Chronic Total Occlusion

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Chronic total occlusion (CTO) is a common heart disorder in many patients with coronary artery disease. About 20% to 25% of patients with coronary artery disease will also have a chronically occluded artery.

If you have CTO, it means you have one or more completely blocked coronary arteries that have been present for at least three months. Although some patients won’t show any symptoms, CTO can lead to:

  • Shortness of breath
  • Chest pain 

CTO often shows up in people with coronary artery disease or those who have previously had a heart attack. The symptoms of CTO can be similar to other heart and artery problems and can include:

  • Chest pain
  • Fatigue 
  • Inability to exercise

A Patient's Symptoms

Jim Rohan didn't know his shortness of breath meant his life was in danger. Jim talks about his symptoms and getting CTO treatment. View coronary artery disease transcript.

Other Risk Factors

  • A family history of coronary artery disease 
  • Tobacco use
  • Diabetes 
  • High cholesterol

Your doctor will pass a cardiac catheter (a small, flexible tube) through your coronary artery to test for blockage. 

CTO Treatment at UVA

Treatment may start with medications, but if your symptoms persist, you may be considered for bypass surgery or a catheter-based procedure.

Catheter-based treatment for CTO requires a specialized form of angioplasty, a process in which your doctor widens your arteries using catheters. UVA is among the few hospitals treating CTO using a minimally invasive catheterization-based method with an 80 to 90 percent success rate. Unlike bypass surgery, this procedure greatly reduces your recovery time and allows you to resume normal activities as soon as a week after the procedure.