PD MD Wolfgang Harringer
Constrictions and occlusions in coronary arteries can cause an insufficient perfusion of the heart. Chest pain (Angina pectoris) and respiratory distress associated with decreased oxygen-carrying capacity might be early warning signs of cardiac infraction. An improvement of blood circulation can often be achieved by using dilation, stenting or drug therapy.
Less often are indications for a bypass surgery. In order to avoid occluded segments coronary collateral arteries provide alternate pathways of blood flow in the area of the left internal mammary artery, of the great saphenous vein or of the radial artery. Therefore an open-heart surgery is performed while using a heart-lung machine, so a bypass can easily be done on an artery. In cases of patients at risk an operation can be done without a heart-lung machine, the bypass can be fixed on the beating heart (OPCAB procedure). It is possible to use the left internal mammary artery as a bypass if only the front heart wall vessel is affected. The operation can be performed beneath the nipple (MIDCAB procedure) through a small cut.
The cardiac valve‘s abilities to open and to close can be limited by rheumatic fever in youth, degenerative changes in the advanced years or because of enodocarditis. As a result, the power of the heart is limited or the patient’s heart gets a long-lasting damage. Depending on the type of the valve and how serious its structure was changed the patient needs a reconstruction or a replacement for the valve concerned. In such cases we distinguish between a biological and a mechanical plastic valve. The benefit of the biological valve is the abdication of anticoagulants throughout the patients life, the downside is the lower life expectancy compared to the plastic valve.
Currently the trend goes towards preservation of the heart valve, as it is now standard with mitral valves. On the field of aortic valve surgeries new methodes win recognition (e.g. David–Procedere, Ross-OP).
According to the history of development every human possesses a natural opening in partition walls between the two atria of heart. Normaly, this opening seals off after birth, but sometimes it stays open till adulty. In such cases a cardiac insuffiency can slowly be developed during the years. It needs to be sealed off surgically and is the most frequent cardiac deformity. We’re looking forwart to inform you about other cardiac deformities as well and how they can be cured.