The different techniques of heart surgery

Today, cardiology surgeons are capable of doing what was still unthinkable a few years ago: replacing defective parts of the heart, adjusting its beats, adapting new vessels, in short, offering a wide range of adapted interventions for each pathology. Jimy medical provides stock of the surgical instruments frequently used in hospitals and presents the therapeutic perspectives offered by research.

Angioplasty or arterial dilation

Used since 1977, angioplasty restores normal blood flow in arteries narrowed by atherosclerotic plaque (accumulation of cholesterol). It consists of inserting into the blocked artery a thin catheter terminated by a balloon, which once inflated, dilates the artery and allows a reestablishment of blood flow.

But in the six months following this intervention, three complications can occur:

- An elastic retreat of the arterial wall, thereby reducing its diameter;

- Proliferation of cells due to tissue scarring;

- Chronic vasoconstriction of the vessel: post-angioplasty restenosis. A small metal mesh, the stent, can then be placed inside, which, like a spring, keeps the artery open when the balloon is withdrawn. It reduces the rate of restenosis by 30% by limiting elastic recoil and vasoconstriction, but it does not prevent cell proliferation. In this context, the use of ionizing radiation could provide an effective solution.

Ablation

Ablation is a procedure to restore the normal rhythm of the heart. Ablation can be used to treat:

- A heart whose beating is too fast (more than 100 beats per minute);

- A problem called tachycardia;

- A heart that beats while contracting in a disorderly fashion (fibrillation).

Although performed less often, surgical removal can be combined with other open heart surgeries (bypass, valve repair or replacement ....).

There are two kinds of surgical removal techniques: those in which the heart is stopped and the patient is connected to a heart-lung machine, and those performed on a beating heart. New techniques have also been developed to make cardiac ablation possible without making incisions in the heart ("minimally invasive atrial fibrillation heart surgery") or without stopping the heart (catheter surgery).

Valve interventions

Valve procedures aim to repair or replace one or more valves or valves in the heart that are malfunctioning due to valve disease with the help of open heart surgical instrument set. Surgical procedures are open-heart operations, that is, they involve opening the chest by cutting the sternum. These major interventions usually last at least two hours and require several weeks of convalescence.

The implantable pacemaker

As its name suggests, this device is used to stimulate the rhythm of the heart. It is used when the heart rate slows down too much. The pacemaker housing contains electronic circuitry that is powered by a battery. Thanks to these elements, the device analyzes the rhythm of the heart throughout the day, detects the appearance of abnormalities and, when they occur, triggers an electrical stimulation that determines a heartbeat and prevents the possible appearance of a heartbeat.

Europe has around 2 million people living with a pacemaker. It is about a not very dangerous operative act which one carries out in patients sometimes very old. Most often, it consists of introducing through a small skin incision one or more probe-electrodes through the venous route, generally in the region of the clavicle, then pushing this or these electrode (s) into the heart. The pacemaker housing is then connected to the leads and implanted under the skin below the collarbone.

Cardio version or DC current

Cardio version or DC current can restore a normal heart rhythm from an abnormal rhythm. They are indicated to treat atrial fibrillation and arrhythmias of the upper chambers of the heart.

The operation involves placing two electrodes on the patient's rib cage or one on the chest and the other on the patient's back. A predetermined amount of energy or electrical impulse is carried by the electrodes through the body to the heart. This discharge of energy makes the heart jump, interrupts atrial fibrillation and restores the heartbeat. It is similar to defibrillation, but with more electricity.

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