In some cases, heart surgery with bypass grafts — an operation to improve blood flow to the heart — is vital to improve your heart health and long-term survival. But the good news is that thanks to advancements in medical science, less invasive surgical options with faster recovery times may be an option for you.

Today, we will explore how minimally invasive cardiac procedures are used to treat a range of conditions, including coronary artery blockages. Read on to learn more.

 

What treatments are available?

A diagnosis of significant coronary artery disease (CAD) may be daunting but it’s important to remember that CAD is common and treatable. The foundation for treating coronary artery disease is a healthy active lifestyle and balanced diet along with consideration of medications aiming to stabilise blood vessel narrowings.

Beyond basic medical treatment, you may also require revascularisation. Here we aim to improve your quality of life but this treatment may also reduce the risk of sudden heart attack or dying from heart-related causes. Revascularisation can either be with stenting or alternatively traditional open-heart surgery (coronary bypass surgery).

 

Medication

Certain medications for coronary artery disease help stabilise artery narrowings and relieve unpleasant symptoms, and lower the risk of complications such as heart attack and stroke. These include statins amongst other classes of drugs.

 

Revascularisation – stent(s) and/or coronary bypass graft surgery

Revascularisation, or “replumbing” as you may think of it, is a treatment performed by either stenting or coronary bypass graft surgery. Both procedures aim to improve your quality of life and reduce your risk of heart attack and stroke. The type of procedure used depends on the severity of your blockages and your medical history. Importantly, the chosen procedure should be determined using your wishes as an individual patient. Best practice guidelines suggest the decision should be made using a ‘heart team’ incorporating different cardiology specialists. Associate Professor Tom Ford has brought this into practice with friends and colleagues at Gosford Hospital using technology to share patient presentations with visiting specialists from Central Coast Local Health District, St Vincent’s Hospital, and Royal North Shore Hospital.

 

How is stenting done and how long will it take to recover?

Stenting is a minimally invasive heart procedure. The procedure, known as an angioplasty, is a common treatment performed while you’re awake but under sedation. It’s typically performed by inserting a soft guide catheter (a narrow and flexible tube) into your wrist and guiding it up to your heart. A small balloon at the end of the tube is blown up to widen the narrowed part of your artery.

An angioplasty is typically combined with the permanent placement of a stent. Stents are flexible frames of tubes made of metal mesh that act like a scaffold to help keep your artery open and decrease its chance of narrowing again.

Stenting can improve symptoms of blocked arteries, such as chest pain and shortness of breath. Recovery time from a non-emergency stenting procedure may be as little as 1–2 days, at which point you can return to work and many routine activities.

Left – coronary drill (rotablation) – this device allows treatment of heavily calcified blocked arteries. Dr Ford is an invited proctor (teacher) for this technique.
Right – access site for performing coronary interventions (distal radial artery day one after complex stenting).

 

Advancements in stent techniques

Complex stenting is a rapidly evolving subspecialist field. Techniques have evolved even in the last decade. Associate Professor Tom Ford’s main area of interest is angina and complex stenting. He has internationally recognised expertise and spent years of additional training post-qualification to be a better operator by adopting modern techniques including the use of tools to drill and modify calcified arteries, open completely occluded arteries, and ensure that stenting is needed (by measuring heart artery blood flow). His stents are typically implanted and guided using invasive imaging techniques to ensure the best long-term patient outcomes.

 

How is a coronary bypass graft done and how long will it take to recover?

Coronary bypass graft surgery is a major invasive procedure. It typically involves opening the chest and stopping the heart (cardioplegia) to allow a healthy blood vessel from your chest or leg to create an alternative pathway for blood to reach your heart muscle. The bypass restores blood flow to areas of the heart that may have been restricted due to severe blockages in the coronary arteries.

Recovery time from a coronary bypass graft surgery is typically longer than stenting but may reduce the need for future procedures compared with stenting. If long-term survival is similar between the two approaches then many doctors (and their patients) prefer stenting particularly as it improves quality of life more in the first year after the procedure.

 

Contact Central Heart to find out how we can help

Your heart health is important to us. Central Heart is a specialist cardiology practice providing advanced diagnostic tools and minimally invasive treatment for patients based on the Central Coast.

If you want to explore what alternatives to heart bypass surgery may be an option for you, contact our friendly team.