What is the difference between Coronary Angiography and Coronary Angioplasty?
While both terms may sound similar, they have a vast difference. Coronary Angiography and Coronary Angioplasty are two varied medical procedures but related commonly to the blood vessels; however, one is a detection procedure while the other is a course of treatment. Coronary Angiography is used to examine the blood vessels to detect a potential heart disease or problem, whereas Coronary Angioplasty is a surgical procedure performed to restore the flow of blood in the heart by removing the blockages from the coronary arteries. Coronary Angiography The procedure to check the arteries for any blockages in blood flow is referred to as Coronary Angiography. The test helps determine if there is any blockage in blood flow or any artery has been compromised, narrowed, blocked, enlarged, or malformed. This technique of detection uses X-rays to examine the ‘route maps’ of blood vessels and arteries in the heart, their passage, and overall functioning. A Coronary Angiography detects the blood pressure and oxygen level in the heart, providing a broader picture of the heart’s heath. The images generated from this process are called ‘angiogram’. Coronary Angiography uses a special dye known as ‘contrast medium’ to unravel the heart’s condition clearly. The dye is inserted through a thin, fine tube or catheter through an access point – most commonly the groin or arm. As soon as the dye comes in contact with the blood vessels, it provides an absolutely clear image of the blood vessels’ problems and can point any possible diseases or heart condition. The dye is later expelled from the body through urine or kidneys. This medical procedure takes anywhere between 30 minutes to two hours of time but is completely safe and painless with almost negligible risks associated. Though in very rare cases, people might experience bruising, soreness, or bleeding on the point of insertion of the tube; or small allergic reactions to the dye. In the worst case scenario, there is a minute chance of experiencing severe allergies, dizziness, shortness of breath, anxiety, stroke, and internal bleeding causing kidney damage. These conditions are extremely rare, temporary, and can be treated with proper attentive medical care. Most of these complications are likely to develop based on factors such as age, kidney disease history, previous heart attack or stroke, or history of heart diseases. Though after a Coronary Angiography, the doctor may retain the patient in supervision for a few hours or overnight to check for any complications post procedure. You will be asked to drink a lot of fluids to flush the dye from the system and stay hydrated. Post a Coronary Angiography, if the X-rays show a possible blockage, narrowing, widening, malformation, etc. in the blood vessel, the next step would be to opt for a Coronary Angioplasty. Coronary Angioplasty Coronary Angioplasty is a non-invasive surgical procedure performed to restore the optimum blood flow to the heart by removing the blockage from the artery, widening the artery for smooth flow, and ensuring optimal heart heath. A blocked or narrowed artery...Read More
Transcatheter Aortic Valve Replacement (TAVI/TAVR)
A Transcatheter Aortic Valve Replacement (TAVR) or Transcatheter Aortic Valve Implantation (TAVI) is a surgical method performed to repair a compromised, blocked or narrowed artery which was causing disruption in the blood and oxygen supply to the heart. This surgical procedure is recommended for patients who have higher risk or are too sick, or too old for an open heart surgery. This breakthrough procedure is advanced than a standard valve replacement. Where no other procedure guarantees long term benefits, this procedure provides statistically significant mortality rate and is regarded a boon for people who were considered inoperable. It was in fact first tested in 2002 on patients with severe aortic stenosis (a narrowing of the aortic valve opening), who were considered unfit for an open heart surgery. TAVI/TAVR outperformed in the trials with patients’ significantly better recording higher mortality rate. The Transcatheter Aortic Valve Replacement (TAVI/TAVR) procedure involves the implantation of aortic valve via a catheter without removing the damaged, old valve. Instead, TAVI/TAVR wedges another valve into the aortic valve’s place (valve-within-valve). The approach is very similar to the placement of a stent – a stainless steel mesh – in the artery. In a TAVI/TAVR procedure, a small incision either through the upper chest or groin is made to place a small, hollow fine tube (sheath) that provides access to the aortic valve by placing a catheter mounted with a balloon. Once, the catheter is in place, the balloon is inflated at the termination point to push the plaque to the sides. Once the compromised valve is opened, a completely collapsible valve (artificial, biological or a combination of the two) in replacement, on the site of the old valve is placed through the catheter. Once, the placement is made, the new valve expands and drives the old one out of the place, enabling the new tissue in the valve to become the primary medium of regulating blood flow in the heart. Post successful positioning, the balloon is deflated and removed. Where a standard valve replacement surgery involves an open heart surgery by a sternotomy via a surgically opened chest, a TAVI/TAVR process is less invasive and involves small openings that do not harm the chest bones. A TAVI/TAVR procedure can be performed in two ways: Transfemoral Approach: In this, the doctor enters through the large artery in the groin, without any surgical incision in the chest. Transapical Approach: In this one, the doctor enters through the large artery in the chest by making small incisions on the chest. This procedure reduces the symptoms of severe aortic valve stenosis - such as shortness of breath, cheat pain, fainting, fatigue, heart palpitations, swelling in legs, etc. - and also increases chances of survival amongst people who have a high risk of surgical drawbacks/ failures or are considered high/intermediate risk patients for a standard valve replacement surgery. While the surgery is less invasive, it is still very crucial to undertake proper precautions and follow accurate instructions to prepare for the surgery. The...Read More
Cardiac surgery – Ultimate guide for patients
The heart – the most vital organ of the body responsible for pumping blood and oxygen throughout the body enabling proper functioning of the organs – is also very fragile and could need some repairing or resurrection in some cases depending on the situation. A person diagnosed with a heart disease - such as coronary artery disease, heart valve disease, mitral valve disease, or tricuspid valve disease – would require a cardiac surgery given all other methods including medication have failed to provide benefits. Procedure of a cardiac surgery As per the traditional method, a cardiac surgery involves opening the chest by dividing the chest bone, allowing the surgeon to operate on the heart as per the patient’s condition. During this time, the heart is connected to a heart-lung machine that substitutes the heart functioning. Post a successful procedure, the heart starts beating and functioning on its own and the incision in the chest is sealed which almost takes 6-8 weeks to recover. The sternal wires used to bind the chest bones are left to dissolve eventually, staples made are removed between 7-14 days after surgery, and the glue goes off ultimately on its own. Further, you can check with the doctor for the procedure proposed, its risks and benefits, and prepare yourself for it. Length of a typical cardiac surgery and risks The length of a cardiac surgery depends on the patient’s condition and circumstances of operation. Typically, a cardiac surgery takes at the least 4-5 hours including 60 minutes of preparing for the surgery. While risks of a cardiac surgery are different in each case and subjective to a patient, even then some patients might not experience any of these risks listed below: InfectionAnxietyShortness of breathDizzinessFatigue and NauseaFeverBlood lossBlood clotKidney disease or failureHeart attack or stroke These risks will depend on the condition of the patient and one must check with the doctor before arriving at conclusions. Preparing for the cardiac surgery Once a heart disease or a demand/need of an operation arises, consult your doctor and discuss all possible options. After serious discussions, have a plan ready with the surgery hospital, time, date, recovery period, management, and more. More than that, you need to do the needful for a successful cardiac surgery: Pre operative testing: The surgeon will ask for a couple of tests to be conducted before the cardiac surgery. These tests may include carotid ultrasound, chest x-ray, EKG, blood work, dental clearance, etc.Medications: There might be certain regular medications that would hamper the surgery and create complications. Hence, it is best to consult the surgeon about any on-going treatment or medications. Inform the doctor about any supplements or allergies you have.Blood requirements: Though it is the responsibility of the hospital holding the surgery, it is still best to have a back-up of matching blood handy because loss of blood or anaemia is quite common after a cardiac surgery.Check the vitals: Before undergoing the surgery, ensure your vitals including blood pressure, cholesterol, pulse, etc. are monitored...Read More