Heart

Chronic Total Occlusion

Our team of heart experts treats chronic total occlusion with advanced therapies designed to clear completely blocked arteries.

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Unmatched Expertise in Artery Care

Our nationally recognized heart experts take a team-based approach to your care. We use a full range of medical and surgical therapies to treat chronic total occlusion (CTO). Our Complete Coronary Revascularization in Complex Higher-Risk and Indicated Patients Program (CHIP)—a multidisciplinary team of cardiovascular experts—evaluates your treatment options. You can count on us for a customized care plan that meets your unique needs.

An Expert Evaluation to Determine Treatment

Skilled, experienced evaluations can open the door to personalized treatment for CTO. Our CHIP team is on the leading edge of this care. If you’ve been told treatment isn’t possible, we’ll work with you to identify potential care options. Consult our CHIP team if you:

Have been told no treatment exists for your blocked heart arteries
Have been told you don’t qualify for coronary artery bypass grafting (CABG)
Need a second opinion
Want to avoid open heart surgery

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Overview

Chronic total occlusion (CTO) is a condition in which a coronary artery has been blocked for at least three months. They develop slowly when you have coronary atherosclerosis. Over time, fatty deposits (plaque) build up in your arteries, limiting blood flow to your heart. As a result, your heart may grow new blood vessels to go around the blockage.

CTOs are common. They can impact nearly 20 percent of people who have significant coronary artery disease. Common risk factors include:

Advancing age
Diabetes
Family history
High blood pressure
High cholesterol
History of heart attack or bypass surgery
Lack of exercise
Overweight or obesity
Poor diet
Tobacco use

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Screening

CTO causes symptoms that develop over weeks or months. So, they may be difficult to notice. The most common CTO symptoms include:

Chest pressure or tightness
Fatigue or lack of energy
Shortness of breath

If you experience any of these symptoms, our care team offers comprehensive testing and a wide range of treatment options.

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Diagnosing Chronic Total Occlusion

If your doctor suspects you have CTO, they will perform a complete physical exam, discuss your personal medical history and order an imaging test called coronary angiography.

During this test, we thread a small tube (catheter) through a blood vessel in your wrist or groin up to your heart. Then, we inject a special dye that shows up on X-rays to spot any blockages.

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Chronic Total Occlusion Treatment

We offer some of the most advanced medical and surgical treatments available. We will base our treatment recommendation on your symptoms, overall health and the number, size and location of your blocked blood vessels. Your treatment plan may include one or more of the following:

Medication

As the most common CTO treatment, medications restore blood flow and relieve your symptoms.

Coronary Artery Bypass Graft (CABG) Surgery

During this open-heart procedure, our surgeon removes part of a healthy vein or artery and attaches it to your heart above and below the CTO. As a result, blood flow to your heart improves.

Percutaneous Coronary Intervention (PCI)

This minimally invasive, nonsurgical procedure is also called coronary angioplasty. It uses a balloon, catheter and stent to break up plaque and open your blockage.

It’s important to protect your heart health after treatment. A cardiac rehabilitation program can help you adopt healthy lifestyle changes. These can include: