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Coronary Artery Disease (CAD), often referred to as
atherosclerosis, affects the blood vessels that nourish the heart muscle. It is
caused by deposits of calcium, fat and fibrous tissues, which narrow the
arteries, and it is one of the most common heart disorders.
Fortunately, there have been many advances in the
treatment of CAD. Some of the many state-of-the-art treatment options
include:
Non-Surgical Treatments:
Medication:
Your doctor will also advise
you how to slow the progression of atherosclerosis through proper diet and
exercise, smoking cessation, and controlling weight, high blood pressure,
diabetes and elevated cholesterol.
Your
doctor will also advise you how to slow the progression of atherosclerosis
through proper diet and exercise, smoking cessation, and controlling weight,
high blood pressure, diabetes and elevated cholesterol.
Thrombolysis:
Powerful medications called thrombolytics can be used to
dissolve blood clots which choke off the circulation. This type of treatment is
being used to help patients that are having strokes, heart attackes or sudden
loss of blood flow into the arms or legs.
Angioplasty and Stents:
Angioplasty and stent procedures are used to correct the
narrowing of arteries. In a balloon angioplasty, a catheter with a deflated
balloon on its tip is introduced into the body, usually through the leg. The
catheter is threaded through the blood vessels into the blocked heart artery.
The balloon is then inflated, opening the vessel and improving the blood
flow.
Rotational atherectomy utilizes a rotating device at the
end of the catheter, rather than a balloon. After being guided to the blocked
heart artery, the device clears away the material blocking the blood
vessel.
Stent
procedures use a wire mesh tube that props open a blood vessel that has just
been cleared using angioplasty. The stainless steel tube is first collapsed and
placed on a balloon angioplasty catheter. When the tube reaches the blocked
site, the balloon is inflated, expanding the stent into a position that holds
the artery open. Stents can reduce the incidence of re-narrowing that occurs in
angioplasty patients.
Most
patients treated with angioplasty or stents are walking within less than 24
hours and can then be discharged.
Surgical Treatments:
Bypass Surgery:
Bypass operations have been traditionally performed by
stopping the patient's heart and using a heart-lung machine to maintain blood
flow to the body. The recent development of off-pump surgery allows surgeons to
operate on a beating heart.
Off-Pump Bypass Surgery:
At Temple, bypass surgeries are being done on beating
hearts, making it unnecessary to place the patient on a heart-lung machine. For
elderly patients and those with vascular disease affecting the brain and
kidneys, this off-pump method significantly lowers any risk of stroke or kidney
failure and makes the road to recovery smoother and shorter. Some bypass
operations are now even managed with local anesthesia.
Arterial Revascularization
Another improvement to traditional bypass operations has
been the use of the patient's arteries, rather than veins to reroute the blood
flow. Rather than utilize a vein from the patient's leg, the mammary or radial
artery are utilized, making the bypass results last longer. Patients also heal
more quickly without painful leg incisions.
Transmyocardial Laser Revascularization
(TMR):
TMR is a new procedure that
is not yet widely available. It offers hope to patients with angina that has
been unresponsive to more conventional therapies. For patients who endure
constant chest pain and those who are not candidates for bypass, TMR can relive
much of their pain. A laser is used to make holes through the heart, destroying
the nerves that sense the pain of angina. This "dennervating" of the heart
relieves all pain in the vast majority of patients. While the procedure has not
been shown to improve the length of the patient's life, it improves quality of
life greatly.
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