What Is Heart Stent Surgery

What Is A Cardiac Catheterization

Coronary artery disease is the narrowing or blockage of the coronary arteries, as shown in the illustration below. After an interventional procedure, the coronary artery is opened, increasing blood flow to the heart.

Cardiac catheterization is an invasive imaging procedure that allows your doctor to evaluate your heart function. Cardiac catheterization is used to:

• Evaluate or confirm the presence of coronary artery disease, valve disease or disease of the aorta
• Evaluate heart muscle function
• Determine the need for further treatment

During a cardiac catheterization, a long, narrow tube called a catheter is inserted through a plastic introducer sheath . The catheter is guided through the blood vessel to the coronary arteries with the aid of a special x-ray machine. Learn more about cardiac catheterization.

With IVUS, a miniature sound-probe is positioned on the tip of a coronary catheter. The catheter is threaded through the coronary arteries and, using high-frequency sound waves, produces detailed images of the inside walls of the arteries. IVUS produces an accurate picture of the location and extent of plaque.

With FFR, a special wire is threaded through the artery and a vasodilator medication is given. This test is functionally performing a very high quality stress test for a short segment of the artery. What is an interventional procedure?

What Are The Complications And Risks Associated With A Stent Surgery

Any surgery brings risks. Placing a stent might require accessing arteries of the heart or brain. This causes an increased risk of adverse impacts.

The dangers connected with stenting consist of:

• an allergic reaction to medications or dyes used in the procedure
• breathing problems due to anesthesia or using a stent in the bronchi
• bleeding

Your Cardiac Catheterization At The University Of Michigan

If you have reduced blood flow to the heart due to a narrowed coronary artery, you may be a good candidate for angioplasty and stenting, minimally invasive procedures that can restore blood flow and let you get back to your daily life. At Michigan Medicine, our Advanced Interventional Cardiology Program offers comprehensive and individualized care, using the latest technologies currently available for angioplasty and stenting, performed by our skilled team of interventional cardiologists.

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When Do You Need A Stress Test After A Stent Procedure

You may need a stress test if:

• Your symptoms come back or get worse.
• Youre finding it harder to exercise or climb stairs.
• Your doctor wants to check blockages that werent severe enough to treat when your stent was inserted. Your doctor can do this with a single test. You dont usually need yearly tests.
• You have had multiple heart procedures in the past, such as stents after a bypass surgery.

This report is for you to use when talking with your healthcare provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.

6/2015

Stenting Pros And Cons

Stenting is generally preferred over CABG in emergency situations. If you have a type of heart attack known as acute ST-Segment elevation myocardial infarction , angioplasty can be a life-saving intervention because it’s a quick way to open the blocked artery.

Another advantage of angioplasty and stenting is that stents come in different sizes, shapes, and materials, which can give your healthcare provider options when it comes to your treatment.

Because the procedure is minimally invasive, the recovery process after angioplasty is not typically as taxing as it is after a CABG.

It is considered a high-risk procedure, however. Rarely, an unexpected complication may occur, such as severe bleeding, and the procedure might need to be rapidly converted to open surgery.

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What Are Heart Stents

Stents are thin wire metal meshes of stainless steel that offer structural rigidity to keep the arteries open when they are surgically placed in the right position. They prop open the arteries to facilitate blood flow. These stents are used in angioplasty and bypass surgeries of the heart, as part of interventional cardiology. Heart stent surgery is a technological wonder that has helped prolong the life of countless heart disease victims.

What Is A Heart Stent Operation

Heart surgery using stents is an indispensable and lifesaving surgical procedure mostly used when the patient has severe heart blockage, risk of a heart attack or arterial blockage. This article is an eye-opener on heart stent surgery. It discusses in detail, the risks from heart stents and their side effects. Read on to know in detail about heart stent surgery.

Heart surgery using stents is an indispensable and lifesaving surgical procedure mostly used when the patient has severe heart blockage, risk of a heart attack or arterial blockage. This article is an eye-opener on heart stent surgery. It discusses in detail, the risks from heart stents and their side effects. Read on to know in detail about heart stent surgery.

Heart blockage is local blocking or narrowing in the arterial network of the body by accumulated deposits of plaque, which is mostly bad cholesterol. Every artery in the body is a blood pipeline. These pipelines get blocked with accumulation of bad cholesterol, assimilated through food. At such times, a heart surgery using stents is carried out by doctors to open up the clogged pipelines and make blood flow possible again.

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Diagnostic Tests And Procedures

To diagnose narrowed arteries or an aortic aneurysm, your doctor may have you undergo some of the following tests and procedures:

• Chest magnetic resonance imaging to look for aneurysms in the aorta. This test works well for detecting aneurysms and pinpointing their size and exact location.
• Computer tomography angiography and magnetic resonance angiography to take pictures of your blood vessels. These tests may give your doctor more information about the flow of blood and whether arteries are narrowed or have aneurysms.
• Coronary angiography to see how blood flows through your coronary arteries. This type of test involves injecting dye into your blood so that your blood vessels can be seen by X-ray.
• Fractional flow reserve can help determine how narrow the artery is. This is an added test done during CTA or coronary angiography to check the blood pressure in a specific artery.
• Ultrasound to see whether plaque has narrowed or blocked your carotid or peripheral arteries or to see if you have an aneurysm and where it may be located. This painless test uses high-energy sound waves to create pictures of the insides of your blood vessels.
• Echocardiography to evaluate the structure and function of your heart. Echocardiography uses sound waves to create moving pictures of your heart.
• Nuclear imaging to see whether the blood is flowing normally to the heart. Your doctor will inject a tracer substance that will show whether the heart is receiving enough blood flow.

Meeting With Your Doctor

If your angioplasty isnt done as emergency treatment, youll meet with your doctor before the procedure. Your doctor will go over your medical history , do a physical exam and talk about the procedure with you. Your doctor also will order some routine tests, including:

• Blood tests
• A chest x-ray

When the procedure is scheduled, you will be advised:

• When to begin fasting before the procedure. Often you have to stop eating or drinking by midnight the night before the procedure.
• What medicines you should and shouldnt take on the day of the angioplasty.
• When to arrive at the hospital and where to go.

Even though angioplasty takes one to two hours, you will likely need to stay in the hospital overnight. In some cases, you will need to stay in the hospital longer. Your doctor may advise you not to drive for a certain amount of time after the procedure, so you may have to arrange for a ride home.

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What To Expect After Your Pci/angioplasty Procedure

Once your procedure is complete, your doctor will remove the catheters and wires and place a bandage on your puncture site.

During your recovery after angioplasty, you may lie flat for several hours to make sure your blood vessel heals all the way. In most cases, youll stay in the hospital overnight.

Once you are able to go home, your doctor will give you information about:

• When you can return to your normal activities
• How to check your puncture site for signs of infection
• What medications you may need to take
• When to call your doctor or 9-1-1 if you have certain symptoms

What Are The Risks Of Angioplasty

Possible risks linked to angioplasty, stenting, atherectomy, and related procedures include:

• Bleeding at the site where the catheter is put into the body

• Blood clot or damage to the blood vessel from the catheter

• Blood clot within the treated blood vessel

• Infection at the catheter insertion site

• Abnormal heart rhythms

• Rupture of the coronary artery or complete closing of the coronary artery, needing open-heart surgery

• Allergic reaction to the contrast dye used

• Kidney damage from the contrast dye

You may want to ask your healthcare team about the amount of radiation used during the procedure and the risks related to your particular situation. It’s a good idea to keep a record of your radiation exposure, such as previous scans and other types of X-rays, so that you can tell your healthcare team. Risks linked to radiation exposure may be related to the total number of X-rays or treatments over a long period.

For some people, having to lie still on the procedure table for the length of the procedure may cause some discomfort or pain.

There may be other risks depending on your specific health condition. Discuss any concerns with your healthcare team before the procedure.

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How Safe Is A Coronary Angioplasty

A coronary angioplasty is 1 of the most common types of treatment for the heart.

Coronary angioplasties are most commonly performed in people aged 65 or older, as they’re more likely to have heart disease.

As the procedure doesn’t involve making major incisions in the body, it’s usually carried out safely in most people. Doctors refer to this as a minimally invasive form of treatment.

The risk of serious complications from a coronary angioplasty is generally small, but this depends on factors such as:

• your age
• whether you’ve had a heart attack

Serious problems that can occur as a result of the procedure include:

• excessive bleeding

Read more about the possible complications of a coronary angioplasty.

What To Expect When Getting A Stent

Having a stent placed is a minimally invasive procedure, meaning it is not a major surgery. Stents for coronary arteries and carotid arteries are placed in similar ways. A stent graft is placed to treat an aneurysm in a procedure called aortic aneurysm repair. Airway stents are placed in a procedure that helps open airways in the lung. For most stents, you will be given medicine to make you sleep during the procedure. The stent procedure may be planned ahead of time or it may be performed in an emergency situation.

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When A Coronary Angioplasty Is Used

Like all organs in the body, the heart needs a constant supply of blood. This is supplied by the coronary arteries.

In older people, these arteries can become narrowed and hardened , which can cause coronary heart disease.

If the flow of blood to the heart becomes restricted, it can lead to chest pain known as angina, which is usually triggered by physical activity or stress.

While angina can often be treated with medication, a coronary angioplasty may be required to restore the blood supply to the heart in severe cases where medication is ineffective.

Coronary angioplasties are also often used as an emergency treatment after a heart attack.

What Is An Interventional Procedure

An interventional procedure is a non-surgical treatment used to open narrowed coronary arteries to improve blood flow to the heart. An interventional procedure can be performed during a diagnostic cardiac catheterization when a blockage is identified, or it may be scheduled after a catheterization has confirmed the presence of coronary artery disease.

An interventional procedure starts out the same way as a cardiac catheterization. Once the catheter is in place, one of these interventional procedures is performed to open the artery: balloon angioplasty, stent placement, rotablation or cutting balloon.

Balloon angioplasty: A procedure in which a small balloon at the tip of the catheter is inserted near the blocked or narrowed area of the coronary artery. The technical name for balloon angioplasty is percutaneous transluminal coronary angioplasty or percutaneous coronary intervention . When the balloon is inflated, the fatty plaque or blockage is compressed against the artery walls and the diameter of the blood vessel is widened to increase blood flow to the heart. This procedure is sometimes complicated by vessel recoil and restenosis.

Angioplasty with stenting is most commonly recommended for patients who have a blockage in one or two coronary arteries. If there are blockages in more than two coronary arteries, coronary artery bypass graft surgery may be recommended.

If you have concerns about drug-eluting stents, please talk with your physician.

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Difference Between Open Heart Surgery And Angioplasty

Key Difference: Open heart surgery deals with the structures inside the heart. In an open-heart surgery, a large incision in the chest is made to open the rib cage. A heart-lung machine is required in an open heart surgery. An angioplasty is a procedure in which coronary arteries are unblocked. An angioplasty procedure does not require an open heart surgery.

Open heart surgery is traditionally associated with the types of surgery that involves cracking the walls of the chest. However, the other types of open heart surgery includes less invasive surgeries in which small incisions are made between ribs. In broad context, it refers to a type of surgery that involves repairing or fixing structures that are located inside the heart. In this type of surgery, the chest wall is surgically opened and the heart is exposed. Open refers to the chest not the heart. However in few cases, surgeon may also open the heart. This surgery is performed on the muscles, valves, or arteries of the heart. The function of the heart during this surgery is conducted by a heart-lung machine. During this surgery, heart beats are temporarily stopped and the demand of oxygen is fulfilled by a heart-lung machine. Special tubes called cannular are placed in the veins as well as in the arteries of the heart. A variant of open heart surgery is known as the beating heart surgery. In this type of surgery, the heart is not stopped from beating.

Comparison between Open Heart Surgery and Angioplasty:

What Is Angioplasty

Angioplasty is a procedure used to open blocked coronary arteries caused by coronary artery disease. It restores blood flow to the heart muscle without open-heart surgery. Angioplasty can be done in an emergency setting such as a heart attack. Or it can be done as elective surgery if your healthcare provider strongly suspects you have heart disease. Angioplasty is also called percutaneous coronary intervention .

For angioplasty, a long, thin tube is put into a blood vessel and guided to the blocked coronary artery. The catheter has a tiny balloon at its tip. Once the catheter is in place, the balloon is inflated at the narrowed area of the heart artery. This presses the plaque or blood clot against the sides of the artery, making more room for blood flow.

The healthcare provider uses fluoroscopy during the surgery. Fluoroscopy is a special type of X-ray thats like an X-ray “movie.” It helps the doctor find the blockages in the heart arteries as a contrast dye moves through the arteries. This is called coronary angiography.

The healthcare provider may decide that you need another type of procedure. This may include removing the plaque at the site of the narrowing of the artery. In atherectomy, the provider may use a catheter with a a rotating tip. When the catheter reaches the narrowed spot in the artery, the plaque is broken up or cut away to open the artery.

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What Are The Risks

Most heart surgeries are major surgeries. Although often successful, they do entail risks. The National Heart, Lung, and Blood Institute identifies some of these risks as:

• Bleeding
• Damage to tissues in the heart, kidneys, liver, and lungs
• Stroke
• Death, especially for someone who is already very sick before surgery

The risk is higher if you have other diseases or conditions, such as diabetes, peripheral artery disease, or kidney or lung disease.

What Is The Stenting Procedure

Stents are placed during a coronary angiogram. A small tube called a balloon catheter is inserted into the femoral artery or the radial artery , and advanced toward the heart to the very top of the aorta. After the blockage is identified, a wire is placed into the coronary artery to the site of the blockage and the stent is loaded on to the wire. The stent is expanded to the size of the artery and may be expanded by inflating a balloon within the stent. Then the wires are removed along with the catheter, while the stent stays in the artery permanently.

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Why Do I Required A Stent Surgery

Stents are usually essential when plaque obstructs a blood vessel. Plaque is made of cholesterol and other substances that connect to the walls of a vessel.

You may need a stent during an emergency situation procedure. An emergency situation procedure is more common if an artery of the heart called a coronary artery is blocked. Your doctor will first place a catheter into the blocked coronary artery. This will permit them to do a balloon angioplasty to open the clog. Theyll then place a stent in the artery to keep the vessel open.

Stents can likewise be useful when theres an aneurysm in your brain.

Besides blood vessels, stents can open any of the following passageways:

• bile ducts, which are tubes that bring bile to and from digestive organs
• bronchi, which are little respiratory tracts in the lungs
• ureters, which are tubes that bring urine from the kidneys to the bladder

These tubes can become blocked or harmed much like blood vessels can.