Coronary Interventions

May 19, 2024

Coronary Interventions

Introduction

  • Definition: Medical procedure to widen blocked coronary arteries.
  • Importance: Restores blood flow, treats chest pain (angina), and heart attacks.
  • Presenter: Dr. Lee from Seoul Summary's Hospital.

Coronary Stent Procedure

  • Process:
    • Inserted through wrist or leg vessels.
    • Stent navigated to heart via tube.
    • Metal stent expands narrowed vessels.

Before Stents

  • Procedure: Only balloon dilation.
  • Condition:
    • Atherosclerosis: Cholesterol buildup in blood vessels.
    • Angina: Insufficient blood supply to the heart muscle.
    • Myocardial Infarction: Complete blockage causing muscle necrosis.

Advantages Over Surgery

  • Quicker: 1-2 hour procedure with same or next-day discharge.
  • Fewer Complications: Less risk of wounds and post-surgery issues.
  • Preference: Often recommended over surgery, unless in cases of severe conditions or multivascular diseases.

Coronary Stent Details

  • Material: Metal, remains in the blood vessel post-procedure.
  • Drug Stents: Coated with anti-cancer drugs to prevent muscle cell proliferation and restenosis.
  • Lifespan: Permanent once placed.

Risks and Complications

  • Complications: Leakage, rupture, stent displacement, blocking blood flow, and infection.
  • Restenosis Rate: 5-10% recurrence per year; higher if medication is stopped.
  • High-Risk Patients: Myocardial infarction patients are at greater risk of recurrence.

Contraindications and Post-Procedure Care

  • Contraindications: Limited life expectancy or severe comorbid diseases.
  • Medication: Long-term antiplatelet drugs (6-12 months dual therapy, then lifelong single drug).

Rehabilitation and Lifestyle Changes

  • Rehabilitation: Active medication and cardiac rehabilitation exercises essential post-procedure.
  • Complications of Myocardial Infarction:
    • Reduced heart function.
    • Longer closure period and larger range: More severe and sometimes non-recoverable complications.

Prevention

  • Lifestyle Management: Cannot cure heart disease, only provide temporary relief.
  • Risk Factors:
    • Diabetes, high blood pressure, and hyperlipidemia management.
    • Adopting healthier habits: Low salt, low grease diet, quit smoking, regular exercise (e.g., walking).

Conclusion

  • Key Takeaway: Coronary Interventions are life-saving, require medication and lifestyle changes.
  • Questions/Comments: Encouraged for further clarity.