Angina Pectoris is basically chest pain that occurs when your heart muscles are not getting enough oxygen-rich blood supply as a result of a plaque build up in the coronary arteries.
Treatment for angina pectoris may require surgical intervention, with or without the previous use of medications.
The following procedures may be recommended by your healthcare provider to help correct the blockage and prevent further damage to the heart and its vessels.
A Coronary Angioplasty is a surgical treatment for angina pectoris that involves inserting a small catheter (a little tube or balloon) into a narrowed or blocked artery.
This procedure is done to open up the arteries and restore normal blood flow to blocked arteries.
Coronary angioplasty can come in the following forms
- Percutaneous coronary intervention
- Stent Placement
Percutaneous Coronary Intervention
This procedure is performed under stable conditions such as stable angina when a patient’s angina is well managed. A local anesthetic is usually used for this procedure.
A Percutaneous Coronary Intervention is a coronary intervention that has a little balloon at the top of the catheter that the health care provider inflates when the catheter has reached the blocked part of the artery.
It is called percutaneous because the procedure is done through the skin. The balloon, when inflated, helps to push the plaque against the wall of the artery.
Once the balloon is deflated, it often opens up the blockage enough for more blood to flow through the artery, and this should lessen the pain.
Stent placements is also known as stenting is a form of coronary angioplasty that uses a small device called a stent.
Stents are mesh-like stainless steel tubes that are expendable and will be put in place to help open up the blocked artery open and restore the normal flow of blood through the previously blocked artery.
Coronary Artery Bypass Graft (CABG)
Another surgical treatment for angina pectoris is the coronary artery bypass graft, sometimes referred to as coronary artery bypass surgery.
This surgical procedure is usually recommended when several arteries are severely blocked such as with the case of an acute coronary syndrome.
If several arteries are blocked, more than one arteries may need to be bypassed during the procedure.
During the procedure, an incision is made on the skin over the sternum (breast bone).
Then the surgeon cuts through the sternum and exposes the ribcage to get to the heart.
The CABG procedure involves taking a healthy artery or vein from a part of your body.
The veins that are commonly used are the Saphenous vein from the leg or the Internal thoracic artery that is found in the chest.
This vein is then grafted to the heart to help the blood go around (or bypass) the blockage.
The Coronary Artery Bypass Graft is generally performed in two ways: The procedure is either performed on a non-beating heart (arrested heart) or on a beating heart.
Coronary Artery Bypass Graft is usually performed with the patient placed under general anesthesia which puts the patient in a deep sleep, this will help the healthcare providers to perform the procedure effectively.
The procedure generally lasts a duration of 4 – 6 hours and the patient will be catheterized.
1.CABG Arrested Heart Surgical Procedure
For an arrested heart surgical procedure, the heart must be stopped first. However, throughout the procedure, the patient will be connected to a cardiopulmonary bypass pump also known as a heart-lung machine.
The heart-lung machine will perform the job of heart and lungs which are pumping blood to the rest of the body and breathing respectively.
The cardiac surgeon will utilize the help of special types of equipment to perform this procedure effectively.
After the vein is grafted to the heart and the graft is secured with a stitch, an electrical device will be used to shock the heart to restore the heartbeat.
A cardiac pacemaker will then be placed temporarily on the patient.
The patient will be monitored until the heart starts to beat normally again and then the cardiopulmonary machine is then disconnected from the patient.
2. CABG Beating Heart Surgical Procedure
As the name suggests, this procedure is usually performed while the heart is beating.
This procedure is also called an off-pump bypass surgery because it does not require the use of a cardiopulmonary bypass pump (the heart-lung machine).
Please note that one of the different types of CABG surgical procedures will be used based on their individual situation.
After a CABG procedure, the patient will be placed in an intensive care unit (ICU) for critical monitoring, for the first 24 to 48 hours after the procedure.
During this time, ongoing care will be provided to the patient such as surgical wound dressing care, catheter care, chest tube care, and other assessment will be thoroughly monitored.
The diagnosis of angina is important because, if this disease is not properly managed, it may result in a myocardial infarction, which is a heart attack. Subsequently, the treatment of angina pectoris goes hand in hand with its diagnosis.
Thus, with a diagnosis of acute coronary syndrome, your health care provider may prescribe medications or recommend the above surgical intervention that will help prevent further injury to the heart and preserve the heart tissues.
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Pam is the founder and author of InfoWatchNurse and ThinkStethoscopes. Pam is an award-winning leader. In 2017, She pioneered the first ever peer tutoring program for nursing students at York University. She was also a Peer Tutor and Mentor for nursing students. Today, Pam creates posts and articles on health topics to give back to the nursing community. She blogs about nursing, health, nursing skills and other health related topics on her websites. You can connect with Pam on Linkedin and Instagram.