Ischemic Heart Disease

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Surgical-Treatment

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Atherosclerosis in its advanced stages requires special invasive procedures like coronary angioplasty known as balloon angioplasty, coronary artery bypass graft operation, atherectomy and laser angioplasty in order to improve blood flow and to ease acute chest pain, to extract a blood cloth or to relieve major blockages in blood vessels or arteries.

One of the most commonly used procedures is coronary angioplasty, or balloon angioplasty. The procedure consists in inserting a fine tube, or catheter with a tiny balloon at its tip, into the narrowed blood vessel. This balloon is inflated and deflated repeatedly in order to open and stretch the narrowed artery, and to improve blood flow, then it is deflated removed along with the catheter. Moreover a wire mesh tube called stent is inserted in order to permanently keep the artery open after the intervention.

Angioplasty is not considered surgery. The procedure takes about 1 up to 2 hours and it is performed while the patient is awake.  Angioplasty is not a long term solution for those who have the procedure, almost a third of them experience vessel blockages within 6 months period post-angioplasty, arteries with a stent may also reclose and they’ll need another angioplasty or a coronary artery bypass surgery.

Coronary artery bypass graft operation or bypass surgery, is other common procedures used in order to restore normal blood flow to the heart, it consist in engrafting a piece of healthy vein, usually taken from the leg, or an piece of healthy chest or wrist artery into the damaged artery bypassing the narrowed area, the attachment of the graft is made above and below the blockage. In severe cases more then one bypass is required.  Bypass surgery is used in the cases where angioplasty failed to sufficiently widen the blood vessel or if the blockage is too long or it cannot be reached by an angioplasty routine procedure. Bypass surgery is indicated to diabetic patients who suffer from coronary heart disease.  In about 10% of the cases a bypass can close but this happens in isolated cases after 10 years or even more.

In atherectomy, a catheter, carrying special equipment is threaded through the artery towards the blockage, where it shaves off thin plaque layers until its complete removal, then angioplasty may follow the procedure.

Other procedure that can be combined with balloon angioplasty is laser angioplasty. This procedure consists in inserting a catheter equipped with a laser tip into the narrowed artery; the laser burns out, vaporizes, or breaks down the plaque.

A heart transplant may be the answer for patients with severe heart damages and a large area of necrosis the myocardium tissue level, nowadays have been developed even implantable artificial heart pumps, but these are advanced treatments accessible only to a small amount of patients.

These procedures are used for relieving the symptoms of ischemic heart disease and coronary heart disease, like acute chest pain and effort intolerance, but they cannot cure this condition; drug therapy and lifestyle changes in patient’s life should follow.

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