Sunday, December 6, 2009

Operations: Which is Best for you?

What do the doctors do to your heart when they perform a heart bypass operation?

They use segments of healthy veins or arteries from other parts of the body to bypass the blocked parts of the coronary vessel.

What is a double bypass, triple bypass or quadruple bypass?

It refers to the number of vessels that are fixed.

What are the dangers of bypass surgery?
Stroke, heart attack, arrhythmias, kidney failure, death.

Will a bypass last forever or does it have to be redone?

A bypass doesn't last forever. In general, after 10 years patients may have an event such as angina, another heart attack or arrhythmia. 

What is angioplasty?

Opening of the blood vessel by a balloon and possibly placing a stent.

What is a stent?

A stent is a metal lattice work which is used to prop open the vessel to increase the lumen size.

What is the difference between a regular stent and a drug coated stent?

A drug coated stent has medication on it which reduces the risk of re-clogging of the vessel. 

Are stents likely to reclog?

Regular non-coated stents are more likely to re-clog. There is a 30% chance in the first year. Drug coated stents have a lower chance of 10%, but they can form an acute clot sometimes. For this reason a blood thinner is recommended after placement of the stent. 

Can stents be put in at all hospitals?

No.

Do stents set off metal detectors at airports?



No.

How many stents can be placed in a person?

It varies, and the number may be several.

What will the stents feel like inside the patient?

There is no sensation with the stent.

What makes some people candidates for angioplasty and others for bypass?

This depends on many variables including the expertise of the heart center, but in general the more technically challenging an angioplasty may be then the more likely that a bypass will be preferred. Also patients with left main artery disease or 3 vessel disease especially in diabetics may be recommended for bypass rather than for an angioplasty.

Do the doctors always clear out all blockages?

No, there's usually some blockage left. It can't be mashed into the wall. 

Why would they leave blockage in a patient's heart?



Not all blockage is significantly limiting the function of the heart.