What surgeries are available to treat heart attacks?
Coronary angioplasty. Emergency angioplasty, a procedure available at large medical centers, opens blocked coronary arteries, letting blood flow more freely to your heart. Doctors insert a long, thin tube (catheter) that's passed through an artery, usually in your leg, to a blocked artery in your heart. This catheter is equipped with a special balloon tip. Once in position, the balloon tip is briefly inflated to open up a blocked coronary artery. At the same time, a metal mesh (stent) may be inserted into the artery to keep it open long-term, restoring blood flow to the heart. Coronary angioplasty may be done at the same
time as a coronary catheterization (angiogram), a procedure that doctors do first to locate narrowed arteries to the heart. Overall, angioplasty is very safe. As with any invasive procedure, however, complications are possible. The rate of these complications can be reduced by carefully evaluating patients. An accidental cut or tear in the vessel itself is the most serious complication of angioplasty. The catheter may snag on the vessel it passes through. If that happens, the doctors must work quickly and move the patient into an operating room for emergency coronary artery bypass surgery. Emergency surgery is required in about 3 percent of angioplasty procedures. Angioplasty restores blood flow through a vessel narrowed by atherosclerosis. The procedure works best on vessels that are severely narrowed, rather than completely blocked. Heart attack patients with unstable ischemia are the most common candidates.
Coronary artery bypass surgery. In rare cases, doctors may perform emergency bypass surgery at the time of a heart attack. Bypass surgery involves sewing veins or arteries in place at a site beyond a blocked or narrowed coronary artery (bypassing the narrowed section), restoring blood flow to the heart. Or your doctor may suggest that you have this procedure after your heart has had time to recover from your heart attack. The procedure is extensive surgery that often requires opening the chest and temporarily stopping the heart. During this time, blood flow is maintained to body tissues by a heart-lung machine, which replicates the pumping action of the heart. (A newer procedure allows the heart to continue to beat, but this procedure is not as widely used.) One end of the transplanted vessel called a graft is connected below the blockage in the coronary artery while the other end is attached to the aorta, the major artery that carries blood away from the heart and into the body. The bypass procedure is repeated for each blocked coronary artery.
Transmyocardial revascularization. In this procedure, a surgeon makes a small incision in the left side of the chest and uses a laser beam to make 15 to 30 tiny holes in the heart. The laser beam fires at the left ventricle between heartbeats. One-millimeter holes are created. The surgeon presses a finger on the holes on the outside of the heart to seal the outer openings. But the inner sides of the holes are left open, allowing oxygen-rich blood to flow through the heart muscle. This procedure has produced promising results, but there are limited follow-up data.
Atherectomy. Atherectomy is done in the catheterization laboratory to open coronary arteries blocked by plaque. A rotating shaver, which is a disk or burr device on the end of a catheter, is inserted through an artery in the leg (or arm) and threaded through the blood vessels into the blocked coronary artery. The tip of the catheter has a high-speed rotating device that grinds the plaque up into minute particles. One such device, called the Rotablator, rotates at close to 200,000 rpm, grinding away plaque material that blocks arteries. If necessary, balloon angioplasty may then be used on the artery treated with atherectomy.
Laser angioplasty. This technique is used in some people to open coronary arteries blocked by plaque. A catheter with a laser at the tip is inserted into an artery and advanced through the blood vessels to the blocked coronary artery. The laser emits pulsating beams of light that vaporize the plaque. This procedure has been used alone and in conjunction with balloon angioplasty. The first laser device (the Excimer laser) for opening coronary arteries was approved by the Food and Drug Administration in 1992. The procedure, which is done under local anesthesia, is available at many major medical centers in the United States, but it is not used routinely at most hospitals.
More information on heart attack (myocardial infarction)
What's a heart attack (myocardial infarction)? - A heart attack (myocardial infarction) is the death of heart muscle from the sudden blockage of a coronary artery by a blood clot.
What're the signs and symptoms of a heart attack? - Symptoms of a heart attack include pain and pressure in the chest, which often spread to the shoulder, arm, and neck.
What're the women's heart attack symptoms? - A woman's heart attack has more varied symptoms than a man's. Women are more likely to have nausea and pain high in the abdomen.
What're the warning signs of a heart attack? - Warning signs of a heart attack include uncomfortable pressure, fullness, squeezing, or pain in the center of the chest, cold sweat or paleness.
What causes a heart attack? - Heart attack is caused by a lack of blood supply to the heart for an extended time period. The most common cause of heart attack is atherosclerosis.
What're the complications of a heart attack? - Complications of a heart attack include ventricular tachycardia, ventricular fibrillation, cardiogenic shock, arrhythmias, heart failure.
What're the risk factors for heart attack? - Heart attack risk factors can be devided into two groups: Inherited (or genetic) risk factors and acquired risk factors.
How is a heart attack diagnosed? - The most important factor in diagnosing and treating a heart attack is prompt medical attention. For a complete diagnosis, the medical history is vital.
What're the treatments for heart attack? - The goal of treatment for heart attack is to quickly open the blocked artery and restore blood flow to the heart muscle, a process called reperfusion.
What drugs are used to cure heart attack? - Medications used to treat heart attacks include blood vessel dilators, clot busters, beta blockers, antiarrhythmic drugs, pain relievers.
What surgeries treat heart attacks? - Surgeries to treat heart attacks include coronary angioplasty, coronary artery bypass surgery, transmyocardial revascularization, and atherectomy.
Aspirin and heart attacks - Aspirin is taken daily following a heart attack to reduce the risk of another heart attack. Aspirin reduces heart attacks and improve survival in the patients.
How to survive a heart attack? - In wilderness first aid, a possible heart attack justifies medical evacuation by the fastest available means. Heart attacks are survivable.
How to prevent a heart attack? - Heart attack can be prevented with a healthy liestyle. Daily aspirin therapy or other medical treatment help prevent heart disease and heart attack.
How to recover after a heart attack? - Following discharge from the hospital, patients continue their recovery at home. Lowering cholesterol can reduce the risk for another heart attack.