The operation of stenting of the vessels of the heart is a rather complicated surgical intervention. Only a high-class surgeon with extensive experience working with the vascular system can cope with it. In our country, the most famous center involved in such interventions is Bakulevsky. If a person was sent for such an operation, it must be remembered that the outcome is determined not only by the quality of the surgeon's work, but also by responsible training and the right rehabilitation measures.
general information
The operation of stenting of the vessels of the heart is usually carried out against the background of atherosclerosis. This is the name of a dangerous and common disease in which the vascular lumens gradually become already due to cholesterol deposits that form plaques. This leads to a deterioration in the quality of blood flow. The supply of blood is disrupted, and with it the oxygen and nutrient compounds in individual organs and tissues. Currently, intravascular surgery is considered the most effective way to combat pathology. Stenting is a classic approach that eliminates the severe consequences of atherosclerosis.
The operation of stenting of the vessels of the heart is a minimally invasive operation, in which the doctor normalizes the size of the vascular lumens. Work is underway on arteries affected by cholesterol deposits. Such an intervention can only be performed by a highly skilled experienced surgeon with the appropriate equipment, an office with all the necessary equipment and lighting. The procedure is carried out with constant x-ray control. The readings of the patient’s heart performance are constantly taken - a cardiogram is read. To do this, use a special device. Stenting requires local anesthesia.
What are they doing?
The operation of stenting the blood vessels of the heart involves piercing the vascular wall of the diseased area. A catheter is placed here into which a balloon is inserted. In the zone of impaired blood flow, the balloon is inflated, pumping a special substance safe for humans inside. As a result, the vascular walls expand. To keep the clearance obtained stable, a stent is placed. A stent is called a special mesh, a stable structure made of a material with a minimum degree of probability rejected by the human body.
Various metals are used to make the stent. In fact, they become the skeleton, the base, thanks to which the vascular site will not be able to narrow. If the affected areas are very large, it becomes necessary to install several stents in a row.
Features
Coronary stenting of the vessels of the heart is carried out if angina is fixed. An indication for surgery is the increased risk of heart attack due to organ ischemia. Sometimes, surgery is strictly prohibited. It is not carried out if the vessel itself is very small in diameter. Modern methodologies are such that a stent can be placed only when the clearance is normal from 2.5 mm or more. You can not use the stenting system with a large area of ​​vascular arterial narrowing.
Contraindications to surgery are weakness in the severe form of the kidneys, respiratory system. You can not assign stenting to a person suffering from blood coagulation problems. It is forbidden to carry out an intervention for an allergy to iodine, since this substance is indispensable for x-ray control - it is a contrast compound introduced into the human body.
Relevance of the problem
According to studies on the need for coronary stenting of the blood vessels of our fellow citizens, each year on average about 1.3 million people die due to heart and vascular diseases. The most common causes are hypertension, ischemia, heart attack, stroke, malfunctioning heart rate; accordingly, the relevance of research in the field of new methods of treatment is obvious. These include endovascular surgery, which allows you to organize an intervention with minimal harm to health, and therefore, the smallest possible risks to humans. Of course, it’s better than surgery to prevent the disease, but this is not always possible. Recently, active work has been carried out with the population, designed to make people understand how dangerous heart diseases and vascular pathologies are. This does not negate the fact that it is cardiac ischemia that forms against the background of atherosclerotic lesions that remains the most common cause of deaths in our country.
To reduce risks, it is necessary to promptly send a person to an endovascular surgery. In addition to stenting, angioplasty is performed. Such measures should prevent a heart attack, improve the prognosis of the case and the life expectancy of a person.
Is it carried out and is it successful?
As can be concluded from the reviews, stenting of the vessels of the heart in recent years has been done much more often than it was during the period when such an intervention was just developed. This is due to the fact that practice has proven the effectiveness of this approach. It is no secret that surgery for severe atherosclerosis is the only way to reduce risks for humans. In this case, the best results, as noted by patients, were observed if people were responsible for the doctor’s recommendations. In order to stabilize the state of health, improve the prognosis, reduce the risk of sudden death, you must obey the rules of safe nutrition, review the regimen, so that it has adequate physical activity.
The operation, as those who underwent it, was best performed in the case when people chose a good clinic. In our country, by right the most reliable place is considered NTSSSH them. Bakuleva. A distinctive feature of this center is its highly qualified staff, able to cure young children, and people of middle and old age. The majority of people who underwent surgery here responded positively to the procedure. But those who chose little-known and unreliable hospitals with outdated equipment often found themselves in situations of still high risk to health and life.
Combination and treatment
Currently, cardiovascular surgery is actively developing. Doctors note: only surgery can not cure ischemia, but surgical measures can make predictions worse. In order to achieve a good result, the doctor forms a comprehensive course. It includes taking medication, correcting everyday habits, in order to influence the main risk factors. The doctor selects the drugs shown to the patient, and evaluates when surgery is needed, which method is relevant in a particular case. In our country, endovascular techniques are often referred to as x-ray surgical. In addition to stenting, angioplasty is not less in demand.
Both of these methods are methods of cardiovascular surgery to cope with ischemia. The doctor restores normal gaps using the products provided for this. The most modern methods of treatment allowed to leave in the past general anesthesia, which has a very severe effect on the human heart. It should be noted that general anesthesia was often the main factor that did not allow the patient to be operated on or increased the risk of an unsuccessful outcome. When it was possible to develop methods that do not require such anesthesia, medicine took literally a leap forward.
Why does it work?
Held in the best hospitals in different cities, including Moscow, stenting of the blood vessels of the heart is an operation in which special products are introduced into the vascular lumen. Such cylinders are made from very dense material. Being blown away, they are very small in size, so it is enough to simply carry the product into the affected area. The materials used for the manufacture of cylinders are quite durable. As part of the working process, the product is inflated to a pressure level of about 18 atmospheres. Due to the peculiarities of the walls, this object does not adopt vascular contours. Instead, the balloon distributes atherosclerotic deposits along the arterial walls. As soon as it is possible to achieve the required diameter of the lumen, the balloon is blown off and removed from the patient's body.
Curious to know
Stenting performed at the Bakulevsky center and other medical institutions is an operation in which they work on critical gaps that have reached critical sizes. The main idea of ​​such an event is to debug cardiac blood supply, that is, the body should receive the maximum oxygen that it needs so much. For the first time, the idea of ​​such an event was proposed about four decades ago. The author was Charles Dotter. It was he who considered that it was possible to invent some framework that would be built into the vascular wall and save the patient. It took several decades to work out the details and conduct a variety of experiments.
The first such intervention was carried out in 1986. In 1993, the effectiveness of the application of the new theory was finally proved. It became clear that it can be used to stabilize coronary blood flow, to improve the condition of the artery that feeds the organ. Moreover, it was proved that the stent can keep the vessel in a normal state for a long time, providing a person with a normal life (subject to reasonable restrictions).
Features
How can I find out from specialists NTSSSH them. Bakuleva and other medical institutions involved in the described type of operations, the responsibility for choosing the appropriate stents lies with the doctor. The task of the doctor is to choose the optimal length. In some cases, products made of metal are placed, while other patients are shown systems coated with a special material called an eluting stent.
During surgery, sometimes it becomes necessary to inhale or hold your breath. Since the patient is conscious, the doctor asks him about such an action. You can talk if the doctor asks for it.
It is necessary to select a stent, taking into account compatibility with the patient's body. It is impossible to carry out surgery during an exacerbation of existing chronic pathologies.
Possible complications
The consequences of stenting of the vessels of the heart can be quite negative - such risks are associated with any operation. There is a risk of damage to the vascular wall and bleeding. It is known that in some cases, vascular blockage developed. There is a risk of hematoma formation in the puncture area. Possible deterioration in the functionality of the renal system. There is a risk of blood clots. There is a danger of repeated vascular stenosis.
To minimize the risk of such consequences, you need to be very responsible about the aspects and rules of the rehabilitation period. Stenting of the vessels of the heart during the recovery phase requires the first days to adhere to strictly bed rest. When the patient is discharged, at home he will need to limit physical activity. A shower, a bathtub with hot water are strictly prohibited. You cannot drive vehicles during recovery. After stenting of the vessels of the heart, the rehabilitation period involves the restriction of the diet with the exception of harmful products. The doctor will develop a drug program. The patient's task is to take all the medicines prescribed by a specialist in order to reduce the risk of complications. Life expectancy after stenting of the vessels of the heart depends on the implementation of all the recommendations of the doctor.
About nutrition
In order to maintain a good state of the body after surgery for a long time, you will have to adhere to a diet. After stenting the vessels of the heart should eat as rationally as possible. With products, a person should receive fiber, proteins, minerals, vitamins. Food should give enough energy without excess carbohydrates, fats. If possible, reduce the saturation of the menu with animal fats. Cooking, refuse butter in favor of rapeseed and olive. Useful grains, vegetables, fruits. All of them should be in the daily diet. Sugar is eliminated or reduced in volume. If necessary, sweeten food use dried fruits, honey. The volume of salt is reduced - no more than 5 g per day.
Alcohol is another dangerous product. Such drinks give the body a lot of energy without nutritional compounds. It should exclude beer, strong alcohol. The exception is no more than a glass of natural red table wine per day.
About physical activity
As can be seen in the reviews of stenting of the vessels of the heart, life expectancy is largely determined by how sensitive the patient is to himself, his body, and the recommendations of the doctor. It so happened that people are either very afraid of any load or lean too much on exercise. Both extremes are harmful. The heart needs intelligent activity. It is better to entrust the choice of regimen to the doctor. A feasible load sets the heart system to work efficiently, stabilizes blood pressure, improves the blood lipid profile, and allows you to get rid of extra pounds. The mental status of a person is getting better.
In order not to earn disability after stenting the blood vessels of the heart, you need to deal as responsibly as possible. Only regular training is useful. It is advisable to allocate about half an hour daily for a warm-up, gymnastics, and medical exercises. During the event, the pulse is checked regularly. A normal indicator is calculated as follows: 220 - the age of the person.
About Patients
According to medical statistics, most of the problems of the heart and blood vessels concern people over 50 years of age. In recent years, the upper limit has a tendency to change, more often, ischemia and atherosclerosis are detected in people younger than the indicated age. This is due to environmental pollution, the characteristics of work, life, as well as genetics. The heart is the main organ of the human body that guarantees blood flow. If its performance is impaired, other parts of the body do not receive the necessary substances. When the quality of the arteries deteriorates, numerous severe diseases form. The less traumatic methods available to modern doctors have become a real breakthrough against the background of extensive interventions practiced earlier. However, it so happened that the patient, to whom stenting was recommended, is primarily afraid. Many strive with all their might to avoid the event and postpone it as late as possible.
If the doctor recommended stenting, no need to pull. Every week, every month leads to a deterioration. The danger to life, the risk of unpredictable sudden death grow exponentially. An operation is the only reliable way to save a person, eliminate serious consequences, disability, and death.
Where to operate?
Other it seems that for the operation, the key parameter of choice is price. Stenting of the vessels of the heart is carried out in different hospitals, and the cost of services is very different. For example, in the aforementioned Bakulev center, surgery will cost 250-350 thousand rubles if the patient receives fully paid services. To this price is added the cost of additional research, analysis, as well as being in the hospital, additional services. Of course, treatment abroad will cost even more, but undergoing treatment in a hospital in a small city is much less. True, you need to remember not only about money, but also the quality of the service provided.
Two years ago, the Bakulev Institute celebrated its 60th anniversary. Currently, the hospital is considered in our country the most famous in the field of manipulation of the heart. The most complicated operations are carried out here. Patients are persons of all age groups. As can be concluded from the reviews, the doctors of this hospital saved the lives of those who were refused in other clinics. The local staff are highly qualified doctors, working for a long time on the patient in order to restore his ability to live normally and fully. In just six decades, almost half a million people with severe heart diseases have been brought back to life within the walls of this clinic.
At first, the Bakulev center was a very small clinic - an operating table, three wards. At that time it was part of a city hospital. Today the center is one of the largest in the country. About six thousand open heart surgeries are performed here annually. Doctors from leading clinics from around the world come here - the experience of Moscow surgeons is so unique.