Koroner Kalp Hastalığında Tedavi Stratejisi
Coronary Heart Disease Story is Written by Heart Surgeon and Cardiologist together
Coronary arteries, which nourish the heart, narrow in time due to atherosclerosis. Medical therapy suffices, if this condition is mild. In case of a severe stenosis, narrowed segment can be dilated by balloon angioplasty (PTCA) and stenting. But this segment may narrow again several months following this simple and comfortable procedure. To decrease this incident drug-eluting stents have been invented.
The most important artery of the heart itself is left anterior descending (LAD) artery which nourishes approximately 40% of the heart. This vessel determines the long term survival of the patient. When this artery is affected, the ideal decision is made by the heart surgeon and the cardiologist together. To achieve a long term wellness, a long term planning is necessary. This prevents suboptimal treatments preis viagra sildenafil. PTCA-stenting or coronary bypass does not remove the disease but only relieve the danger of life. Additional stenosis can be expected in future. The optimal treatment option should not be put away.
Today, optimal treatment of coronary artery disease consists of medical treatment + PTCA-stenting done by a cardiologist and coronary bypass operation done by a surgeon at different terms of the disease. In this way patients may take the advantages of different treatment modalities and live longer.
PTCA-stenting applied several times may end-up with lost chance for coronary bypass operation since it prevents finding a suitable location for surgical anastomosis. The diameter of coronary arteries is normally 2 mm; vessels narrower than 1mm have less favorable results after surgery. As such, in diabetic patients PTCA-stenting has less favorable results. As a result, if cardiologist and surgeon do not participate in planning at the beginning may lead to suboptimal treatments.
It is supposed that approximately 2 million person in this country have coronary heart disease. But very few amount of them benefit from PTCA-stenting and coronary bypass.
Coronary bypass operations are frequent operations among all heart operations. In the world, 3000 people undergo this operation everyday. The annual number is 400.000 in United States and 25.000 in our country. The surgery is carried with 99% success if modern surgical concepts are applied.
The scientific basis of coronary bypass operation teaches us to use arterial grafts for narrowed arteries. The LAD, which is the most important artery of the heart, should be bypassed by an artery. If this could not be done than the procedure is suboptimal. LIMA (mammarian artery) is the most atherosclerosis resistant vessel of the body. If a patient is deprived of LIMA-LAD bypass during the course of his coronary artery disease, then it is hard to say that this particular person get the absolute aid of modern medicine.
‘Prof.Kucukaksu & Coronary bypass surgery’
LIMA-LAD anastomosis is a must for coronary bypass surgery. If this artery would not exist, the coronary bypass operation would be outdated except for some emergency situations. The other arteries of the heart can be bypassed by radial artery of the arm, which gained popularity lately, or by saphenous vein of the leg. With either method the aim is a safe anastomosis.
LIMA, which is a blessing of God for coronary artery disease patients, stays a few centimeters away from the LAD. LIMA and LAD unifies so beautifully that it is not an exaggeration to call it “spare artery of heart”.
In the modern medicine of this century, for a long and qualified life of coronary artery disease patients, the aim is to service them with the convenience of cardiology and wide opportunities of surgery.