Type of Surgery
Last updated: 11/24/2009
Often the first test done to diagnose coronary artery disease is an electrocardiogram, to show the heart's rhythm. A stress test, or exercise electrocardiogram, may be performed as well, though this test can be too strenuous for some patients....
Cardiac catheterization is considered the most definitive test. It requires the injection of a special dye into the coronary arteries at the same time that a catheter is threaded up into the heart's arteries and x rays are displayed on a monitor to show any narrowing or blockage. To diagnose clogged arteries in other areas of the body, such imaging techniques, as computed tomography (CT) or magnetic resonance imaging (MRI) may be used to visualize the presence and extent of narrowing in the blood vessels. Diagnostic procedures for aneurysm may include these same imaging tests; but often, because of the emergency nature of aneurysm, there is little time to conduct extensive testing beyond immediate confirmation of the presence of the aneurysm.
For up to twelve hours before a stent procedure or combined angioplasty and stent surgery, the patient will have to avoid eating or drinking. An intravenous line will be inserted so that medications (anticoagulants to prevent clot formation and radioactive dye for x rays) can be administered during the surgery. The patient's groin area will be shaved and cleaned with an antiseptic to prepare for the incision. About an hour before the procedure, the patient may be given a mild sedative to ensure that he or she will relax sufficiently for the procedure.
This narrated animation describes the steps involved in a coronary angiography, coronary angioplasty, and stent deployment in the coronary artery.
Endovascular stent surgery is a minimally invasive surgical procedure that uses advanced technology and instrumentation to treat such disorders of the circulatory system as blockage or damage to blood vessels caused by the build up of plaque (fatty deposits, calcium deposits, and scar tissue) in the arteries, a condition called atherosclerosis (hardening of the arteries). The surgeon may recommend the placement of an endovascular stent, a small wire-mesh tube that surgeons call a scaffold, in an affected artery. The procedure may be done in conjunction with cleaning or repairing the artery. The twofold procedure opens, enlarges, and supports artery walls for a long-lasting improvement in blood flow and a decrease in the risk of heart attack or stroke. In endovascular stent surgery (endo, within, and vascular, blood vessel), all of the work done by the surgeon is within the blood vessels themselves. Nearly all of the medium-sized and large blood vessels in the body's vascular system can be accessed from within the vessels. This fact has contributed to a rapid increase in the performance of endovascular stent surgery.
We are trying to balance those kinds of losses with the profitable side of business, which includes doing more cardiac surgeries. An emphasis has been placed on cardiac care because the medium age of residents is increasing, and more people are showing up with symptoms of heart disease.
-Kevin M. Spiegel
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