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September 25, 2023
Heart disease is a major cause of death and disability across the globe, as well as in Malaysia. It can affect anyone and cause chest discomfort, difficulty in breathing, palpitations, fatigue, and severe complications such as heart attack, heart failure, stroke, or sudden cardiac death.
Thankfully, there are methods for preventing and treating heart disease and improving the quality of life. One way is a cardiac intervention that increases oxygen and blood supply to the heart muscle. Cardiologists perform these procedures using thin tubes called catheters inserted through small cuts in the groin, wrist, or arm and guided to the heart using X-ray images. These procedures are less invasive than open-heart surgery, which requires opening the chest or stopping the heart.
Angioplasty & Stent Placement are usually done together to treat arterial blockages around the heart with a balloon catheter. They can reduce heart damage from a heart attack and improve chest pain and shortness of breath.
Angioplasty uses a catheter from the insertion point in the groin or arm to the heart. A balloon at the tip of the catheter inflates to push plaque against the artery wall and widen it. A stent is sometimes put inside the artery to keep it open. Some stents have a drug coating to prevent scar tissue.
Stent placement is a procedure that puts a small tube (stent) inside an artery to keep it open and prevent narrowing. The surgeon usually widens the blocked arteries using angioplasty and then places the stent in the heart. The stent supports the artery and prevents closing. The surgeon leaves the stent after removing the catheter and balloon. Stent placement can improve blood flow to the heart and reduce chest pain and shortness of breath.
Different types of stents are available, such as:
Doctors perform angioplasty and stent placement under local anaesthesia in the area where they insert the catheter. The procedure’s duration may vary from 30 minutes to several hours, depending on the number of arteries treated and the use of stents.
Angioplasty and stent placement has benefits over other treatments for heart disease, such as bypass surgery. It requires less downtime after surgery and on the whole, it is less invasive.
However, angioplasty also has risks, such as:
To prepare for angioplasty, follow your doctor’s instructions on what to eat and drink, what medications to take or avoid, and what tests to have before the procedure. You will also need someone to drive you home after angioplasty.
To recover from angioplasty, you must stay in the hospital for one night or longer, depending on your condition and how well you tolerate the procedure. The doctors will monitor you for any signs of complications and give you medications to prevent blood clots and control your blood pressure and cholesterol levels. You will also receive instructions on how to care for your wound, resume your normal activities, and watch out for any signs and symptoms. You must follow up with your doctor regularly and attend cardiac rehabilitation programs to improve your heart health and prevent future problems.
This procedure removes plaque from the artery wall using a rotating blade, a laser, or a sanding device. It can treat hard or calcified plaque in a way that angioplasty or stent placement cannot.
The surgeon removes plaque from the arteries during an atherectomy of the coronary arteries using a catheter with a cutting or grinding device. It can enhance the heart’s blood flow and reduce chest pain and shortness of breath.
It can also prepare an artery for angioplasty or stent placement by removing hard or calcified plaque.
Atherectomy uses a catheter placed into an arm or groin blood vessel, then directed to the heart. The device at the tip of the catheter rotates at high speed and removes plaque from the artery wall. The plaque debris is suctioned or flushed out.
The surgeon performs an atherectomy under local anaesthesia in the area where they insert the catheter. The procedure may take 30 minutes to several hours, depending on how many arteries they treat and whether they also do angioplasty or stent placement.
Atherectomies can of various types based on the medium used to destroy the plaque:
Atherectomy has some benefits over other treatments for heart disease, such as angioplasty or stent placement alone. It can treat resistant blockages and reduce restenosis risk by removing more plaque.
However, atherectomy also has some risks, such as:
Before an atherectomy, your healthcare provider might recommend some tests to understand the level of blockages in your arteries. They may also perform an angiography or vascular ultrasound. Understand your medical team’s instructions on what to eat or drink and which medications to take while preparing for an atherectomy.
As the name suggests, this procedure is performed to replace a patient’s heart valves with a biological or mechanical valve. Four valves in our heart control where the blood goes in our heart. The valves open and close completely when the heart beats, thus moving blood in an organised manner.
Sometimes the valve is not formed in the right way when a baby is born. And sometimes the valve gets too narrow or stiff. All these cause hindrances to the movement of blood in the heart. While replacing the heart valve is not the primary choice of treatment, when medicines don’t work, surgery may be required.
One of the types of heart valve surgery is Transcatheter Aortic Valve Replacement (TAVR). This is used for patients with severe narrowing causing a high risk to the patient’s life. In this procedure, a catheter is used to replace the damaged valve with a biological valve. The catheter may be inserted through an artery in the groin or an incision in the chest. This procedure is commonly used to replace the pulmonary valve (the valve that delivers blood to our lungs).
It is essential to follow your medical team’s advice while preparing for a heart valve replacement procedure. Avoid drinking or eating the night before or the day of your surgery. Follow your doctor’s advice regarding the medicines to take (or not take) before the operation. Your medical team may conduct a few tests such as an electrocardiogram and chest x-ray a day before the operation to evaluate your health condition.
Cardiac catheterisation introduces a tiny tube into the heart (catheter) through a blood vessel and guides it to the heart using X-ray images. It can diagnose and treat various heart conditions by measuring pressure and oxygen levels, taking tissue samples (biopsy), injecting contrast dye (angiography), opening blocked arteries (angioplasty), placing stents, closing holes in the heart, repairing valves or destroying abnormal tissue (ablation). However, it may cause bleeding, infection, artery damage, an allergic reaction, kidney problems, or blood clots.
The surgeon performs cardiac catheterisation under local anaesthesia in the area where they insert the catheter. The procedure may take 30 minutes to several hours, depending on the tests or treatments.
It has many benefits for diagnosing and treating heart problems, such as:
However, cardiac catheterization also has some risks and complications, such as:
The procedure influences complication risk by age, health status, type and number of tests or treatments performed, and the cardiologist’s experience. Your doctor will review cardiac catheterisation’s advantages and potential hazards before the procedure and help you make an informed decision.
In minimally invasive heart surgery, a surgeon makes small incisions in the chest and reaches the heart going in between the ribs. Unlike traditional open-heart surgery, the breastbone is not cut in this kind of surgery.
Minimally invasive surgery is less painful than an open-heart surgery and has a quicker recovery time. It has a lower risk of infection and results in lesser blood loss. Patients need to spend less time in the breathing tube (ventilator) as well as less time in the hospital. The scar from the surgery is also smaller and heals quicker.
This surgery is used to treat a variety of heart conditions such as
The most common types of minimally invasive surgeries are robot-assisted heart surgery and thoracoscopic surgery.
However, it is not suitable for everyone. The medical team decides its suitability based on the history of the patient and the results of various tests conducted. Minimally invasive heart surgery requires extreme expertise and hence performed by only specialised doctors.
Cardiac intervention procedures prevent or treat cardiac conditions such as coronary artery disease and heart attacks. These procedures are less invasive than open-heart surgery, as they use catheters inserted through small incisions and directed to the heart using X-ray pictures.
Cardiac intervention can improve your heart health and quality of life by relieving symptoms, increasing blood flow, preventing or limiting heart damage, reducing the need for more surgery, enhancing physical activity and exercise, and lowering future heart risks.
It does not, however, treat cardiac problems. You must still change your lifestyle by quitting smoking, managing stress, eating well, and exercising regularly. These changes can prevent further heart damage and help you live longer and healthier.
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