CTOs)

Chronic total occlusion (CTO) is a complete or nearly complete blockage of one or more coronary arteries. The blockage, typically present for at least three months, is caused by a buildup of plaque within a coronary artery. When this happens, blood flow to the heart is compromised.

What can I do to support my health when I have chronic total occlusions (CTOs)?

CTO is a common heart disorder in patients with coronary artery disease (CAD). Between 20 and 25 percent of patients with CAD also have a chronically blocked artery.

Symptoms of CTO typically occur during times of activity but may also occur at rest. Symptoms may include:

  • Fatigue.
  • Nausea.
  • Dizziness.
  • Shortness of breath.
  • Rapid or irregular heartbeat.
  • Pain in the upper body or arm.
  • Chest discomfort (pain, pressure, or tightness).

What can I do to support my health when I have chronic total occlusions (CTOs)?

Risk factors for chronic total occlusion include:

  • Obesity.
  • Smoking.
  • Diabetes.
  • High cholesterol.
  • Hypertension (high blood pressure).
  • History of heart attack or known coronary artery disease.

What can I do to support my health when I have chronic total occlusions (CTOs)?

Diagnosis of chronic total occlusion is based on a patient’s medical history, a physical exam, and a coronary angiogram procedure. During this procedure, contrast material is injected into the coronary arteries, and pictures are taken. These images reveal whether there are blockages in the coronary arteries and how well the heart is functioning.

A doctor may also order the following tests to fully understand a patient’s condition:

  • Cardiac MRI.

  • Echocardiogram.

  • Exercise stress test.

  • Electrocardiogram (EKG).

  • Nuclear medicine PET scan.

What can I do to support my health when I have chronic total occlusions (CTOs)?

There are two surgical procedures used for CTOs:

  • CABG: In the past, treatment options for patients suffering from CTO symptoms were limited to medication or coronary artery bypass graft (CABG). CABG is an open-heart surgery where a vein or artery is taken from another part of the body and used to create a new path for blood to flow.

  • Stenting: A less invasive method for treating CTO includes stenting, where cardiologists place a small mesh tube in narrow or blocked arteries to widen and support the walls of the arteries and restore normal blood flow. Two catheters are placed in arteries (leg or wrist) to allow the ability to go forwards or backward as needed. The procedure lasts 3-4 hours and most patients are discharged the next day.

What can I do to support my health when I have chronic total occlusions (CTOs)?

Take your medications as prescribed. See your doctor regularly so they can monitor how you are doing.

Lifestyle changes you can make to improve your heart health include:

  • Reduce salt in your diet.
  • Maintain a healthy body weight.
  • Never smoke, or stop smoking.
  • Drink only moderate amounts of alcohol, if any. This means an average of one to two drinks per day for men and one drink per day for women.
  • Eat a healthy, well-balanced diet, rich in fresh fruit and vegetables but low in saturated fats, processed sugar, and salt.
  • If you have diabetes, work closely with your doctor to make sure it is controlled.
  • Get at least 150 minutes of moderate to intense physical exercise every week.

Why choose Presbyterian for chronic total occlusions (CTOs) treatment?

Presbyterian Heart and Vascular Care has a skilled vascular care team who can provide a wide range of services from diagnosis to treatment. Their surgeons are trained in many different techniques and procedures, many of which can provide you with a shorter recovery period and less hospital time.