main cause of the most serious manifestations of coronary heart disease, myocardial infarction, is a violation of muscle power due to atherosclerotic vascular lesions.
Atherosclerosis affects the artery wall.Because of the loss of elasticity is lost sufficient opportunity to expand.inside the deposition of atherosclerotic plaque causes narrowing of the vessel diameter, it complicates delivery of nutrients.The critical reduction of 50% is considered diameter.At the same time begin to show clinical symptoms of hypoxia (lack of oxygen) of the heart.This is expressed in strokes.
complete blockage of a coronary artery leads to the development of the area of necrosis (necrosis) in myocardial infarction.In the world, this pathology is still considered one of the main causes of adult mortality.
Timely stenting vessels of the heart to prevent the development of serious complications of atherosclerosis.
What is "stenting"?
term "stent" refers to an operation to install the stent inside the artery, resultin
In surgery established methods not only coronary stenting (heart blood vessels), but also attaching the stents in the carotid artery to eliminate signs of cerebral ischemia in the femoral - for the treatment of atherosclerotic changes legs in the abdominal aorta and iliac - in the presence of pronounced signs of atheroscleroticdefeat.
What is a "stent", variety
stent - a lightweight mesh tube, is strong enough to provide a framework artery for a long time.Stents are made of metal alloys (often cobalt) to high technology.There are many types.They differ in size, the mesh structure, the nature of the coating.
stents differ in size, the grid structure, the nature of the coating
two groups of stents can be distinguished:
- uncoated - used in operations in the medium-sized arteries;
- covered with a special coating of the polymer is isolated in the course of the year a drug that prevents the artery restenosis.The cost of these stents are much more expensive.They are recommended for use in the coronary vessels, require constant medication, reduce the formation of blood clots.
How is surgery performed?
catheter, which is located at the end of a tiny balloon to put on it the stent for stenting, cardiac vessels in the femoral artery.Under the control of the X-ray catheter device is introduced into the mouth of the coronary arteries and is moved to a desired portion of the constriction.Then the balloon is inflated to the desired diameter.This atherosclerotic deposits are pressed into the wall.The stent, as the spring expands and is left in place after deflating the balloon and removing the catheter.As a result - the blood flow restored.
Arrangement of the stent within the vessel
operation is usually performed under local anesthesia.It lasts from one to three hours.Before the surgery, the patient is administered blood thinning medication for the prevention of thrombosis.If necessary, install several stents.
After surgery the patient spends in the hospital up to seven days under the supervision of a physician.It is recommended to drink plenty of liquids excreted in the urine of contrast agents.Assign an anticoagulant to prevent platelet adhesion and thrombus formation.
This shows the operation, inspection
Treatment of complications of myocardial infarction
selection of patients with coronary heart disease for surgery has been a consultant cardiac surgeon doctor.The local polyclinic patient undergoes the required minimum inspection, including all mandatory blood and urine tests to determine the functioning of internal organs, lipogram (total cholesterol and its fractions), blood clotting.Electrocardiography allows you to specify the lesions of the myocardium after infarction, the prevalence and localization process.Ultrasound examination of the heart clearly in the pictures shows the functioning of all parts of the atria and ventricles.
necessarily spend angiography in the inpatient unit.This procedure is the intravascular administration of contrast medium and a series of X-rays carried out at least fill the vascular bed.Identify the most affected branches, their location and the degree of narrowing.
Intravascular ultrasound helps evaluate the possibilities from within the artery wall.
survey allows vascular surgeon to determine the exact location of intended stent deployment, identify possible contraindications to surgery.
Indications for surgery:
- frequent severe angina, defined by a cardiologist PIS;
- support coronary artery bypass (bypass surgery - is the installation of artificial blood vessel bypass overlapped), which tends to narrow over ten years;
- life-saving in severe transmural infarction.
impossibility stent insertion is determined at the time of the survey.
- common lesion of the coronary arteries, because of which there is no specific place for stenting.
- narrowed artery diameter less than three mm.
- Reduced blood clotting.
- Impaired renal function, liver, respiratory failure.
- allergic patient reaction to iodine preparations.
stenting advantage over other operations:
- small traumatic methods - no need to open the chest;
- a short period when a patient in a hospital;
- relatively low cost;
- rapid recovery, return to work, the lack of long-term disability of the patient.
Complications of surgery
1/10 operated had complications or undesirable effects:
- perforation of the vessel wall;
- formation of blood accumulation in the form of hematoma at the puncture of the femoral artery;
- stent thrombosis and the need to re-stenting;
- renal dysfunction.
Video, clearly showing the essence of the operation:
Transferred heart vessels stenting allows much improved patient well-being, but it does not stop the atherosclerotic process, it does not alter the abnormal fat metabolism.Therefore, the patient will have to follow the doctor's appointment, to monitor the level of cholesterol and blood sugar.
be excluded from the food animal fats and limit carbohydrates.It is not recommended to eat fatty pork, beef, lamb, butter, bacon, mayonnaise and spicy seasonings, meats, cheese, eggs, from unsteady wheat pasta, chocolate, sweets and pastries, white bread, coffee, strong tea, alcoholand beer, carbonated soft drinks.
Diet requires necessarily enter into the diet of fruits and vegetables in salads, or fresh juice, boiled poultry, fish, cereals, pasta from durum, cottage cheese, dairy products, green tea.
There should be 5 - 6 meals a day to watch weight.If necessary, arrange fasting days.
daily morning exercise increases metabolism, improves mood.You can not just take up heavy exercise.Recommended walking, first over short distances, and then with increasing distance.A popular walking slowly up the stairs.You can engage in at the gym.patients should be sure to learn to count in his pulse.Avoid large overload with an increase in heart rate.From sports recommended cycling and swimming pool.
dosage load helps to restore
coronary circulation Medication reduced to means of lowering blood pressure (hypertensive patients), statins to normalize cholesterol levels and drugs that reduce thrombosis.Patients with diabetes should continue treatment for a specific purpose endocrinologist.
better if rehabilitation after stenting will be held in sanatorium conditions, under the supervision of physicians.
Operation stenting has been held for nearly forty years.Methodology and technical support is constantly being improved.Expanding indications, there is no age limit.It is recommended for all patients with coronary artery disease are not afraid to consult a surgeon, it is possible to extend the active life.