Cardiovascular Interventional Surgery

Introduction

Cardiovascular interventional therapy is a medical technology that diagnoses and treats heart and blood vessels through non-surgical methods. It has the advantages of being minimally invasive, safe and effective, and can significantly improve the quality of life of patients.

Cardiovascular interventional therapy originated in the 1950s and was initially used mainly for the diagnosis of heart disease. With the advancement of materials science, imaging technology and medical theory, cardiovascular interventional therapy has gradually developed into an important treatment method. At present, cardiovascular interventional therapy has become an important branch of cardiology and is widely used in clinical practice.

Scope and limitations

Cardiovascular interventional therapy is suitable for the diagnosis and treatment of a variety of heart diseases, such as coronary heart disease, arrhythmia, congenital heart disease, etc.

Cardiovascular interventional therapy is not suitable for all heart diseases. For some complex or severe heart diseases, traditional surgical treatment is still required.

Cardiovascular interventional therapy technology

Percutaneous coronary intervention

Percutaneous coronary intervention is a method of clearing coronary artery stenosis or occlusion lesions through catheter technology to improve myocardial blood supply. Through catheter technology, balloons, stents and other devices are delivered to the narrowed or occluded parts of the coronary artery to dilate the blood vessels and restore blood flow, thereby improving myocardial blood supply. This treatment method has significant effects on severe cardiovascular diseases such as acute myocardial infarction and unstable angina.

Heart valve interventional treatment

Heart valve interventional treatment is a method of repairing or replacing heart valves through catheter technology to improve heart function. It is mainly used to treat lesions such as heart valve stenosis or insufficiency. The artificial valve or valve dilator is delivered to the lesion valve through the catheter to improve the valve function and thus improve the heart function. This treatment method has little trauma and fast recovery, which is of great significance for elderly and high-risk patients who are not suitable for open-chest surgery.

Congenital heart disease interventional treatment

Congenital heart disease interventional treatment is a method of correcting congenital heart structural abnormalities through catheter technology. It is mainly used to correct congenital heart structural abnormalities, such as atrial septal defect and ventricular septal defect. Through catheter technology, occluders and other devices are delivered to the lesion site to block the defect or abnormal channel, improve the heart structure, and thus improve the heart function. This treatment method has the characteristics of less trauma and faster recovery, and has become one of the common methods for the treatment of congenital heart disease.

Peripheral vascular interventional therapy

Peripheral vascular interventional therapy is a method of treating peripheral vascular diseases through catheter technology. It is mainly used to treat peripheral vascular stenosis, occlusion and other lesions, such as lower limb arteriosclerosis occlusive disease. Through catheter technology, balloons, stents and other devices are delivered to the lesion site to dilate blood vessels and restore blood flow, thereby improving limb ischemia symptoms. This treatment method has the characteristics of less trauma and faster recovery, and has become one of the common methods for the treatment of peripheral vascular diseases.

Stent implantation surgery steps

1.Puncture and catheterization

Anesthesia is given at the puncture site, and then the catheter sheath is placed after puncturing the puncture site.

2.Guidewire catheter entry

The guide wire is entered from the catheter sheath, and the guide wire will reach the heart along the artery, and then the angiography catheter is placed along the guide wire. Both go deep into the heart until they reach the coronary artery.

3.Angiography

The whole process is carried out under X-ray monitoring. Then the guide wire is removed and contrast agent is pushed in through the angiography catheter to clearly show the blood vessels under X-ray and find the lesion site.

4.Balloon dilatation

After determining the blockage site, the doctor will follow the guide wire and send the balloon catheter into the blood vessel at the lesion site. By inflating/deflation of the balloon, the blood vessel wall is pushed outward to restore blood vessel patency.

5.Stent placement

Some patients also need to undergo further stent implantation. The doctor sends a balloon wrapped with a stent into the lesion site along the catheter. The balloon is inflated and the metal stent is propped open with a pressure of about 10 times the atmospheric pressure.

Complications and treatment of cardiovascular interventional treatment

Bleeding and hematoma

Bleeding and hematoma are common complications in cardiovascular interventional treatment, which may cause pain, blood loss and shock to patients. It usually occurs at the surgical site or vascular puncture site, which may be related to factors such as anticoagulant therapy, vascular injury, and improper hemostasis techniques. Patients may experience symptoms such as local swelling, congestion, and pain, which may cause hemorrhagic shock in severe cases.

For bleeding and hematoma, doctors usually take measures such as compression hemostasis, ice compress, pressure bandage, and adjust the dosage of anticoagulants. If the symptoms are severe or last for a long time, surgical treatment may be required.

Vascular complications

Vascular complications include vascular damage, thrombosis, vascular occlusion, etc., which may lead to blood circulation disorders and organ ischemia.

During cardiovascular interventional treatment, catheters, guidewires and other devices may cause mechanical damage to blood vessels, and anticoagulant treatment may also increase the risk of thrombosis. Vascular complications may cause symptoms such as local pain, limb numbness, hemiplegia, etc., which may be life-threatening in severe cases.

For vascular complications, doctors usually use drugs such as thrombolysis, anticoagulation, and vasodilator treatment, as well as surgical thrombectomy or bypass surgery. At the same time, care before and after interventional treatment is also very important, such as keeping the affected limb high, observing limb color and temperature changes, etc.

Arrhythmia

Arrhythmia is one of the common complications in cardiovascular interventional treatment, which may cause patients to experience symptoms such as palpitations, chest tightness, and dizziness.

The occurrence of arrhythmia may be related to factors such as catheter stimulation of the heart, myocardial ischemia, and electrolyte disorders. Patients may experience symptoms such as tachycardia, bradycardia, and arrhythmia, which may cause syncope or sudden death in severe cases.

For arrhythmias, doctors usually take measures such as drug treatment, electrical cardioversion, or pacemaker installation. At the same time, the stimulation and damage to the heart should be minimized during interventional treatment.

Other complications

Other complications may also occur in cardiovascular interventional treatment, such as infection, pneumothorax, and allergic reactions.

Infection may be caused by improper surgical operation or postoperative care, and patients may experience fever, redness and swelling of the wound, etc. Pneumothorax may be caused by puncture damage to the pleural cavity, and patients may experience symptoms such as dyspnea and chest pain. Allergic reactions may be caused by drugs or materials, and patients may experience symptoms such as rash and dyspnea.

For these complications, doctors usually take corresponding antibiotic treatment, exhaust treatment, anti-allergic treatment and other measures, and strengthen postoperative care and monitoring to promptly detect and deal with problems.

Rehabilitation and nursing of cardiovascular interventional treatment

Postoperative rehabilitation guidance

According to the type of surgery and condition, guide patients to carry out appropriate activities, such as walking, jogging, etc., to promote blood circulation and physical recovery.

Ensuring adequate rest and sleep is helpful for physical recovery and adjustment of mental state.

Guide patients to arrange meals reasonably, control the intake of salt, sugar and fat, and maintain balanced nutrition.

Home care and self-management

Conduct regular checkups according to the doctor's advice to timely discover and deal with possible problems.

Ensure that patients take medications on time and in the right amount to avoid missing or taking the wrong medication.

Guide patients to adjust their lifestyle habits, such as quitting smoking, limiting alcohol, and having a regular work and rest schedule, to reduce the risk of recurrence of cardiovascular disease.

Psychological support and counseling

Pay attention to the patient's emotional changes, provide psychological support and counseling, and help patients relieve anxiety, depression and other negative emotions.

Help patients adjust their thinking through psychological treatments such as cognitive behavioral therapy, and establish correct disease concepts and life attitudes.

Encourage patients to actively participate in social activities, keep in touch with family and friends, and get more emotional support and companionship.

Future prospects for cardiovascular interventional treatment

Development and application of new technologies

Drug-eluting balloon: By coating the balloon with drugs, local drug release is achieved during vascular dilation to reduce the occurrence of restenosis.

Biodegradable materials: used to make implants such as stents, which can be naturally degraded by the human body after completing the therapeutic effect, reducing the risk of long-term complications.

Gene therapy: Genetic engineering technology is used to genetically intervene in cardiovascular diseases, providing a new way to treat hereditary cardiovascular diseases.

Individualized treatment strategy

Develop an individualized treatment plan based on the specific situation of the patient: Comprehensively consider the patient's age, gender, condition and other factors to develop the most suitable treatment plan for the patient.

Precision medicine: Use technologies such as genetic testing to accurately diagnose and classify cardiovascular diseases, providing a scientific basis for individualized treatment.

Combination of drug therapy and interventional therapy: According to the specific situation of the patient, choose drug therapy or interventional therapy, or use it in combination to achieve the best treatment effect.

Telemedicine and intelligent management

Remote monitoring and diagnosis: Use telemedicine technology to monitor and diagnose patients with cardiovascular diseases in real time to improve the efficiency of diagnosis and treatment.

Intelligent management system: Establish a database of patients with cardiovascular diseases, use big data and artificial intelligence technology for data analysis and prediction, and provide patients with personalized health management plans.

Mobile health care: Through mobile devices such as mobile phones, convenient medical services and health management tools are provided to patients with cardiovascular diseases to improve patient self-management and participation.

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