The left main coronary artery is the most critical vessel that provides nutrition to the heart. Any blockage in the left coronary artery can jeopardize the entire myocardium. It can increase cardiovascular morbidity and mortality. Traditionally, coronary artery bypass surgery was considered the gold standard for treating left coronary artery disease. However, remarkable advancements in medical sciences have made percutaneous coronary intervention a non-invasive method to treat coronary heart diseases. At Aster Hospitals, we have the latest technology for all emergency conditions. Coronary heart diseases are among the most important causes of cardiovascular morbidity and mortality.
Percutaneous coronary intervention is a procedure currently used to open the blocked coronary arteries, especially the left coronary artery. It was earlier referred to as coronary angioplasty. The interventional cardiologist will use a balloon to open the blocked vessel and place a small, permanent stent to keep the lumen of the vessel patent. The stent usually contains medications. These medications are released directly into the blood, reducing the risk of re-narrowing the artery.
One may be advised to undergo this procedure if one has atherosclerosis. Atherosclerosis is a pathological condition in which fatty substances deposit on the walls of the arteries. It enhances the chances of cardiovascular diseases and reduces the blood flow to the heart. And when your heart does not pump blood efficiently, it can lead to chest pain.
Although percutaneous coronary intervention is preferred for blockage of arteries, the doctor must discuss the treatment modality that would work best for the patient. One may need only medications or have to undergo procedures such as percutaneous coronary interventions or coronary artery bypass surgery depending on the following factors:
- The number and characteristics of the blockages
- The presence of other cardiac and non-cardiac medical conditions
- How well the heart muscle is functioning
- Age of the person
The doctor will help you through the entire procedure of percutaneous coronary intervention. If it is a planned procedure, one may be asked to remain hungry for several hours before it begins. One may be asked to stop taking anticoagulants temporarily before the procedure starts. These medications increase the chances of bleeding during the procedure. Once the patient is taken for the procedure, the interventional cardiologist gives a sedative to help him stay calm and relaxed. A small hollow tube is put inside a blood vessel in the arm or thigh. The tube is guided till it reaches the heart. A contrast dye is put, and X-rays are taken to view the catheter. The blocked artery is located, and the balloon attached to the tip of the catheter is inflated. A stent is put in its place to keep the lumen patent. The stent is usually coated with medications to prevent restenosis of the artery.
Percutaneous coronary intervention is done to treat heart conditions in which one or more arteries are blocked. It treats people with stable symptoms or during a heart attack.
Certain risks involved with this procedure are bleeding, heart attack, arrhythmias, blood clots in the stent, and stroke. Patients above 65 years of age and suffering from chronic kidney disease, acute coronary syndrome, or heart failure have a higher risk of developing complications.
As an alternative to percutaneous coronary intervention, coronary bypass surgery is an open heart surgery. It uses a healthy blood vessel from the chest or leg to create a new path for the blood to flow. The new path increases the blood flow to the heart. It does not cure the disease that caused the blockage, but it reduces the severity of the symptoms that one faces. Your cardiologist may recommend undergoing coronary bypass surgery in the following conditions:
- A blockage in the left main heart artery, which supplies the maximum amount of blood to the heart
- Severe narrowing of the leading heart artery
- Severe chest pain due to the narrowing of the heart arteries, which reduces the blood flow to the heart, even during light exercise
- Presence of more than one diseased artery and if the left heart chamber is not working well
- A blocked artery that can not be treated by angioplasty
- Failure of the angioplasty procedure
Health Conditions Treated
- Coronary artery disease
- Acute coronary syndrome
- Heart attack
- Unstable angina
FAQs
At Aster Hospitals we provide the highest quality of care and a transformative experience for all your healthcare needs. With our network of multi-speciality hospitals, specialised doctors, and world-class technology, we bring global standards of medical care to our patients.
How serious is coronary bypass surgery?
As with any other surgery, coronary bypass surgery has its complications. Although the complications are mild and not risky, a heart attack or stroke may occur after coronary bypass surgery.
How important is the left main coronary artery?
The left main coronary artery supplies the left side of the heart. The left side of the heart is mainly responsible for pumping blood to the entire body. Any disturbance in blood supply to the left side can decrease the efficiency of the heart pumping blood.
Which is the best graft for coronary artery bypass surgery?
A graft taken from an internal thoracic artery is considered the best for coronary bypass surgery.
What is the difference between percutaneous coronary intervention and stenting?
Coronary intervention or angioplasty is known as percutaneous transluminal coronary angioplasty (PTCA). Percutaneous coronary intervention is a combination of coronary angioplasty and stenting.
How can left coronary central artery disease be prevented?
Left main coronary artery disease can be prevented by making lifestyle changes and including diet modifications and regular exercise. Smoking should be avoided, and lipid-lowering medications should be taken after consulting a doctor. Blood sugar and blood pressure levels should be kept under control.
Is coronary artery bypass surgery or percutaneous coronary intervention better?
Percutaneous coronary intervention is done if only a few arteries are involved. Coronary bypass surgery is considered if there is severe narrowing of the left coronary artery or any of the three arteries.
What are the contraindications of undergoing coronary bypass surgery?
The contraindications of performing a bypass surgery are:-
- If the patient is not willing for surgery
- Coronary arteries are incompatible with the graft
- Absence of viable myocardial tissue
What are the complications associated with percutaneous coronary intervention?
The complications associated with percutaneous coronary intervention include injury to vessels, infection, injury, and vessel bleeding.
Advanced Technology & Facilities
At Aster Hospitals, we have the latest technology for all emergency conditions. Coronary heart diseases are among the most important causes of cardiovascular morbidity and mortality. The various diagnostic facilities available at Aster Hospitals are:
- Electrocardiograms can be done to record the electrical signals generated by the heart.
- Coronary calcium scan is done to measure the amount of calcium deposited in the walls of coronary arteries. It helps assess whether the patient is at risk of developing coronary artery disease.
- Stress tests record the function of the heart at the time of exercise. It records the efficacy of the heart to pump blood.
- Cardiac MRI helps to detect tissue damage caused due to insufficient blood supply to the heart. It helps diagnose microvascular diseases of the heart and obstructive and non-obstructive coronary artery disease.
- Coronary positron emission tomography test helps to assess the amount of blood flowing through the coronary artery and into the blood vessels. This type of nuclear scan helps to diagnose microvascular diseases of the heart.
- Coronary angiography is an invasive procedure that helps to confirm the presence of coronary heart disease.
Once the diagnosis of coronary heart disease is confirmed, treatment of the same is done using the latest technology that is available. Although coronary bypass surgery was considered the gold standard for left coronary artery blockage, advancement in percutaneous coronary intervention has made it a choice.
- Coronary artery bypass surgery is an open heart procedure that uses a part of a healthy blood vessel from any part of the body to create an alternative passage for the blood to flow.
- Percutaneous coronary intervention is an interventional procedure that uses a catheter to locate the site of the blockage, inflates a balloon, and puts a stent in place to prevent restenosis.
