Olanrewaju Efuntade

MEDICAL PROCEDURES

CORONARY ARTERY BYPASS GRAFT (CABG)

•Coronary artery bypass graft (CABG) is a surgical procedure that reroutes blood flow around a blocked coronary artery. In the procedure, a transplanted piece of vessel, called a graft, allows blood to "bypass" the blockage in the artery. CABG surgery creates new routes around narrowed and blocked arteries, allowing sufficient blood flow to deliver oxygen and nutrients to the heart muscle.

•ACBG surgery is advised for selected groups of patients with significant narrowing’s and blockages of the heart arteries (coronary artery disease).

Coronary artery disease (CAD) occurs when atherosclerotic plaque (hardening of the arteries) builds up in the wall of the arteries that supply the heart. This plaque is primarily made of cholesterol. Plaque accumulation can be accelerated by smoking, high blood pressure, elevated cholesterol, and diabetes. Patients are also at higher risk for plaque development if they are older (greater than 45 years for men and 55 years for women), or if they have a positive family history for early heart artery disease. When a blood clot (thrombus) forms on top of this plaque, the artery becomes completely blocked causing a heart attack.

CABG… CORONARY ARTERY BYPASS GRAFT

Grafts are created using healthy blood vessels taken from other parts of the body. Both the saphenous vein then and internal mammary artery is frequently used. The internal mammary arteries are close to the heart. In a CABG procedure using mammary arteries, one end of the vessel remains attached to the blood source while the other end is rerouted and connected beyond the blockage in your coronary artery.In the procedure using saphenous vein, a part of the vessel is removed from your leg. The resulting graft is like a small section of a hose. One end of the graft is connected to the aorta, the large artery that feeds the coronary arteries, and the other end is connected to a point on the coronary artery just beyond the blockage. This creates a detour for oxygen-rich blood to reach the heart

Coronary Artery Bypass Grafting is a treatment option when other measures fail, when there are multiple blockages in the arteries, or when critically blocked coronary arteries create an imminent risk for a heart attack. CABG surgery and is associated with certain risks; however, the procedure has become very common. It is one of the most effective treatments for CAD.

HEART VALVES REPLACEMENT…….Heart valve surgery is used to repair or replace diseased heart valves. There are four valves in the heart:1. Aortic valve

2. Mitral valve

3. Tricuspid valve

4. Pulmonary valve

The valves control the direction of blood flow through your heart. The opening and closing of the heart valves produce the sound of the heartbeat.

VALVES……..DEFECTS

Heart valve surgery may be recommended for the following conditions:

Narrowing of the heart valve (stenosis)

Leaking of the heart valve (regurgitation)

Valve problems may be caused by:

Birth defects

Calcium deposits (calcification)

Infections such as rheumatic fever

Medications

PROCEDURE……..

Heart valve surgery is open-heart surgery that is done while the patient is under general anesthesia. A cut is made through the breast bone (sternum). The blood is routed away from the heart to a heart-lung bypass machine. This machine keeps the blood circulating while the heart is being operated on.

VALVES……..TYPES

Valves may be repaired or replaced. Replacement heart valves are either natural (biologic) or artificial (mechanical):

Natural valves are from human donors (cadavers).

Modified natural valves come from animal donors. (Porcine valves are from pigs, bovine are from cows.) These are placed in synthetic rings.

Artificial valves are made of metal.

IMPLANTABLE CARDIOVERTER DEFIBRILLATOR…(ICD)

An ICD (implantable cardioverter defibrillator) is an electronic device that constantly monitors your heart rhythm. When it detects a very fast, abnormal heart rhythm, it delivers energy to the heart muscle. This causes the heart to beat in a normal rhythm again.

ICD………..PROCEDURE

The ICD is usually implanted using the endocardial (transvenous) approach. During the procedure, a local anesthetic is injected to numb the area, and the patient is usually awake during the procedure.

Small incisions are made in the chest where the lead (or leads) and device are inserted. The lead is inserted through the incision and into a vein, then guided to the heart with the aid of the fluoroscopy machine. The lead tip is attached to the heart muscle, while the other end of the lead is attached to the pulse generator. The generator is placed in a pocket created under the skin in the upper chest.

ICD……FUNCTIONS

The ICD monitors the heart rhythm, identifies abnormal heart rhythms and determines the appropriate therapy to return your heartbeat to a normal heart rhythm. Your doctor programs the ICD to include one or all of the following functions:

•Anti-tachycardia pacing (ATP) – When the heart beats too fast, a series of small electrical impulses are delivered to the heart muscle to restore a normal heart rate and rhythm.

•Cardioversion – A low energy shock is delivered at the same time as your heartbeat to restore a normal heart rhythm.

•Defibrillation – When the heart is beating dangerously fast, a high-energy shock is delivered to the heart muscle to restore a normal rhythm.

•Bradycardia pacing – When the heart beats too slow, small electrical impulses are sent to stimulate the heart muscle to maintain a suitable heart rate.

REFERENCE……….

• http://my.clevelandclinic.org/heart/services/tests/procedures/icd.aspx

• http://www.medmovie.com/mmdatabase/MediaPlayer.aspx?ClientID=65&TopicID=594

• http://www.nlm.nih.gov/medlineplus/ency/presentations/100161_1.htm

• http://www.nlm.nih.gov/medlineplus/ency/article/002954.htm

• http://www.adamimages.com/