With a little help from an Interventional Cardiologist, of course.
As an interventional cardiologist, Dr. Pranab Das knows the best way to a patient's heart is often through an artery with a 40-inch catheter.
It's less invasive than a surgeon's scalpel, and the recovery time is considerably shorter.
One particularly promising procedure called TAVR or transcatheter aortic valve replacement has been a game-changer for some patients for whom open-heart surgery may be too risky because of advanced age, fragility, or medical conditions.
"The TAVR is one of the most satisfying and gratifying things I have been doing," said Das, who is with the multi-specialty Saint Francis Medical Partners. "The aorta pumps blood to the rest of the body and when an aortic valve doesn't open and close correctly the body does not get enough oxygenated blood and you begin having problems. When an older patient has open-heart surgery, they may die or end up with more complications and prolonged hospital stays."
Das, who has practiced in Memphis for 14 years, is medical director of the Cardiac Cath Lab at Saint Francis Hospital-Memphis where he also is chairman of the Department of Cardiology.
The minimally invasive TAVR procedure involves inserting a new valve inside the faulty valve with a catheter that is threaded to the site through the femoral artery. This helps restore blood flow and reduces symptoms of aortic valve stenosis, symptoms such as shortness of breath, fainting, fatigue, and chest pain.
"I did one today on an 89-year-old lady and she said her only goal in life was to cross the road again to visit her neighbor of six years," said Das, adding that his patient's deteriorating heart condition had ended those visits. "Since she's had her new heart valve, she's feeling so good she's going to her neighbor's every day. She said she feels like a new person. In less than 24 hours she went home.
"This is one of the most gratifying and most advanced procedures I have seen in the field of interventional cardiology."
February is American Heart Month, established by a 1963 joint resolution of Congress as a time for Americans to focus on their cardiovascular health. Heart disease is the number one cause of death in the United States, with more than 650,000 lives lost each year. Coronary artery disease is the most common, killing 360,900 people in 2019, according to the Centers for Disease Control and Prevention.
"The causes include age, smoking, diabetes, hypertension, high cholesterol and sometimes genetics," said Das, who performs 15 to 20 heart procedures each week. "These are some of the risk factors, as well as lack of mobility and poor lifestyles.
"People are becoming less mobile, more sedentary and less healthy today. That's leading to heart disease in a lot of younger people. I am used to doing heart procedures in older patients in their 60s, 70s and 80s, but I'm now opening the arteries of a patient just 24 years old. That's not good, because they have many more years to live and they're already dealing with heart disease. Instead of walking, we do everything in cars. We are not getting as much physical activity and that's adding a burden to the heart."
The heart is a fist-sized organ that each day beats more than 100,000 times and pumps some 2,000 gallons of blood through the body. Das says taking care of one's heart is not optional, and he doesn't mind stating what should be obvious to make his point.
"If you have no functioning brain, you can still be alive," he said. "If one kidney is dead, or both kidneys are dead, you can stay alive with dialysis. You can live with just part of a liver, but you cannot live without a heart. If you have no heart, you are dead.
"I feel like the heart is the single most important thing that God has given us, and we have to preserve and protect and take care of it. It doesn't just keep running, and God didn't give us a lifetime warranty. If I am running late, I say that as long as a heart is ticking, I have to work, too."
His work often involves cardiac catheterization procedures in which he inserts a catheter through a large blood vessel - usually the femoral artery near the groin or the radial artery in the wrist - and into the heart to check for diseases in the heart muscle, heart valves or the coronary arteries.
"For the diagnostic part, you just take pictures to find the blockages, but then to do intervention, the trick is you have to put the catheter wire across the blockage and you have to have the skill to negotiate the different bends," Das explained. "If you cannot get your wire through the blockage, you cannot put in a stent.
"The skill is getting the wire to a particular area and sometimes people have a lot of calcium in the artery where the wire does not cross the blockage very easily. So, you have to use all of your skills and a lot of help from different devices, and then you can deploy your stent."
Not only has he perfected his procedural techniques from countless procedures, but Das also has learned to recognize when it's time to pull back.
"If something doesn't work then you try a different approach, but sometimes you have to learn when to stop," he said. "You cannot keep on going, going, going. You have to see this is your ego telling you 'If I can't do it, then that's it. Oh my gosh. What will people think?' Then you are doing more harm to the patient. There is always tomorrow, you know? The most important skill is to control yourself and to know your limits. That does not come without experience."
Das, a native of Bangladesh, began medical school at age 18 in India and came to the United States 28 years ago to continue his advanced medical training.
"It was not until after my residency in internal medicine that I learned how quickly I could help a patient when I got into intervention cardiology," he said. "I have seen a patient come in with a massive heart attack and chest pain, you go in the cath lab and open the artery and in one minute he will say 'Doctor, I do not know what you have done, but I am feeling so much better. Thank you. Thank you.' That kind of immediate satisfaction you cannot get in any other specialty."
Dr. Das and his wife, Dr. Monisha Dutta, a neurologist, have two sons, ages 19 and 11. He hopes one of them will pursue a career in medicine, but he wants that to be their decision.
"I now consider Memphis my home and I appreciate the support I have received from the community and the medical professionals in the area," he said. "I want to give my patients the care and treatment they deserve. This is my mission in life, and it makes me happy and thankful."