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The advances in cardiology have been amazing. Heart transplantation, which was a sensation 40 years ago, is now simply one treatment for heart disease. What else does modern cardiology offer to patients? Angioplasty, by-passes, stents (ballooning of the arteries), laser plaque removal are procedures that allow doctors to successfully fight atherosclerosis.

Cardiologyis a field of medicine where you can clearly see howmodern treatment methodsare becoming a standard. Take, for example, statins - they have been known for twenty years, but they are still an extremely valuable drug for heart patients. Their use extends life and improves its quality in people with coronary heart disease, atherosclerosis, as well as those with high risk factors for the development of heart disease, including diabetes. Today, after many clinical trials, it is known that statins protect against heart attack, stroke, and reduce the level of bad LDL cholesterol. These drugs have a beneficial effect on thrombocytes, i.e. platelets responsible for its clotting. Statins prevent these plaques from sticking together, so they prevent the arteries from being blocked by a clot. Another advantage of these drugs is that they make the endothelial cells that line the blood vessels work better. As a result, the vessels are more flexible and can contract and relax more freely. Statins administered after cardiac surgery prevent the blood vessels from closing again and therefore make this therapy more effective. Taking them is of great importance for people with high levels of bad cholesterol, because it stops the progression of atherosclerosis.

Methods of treating heart diseases: angioplasty

Advanced atherosclerosis cannot always be overcome with drugs. Then invasive cardiology comes to the rescue of our heart. Forcing the arteries, as this is what patients call angioplasty, is performed in the treatment of coronary artery disease, acute myocardial infarction or in the case of previously implanted by-passes. Through a small puncture of the artery in the groin (or, more rarely, on the forearm), the doctor introduces a special guide and a catheter ending with a balloon into the artery. When the balloon is in the place of the constriction of the coronary artery, it is pumped. By increasing its volume, it presses the plaque into the artery wall and restores its patency.With large atherosclerotic lesions, a balloon alone is not enough to open the artery. Then a special scaffolding is needed, i.e. a stent.

Stent - a method of treating heart diseases

A stent is a very thin tube made of a thin mesh, which expands when introduced into the vessel and is a support for the vessel's weak walls. Stents are placed mainly because the walls of the vessels cleared of cholesterol deposits are flaccid - they can collapse immediately or after some time and block the blood flow again. But there is another reason - after a while, cholesterol builds up on the walls again, and the stent can prevent this from happening. Arming the artery with stents takes place under the control of the X-ray machine so that they only go to the right place. The experience of medics shows that during ballooning of arteries, the plaque delamination or rupture occurs (approx. 20% of cases). This is conducive to restenosis, i.e. recurrent overgrowth of arteries. To prevent this, nowadays, stents coated with drugs that delay the growth of atherosclerotic plaque are more and more often inserted. The hit of recent years are scaffolding covered with goretex (we have jackets and shoes made of this fiber). They are usually used to treat aortic aneurysms to replace the damaged vessel wall.

By-passes or new bridges

When arteries are completely overgrown, they cannot always be restored to function with ballooning or stents. Then a decision is made to make new connections through which blood will flow. This is called Coronary bypass, or bypass. The procedure is performed under anesthesia. First, cardiologists take a he althy blood vessel (usually from a vein in the leg). Then, after opening the chest, the vein is implanted. One end of it is implanted above the obstruction of the coronary artery, and the other end below, i.e. between the aorta and the coronary vessel that distributes blood throughout the heart. For the operation to run smoothly, the patient is connected to a device called the heart-lung machine (the so-called extracorporeal circulation) for the duration of the procedure and the heart stops working. After the procedure, blood may flow through a new, he althy vein or artery, bypassing the fragment damaged by atherosclerosis. It happens that several such bridges are made during one operation. New connections are just as vulnerable to atherosclerosis as others. Therefore, without supportive treatment, changes in nutrition and physical activity, the situation may repeat itself. it is also possible to bypass the arteries without opening the chest. During such an operation, the cardiac surgeon makes a small incision in the chest through which he can enter the front wall of the heart.which is constantly working.

Laser plaque removal

Laser plaque removal is used very rarely. It is still an experimental method of getting rid of atherosclerotic deposits. During such angioplasty, the doctor inserts a special catheter into the femoral artery and then into the coronary artery. when it reaches the diseased area, it activates a laser beam from a special tip of the catheter. More often, the laser is used to treat extreme heart failure - it is used to make the blood flow channels from the side of the heart ventricle.


Cardiology: therapies for the future

Cardiologists are helpless when all vessels are damaged and no vein can be harvested from him for bypassing. Such situations prompted scientists to take a risky venture - to grow new vessels in the laboratory. The tasks were undertaken by scientists from Duke University Medical Center. They built a tube-shaped scaffold from flakes of a self-decomposing polymer. They placed the cells taken from the patient's vein on the surface and immersed them in a nutrient. After seven weeks, the cells multiplied and the new vein was ready. Growing dishes is still an experiment, but it gives the sick a new hope. the fact that the vessels are made of cells taken from the patient suggests that they will not be rejected by the body. Work on this technique is ongoing, but we have to wait for putting it into practice. It is similar with plasmids injected into the heart by Polish scientists. They are tiny pieces of DNA in which the task of rebuilding the endothelium of the intramuscular vessels is stored in the memory. They were injected into the most ischemic part of the heart. a few days after the procedure, it turned out that the heart has much better blood supply and works more efficiently.

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