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Angioplasty
During angioplasty, a catheter is fed into the femoral artery of the upper leg (A). The catheter is fed up to coronary arteries to an area of blockage (B). A dye is released, allowing visualization of the blockage (C). A stent is placed on the balloon-tipped catheter. The balloon is inflated, opening the artery (D). The stent holds the artery open after the catheter is removed (E). (Illustration by Argosy.)




Stress Test
Doctors monitor a patient's vital signs during a stress test. (Photograph by Mug Shots. The Stock Market. Reproduced by permission.)




Cardiac Catheterization
During cardiac catherization, a catheter is fed into the femoral artery of the upper leg (A). The catheter is fed up to coronary arteries to an area of blockage (B). A dye is released, allowing visualization of the blockage (C). (Illustration by GGS Inc.)




Carotid Endarterectomy
In a carotid endarterectomy, the carotid artery is access through an incision in the neck (A). A measurement of the pressure inside the vessel is taken to assess the degree of blockage (B). The carotid is clamped above and below the incision, and a shunt is inserted to maintain blood flow (C). Plaque lining the artery is removed (D). The shunt is taken out (E), and the incisions are repaired (F). (Illustration by GGS Inc.)




Angiography
X ray showing a brain aneurism (to the right of the midline). (CNRI/National Audubon Society Collection/Photo Researchers, Inc. Reproduced by permission.)




Aortic Valve Replacement
The heart is accessed through a chest incision (A). The patient's heart function is replaced by the heart-lung machine. The aorta is cut open to reveal a diseased aortic valve (B), which is then removed. A valve sizer is placed in the opening to determine the size of prosthesis needed (C). A prosthetic valve is sutured in place (D and E). (Illustration by Argosy.)




Defibrillation
A portable defibrillator is used in an attempt to revive a man who had a heart attack before he is transported to an emergency room. (Photograph by Adam Hart-Davis. Science Source/Photo Researchers. Reproduced by permission.)




Mitral Valve Repair
During a mitral valve repair, the patient's chest is opened along the sternum (A). The heart is connected to a heart-lung machine, and an incision is made into the right atrium, or upper chamber of the heart (B), exposing the mitral valve (C). A section of the valve is removed, and the area is repaired with sutures (D and E). A flexible fabric ring may be stitched to the outside of the valve to strengthen it, in a procedure called an annuloplasty (F). (Illustration by GGS Inc.)




Endotracheal Intubation
The doctor inserts the laryngoscope into the patient's mouth, advancing through the trachea to the vocal cords (A). An endotracheal tube is inserted into the airway (B). The balloon cuff is inflated, and the laryngoscope is removed (C). (Illustration by GGS Inc.)




Peripheral Vascular Bypass Surgery
In this femoropopliteal bypass, a portion of the saphenous vein can be removed and used to bypass a portion of a diseased artery. To accomplish this, an incision is made down the inside of the leg (A). The saphenous vein is tied off from its tributaries and removed (B). An incision is made in the recipient artery (C), and the vein is stitched to it at the top and bottom of the leg (D). (Illustration by GGS Inc.)




Aortic Aneurysm Repair
An incision is made in the abdomen (A), and the aneurysm is visualized (B). The aorta is clamped above the aneurysm, and the aorta is cut open (C). The clotted blood is removed (D). A synthetic graft may be used to replace the part of the aorta that had the aneurysm, and it is stitched in place (E). The aorta is then closed over the graft (F). (Illustration by GGS Inc.)




Coronary Stenting
During coronary stenting, a catheter is fed into the femoral artery of the upper leg (A). The catheter is fed up to coronary arteries to an area of blockage (B). A dye is released, allowing visualization of the blockage (C). A stent is placed on the balloon-tipped catheter. The balloon is inflated, opening the artery (D). The stent holds the artery open after the catheter is removed (E). (Illustration by GGS Inc.)




Heart Transplantation
For a heart transplantation, the area around the heart is exposed through a chest incision (A). The blood vessels leading to the heart are clamped, and the heart function is replaced by a heart-lung machine. The diseased heart is removed (B). The donor heart is placed in the chest, and the left atrium is attached (C). The right atrium is connected (D), and the aorta and pulmonary artery are finally attached (E). (Illustration by GGS Inc.)




Minimally Invasive Heart Surgery
In traditional open heart surgery, a large incision is made in the chest, and the sternum must be broken (A). Minimally invasive surgery uses a much smaller incision between the ribs to access the heart (B). (Illustration by GGS Inc.)




Coronary Artery Bypass Graft Surgery
During a coronary artery bypass graft (CABG), the chest is opened to visualize the heart (A). A heart-lung machine takes over the function of the heart during the procedure. A portion of the saphenous vein of the leg is removed (B). This vessel is used to bypass a blockage of the coronary artery. It is attached from the aorta past the point of blockage (C). Another option is to bypass a blockage with the mammary artery (D). The bypass increases blood flow to the area served by the coronary artery (E). (Illustration by Argosy.)




Portal Vein Bypass
Portal vein bypass can be achieved through one of two incisions (A). Once the abdomen is entered, the inferior vena cava is exposed (B). Further exposure reveals the portal vein. Both the portal vein and inferior vena cava are clamped (C). Windows are cut in both vessels (D), and the two are connected with sutures (E). (Illustration by GGS Inc.)




Heart-Lung Transplantation
Chest is opened to expose the diseased heart and lung to be removed (A). Heart and lung function is taken over by a heart-lung machine. Major blood vessels are severed, and the heart is removed (B). Bronchus and blood vessels leading to the lung are severed, and the lung is removed (C). Donor heart and lung are placed in the patient's the chest cavity (D). They are sutured to their appropriate connections, and the heart is restarted before the patient is taken off the heart-lung machine (E). (Illustration by GGS Inc.)




Implantable Cardioverterdefibrillator
To place an implantable cardioverter defibrillator, a lead wire is inserted into the cephalic vein of the shoulder and fed into the heart chambers (B). An electrode is implanted in the heart muscle of the lower chamber, and the device is attached (C). (Illustration by Argosy.)




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