Largely responsible for this result, Samin Sharma, MD, Director of Interventional Cardiology at Mount Sinai, achieved the highest level of success for angioplasty safety in the state among all physicians. Dr. Sharma has served as Director of the Mount Sinai Catheterization Laboratory since 1996. He is widely recognized for his expertise in angioplasty, having performed 1,447 interventions from 1995 to 1997 and more than 1,000 a year since, with an extremely low complication rate (less than two-tenths of one percent). He is also known for taking the most difficult cases referred from other hospitals.

"As a team, we really have developed a system of opening the blockage in the safest way," Dr. Sharma explains. "To achieve optimal success in angioplasty, it is absolutely essential to understand the health of the patient as a whole, rather than focus solely on the procedure. When I'm doing a procedure, I am not just looking at the region of blockage. I am also seeing how the patient is doing, how the blood pressure is, how the chest pain is. I'm looking at everything."

"In addition to procedural techniques, this [whole-patient approach] is what I teach, " says Dr. Sharma, who received the Teacher of the Year Award in 2000. "I also emphasize to my students that trust must be built between the doctor and the patient, ensuring the patient's complete confidence."

Angioplasty, a non-surgical procedure, is used to open arteries clogged by the accumulation of cholesterol and other fatty molecules, known as plaque, inside an artery. Plaque can slow or stop the flow of blood to the heart, and cleaning arteries by means of angiolplasty, to restore normal blood flow, is often the treatment of choice.

Balloon angioplasty (technically called percutaneous transluminal coronary angioplasty, or PTCA) is the most common form of angioplasty. In this procedure, the interventional cardiologist inserts a hollow, narrow tube, called a catheter, into the groin of the patient. Monitoring the path of the catheter with X-ray technology, the cardiologist then painstakingly threads the catheter up to the arterial blockage. A second, thinner catheter is then inserted into the first hollow tube.

Once in position, a miniature balloon at the tip of the inner catheter is inflated, pushing out against the artery-clogging plaque and making the opening slightly wider. Frequently a thin wire mesh tube, called a stent, is inserted by a third catheter. The stent functions as scaffolding, helping to prevent the artery from reclogging.

"Success is due to careful preparation of the patient and the skilled use of various devices, including the rotoblator, " says Dr. Sharma, who is considered by cardiologists to be a master in the skilled use of this difficult instrument. Attached at the tip of another catheter, the rotoblator is a miniature, diamond-tipped power drill that can operate at a speed 60 times that of a car engine. When used during angioplasty, it is inserted through the first catheter before the insertion of the balloon catheter to pulverize plaque when the blockage is especially dense.