Modern methods of surgical treatment of heart disease

Surgery is a section of medicine that studies various diseases and pathological processes occurring in the human body that can be treated by surgical intervention. Any surgical treatment in itself includes a number of consecutive steps: preparation of the patient, the use of an analgesic, the operation itself.

If earlier the surgery was more aimed at radically eliminating the cause of the disease, today surgeons are increasingly considering options for the reconstruction of one or another part of the body.<

Surgical treatment is very extensive and is associated with various areas of medicine. For the treatment of cardiovascular diseases in surgery there is a separate section - cardiosurgery. Modern achievements in this area allow the most effective treatment of ischemic heart disease, as well as to take preventive measures for the development of myocardial infarction.

Video Heart Disease Treatment. Modern methods of diagnosing and treating heart disease

The main types of modern cardiosurgery

The real revolution in cardiac surgery began after the intensive research and implementation of endovideo-surgery was started. Such progressive technologies have made it possible to move from large cuts to the thorax to almost imperceptible after using less invasive treatments.

The most famous modern ways of surgical treatment of heart disease:

• Coronary angioplasty is one of the leading methods by which it has been possible to save and improve the quality of life of many patients with ischemic heart disease.
• Balloon angioplasty is another way of treating ischemic coronary vessels, which can restore blood circulation in the affected area of the heart.
• Coronography - this method is both diagnostic and therapeutic, so depending on the course of the IBS can be used for one or another purpose.
• Aortocoronary bypass is a relatively old method, nevertheless continues to be actively used, since it allows you to create a bypass message for blood circulation, which is often necessary for serious atherosclerotic lesions of the heart vessels.

Other equally well-known methods of surgical treatment of heart disease are radiofrequency ablation, operations on the heart valves, and minor invasive operations on the heart. Depending on the indications, one or another type of surgical intervention is performed, after which the patient, as a rule, manages to lead a more full and rich life.

Coronography

It is a gold standard in diagnosing ischemic heart disease. Jointly used with many methods of surgical treatment of cardiovascular diseases. Most often it is performed before the aortocoronary bypass, balloon and coronary angioplasty.

Video coronary angiography

Stages of coronary angiography:

• A non-essential analgesic agent is introduced.
• A small incision is performed on the femoral artery.
• A catheter is installed in the vessel, of small size.
• The catheter moves towards the coronary vessels and heart.
• When the catheter reaches the desired location through it, the contrast medium is displayed in the vessels, which is clearly visible on the special equipment.
• Normally, all vessels should be crossed for contrast, with constriction of the arteries there are winding or sharply "torn" vessels.

By the results of coronary angiography, the doctor can determine the number and location of narrowed vessels, as well as the approximate volume of blood passing through them. In some cases, the procedure is conducted to determine the results of a previously performed CABG.

Coronary angioplasty

Refers to modern innovative operations. The essence of its conduct is to restore the lumen of the coronary vessel, which was stenosed or occluded, due to which the normal blood circulation was disturbed.

In the course of coronary angioplasty, stenting or ballooning of the pathological site of the vessel is performed .

With the help of coronary angioplasty, combined with coronary stenting, the following diseases are treated:

• ischemic heart disease;
• angina pectoris
• peripheral vascular disease;
• Renovascular disease
• myocardial infarction.

In some cases, coronary angioplasty does not bring the expected results, then an aortic coronary bypass (CABG) is performed. But angioplasty has key benefits to the CABG. In particular, there is no need for an endotracheal anesthesia, after the operation of rehabilitation passes faster, if necessary, the same procedure can be repeated. In addition, angioplasty is considered to be a minimally invasive surgical procedure, so if necessary, it can be used to treat elderly patients.

Balloon angioplasty

This method of treating patients with stenosis of arteries of different localization is very similar to coronary angioplasty. The only one used during the operation is a special cylinder inserted into the vessel in a blown state. At the beginning of an operation, anesthesia is performed at the injection site, after which a guide is directed to the vessel, which allows you to evaluate the condition of the vessels and identify the sites of narrowing of the arteries. This procedure is called angiography.

The determination of the stenotic area and the decision to conduct balloon angioplasty allow the use of another conductor, at the end of which there is a blown bottle. When the lesion is reached, the air is pushed through the conductor and the balloon is inflated, automatically expanding the narrowed area. Then the balloon is blown off and removed from the vessel.

After balloon angioplasty, stenting should be performed, since the dilated vessel is often narrowed, which leads to attacks of the coronary heart disease.

It is important to note that coronary and balloon angioplasty are conducted without any painful sensations. Enough local anesthesia is performed, so that the entire course of the operation is ensured by normal anesthesia. This is due to the fact that the advancement of the conductor on vessels is practically not felt.

When is balloon angioplasty contraindicated? The operation is not performed with chronic renal failure, infectious diseases, pulmonary edema, heart failure in the stage of decompensation, serious disorders of the hematopoiesis.

Successful operation on restoring blood flow in coronary vessels allows to significantly improve the quality of life of the patient. The period of effectiveness of such treatment is about five years, most importantly, that in the first year there was no restenosis, that is, re-stenting of the vessel.

Aortic coronary bypass

Restorative operation aimed at normalizing the blood supply system, disturbed due to stenosis of one or several vessels. Unlike angioplasty, ACS uses a method of generating bypass shunts, which are vascular prostheses. The installation of shunts allows to restore normal circulation of blood through coronary vessels, thereby eliminating the prerequisites for the formation of coronary heart disease, angina pectoris and myocardial infarction.

As a vascular prosthesis, subcutaneous veins of the leg or artery of the chest wall, most often left, appear. In the latter variant, the effectiveness of using the shunt is higher, since the arteries do not fall as fast as it does with the veins.

The technique of performing an ACS is different today, but there are some peculiarities of the operation that should be known by the patient who is preparing for the bypass:

• At the beginning, the question of connecting an artificial blood supply system (ISC) or performing an operation on a living heart is being solved.
• Advantages of the operation without ISK: blood cells are not damaged, the operation lasts less, after the operation of rehabilitation passes more successfully, and there are also no complications that appear after the ISK.
• The duration of the operation depends on the chosen method of taking the implant, as well as the method of conducting an ACS - with or without an ISK. In most cases, the present surgical treatment takes 3-4 hours.

Video Coronary artery bypass surgery. Heart surgery

In recent times, the execution of coronary artery bypass graft has become increasingly successful. Issues with the most optimal vascular prostheses continue to be solved, and the time spent on surgery is getting smaller.

Operations on the valves of the heart

There are many different techniques associated with operations on heart valves that are performed to eliminate their deficiency or stenosis. Among the main ones are the following surgical interventions:

1. Ball valvuloplasty - Used for valve stenosis of moderate or severe degree of development. Refers to non-surgical methods of treatment, during the operation, a balloon is inserted into the valve opening, which is then opened and retrieved.
2. Anuloplasty - refers to the surgical methods of plastic that are used to treat valve insufficiency. In the course of operation, calcium deposits are removed if necessary, and the structure of the tendon chords can be restored. The results of the operation are most often positive, but much depends on the complexity of the affected area.
3. Suture plastic - refers to reconstructive surgical interventions that can be based on crosslinking of split valves, shortening of chords placed near the valves. Reconstructive plastic is increasingly used today, and unlike implantation of prosthetic valves, the heart valves are considered more gentle and successful. But their carrying out is possible only in the absence of gross deformations of the valves.

<How to prepare for surgery on the valves of the heart? First of all, consultation with the attending physician is carried out. If necessary, a conversation with various narrow-minded specialists (surgeon, anesthesiologist, cardiologist) is conducted. If necessary, prior to surgery, a consultation with relatives is carried out. It is important that before the operation 8 hours before the start of the food is no longer usable.

Minimally invasive heart surgery

At present, they relate to advanced methods of surgical treatment of heart disease. Conducted with the use of endoscopic technologies, which allow for performing less traumatic and highly effective procedures.

Endoscopic technologies are based on the use of an endoscope - special tubes that are flexible enough, elastic and thin to pass through small punctures into the skin. All endoscopes are equipped with lighting systems, which help to see all the intricacies of surgical intervention.

Minimally invasive surgery is most commonly used to treat coronary heart disease in adults and congenital heart disease in children.

After a minor invasive surgical intervention, the rehabilitation period is faster and easier. Postoperative pains are expressed insignificantly, infarction of the lungs and other infectious complications also occur much less often. But this method may not always be used, so more information is provided by the attending physician or cardi surgeon during the consultation.

Video Minor invasive heart surgery in Israel. Questions and Answers