Coronary Artery Bypass Graft (CABG)
Coronary artery bypass graft surgery is an open-heart operation in which arteries or veins are taken from another part of the body to channel needed blood flow to the coronary arteries. During surgery these arteries or veins are connected directly to the coronary arteries on the surface of the heart beyond the blockages. This approach allows blood to flow through the grafted arteries or veins to bypass the narrowed or closed points.
Coronary artery bypass graft operations usually last from three to six hours, their duration depending on the number of vessels to be grafted. Each operation varies in complexity, so its duration can only be estimated.
Valve Replacement
Valve Replacement (Aortic, Mitral & Tricuspid), If a valve can be repaired, it may be replaced with a prosthetic valve. Two kinds of prosthetic heart valves are available. Mechanical valves are created from man made materials. Lifetime therapy with anticoagulant medication, to prevent blood clots on or around the valve, is necessary when these types of valves are used. Biological (tissue) valves are taken from pig, cow, or human donors. Biological valves don't last as long as mechanical valves. However, when biological valves are used, long-term therapy with anticoagulant medication often isn't necessary. The surgeon discusses which type of valve is best for you. Factors considered are your age, occupation, the size of your valve, how well your heart is working, your hearts rhythm, your ability to take anticoagulant medications, and how many new valves you need.
Coronary Angioplasty
Localized narrowing (“lesions”) in the coronary artery can be treated without resorting to surgery. This procedure known as coronary angioplasty entails placing a balloon at the site of the lesion & inflating it thus widening the passage. This procedure improves blood flow to the heart.
Coronary Stent
A stent is a mesh- like metallic tube somewhat like a spring in a ball-point pen. It is used to hold an artery open after balloon angioplasty. In its collapsed form, a stent is usually less than a millimeter in diameter & is mounted over a balloon catheter. Just like an angioplasty balloon, the stent is passed into the coronary artery via the forearm or leg artery. It is then placed at the site of coronary block & expanded using high inflation pressure of the balloon. The stent remains permanently at the lesion site & acts as a scaffold to keep the artery from collapsing back to narrow size. In addition, stent placement helps to reduce the chance of recurrence of coronary blocks at the site of implantation.
When a coronary block is cleared using plain balloon angioplasty, there is a 30-40% chance that the block will recur. This process is called as restenosis. Stent placement at the lesion site reduces the chances of restenosis to about 15- 20%. Medicated stents or drug-eluting stents are latest form of technology to combat this problem of recurrence. In a DES, an ordinary stent is coated with a special medication. After stent placement, the medication is leached slowly into the surrounding blood vessel & this prevents restenosis. With DES, restenosis rates are generally about 5-6% in most cases.
Pacemaker Implantation (Single and Dual Chamber)
A Pacemaker implantation is a procedure to put a small medical device which uses electrical impulses for the beating of the heart and this is inserted just under the skin of your chest, just below your collarbone, to help your heart beat regularly. The purpose of a permanent or artificial pacemaker is to maintain an adequate heart rate, either because the existing heart's pacemaker is not fast enough.
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