Surgeries and invasive studies of the heart. Surgeries on the heart and blood vessels: types, features How to perform heart surgery

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.

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 be cured only by surgery. 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 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.

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.

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:

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

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 in case of 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. 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.

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

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:

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.
Prosthetic replacement 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.

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 the 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.

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 the lower limb; sometimes a part of the internal mammary vein or radial artery is also used.

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.

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 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.

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

There are the following types of operations on the 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 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

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 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 location 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, that is, maintenance therapy, is needed. 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 mandatory 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.

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

link to article.

Clinic name	Address and telephone	Type of service	Price
Research Institute of SP named after. N.V. Sklifosovsky	Moscow, Bolshaya Sukharevskaya square, 3	CABG without IR CABG with valve replacement Aortic stenting Valve replacement Valvoplasty	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 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	Angioplasty and stenting of coronary arteries Aortic stenting Valve replacement Valvoplasty	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	Angioplasty and stenting of coronary arteries Aortic stenting Valve replacement Valvoplasty Multivalve replacement Probing of the heart 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	Angioplasty and stenting of coronary arteries Valve replacement Multivalve replacement	187000-220000 rub. 33000 rub. 198000-220000 rub. 330,000 rub. 33000 rub.
Sheba MC	Derech Shiba 2, Tel Hashomer, Ramat Gan	Valve replacement	30000 dollars 29600 dollars

Cardiac surgery is a branch of medicine devoted to the surgical treatment of the heart. In case of pathologies of the cardiovascular system, such intervention is a last resort. Doctors try to restore the patient’s health without surgery, but in some cases only cardiac surgery can save the patient. Today, this field of cardiology uses the latest advances in science to return the patient to health and a full life.

Indications for operations

Invasive cardiac interventions are complex and risky work; it requires skill and experience, and the patient – preparation and implementation of recommendations. Because such operations involve risks, they are performed only when absolutely necessary. In most cases, they try to rehabilitate the patient with the help of medications and therapeutic procedures. But in cases where such methods do not help, heart surgery is needed. The surgery is performed in a hospital setting and in complete sterility, the patient being operated on is under anesthesia and under the control of the surgical team.

Such interventions are needed for congenital or acquired heart defects. The first include pathologies in the anatomy of the organ: defects of the valves, ventricles, impaired blood circulation. Most often they are discovered during pregnancy. Heart defects are also diagnosed in newborns; often such pathologies need to be eliminated urgently in order to save the baby’s life. Among acquired diseases, coronary disease is the leader; in this case, surgery is considered the most effective method of treatment. Also in the heart area there are: impaired blood circulation, stenosis or valve insufficiency, heart attack, pericardial pathologies and others.

Heart surgery is prescribed in situations where conservative treatment does not help the patient, the disease progresses rapidly and is life-threatening, in pathologies that require urgent and immediate correction, and in advanced forms of disease, late consultation with a doctor.

The decision to prescribe an operation is made by a council of doctors or. The patient must be examined to establish an accurate diagnosis and type of surgical intervention. Chronic diseases and stages of the disease are identified, risks are assessed, in which case they talk about planned surgery. If emergency assistance is needed, for example, in case of a blood clot or aneurysm dissection, minimal diagnostics are performed. In any case, the function of the heart is surgically restored, its parts are rehabilitated, blood flow and rhythm are normalized. In severe situations, the organ or its parts can no longer be corrected, then prosthetics or transplantation are prescribed.

Classification of heart operations

There can be dozens of different diseases in the area of the heart muscle, these are: failure, narrowing of the lumens, ruptures of blood vessels, stretching of the ventricles or atria, purulent formations in the pericardium and much more. To solve each problem, surgery has several types of operations. They are distinguished by urgency, effectiveness and method of influencing the heart.

The general classification divides them into operations:

Buried - used to treat arteries, large vessels, aorta. During such interventions, the chest of the person being operated on is not opened, and the heart itself is also not touched by the surgeon. That’s why they are called “closed” - the heart muscle remains intact. Instead of a strip opening, the doctor makes a small incision in the chest, most often between the ribs. Closed types include: bypass surgery, balloon angioplasty, stenting of blood vessels. All these manipulations are designed to restore blood circulation; sometimes they are prescribed to prepare for future open surgery.
Open – carried out after opening the sternum and sawing the bones. During such manipulations, the heart itself can also be opened to get to the problem area. Typically, the heart and lungs must be stopped for such operations. To do this, they connect the artificial blood circulation machine - AIK, it compensates for the work of the “disabled” organs. This allows the surgeon to carry out the work carefully, and the procedure under AI control takes longer, which is necessary when eliminating complex pathologies. During open operations, the AIC may not be connected, but only the desired zone of the heart can be stopped, for example, during coronary artery bypass grafting. Opening the chest is necessary to replace valves, prosthetics, and eliminate tumors.
X-ray surgery - similar to a closed type of operation. The essence of this method is that the doctor moves a thin catheter through the blood vessels and gets to the heart. The chest is not opened; the catheter is placed in the thigh or shoulder. A contrast agent is supplied through the catheter, which stains the vessels. The catheter is advanced under X-ray control, and the video image is transmitted to the monitor. Using this method, the lumen in the vessels is restored: at the end of the catheter there is a so-called balloon and a stent. At the site of narrowing, this balloon is inflated with a stent, restoring normal patency of the vessel.

The safest are minimally invasive methods, that is, x-ray surgery and closed type operations. With such work there is the least risk of complications, the patient recovers faster after them, but they cannot always help the patient. Complex operations can be avoided with periodic examinations. The earlier the problem is identified, the easier it is for the doctor to solve it.

Depending on the patient’s condition, there are:

Planned surgery. It is carried out after a detailed examination, within a specified time frame. A planned intervention is prescribed when the pathology does not pose a particular danger, but it cannot be postponed.
Emergency - these are operations that need to be done in the next few days. During this time, the patient is prepared and all the necessary studies are carried out. The date is set immediately after receiving the necessary data.
Emergency. If the patient is already in serious condition, the situation can worsen at any moment - surgery is scheduled immediately. Before it, only the most important examinations and preparations are carried out.

In addition, surgical assistance can be radical or auxiliary. The first implies complete elimination of the problem, the second - elimination of only part of the disease, improving the patient’s well-being. For example, if a patient has a pathology of the mitral valve and stenosis of a vessel, the vessel is first restored (auxiliary), and after a while valve plastic surgery is prescribed (radical).

How are surgeries done?

The course and duration of the operation depends on the pathology being treated, the patient’s condition, and the presence of concomitant diseases. The procedure may take half an hour or may take 8 hours or more. Most often, such interventions last 3 hours, take place under general anesthesia and control of an artificial cardiologist. First, the patient is prescribed a chest ultrasound, urine and blood tests, an ECG, and consultation with specialists. After receiving all the data, the degree and location of the pathology is determined, and it is decided whether there will be an operation.

As part of the preparation, a diet low in fatty, spicy and fried foods is also prescribed. 6-8 hours before the procedure, it is recommended to refuse food and drink less. In the operating room, the doctor assesses the patient’s well-being and puts the patient into medical sleep. For minimally invasive interventions, local anesthesia is sufficient, for example during x-ray surgery. When the anesthesia or anesthesia takes effect, the main actions begin.

Heart valve surgery

The heart muscle has four valves, all of which serve as a passage for blood from one chamber to another. The most commonly operated valves are the mitral and tricuspid valves, which connect the ventricles to the atria. Stenosis of the passages occurs when the valves are insufficiently widened, and blood flows poorly from one section to another. Valve insufficiency is a poor closure of the valves of the passage, and there is an outflow of blood back.

The plastic surgery is performed openly or closed; during the operation, special rings or sutures are applied manually along the diameter of the valve, which restore normal lumen and narrowing of the passage. Manipulations last on average 3 hours; for open types, an AIK is connected. After the procedure, the patient remains under the supervision of doctors for at least a week. The result is normal blood circulation and functioning of the heart valves. In severe cases, the original valves are replaced with artificial or biological implants.

Elimination of heart defects

In most cases, defects are congenital; the reason for this may be hereditary pathologies, bad habits of parents, infections and fever during pregnancy. At the same time, children may have different anatomical abnormalities in the heart area; often such anomalies are poorly compatible with life. The urgency and type of surgery depend on the child’s condition, but they are often prescribed as early as possible. For children, heart surgery is performed only under general anesthesia and under the supervision of medical equipment.

At older ages, heart defects develop due to atrial septal defects. This happens with mechanical damage to the chest, infectious diseases, or due to concomitant heart diseases. To eliminate this problem, open surgery is also needed, often with artificial cardiac arrest.

During the manipulations, the surgeon can “patch up” the septum with a patch, or suture the defective part.

Bypass surgery

Coronary artery disease (IHD) is a very common pathology that mainly affects the generation over 50 years of age. Appears due to impaired blood flow in the coronary artery, which leads to oxygen starvation of the myocardium. There is a chronic form, in which the patient has constant attacks of angina, and an acute form, which is myocardial infarction. They try to eliminate chronic ones conservatively or using minimally invasive techniques. Acute requires urgent intervention.

To prevent complications or alleviate the disease, use:

coronary artery bypass grafting;
balloon angioplasty;
transmyocardial laser revascularization;
coronary artery stenting.

All these methods are aimed at restoring normal blood flow. As a result, enough oxygen is supplied to the myocardium with blood, the risk of heart attack is reduced, and angina is eliminated.

If it is necessary to restore normal patency, angioplasty or stenting is sufficient, in which the catheter is moved through the vessels to the heart. Before such an intervention, coronary angiography is performed to accurately determine the blocked area. Sometimes blood flow is restored bypassing the affected area, while a bio-shunt (often a section of the patient’s own vein from the arm or leg) is sutured to the artery.

Recovery after interventions

After surgery, the patient remains in the hospital for another 1-3 weeks, during which time doctors will evaluate his condition. The patient is discharged after verification and approval by the cardiologist.

The first month after surgical procedures is called the early postoperative period; during this time it is very important to follow all the doctor’s recommendations: diet, a calm and measured lifestyle. Nicotine, alcohol, junk food and exercise are prohibited regardless of the type of intervention.

The doctor's recommendations must also contain a warning about dangers and complications. Upon discharge, the doctor will set a date for the next appointment, but you need to seek help unscheduled if the following symptoms occur:

sudden fever;
redness and swelling at the incision site;
discharge from the wound;
constant chest pain;
frequent dizziness;
nausea, bloating and stool disorders;
difficulty breathing.

During routine examinations, the cardiologist will listen to your heartbeat, measure your blood pressure, and listen to your complaints. To check the effectiveness of the operation, ultrasound, computed tomography, and x-ray examinations are prescribed. Such visits are scheduled once a month for six months, then the doctor will see you once every 6 months.

Often, in addition to surgical care, medications are prescribed. For example, when replacing valves with artificial implants, the patient takes anticoagulants for life.

In the postoperative period, it is important not to self-medicate, since the interaction of permanent medications and other medications can give a negative result. Even regular painkillers need to be discussed with. To keep fit and restore health faster, it is recommended to spend more time in the fresh air and walk.

Life after heart surgery will gradually return to normal; full recovery is predicted within a year.

Cardiac surgery offers a variety of methods for cardiac rehabilitation. Such operations are designed to restore physical and moral strength to the patient. There is no need to be afraid or avoid such procedures; on the contrary, the sooner they are carried out, the greater the chances of success.

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. 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 defect

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.

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 a violation of the heart rhythm, 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 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

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; stenting of coronary arteries; 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 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

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 the main cause of its disturbances.

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.

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 mitral valve replacement. The indication for heart valve replacement surgery may be severe valvular insufficiency or fibrosis of the leaflets.

If there is a serious disturbance of the heart rhythm and the presence of atrial fibrillation, there is a serious need for the installation of 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 medications is often prescribed.

Glenn operation and Ross operation

Glenn's operation is part of the complex correction of 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.

Laser cauterization can also be used to treat arrhythmia. 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 effectively treat arrhythmia, eliminate heart defects in newborns, or cure other pathologies using 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

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.

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).

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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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 from animal biological material).

Valve implant placement

Plastic surgery of septal defects

It can be carried out in 2 options, for example, suturing the defect or plasticizing it. 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. Prosthetic replacement 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.

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 the 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)

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:

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 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.

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

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 location of organs after heart surgery. And the bandage helps relieve stress on the organs.

After all types of heart surgery, drug rehabilitation, that is, maintenance therapy, is needed. 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

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. 33000 rub. 198000-220000 rub. 330,000 rub. 33000 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

Do you still think that it is impossible to get rid of HEART DISEASES!?

Do you often experience discomfort in the heart area (pain, tingling, squeezing)? You may suddenly feel weak and tired... You constantly feel high blood pressure... There is nothing to say about shortness of breath after the slightest physical exertion... And you have been taking a bunch of medications for a long time, going on a diet and watching your weight...

But judging by the fact that you are reading these lines, victory is not on your side. That is why we recommend reading the story of Olga Markovich, who found an effective remedy for cardiovascular diseases. >>>

Let us know about it -

rate

Morning. Petroverigsky lane, house 10. At this Moscow address in the Kitay-Gorod area, I arrived at the federal center for the diagnosis and treatment of cardiovascular diseases angiography.su, part of the state research center for preventive medicine, to again put on a sterile suit and visit in the operating room.

Angiography is a method of examining blood vessels using x-rays and contrast fluid. It is used to identify damage and defects. Without it, the operation I am about to talk about—stenting—would not have been possible.

There will still be some blood. I think I should warn impressionable people about this before they open the entire post.

Who has never heard of cholesterol plaques? he didn’t watch Elena Malysheva’s show. Plaques are deposits on the inner walls of blood vessels that accumulate over years. Their consistency is similar to thick wax. The plaque consists not only of cholesterol, calcium in the blood sticks to it, making the deposits even denser. And this whole structure slowly but surely clogs the blood vessels, preventing our fiery motor, or rather pump, from delivering nutrients and oxygen to various organs, including the heart itself.

Before the advent of the stenting method, which will be discussed, doctors had only the surgical method of bypass surgery, which became popularly famous thanks to Boris Nikolayevich Yeltsin’s heart surgery in 1996 in a round operating room. I remember this incident vividly (a childhood memory), although a similar operation was performed on many famous people.

Bypass surgery is a cavity operation. The person is given anesthesia, the chest is sawed open (they actually saw it, it can’t be done with just a scalpel), the heart is stopped and the artificial circulation system is started. The beating heart beats very hard and interferes with the operation, so it has to be stopped. To get to all the arteries and bypass, you need to take out the heart and turn it over. A shunt is a donor artery taken from the patient himself, for example, from the arm. Quite a stress for the body.

During stenting, the patient remains conscious (everything happens under local anesthesia) and can hold his breath or take deep breaths at the request of the doctor. Blood loss is minimal, and the incisions are tiny, because the arteries are entered through a catheter, which is usually installed in the femoral artery. And a stent is placed - a mechanical dilator of blood vessels. All in all, an elegant operation (-:

The operation was performed on Sergei Iosifovich in three stages. I found myself on the final operation in the series. It is not possible to place all stents at once.

The surgical table and the angiograph (a semicircular device hanging over the patient) form a single mechanism that works together. The table moves back and forth and the machine rotates around the table to take X-ray images of the heart from different angles.

The patient is placed on the table, fixed and connected to a cardiac monitor.

To make the device of the angiograph clear, I will show it separately. This is a small angiograph, not as big as the one in the operating room. If necessary, it can even be brought to the ward.

It works quite simply. There is an emitter installed at the bottom, and a converter at the top (a smile is glued to it), from which the signal with the image is already transmitted to the monitor. There is virtually no scattering of X-rays in space, but everyone present in the operating room is protected. About eight such operations are performed per day.

A special catheter is inserted through a vessel on the arm or thigh, as in our case.

A thin metal wire called a conductor is inserted into the artery through a catheter to guide the stent to the site of the blockage. I was amazed at its length!

A stent - a mesh cylinder - is attached to the end of this wire in a compressed state. It is mounted on a balloon that will be inflated at the right time to deploy the stent. Initially, this design is no thicker than the conductor itself.

This is what the deployed stent looks like.

And this is a scale model of a different type of stent. In cases where the walls of blood vessels are damaged, those with a membrane are installed. They not only maintain the vessel in an open state, but also act as vessel walls.

An iodinated contrast agent is injected through the same catheter. With the blood flow it fills the coronary arteries. This allows the X-ray to visualize them and calculate the sites of blockage where stents will be placed.

This is what the Amazon basin looks like when you inject contrast.

All eyes on the monitors! The entire process of stent installation is observed through X-ray television.

After the stent is delivered to the site, the balloon on which it is attached must be inflated. This is done using a device with a pressure gauge (pressure meter). This device, similar to a large syringe, is visible in the photo with long conductor wires.

The stent expands and is pressed into the inner wall of the vessel. To ensure that the stent has expanded correctly, the balloon remains inflated for twenty to thirty seconds. It is then deflated and pulled out of the artery on a wire. The stent remains and maintains the lumen of the vessel.

Depending on the size of the affected vessel, one or more stents may be used. In this case, they are placed one after another overlapping.

Here's how the stent works. Below are screenshots from the X-ray TV. In the first picture we see only one artery, a curly one. But another one should be visible, underneath it. Due to the plaque, the blood flow is completely blocked.

The thick sausage on the second one is a stent that has just been deployed. The arteries are not visible because contrast is not running in them, but the wires are clearly visible.

The third shows the result. The artery appeared, blood flowed. Now compare the first picture with the third again.

The concept of expanding the affected areas of the vessel using a certain frame was proposed forty years ago by Charles Dotter. The development of the method took a long time; the first operation using this technology was performed by a group of French surgeons only in 1986. It was only in 1993 that the effectiveness of the method for restoring the patency of the coronary artery and maintaining it in a new state in the future was proven.

Currently, foreign companies have developed about 400 different models of stents. In our case, it is Cordis from Johnson & Johnson. Artem Shanoyan, head of the department of x-ray endovascular methods of diagnosis and treatment at the center, answered my question about Russian manufacturers of stents and replied that they simply do not exist.

The operation lasts about half an hour. A pressure bandage is applied to the arterial puncture site. From the operating room, the patient is sent to the intensive care ward, and two hours later to the general ward, from where he can write joyful text messages to his family with all his might. And in a few days they will be able to see each other at home.

Lifestyle restrictions typical for heart patients are usually removed after stenting, the person returns to normal life, and monitoring is carried out periodically by a doctor at his place of residence.

Review

Open heart surgery is a surgical procedure that opens the chest and affects the muscles, valves, or arteries of the heart.

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.

Reasons

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 fatty deposits create plaque 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, a heart attack can occur.

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 bypass operations); heart attack or stroke; heart rhythm disturbance; damage to the lungs or kidneys; chest pain, low-grade body temperature; 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 avoid smoking and stop taking vasoconstrictor 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.

You will most likely spend the first night in the intensive care unit. 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; limiting salty, fatty and sweet foods; maintaining physical activity; quitting smoking; control high blood pressure and cholesterol levels.

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.

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:

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

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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.

Review from our reader Victoria Mirnova

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)

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:

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.

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

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 location of organs after heart surgery. And the bandage helps relieve stress on the organs.

After all types of heart surgery, drug rehabilitation, that is, maintenance therapy, is needed. 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

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

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. 33000 rub. 198000-220000 rub. 330,000 rub. 33000 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