The prowess of the cardiac surgery

Today, heart surgeons are able to realize yet what was unthinkable a few years ago: replace defective parts of the heart, adjust its beats, adapting new vessels, in short, offer a wide range of interventions tailored to each pathology. Is Doctissimo point on the techniques frequently used in hospitals and this therapeutic prospects offered by research.

Angioplasty or arterial dilatation
Since 1977, the angioplasty to restore normal blood flow in the arteries narrowed by plaque of atherosclerosis (build-up of cholesterol). It involves inserting into the clogged artery catheter end completed by a balloon, which once inflated, dilate the artery and allows recovery of blood flow.

cardiac surgery

But in the six months following this intervention, three complications may occur: an elastic recoil of the arterial wall decreasing its diameter, a proliferation of cells due to the healing of tissues and chronic vasoconstriction of the ship. This is what is called post-angioplasty Restenosis. You can then drop in a small wire mesh stent that such a spring, holds the artery open when the balloon is removed. It reduced the rate of Restenosis by 30% by limiting the elastic recoil and vasoconstriction, but it does not prevent cell proliferation. In this context, the use of ionising radiation could provide an effective solution.

Radiation for better circulation
Published in January 2001, two studies by Prof. Jack (1 ) of the University of Geneva hospital and by the Dr. Leon of Lennox Hill Hospital, New York2, detail the benefits brought by the use of ionizing radiation at low doses, in the prevention of Restenosis. Dropping a source of beta radiation, or gamma in the artery of patients for a few minutes, they managed to reduce by 70% the Restenosis rate. These two technical, high-performance, allow not only to avoid that the artery fills, but also to increase its enlargement.

However the gamma irradiation must be coupled with a regular intake of aspirin to prevent the formation of blood clots. By allowing enlargement in the long term, this technique would save patients the need for a new intervention. These low radiation don’t have of the benefits? Yes, a-priori, but it is difficult for a newer technique to assess possible side effects in the medium and long term.

Delphine Berdah
1 and 2 – New England Journal of Medicine, 25 jan 2001 (vol. 344, no. 4)

Coronary artery bypass
We realize a coronary when angioplasty is not feasible. This technique, developed since 1964, involves implanting a vein or an artery serving as bridge between the aorta and the part of the coronary vessel located downstream from the obstruction. When coronary artery is clogged in many places, it performs a multiple bypass surgery.