Indications for heart surgery, types of techniques. Heart surgery: necessary recommendations Open heart surgery

Surgical interventions on the heart are necessary in the treatment of many pathologies of cardio-vascular system, not amenable to standard drug therapy. When implementing surgical treatment there is an opportunity to improve general state patient and prolong his life. But depending on the pathology, there are different heart surgeries, which differ in their technique.

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Classification of operations

Cardiac surgery is aimed at treating cardiac pathologies by indirectly or directly affecting this organ. There are the following types of heart surgeries:

Closed, but the heart itself is not affected. Such operations are performed outside the heart, so they do not require the use of special equipment, with the exception of classical surgical instruments. The cavities of the heart remain closed, hence the name of this category.
Open, they require opening the cavities of the heart, which requires the use of special equipment, such as a heart-lung machine. At the time when such surgery is performed, the heart and lungs are not functioning, which allows the specialist to work with a stopped heart.
X-ray surgery, in which special catheters and devices attached to them are used; they are inserted into the cavity of the heart or the lumen of a vessel to correct the defect. The progress of such an operation is monitored using a monitor screen.

In addition, types of surgical interventions in cardiac surgery are classified according to the patient’s condition and type of defect, as well as the approach to treatment.

Depending on the patient’s condition and type of defect, the following are distinguished:

Emergency operations - when action must be taken immediately after the diagnosis has become clear, otherwise the pathology threatens the patient’s life.
Urgent - they do not require a lightning-fast reaction and a quick start of action. They are prepared for several days, but not longer, due to the high risks of complications or death.
Planned - interventions, the implementation of which is desirable, but not essential in the near future. They are prescribed by surgeons after consultation with patients.

Depending on what approach surgical treatment requires:

Radical - they are aimed at the complete elimination of vices.
Palliative - they are additional or auxiliary, their goal is to improve the patient's condition or prepare him for radical intervention.

Radiofrequency ablation

Surgical intervention such as radiofrequency ablation refers to x-ray surgical procedures. It is carried out to improve the condition of a patient suffering from heart failure and arrhythmia, and is characterized low performance side effects and complications.

Manipulations during the operation are carried out using special catheters, which are administered to the patient under local anesthesia. The catheter insertion site is distant from the heart itself, therefore local anesthesia is performed at the site where the catheter will be inserted. In most cases it is injected into the inguinal vein or femoral artery. Once in the organ, electrical impulses are given through the catheters to restore the heart rhythm.

Because of this delivery of impulses, which eliminate a small area of cardiac tissue that causes pathological excitation of the myocardium, the technique received a second name - cauterization of the heart.

Valve replacement

Heart valve replacement is used when there is insufficiency or stenosis of the valve, which prevents the normal passage of blood through it. Valve replacement can be done during open surgery, endovascular or mini-access.

In the first case, the patient is under general anesthesia the anterior surface of the chest is processed, the sternum is dissected longitudinally, and the pericardial cavity is opened. To disconnect the heart from blood circulation, the patient is connected to a heart-lung machine, and the myocardium is systematically treated with cold saline during the entire operation in order to avoid its hypoxia.

To install the prosthesis, a longitudinal incision is made, opening the heart cavity, the modified valve structures are removed, it is replaced with an artificial one, and the myocardium is sutured. After this, the surgeon “starts” the heart with an electrical impulse or by performing direct cardiac massage, and turns off the heart-lung machine.

After inspection postoperative appearance heart, pericardium and pleura, remove blood from the cavities and suture the surgical wound layer by layer.

During endovascular surgery there is no need to “disconnect” the heart from circulation. It is carried out through the leg, namely by inserting a catheter with an implantable valve into the femoral artery or vein. After the fragments of the damaged valve are destroyed and removed, a prosthesis is placed in its place, which straightens itself, having a flexible stent frame.

If the option with a mini-access was chosen, then the surgeon makes a 2–5.5 cm long incision on the anterior wall of the sternum in the area of the projection of the apex of the heart. Then a catheter is inserted into the organ through the apex of the heart, advancing it to the affected valve, and replacing it.

In the case of valve replacement, there are several types of implants:

Mechanical - they are made of metal or plastic. When choosing such an implant, the patient will need to constantly take blood thinning medications in the future.
Biological - they consist of animal tissues and do not require further use of drugs, but after several decades they need to be replaced.

Pacemaker installation

If the patient suffers from heart failure, cardiomyopathy and cardiac arrhythmias, the specialist may prescribe a minor operation to install a pacemaker.

The technique for performing such surgical intervention is simple. Local anesthesia with novocaine or lidocaine is performed on the right or left under the left clavicle, after which an incision is made in the skin and subclavian vein to insert a conductor into it, and through it into the superior vena cava and into the heart - an electrode. When the tip of the electrode enters the cavity of the right atrium, the doctor selects a convenient place for optimal stimulation of the heart muscle, and during the search he constantly records ECG changes. When the location is found, the electrode is fixed in the myocardial wall from the inside using antennae or a corkscrew-shaped fastening. After fixation, it is necessary to sew a titanium case under the patient’s arm, which is installed into the thickness of the pectoral muscle on the left. The wound is sutured and an aseptic bandage is applied.

Coronary artery bypass grafting

Coronary artery bypass grafting is a frequently performed heart surgery. It is prescribed when internal walls atherosclerotic plaques accumulate in the coronary vessels that supply the heart, disrupting blood flow. In addition, indications may include:

Stable angina pectoris 3–4 functional class.
Acute coronary syndrome.
Acute myocardial infarction during the first 4–6 hours from the onset of pain.
Severe ischemia without pain.

Before the operation, the patient is given intravenous sedatives and tranquilizers, and the intervention itself is carried out under general anesthesia. Surgical access is made by dissecting the sternum or from a mini-access, making an incision in the intercostal space on the left in the area of the projection of the heart. The manipulation can occur either with or without connecting the patient to the artificial blood circulation machine.

The aorta is clamped and connected to the device, then a vessel is isolated that will become a shunt. This vessel is brought to the affected coronary artery and its other end is sutured to the aorta. As a result, from the aorta, bypassing the area affected by plaques, blood will flow to the coronary arteries without difficulty.

Depending on how many arteries supplying the heart are affected and at what intervals, the number of shunts can vary from 2 to 5.

When the shunts are fixed, metal staples are applied to the edges of the sternum, the soft tissue is sutured and an aseptic dressing is applied. In addition, drainage is removed from the pericardial cavity so that there is an outflow hemorrhagic fluid.

Glenn and Ross operations

Glenn's procedure is otherwise called a bidirectional cavopulmonary connection. In this case, the upper part of the superior vena cava is anastomosed with the right pulmonary artery according to the “end to side” principle.

The Ross procedure involves replacing a patient's damaged aortic valve with their pulmonary valve, and replacing the removed pulmonary valve with a prosthetic valve.

Review

Operation on open heart is a surgical procedure in which the chest is opened and the muscles, valves or arteries of the heart are affected.

According to the US National Institute of Heart, Pulmonology, and Hematology (NHLBI), coronary artery bypass grafting is the most common heart surgery in adults. During this surgery, a healthy artery or vein is transplanted (attached) to a blocked coronary (heart) artery. As a result, the grafted artery delivers blood to the heart bypassing the blocked artery (NHLBI).

Open heart surgery is sometimes called traditional heart surgery. Today, many new heart procedures require only small incisions rather than large incisions. That is, the concept of open heart surgery can sometimes be misleading.

Causes

Open heart surgery allows for coronary artery bypass grafting. Coronary artery bypass grafting may be required in patients with coronary artery disease.

Coronary artery disease occurs when the vessels that carry blood and oxygen to the heart become narrow and inelastic. This disease is known as atherosclerosis.

Atherosclerosis occurs when body fat create plaques on the walls of the coronary arteries. Plaques narrow the arteries, making it difficult for blood to pass through them. If blood does not flow to the heart properly, it may occur. heart attack.

Open heart surgery is also performed to:

repair or replace blood vessels, allowing blood to pass through the heart; repair damaged or abnormal areas of the heart; install medical devices that will help the heart function properly; replace a damaged heart with a donor one (transplantation).

Operation

According to the National Institutes of Health, coronary artery bypass grafting takes four to six hours. Let's look at what it is, step by step.

The patient receives general anesthesia. He falls asleep and does not feel pain from the operation. By making a 20 to 25 centimeter incision in the chest, the surgeon cuts through all or part of the chest bone to gain access to the heart. Once the heart opens, the patient is connected to a heart-lung machine. It diverts blood away from the heart so the surgeon can operate. Some new technologies make it possible to abandon this device. The surgeon uses a healthy vein or artery to create a new path around the blocked artery. The rib cage is held together with wires that remain inside the body. The initial incision is sutured. (NIH)

A chest plate is sometimes used in high-risk patients, especially in the elderly and in those who have had multiple surgeries. In this case, the breast bone is connected after surgery with small titanium plates.

Risks

Risks of coronary artery bypass grafting:

wound infection of the chest (most common in obesity, diabetes, repeated operations by bypass); heart attack or stroke; heart rhythm disturbance; damage to the lungs or kidneys; chest pain, low-grade fever bodies; memory loss or blurred memories; blood clots; blood loss; difficulty breathing.

According to the University of Chicago Medical Center (UCM), using a heart-lung machine increases the risks. These risks will include stroke and memory problems (UCM).

Preparation

Tell your doctor about all the medications you take, including over-the-counter drugs, vitamins and herbs. Report any health problems, including herpes, infection, colds, flu, fever.

Two weeks before surgery, your doctor may ask you to refrain from smoking and stop taking vasoconstrictor drugs medications such as aspirin, ibuprofen, or naproxen.

On the eve of the operation, you will be asked to wash yourself with special soap. It kills bacteria on the skin and reduces the chance of infection after surgery. You may be asked not to eat or drink anything after midnight.

You will receive further instructions when you arrive at the hospital for surgery.

Rehabilitation

When you wake up after surgery, you will have two or three tubes in your chest. They are necessary to remove fluid from the area around the heart.

You may have intravenous tubes that will give you fluids.

You may have a catheter (thin tube) placed in your bladder to drain urine.

You may also have machines connected to you to monitor your heart function. Nurses will be nearby to help you if necessary.

Most likely, you will spend the first night in the department intensive care. After three to seven days you will be transferred to a regular ward.

Long

You must be prepared for gradual recovery. Improvement will occur in about six weeks, and after about six months you will feel the full benefits of the operation. So, the outlook is optimistic for many people, the shunt can work for many years.

However, the operation does not exclude re-occlusion of the vessels. The following measures will help maintain your health:

proper nutrition; restriction of salty, fatty and sweet food; maintaining physical activity; to give up smoking; control high pressure and cholesterol levels.

Heart operations are performed very often today. Modern cardiac surgery And vascular surgery very developed. Surgical intervention is prescribed when conservative drug treatment does not help, and accordingly, normalization of the patient’s condition is impossible without surgery.

For example, a heart defect can only be cured surgically, this is necessary in the case when blood circulation is severely impaired due to pathology.

And as a result, the person feels unwell and serious complications begin to develop. These complications can lead not only to disability, but also to death.

Surgical treatment of coronary heart disease is often prescribed. Since it can lead to myocardial infarction. As a result of a heart attack, the walls of the cavities of the heart or aorta become thinner and protrusion appears. This pathology can also only be cured surgically. Surgeries are often performed due to abnormal heart rhythm (RFA).

They also perform heart transplantation, that is, transplantation. This is necessary in the case when there is a complex of pathologies due to which the myocardium is not able to function. Today, such an operation prolongs the patient’s life by an average of 5 years. After such an operation, the patient is entitled to disability.

Operations can be performed urgently, urgently, or scheduled intervention. This depends on the severity of the patient's condition. Emergency surgery carried out immediately, immediately after diagnosis. If such intervention is not carried out, the patient may die.

Such operations are often performed on newborns immediately after birth with congenital defect hearts. In this case, even minutes matter.

Emergency operations do not require quick implementation. In this case, the patient is prepared for some time. As a rule, this is several days.

A planned operation is prescribed if there is no danger to life at this time, but it must be carried out in order to prevent complications. Doctors prescribe myocardial surgery only if it is necessary.

Invasive research

Invasive methods for examining the heart involve catheterization. That is, the study is carried out through a catheter, which can be installed both in the heart cavity and in a vessel. Using these studies, you can determine some indicators of heart function.

For example, blood pressure in any part of the myocardium, as well as determine how much oxygen is in the blood, evaluate cardiac output, vascular resistance.

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Invasive methods make it possible to study the pathology of the valves, their size and the degree of damage. This study takes place without opening the chest. Cardiac catheterization allows you to take an intracardiac electrocardiogram and phonocardiogram. This method is also used to monitor the effectiveness of drug therapy.

Such studies include:

Angiography. This is a method for which a contrast agent is used. It is injected into the heart cavity or vessel for accurate visualization and determination of pathologies. Coronary angiography. This study allows you to assess the degree of damage to the coronary vessels, it helps doctors understand whether it is necessary surgery, and if not, what therapy is suitable for of this patient. Ventriculography. This is a study using an x-ray contrast method, which will determine the condition of the ventricles and the presence of pathology. All ventricular parameters can be studied, such as cavity volume measurements, cardiac output, measurements of cardiac relaxation and excitability.

In selective coronary angiography, contrast is injected into one of the coronary arteries (right or left).

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Coronary angiography is often performed in patients with angina pectoris of functional class 3-4. In this case, it is resistant to drug therapy. Doctors need to decide what kind of surgical treatment is needed. It is also important to carry out this procedure for unstable angina.

Invasive procedures also include punctures and probing of the heart cavities. Using sounding, you can diagnose heart defects and pathologies in the left ventricle, for example, these could be tumors or thrombosis. For this they use femoral vein(right), a needle is inserted into it through which a conductor passes. The needle diameter becomes about 2 mm.

When performing invasive examinations, local anesthesia is used. The incision is small, about 1-2 cm. This is necessary to expose the desired vein for installing the catheter.

These studies are carried out in different clinics and their cost is quite high.

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Surgery for heart disease

Heart defects include

heart valve stenosis; heart valve insufficiency; septal defects (interventricular, interatrial).

Valve stenosis

These pathologies lead to many disturbances in the functioning of the heart, that is, the goals of operations for defects are to relieve the load on the heart muscle, restore the normal functioning of the ventricle, as well as restore contractile function and reduce pressure in the cavities of the heart.

To eliminate these defects, the following surgical interventions are performed:

Valve replacement (prosthetics)

This type of operation is performed on an open heart, that is, after opening the chest. In this case, the patient is connected to a special machine for artificial blood circulation. The operation consists of replacing the damaged valve with an implant. They can be mechanical (in the form of a disk or ball in a mesh, they are made of synthetic materials) and biological (made of biological material animals).

Valve implant placement

Plastic surgery of septal defects

It can be carried out in 2 options, for example, suturing the defect or plastic surgery. Suturing is carried out if the hole size is less than 3 cm. Plastic surgery is performed using synthetic tissue or autopericardium.

Valvuloplasty

In this type of operation, implants are not used, but simply expand the lumen of the affected valve. In this case, a balloon is inserted into the lumen of the valve and inflated. It should be noted that such an operation is performed only on young people; as for older people, they are only entitled to open-heart surgery.

Balloon valvuloplasty

Often, after surgery for a heart defect, a person is given disability.

Surgeries on the aorta

Open surgical interventions include:

Prosthetics of the ascending aorta. In this case, a valve-containing conduit is installed; this prosthesis has a mechanical aortic valve. Prosthetics of the ascending aorta, without the aortic valve being implanted. Prosthetics of the ascending artery and its arch. Surgery to implant a stent graft in the ascending aorta. This is an endovascular intervention.

Ascending aorta replacement is the replacement of this section of the artery. This is necessary in order to prevent serious consequences, such as rupture. To do this, prosthetics are used by opening the chest, and endovascular or intravascular interventions are also performed. In this case, a special stent is installed in the affected area.

Of course, open heart surgery is more effective, since in addition to the main pathology - aortic aneurysm, it is possible to correct the accompanying one, for example, stenosis or valve insufficiency, etc. But the endovascular procedure gives a temporary effect.

Aortic dissection

When replacing the aortic arch, the following is used:

Open distal anastomosis. This is when the prosthesis is installed so that its branches are not affected; Half-replacement of the arc. This operation consists of replacing the artery where the ascending aorta meets the arch and, if required, replacing the concave surface of the arch; Subtotal prosthetics. This is when, when replacing an artery arch, replacement of branches (1 or 2) is required; Complete prosthetics. In this case, the arch is prosthetic along with all supra-aortic vessels. This is a complex intervention that can cause neurological complications. After such an intervention, the person is entitled to disability.

Coronary artery bypass grafting (CABG)

CABG is an open-heart surgery that uses the patient's blood vessel as a shunt. This heart surgery is needed to create a bypass for blood that will not affect the occlusive portion of the coronary artery.

That is, this shunt is installed on the aorta and brought to a section of the coronary artery unaffected by atherosclerosis.

This method is quite effective in the treatment of coronary heart disease. Due to the installed shunt, blood flow to the heart increases, which means ischemia and angina pectoris do not occur.

CABG is prescribed if you have angina pectoris, in which even the smallest loads cause attacks. Also, indications for CABG are lesions of all coronary arteries, and if a cardiac aneurysm has formed.

Coronary artery bypass grafting

When performing CABG, the patient is put under general anesthesia, and then after opening the chest, all manipulations are carried out. This operation can be performed with or without cardiac arrest. And also, depending on the severity of the pathology, the doctor decides whether the patient needs to be connected to a heart-lung machine. The duration of CABG can be 3-6 hours, it all depends on the number of shunts, that is, on the number of anastomoses.

As a rule, the role of a shunt is performed by a vein from lower limb, also sometimes use part of the internal mammary vein, radial artery.

Today, CABG is performed, which is performed with minimal access to the heart and at the same time the heart continues to beat. This intervention is considered not as traumatic as others. In this case, the chest is not opened; an incision is made between the ribs and a special expander is used so as not to affect the bones. This type of CABG lasts from 1 to 2 hours.

The operation is performed by 2 surgeons, while one makes an incision and opens the sternum, the other operates on the limb to take a vein.

After carrying out all the necessary manipulations, the doctor installs drains and closes the chest.

CABG significantly reduces the likelihood of a heart attack. Angina pectoris does not appear after surgery, which means the patient’s quality and life expectancy increases.

Radiofrequency ablation (RFA)

RFA is a procedure performed under local anesthesia, as the basis is catheterization. This procedure is carried out in order to exfoliate the cells that cause arrhythmia, that is, the focus. This occurs through a guide catheter that conducts an electrical current. As a result, tissue formations are removed using RFA.

Radiofrequency catheter ablation

After conducting an electrophysical study, the doctor determines where the source that causes the rapid heartbeat is located. These sources can be formed along pathways, resulting in a rhythm anomaly. It is RFA that neutralizes this anomaly.

RFA is performed in the following cases:

When drug therapy does not affect arrhythmia, and also if such therapy causes side effects. If the patient has Wolff-Parkinson-White syndrome. This pathology is perfectly neutralized by RFA. If a complication such as cardiac arrest may occur.

It should be noted that RFA is well tolerated by patients, since there are no large incisions or opening of the sternum.

A catheter is inserted through a puncture in the thigh. Only the area through which the catheter is inserted is numbed.

The guide catheter reaches the myocardium, and then a contrast agent is injected. With the help of contrast, the affected areas become visible, and the doctor points an electrode at them. After the electrode has acted on the source, the tissues become scarred, which means they will not be able to conduct the impulse. After RFA, a bandage is not needed.

Carotid artery surgery

These types of operations are distinguished into carotid artery:

Prosthetics (used for large lesions); Stenting is performed if stenosis is diagnosed. In this case, the lumen is increased by installing a stent; Eversion endarterectomy - in this case, atherosclerotic plaques are removed along with the inner lining of the carotid artery; Carotid endarectomy.

Such operations are performed both under general and under local anesthesia. Most often under general anesthesia, since the procedure is performed in the neck area and there are discomfort.

The carotid artery is pinched, and in order for the blood supply to continue, shunts are installed, which are bypass routes.

Classic endarterectomy is done if long plaque lesions are diagnosed. During this operation, the plaque is detached and removed. Next, the vessel is washed. Sometimes it is still necessary to fix inner shell, this is done with special seams. Finally, the artery is sutured using a special synthetic medical material.

Carotid endarterectomy

Eversion endartectomy is performed in such a way that the inner layer of the carotid artery at the site of the plaque is removed. And after that they fix it, that is, sew it on. To perform this operation, the plaque should be no more than 2.5 cm.

Stenting is performed using a balloon catheter. This is a minimally invasive procedure. When the catheter is located at the site of stenosis, it inflates and thereby expands the lumen.

Rehabilitation

The period after heart surgery is no less important than the operation itself. At this time, the patient’s condition is monitored by doctors, and in some cases cardio training, therapeutic diets, etc. are prescribed.

Other recovery measures are also needed, for example, you need to wear a bandage. The bandage secures the suture after the operation, and of course the entire chest, which is very important. This type of bandage should only be worn if open heart surgery is performed. The cost of these products may vary.

The bandage worn after heart surgery looks like a T-shirt with tightness fixers. You can purchase men's and female options this bandage. The bandage is important because it is necessary to prevent congestion of the lungs, for this you need to cough regularly.

Such prevention of stagnation is quite dangerous because the seams can come apart; in this case, the bandage will protect the seams and promote durable scarring.

The bandage will also help prevent swelling and hematomas, and promote the correct positioning of organs after heart surgery. And the bandage helps relieve stress on the organs.

After heart surgery, the patient needs rehabilitation. How long it will last depends on the severity of the lesion and the severity of the operation. For example, after CABG, immediately after heart surgery, you need to begin rehabilitation, this is simple exercise therapy and massage.

After all types of heart surgery, drug rehabilitation is needed, that is, maintenance therapy. In almost all situations, the use of antiplatelet agents is mandatory.

If there is high blood pressure, then prescribe ACE inhibitors and beta-blockers, as well as drugs to lower blood cholesterol (statins). Sometimes the patient is prescribed physical therapy.

Disability

It should be noted that disability is given to people with diseases of the cardiovascular system even before surgery. There must be evidence for this. From medical practice It can be noted that disability is necessarily given after coronary artery bypass grafting. Moreover, there may be a disability of both groups 1 and 3. It all depends on the severity of the pathology.

People who have circulatory disorders, stage 3 coronary insufficiency, or have suffered a myocardial infarction are also entitled to disability.

Regardless of whether the operation has been performed or not yet. Patients with heart defects of the 3rd degree and combined defects can apply for disability if there are persistent circulatory disorders.

Clinics

Name of the clinic Address and telephone Type of service Cost

Research Institute of SP named after. N.V. Sklifosovsky	Moscow, Bolshaya Sukharevskaya square, 3	CABG without IR CABG with valve replacement Angioplasty and stenting of coronary arteries RFA Aortic stenting Valve replacement Valve plastic surgery	64300 rub. 76625 rub. 27155 rub. 76625 rub. 57726 rub. 64300 rub. 76625 rub.
KB MSMU im. Sechenov	Moscow, st. B. Pirogovskaya, 6	CABG with valve replacement Angioplasty and stenting of coronary arteries RFA Aortic stenting Valve replacement Valvoplasty Aneurysm resection	132,000 rub. 185500 rub. 160,000-200,000 rub. 14300 rub. 132200 rub. 132200 rub. 132000-198000 rub.
FSCC FMBA	Moscow, Orekhovy Boulevard, 28	CABG Angioplasty and stenting of coronary arteries RFA Aortic stenting Valve replacement Valve plastic surgery	110000-140000 rub. 50,000 rub. 137,000 rub. 50,000 rub. 140,000 rub. 110000-130000 rub.
Research Institute of SP named after. I.I. Dzhanelidze	St. Petersburg, st. Budapestskaya, 3	CABG Angioplasty and stenting of coronary arteries Aortic stenting Valve replacement Valve plastics Multivalve replacement Probing of cardiac cavities	60,000 rub. 134400 rub. 25,000 rub. 60,000 rub. 50,000 rub. 75,000 rub. 17,000 rub.
St. Petersburg State Medical University named after. I.P. Pavlova	St. Petersburg, st. L. Tolstoy, 6/8	CABG Angioplasty and stenting of coronary arteries Valve replacement Multivalve replacement RFA	187000-220000 rub. 33,000 rub. 198000-220000 rub. 330,000 rub. 33,000 rub.
Sheba MC	Derech Shiba 2, Tel Hashomer, Ramat Gan	CABG Valve replacement	$30,000 $29,600
MedMira	Huttropstr. 60, 45138 Essen, Germany 49 1521 761 00 12	Angioplasty CABG Valve replacement Cardiac examination Coronary angiography with stenting	8000 euros 29000 euros 31600 euros 800-2500 euros 3500 euros
Greekomed	Central Russian office: Moscow, 109240, st. Verkhnyaya Radishchevskaya, house 9 A	CABG valve replacement	20910 euros 18000 euros

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Bondarenko Tatyana

Project expert DlyaSerdca.ru

Heart surgery helps cure many diseases of the cardiovascular system that do not respond to standard therapeutic methods. Surgical treatment can be performed in different ways, depending on the individual pathology and general condition of the patient.

Indications for surgical treatment

Cardiac surgery is a field of medicine in which doctors specialize who study, invent methods and perform operations on the heart. Heart transplantation is considered the most complex and dangerous cardiac surgery. No matter what type surgical intervention will be carried out, there are general indications:

rapid progression of cardiovascular disease;
inefficiency conservative therapy;
failure to consult a doctor in a timely manner.

Heart surgery makes it possible to improve the patient’s general condition and eliminate the symptoms that bother him. Surgical treatment is performed after complete medical examination and establishing an accurate diagnosis.

Surgeries are performed for congenital or acquired heart defects. A congenital defect is detected in a newborn immediately after birth or before birth. ultrasound examination. Thanks to modern technologies and techniques, in many cases it is possible to detect and treat heart defects in newborns in a timely manner.

An indication for surgical intervention can also be coronary disease, which is sometimes accompanied by such a serious complication as myocardial infarction. Another reason for surgical intervention may be cardiac arrhythmia, since this disease tends to cause ventricular fibrillation (disjointed contraction of fibers). The doctor should tell the patient how to properly prepare for heart surgery in order to avoid negative consequences and complications (such as blood clots).

Advice: proper preparation to heart surgery is the key to successful recovery of the patient and prevention postoperative complications, such as a blood clot or blockage of a vessel.

Types of operations

Cardiac surgeries can be performed on an open heart as well as a beating heart. Closed operation on the heart is usually performed without affecting the organ itself and its cavity. Open heart surgery involves opening the chest and connecting the patient to a ventilator.

During open heart surgery, the heart is temporarily stopped for several hours to allow the necessary manipulations to be performed. This technique makes it possible to cure complex heart defects, but is considered more traumatic.

During beating heart surgery, special equipment is used so that the heart continues to contract and pump blood during surgery. The advantages of this surgical intervention include the absence of complications such as embolism, stroke, pulmonary edema, etc.

There are the following types of heart surgeries, which are considered the most common in cardiological practice:

radiofrequency ablation;
coronary artery bypass grafting;
valve replacement;
Glenn operation and Ross operation.

If surgery is performed with access through a vessel or vein, endovascular surgery (stenting, angioplasty) is used. Endovascular surgery is a branch of medicine that allows surgery to be performed under X-ray guidance and using miniature instruments.

Endovascular surgery makes it possible to cure the defect and avoid the complications that abdominal surgery gives, helps in the treatment of arrhythmia and rarely causes such a complication as a blood clot.

Advice: surgical treatment Heart pathologies have their advantages and disadvantages, so the most suitable type of operation is selected for each patient, which carries fewer complications specifically for him.

Radiofrequency or catheter ablation (RFA) is a minimally invasive surgical intervention that has a high therapeutic effect and has a minimal number of side effects. This treatment is indicated for atrial fibrillation, tachycardia, heart failure and other cardiac pathologies.

Arrhythmia itself is not a serious pathology requiring surgical intervention, but can lead to serious complications. Thanks to RFA, it is possible to restore normal heart rhythm and eliminate main reason his violations.

RFA is performed using catheter technology and under X-ray control. Heart surgery is performed under local anesthesia and involves inserting a catheter to the required area of the organ that sets the abnormal rhythm. Through an electrical impulse under the influence of RFA, the normal rhythm of the heart is restored.

Attention! The information on the site is presented by specialists, but is for informational purposes only and cannot be used for self-treatment. Be sure to consult your doctor!

Indications for surgical treatment

Cardiac surgery is a field of medicine in which doctors specialize who study, invent methods and perform operations on the heart. Heart transplantation is considered the most complex and dangerous cardiac surgery. Regardless of what type of surgery will be performed, there are general indications:

rapid progression of cardiovascular disease; ineffectiveness of conservative therapy; failure to consult a doctor in a timely manner.

Heart surgery makes it possible to improve the patient’s general condition and eliminate the symptoms that bother him. Surgical treatment is carried out after a complete medical examination and an accurate diagnosis has been established.

Heart disease

Surgeries are performed for congenital or acquired heart defects. A congenital defect is detected in a newborn immediately after birth or before birth through an ultrasound examination. Thanks to modern technologies and techniques, in many cases it is possible to detect and treat heart defects in newborns in a timely manner.

Advice: proper preparation for heart surgery is the key to the patient’s successful recovery and the prevention of postoperative complications, such as a blood clot or blockage of a vessel.

Types of operations

Cardiac surgeries can be performed on an open heart as well as a beating heart. Closed heart surgery is usually performed without affecting the organ itself and its cavity. Open heart surgery involves opening the chest and connecting the patient to a ventilator.

Endovascular intervention

There are the following types of heart surgeries, which are considered the most common in cardiological practice:

radiofrequency ablation; coronary artery bypass grafting; stenting of coronary arteries; valve replacement; Glenn operation and Ross operation.

Advice: Surgical treatment of heart pathologies has its advantages and disadvantages, therefore, the most suitable type of operation is selected for each patient, which carries fewer complications specifically for him.

Radiofrequency ablation

Coronary artery bypass grafting

Coronary artery bypass grafting (CABG) helps restore blood supply to the heart muscle. Unlike the RFA technique, this treatment gives a high result due to the formation of a new passage for blood flow. This is necessary in order to bypass the affected vessels using special shunts. To do this, take a vein or artery from the patient's lower limb or arm.

This type of heart surgery helps prevent the development of myocardial infarction and atherosclerotic plaques. Its essence lies in the fact that sclerotic vessels are replaced with healthy ones. Often, after bypass surgery, an angioplasty technique is used, when a tube is inserted with a balloon into the damaged vessel through the vessels (femoral artery). Pressurized air puts pressure on the plaques (thrombus) in the aorta or artery and helps remove or promote them.

Stenting of coronary arteries

Stenting

Together with angioplasty, stenting can be performed, during which a special stent is installed. It expands the narrowed lumen in the aorta or other vessel and helps prevent blood clots and remove atherosclerotic plaque, as well as normalize blood flow. All these manipulations can be carried out simultaneously, so that repeated surgery is not prescribed.

The most common heart defect is a narrowing of the valve or its insufficiency. Treatment of such a pathology should always be radical and consist of correction of valvular lesions. Its essence lies in prosthetics mitral valve. Indication for replacement surgery heart valve there may be severe valve insufficiency or fibrosis of the leaflets.

If there is a serious disturbance in heart rhythm and the presence of atrial fibrillation, there is a serious need to install a special device called a pacemaker. A pacemaker is necessary to normalize the rhythm and heart rate, which can be disturbed by arrhythmia. To normalize the heart rhythm, a defibrillator may be installed, which has the same type of effect as a pacemaker.

Heart valve replacement

A patient who has a pacemaker should undergo frequent medical examinations.

During surgery, a mechanical or biological implant is installed. Patients who have a pacemaker must adhere to certain restrictions in their lives. Some time after installation, a blood clot or other complication may appear, so lifelong use of special medicines.

Glenn operation and Ross operation

Glenn's operation is part of the complex correction stage for children who have a congenital heart defect. Its essence is to create an anastomosis connecting the superior vena cava and the right pulmonary artery. After the treatment has been carried out, the patient can live a full life.

Ross's procedure involves replacing a patient's damaged aortic valve with his own pulmonary valve.

Can also be used to treat arrhythmia laser cauterization. Cauterization can be performed using ultrasound or high frequency current. Cauterization helps to completely eliminate the signs of arrhythmia, tachycardia and heart failure.

Thanks to modern technologies and the development of medicine, it has become possible to carry out effective treatment arrhythmias, eliminate heart defects in newborns, or cure other pathologies with heart surgery. Some time after such an operation, many people can live their normal lives, with only some restrictions.

Attention! The information on the site is presented by specialists, but is for informational purposes only and cannot be used for independent treatment. Be sure to consult your doctor!

DlyaSerdca → Symptoms and treatment → Surgeries and invasive studies of the heart

Heart operations are performed very often today. Modern cardiac and vascular surgery are very developed. Surgical intervention is prescribed when conservative drug treatment does not help, and accordingly, normalization of the patient’s condition is impossible without surgery.

For example, a heart defect can only be cured surgically; this is necessary when blood circulation is severely impaired due to pathology.

And as a result, the person feels unwell and serious complications begin to develop. These complications can lead not only to disability, but also to death.

Operations can be performed urgently, urgently, or scheduled intervention. This depends on the severity of the patient's condition. Emergency surgery is performed immediately, immediately after diagnosis. If such intervention is not carried out, the patient may die.

Such operations are often performed on newborns immediately after birth with congenital heart disease. In this case, even minutes matter.

Emergency operations do not require quick implementation. In this case, the patient is prepared for some time. As a rule, this is several days.

Invasive research

For example, blood pressure in any part of the myocardium, as well as determine how much oxygen is in the blood, evaluate cardiac output, vascular resistance.

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Such studies include:

Angiography. This is a method for which a contrast agent is used. It is injected into the heart cavity or vessel for accurate visualization and determination of pathologies. Coronary angiography. This study allows you to assess the degree of damage to the coronary vessels, it helps doctors understand whether surgery is necessary, and if not, what therapy is suitable for a given patient. Ventriculography. This is a study using an x-ray contrast method, which will determine the condition of the ventricles and the presence of pathology. All ventricular parameters can be studied, such as cavity volume measurements, cardiac output, measurements of cardiac relaxation and excitability.

In selective coronary angiography, contrast is injected into one of the coronary arteries (right or left).

Invasive procedures also include punctures and probing of the heart cavities. Using sounding, you can diagnose heart defects and pathologies in the left ventricle, for example, these could be tumors or thrombosis. To do this, use the femoral vein (right), a needle is inserted into it through which a conductor passes. The needle diameter becomes about 2 mm.

When performing invasive examinations, local anesthesia is used. The incision is small, about 1-2 cm. This is necessary to expose the desired vein for installing the catheter.

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These studies are carried out in different clinics and their cost is quite high.

Surgery for heart disease

Heart defects include

heart valve stenosis; heart valve insufficiency; septal defects (interventricular, interatrial).

Valve stenosis

To eliminate these defects, the following surgical interventions are performed:

Valve replacement (prosthetics)

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Valve implant placement

Plastic surgery of septal defects

Valvuloplasty

Balloon valvuloplasty

Often, after surgery for a heart defect, a person is given disability.

Surgeries on the aorta

Open surgical interventions include:

Aortic dissection

When replacing the aortic arch, the following is used:

Coronary artery bypass grafting (CABG)

That is, this shunt is installed on the aorta and brought to a section of the coronary artery unaffected by atherosclerosis.

This method is quite effective in the treatment of coronary heart disease. Due to the installed shunt, blood flow to the heart increases, which means ischemia and angina pectoris do not occur.

CABG is prescribed if you have angina pectoris, in which even the smallest loads cause attacks. Also, indications for CABG are lesions of all coronary arteries, and if a cardiac aneurysm has formed.

Coronary artery bypass grafting

As a rule, the role of a shunt is performed by a vein from the lower limb; sometimes a part of the internal mammary vein or radial artery is also used.

The operation is performed by 2 surgeons, while one makes an incision and opens the sternum, the other operates on the limb to take a vein.

After carrying out all the necessary manipulations, the doctor installs drains and closes the chest.

CABG significantly reduces the likelihood of a heart attack. Angina pectoris does not appear after surgery, which means the patient’s quality and life expectancy increases.

Radiofrequency ablation (RFA)

Radiofrequency catheter ablation

RFA is performed in the following cases:

when drug therapy does not affect the arrhythmia, and also if such therapy causes side effects. If the patient has Wolff-Parkinson-White syndrome. This pathology is perfectly neutralized by RFA. If a complication such as cardiac arrest may occur.

It should be noted that RFA is well tolerated by patients, since there are no large incisions or opening of the sternum.

A catheter is inserted through a puncture in the thigh. Only the area through which the catheter is inserted is numbed.

Carotid artery surgery

There are the following types of operations on the carotid artery:

Such operations are performed under both general and local anesthesia. Most often under general anesthesia, since the procedure is performed in the neck area and there are unpleasant sensations.

The carotid artery is pinched, and in order for the blood supply to continue, shunts are installed, which are bypass routes.

Classic endarterectomy is done if long plaque lesions are diagnosed. During this operation, the plaque is detached and removed. Next, the vessel is washed. Sometimes it is still necessary to fix the inner shell; this is done with special stitches. Finally, the artery is sutured using a special synthetic medical material.

Carotid endarterectomy

Stenting is performed using a balloon catheter. This is a minimally invasive procedure. When the catheter is located at the site of stenosis, it inflates and thereby expands the lumen.

Rehabilitation

The bandage worn after heart surgery looks like a T-shirt with tightness fixers. You can purchase male and female versions of this headband. The bandage is important because it is necessary to prevent congestion of the lungs, for this you need to cough regularly.

Such prevention of stagnation is quite dangerous because the seams can come apart; in this case, the bandage will protect the seams and promote durable scarring.

The bandage will also help prevent swelling and hematomas, and promote the correct positioning of organs after heart surgery. And the bandage helps relieve stress on the organs.

After all types of heart surgery, drug rehabilitation is needed, that is, maintenance therapy. In almost all situations, the use of antiplatelet agents is mandatory.

If there is high blood pressure, then ACE inhibitors and beta-blockers, as well as drugs to lower blood cholesterol (statins), are prescribed. Sometimes the patient is prescribed physical therapy.

Disability

It should be noted that disability is given to people with diseases of the cardiovascular system even before surgery. There must be evidence for this. From medical practice, it can be noted that disability is necessarily given after coronary artery bypass surgery. Moreover, there may be a disability of both groups 1 and 3. It all depends on the severity of the pathology.

People who have circulatory disorders, stage 3 coronary insufficiency, or have suffered a myocardial infarction are also entitled to disability.

Clinics

Research Institute of SP named after. N.V. Sklifosovsky	Moscow, Bolshaya Sukharevskaya square, 3	CABG without IR CABG with valve replacement Angioplasty and stenting of coronary arteries RFA Aortic stenting Valve replacement Valve plastic surgery	64300 rub. 76625 rub. 27155 rub. 76625 rub. 57726 rub. 64300 rub. 76625 rub.
KB MSMU im. Sechenov	Moscow, st. B. Pirogovskaya, 6	CABG with valve replacement Angioplasty and stenting of coronary arteries RFA Aortic stenting Valve replacement Valvoplasty Aneurysm resection	132,000 rub. 185500 rub. 160,000-200,000 rub. 14300 rub. 132200 rub. 132200 rub. 132000-198000 rub.
FSCC FMBA	Moscow, Orekhovy Boulevard, 28	CABG Angioplasty and stenting of coronary arteries RFA Aortic stenting Valve replacement Valve plastic surgery	110000-140000 rub. 50,000 rub. 137,000 rub. 50,000 rub. 140,000 rub. 110000-130000 rub.
Research Institute of SP named after. I.I. Dzhanelidze	St. Petersburg, st. Budapestskaya, 3	CABG Angioplasty and stenting of coronary arteries Aortic stenting Valve replacement Valve plastics Multivalve replacement Probing of cardiac cavities	60,000 rub. 134400 rub. 25,000 rub. 60,000 rub. 50,000 rub. 75,000 rub. 17,000 rub.
St. Petersburg State Medical University named after. I.P. Pavlova	St. Petersburg, st. L. Tolstoy, 6/8	CABG Angioplasty and stenting of coronary arteries Valve replacement Multivalve replacement RFA	187000-220000 rub. 33,000 rub. 198000-220000 rub. 330,000 rub. 33,000 rub.
Sheba MC	Derech Shiba 2, Tel Hashomer, Ramat Gan	CABG Valve replacement	$30,000 $29,600
MedMira	Huttropstr. 60, 45138 Essen, Germany 49 1521 761 00 12	Angioplasty CABG Valve replacement Cardiac examination Coronary angiography with stenting	8000 euros 29000 euros 31600 euros 800-2500 euros 3500 euros
Greekomed	Central Russian office: Moscow, 109240, st. Verkhnyaya Radishchevskaya, house 9 A	CABG valve replacement	20910 euros 18000 euros

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The treatment of heart disease using surgery is the field of surgery and cardiology, which is called cardiac surgery. Today, cardiac surgery is the most effective method treatment of certain types of heart defects, coronary heart disease and helps prevent the development of myocardial infarction, as well as eliminate its consequences - aneurysms.
Surgery used only in cases where conservative treatment methods no longer help and the patient’s condition worsens. A patient’s failure to see a doctor in a timely manner can also lead to heart surgery. the only way The only help left is surgery.

Today, cardiac surgery is one of the most actively developing and technically equipped branches of medicine. Open heart surgery is performed on 700 patients every year. The bulk of operations are in the United States. In Europe, the number of operations is 4 times less. In Asian countries, cardiac surgery is practically absent. In Russia, the number of heart surgeries performed is below the required minimum. This statistic is due to the fact that heart surgery is expensive. In addition to open-heart surgery, surgery is also performed without opening the parts of the heart (for example, implantation of pacemakers, angioplasty).

Surgical intervention is required for diseases such as:

1. Coronary heart disease and its consequences (myocardial infarction);
2. Heart defects.
3. Heart rhythm disturbance.

Cardiac ischemia

Coronary heart disease occurs as a result of insufficient blood supply to the working myocardium. The main reason for the development of coronary heart disease is atherosclerosis (the formation of plaques on the walls blood vessels). A slight narrowing of the lumen of the vessel leads to angina pectoris (a person feels pain only when the heart’s need for oxygen increases, for example, when physical activity). Severe narrowing of the lumen of the vessel causes painful sensations even at rest, pain attacks can also become more frequent and the duration increases - unstable angina. If coronary blood flow is severely impaired, the muscle fibers of the heart die - this is myocardial infarction.

One of severe complications myocardial infarction is the formation of a post-infarction aneurysm of the left ventricle. An aneurysm is a bubble-like protrusion. It forms when dead tissue is replaced by scar tissue, which in turn is unable to contract. Under the pressure of healthy contracting fibers, the scar tissue bulges, and some of the blood is retained in the ventricle in the area of aneurysmal expansion. With each contraction, organs and tissues receive less blood in an amount equal to the volume of the aneurysm. This is its main negative meaning. Very often, blood clots form in the area of the aneurysm, which can break off and be carried by the bloodstream to any organ, causing a heart attack (death of part or all of the organ). When a blood clot enters the brain, a stroke occurs.

Surgical intervention (heart surgery) for coronary heart disease is aimed at restoring normal nutrition to all parts of the heart. The degree of damage to the coronary arteries will determine what kind of surgery should be done. Analysis of the condition of the vessels is carried out using coronary angiography - this is a radiopaque research method that allows you to determine the location, nature and degree of narrowing of the coronary artery. Most often, stenting is performed on the coronary artery that causes pain syndrome. In case of severe atherosclerotic damage to the coronary vessels, the patient requires coronary artery bypass surgery.

Types of surgery for coronary heart disease

Angioplasty and stenting of coronary arteries

Angioplasty and stenting are aimed at removing obstructions to blood flow by widening the artery from the inside.
The operation is carried out as follows: using special equipment, a catheter is inserted through a puncture in the thigh area under the control of a fluorographic drug into the artery that feeds the heart. It must reach the site of narrowing of the artery, where a special balloon with a stent is inflated - a device that does not allow the artery to collapse. The stent remains in the artery, and the catheter is brought out through the same hole in the thigh.

Coronary artery bypass grafting (CABG)

Coronary artery bypass surgery - restoration of blood supply to the heart muscle by creating a new path for blood flow bypassing the affected area coronary vessel using shunts - pieces of arteries or veins taken from the patient himself (for example, in the area of a limb). This operation is aimed at preventing myocardial infarction. Today, CABG operations are performed both using a heart-lung machine and on a beating heart (immobility of the heart only in the operated area).
One of the types of coronary bypass surgery is mammary coronary artery bypass grafting (MCBG). The internal mammary artery is used as a shunt. The use of this vessel is advantageous, since in this case there is no need to make additional incisions due to the close location of the thoracic artery and the heart, and also because atherosclerotic plaques do not form in the artery, and therefore the service life of such a shunt is quite long.

Plastic surgery of post-infarction left ventricular aneurysm

The essence of the intervention is to reduce the volume of the left ventricle by delineating the area of aneurysmal dilatation and the healthy part of the left ventricle. The surgeon removes the resulting blood clots in the area of the aneurysm, then sews a septum made of dense elastic human tissue across the cavity of the left ventricle. Two cavities are formed: one with normal, actively contracting walls, the other - from scar tissue that is not capable of contracting, but does not interfere normal operation hearts. Thus, blood circulation is restored and the danger of blood clot rupture is eliminated.

Heart defects

Heart defects are defects in the structure of the heart that lead to disruption of normal blood circulation, stagnation of blood occurs in the small or big circle blood circulation
The following violations are identified:

- stenosis (narrowing) of the valve apparatus;
With valve stenosis, it stops allowing the required volume of blood through the reduced opening.
- insufficiency of the valve apparatus;
The valve flaps cannot close tightly and allow blood to flow in the opposite direction to normal blood flow.

-defects of the interventricular and interatrial septum;
When these septa are defective, blood enters a cavity with a higher pressure into a cavity with a lower pressure, and deoxygenated blood, poor in oxygen, mixes with oxygenated arterial, which leads to oxygen starvation of tissues.
Heart defects can be congenital or acquired. Most of them do not require surgery. Sometimes the disease proceeds unnoticed by the patient. Congenital heart disease can improve with age, but if this does not happen and signs of heart failure increase, then surgical intervention is required.

Treatment of heart defects is aimed at correcting the existing mechanical defect in the functioning of the heart.

The following types of surgical intervention are distinguished:

Prosthetics and plastic surgery of heart valves

Operations to install prostheses are performed on an open heart, using a heart-lung machine.
Valve prostheses can be mechanical or biological.

Mechanical valves

Mechanical valves are made of metal and plastic. The validity period of such prostheses is about 80 years. However, when using them, a person has to take anticoagulants daily, since blood clots easily form on prostheses, which contribute to the formation of blood clots. In rare cases, a mechanical prosthesis may break, which most often leads to the death of the patient. Mechanical valve prostheses can be in the form
- rotating disk
The disc completely covers the hole, but is secured only at one end. Blood moving in the right direction presses on the disc, rotates it on a hinge and opens the hole; when the blood flows back, the disc completely blocks the hole.
- built on the principle of a ball in a grid
The blood flow in the right direction pushes the ball out of the hole, pressing it to the bottom of the mesh and thereby creating the possibility of further passage of blood; reverse blood flow pushes the ball into the hole, which is thus closed and does not allow blood to pass through.

Biological valves

Biological prostheses are usually made from animal heart tissue and are considered more effective. After their installation, there is no need for treatment with anticoagulants, which have many contraindications. Such a prosthesis lasts from 10 to 20 years, its aging occurs gradually and you can prepare in advance for its replacement as planned. Of course, in this case a repeat operation is needed.
Biological valves do not necessarily require the use of anticoagulants (although it is often recommended), but they wear out faster than mechanical valves.

Plastic surgery of atrial and interventricular septal defects

If the structure of the septum is damaged and the size of the defect is small (the hole size is no more than 3 cm), it is sutured, and if it is large in size, it is repaired with a patch (using synthetic fabrics or autopericardium)

Heart rhythm disturbance

Cardiac arrhythmias are disturbances in the sequence, rhythm and frequency of contractions of the heart. Arrhythmias may occur as a consequence metabolic disorders, for example, endocrine and vegetative, or the effects of certain medications. They are also often caused by heart disease, and sometimes by intoxication.
The danger of arrhythmia is that it can lead to ventricular fibrillation (disjointed contraction of fibers).
Used to treat arrhythmia medicines, catheter ablation, or a pacemaker (pacemaker) is implanted.

Surgical methods for treating arrhythmias:

Radiofrequency ablation

It is minimally invasive surgical method, which is used for:
- high heart rate with pronounced pulse deficit;
- atrial fibrillation;
- progressive heart failure;
- supraventricular tachycardia.

The radiofrequency ablation method involves passing a special catheter to the area of the heart that causes an abnormal pathological rhythm. An electrical impulse is applied to this section, which destroys the area of tissue that sets the wrong rhythm.
Thanks to ablation, normal heart rhythm is restored.

Pacemaker implantation

The operation is performed on patients with heart rhythm disturbances that are life-threatening. A pacemaker aims to control and restore normal heart contraction.
Doctors implant a special device under the skin or under the pectoral muscle. Two or three electrodes extend from the pacemaker and connect to the chambers of the heart to transmit an electrical impulse to them.

Defibrillator implantation

The principle of operation of a defibrillator is similar to a pacemaker. Distinctive feature it is to eliminate too fast and too slow heart rates. Heart rhythm is assessed using electrodes. Installing a defibrillator is similar to installing a pacemaker.

Installation of a defibrillator is indicated for ventricular tachycardia.

Heart transplant

In critical cases, when the heart cannot perform its function and does not respond to any treatment, a heart transplant is resorted to. Thanks to this operation, doctors prolong the patient’s life by about 5 years. Research is currently underway to prolong the life of people who have had heart transplants.

Postoperative recovery period

An important stage of recovery after surgery is the period postoperative recovery. Strict monitoring of human health is necessary. This period is different and individual for each patient. Patients are prescribed special cardio training and diets. Emotional calm is necessary.

Heart surgery is dangerous due to its complications. The main signs of complications are fever, pain in the operated area, tachycardia, falling blood pressure, shortness of breath. The ECG records characteristic changes. Recovery period lasts six months to a year.

An example of monitoring the health of postoperative patients is the work of a doctor medical sciences, professor, arrhythmologist Andrei Vyacheslavovich Ardashev. He performs more than 200 operations per year. Postoperative monitoring of patients began in 2011 using the project. The doctor monitors both the cardiovisor conclusion and the ECG itself in postoperative patients. Using the website service helps monitor the recovery of the health of operated people via the Internet. This is a huge plus because a large number of patients come to Moscow from all over Russia to undergo heart surgery. They pass the postoperative period at home. Using the Cardiovisor allows you to take ECG readings at home and send them to the doctor using the website.

Rostislav Zhadeiko, especially for the project.