Coronary Artery Bypass: From 1 Different Sources
A major heart operation to bypass narrowed or blocked coronary arteries using additional blood vessels (such as a mammary artery) to improve blood flow to the heart muscle. This operation is used when symptoms of coronary artery disease have not been relieved by drugs or balloon angioplasty.
Before surgery, sites of blockage in the arteries are identified using angiography. In some cases, minimally invasive surgery can be used, avoiding the need to stop the heart and use a heart–lung machine during the operation. The long term outlook after a bypass is good, but the grafted vessels may also eventually become blocked by atherosclerosis.
A procedure in which the body’s circulation of blood is kept going when the heart is intentionally stopped to enable heart surgery to be carried out. A HEART-LUNG MACHINE substitutes for the heart’s pumping action and the blood is oxygenated at the same time.... cardiopulmonary bypass
See HEART, DISEASES OF.... coronary thrombosis
A technique by which narrowing or blockage of an artery (see ARTERIES), vein (see VEINS) or a section of the gastrointestinal tract is bypassed using surgery. Arterial blockages – usually caused by ATHEROSCLEROSIS – in the carotid, coronary or iliofemoral arteries are bypassed utilising sections of artery or vein taken from elsewhere in the patient. Tumour growths in the intestines are sometimes too large to remove and can be bypassed by linking up those parts of the intestines on each side of the growth.... bypass operation
A term applied to several structures in the body encircling an organ in the manner of a crown. The coronary arteries are the arteries of supply to the HEART which arise from the aorta, just beyond the aortic valve, and through which the blood is delivered to the muscle of the heart. Disease of the coronary arteries is a very serious condition producing various abnormal forms of heart action and the disorder, ANGINA PECTORIS.... coronary
A technique of dilating atheromatous obstructions (see ATHEROMA) in CORONARY ARTERIES by inserting a catheter with a balloon on the end into the affected artery (see also CATHETERS). It is passed through the blockage (guided by X-ray FLUOROSCOPY) and in?ated. The procedure can be carried out through a percutaneous route.... coronary angioplasty
(See also HEART.) The right coronary artery arises from the right aortic sinus and passes into the right atrio-ventricular groove to supply the right ventricle, part of the intraventricular septum and the inferior part of the left ventricle. The left coronary artery arises from the left sinus and divides into an anterior descending branch which supplies the septum and the anterior and apical parts of the heart, and the circum?ex branch which passes into the left atrio-ventricular groove and supplies the lateral posterior surfaces of the heart. Small anastomoses exist between the coronary arteries and they have the potential of enlarging if the blood-?ow through a neighbouring coronary artery is compromised. Coronary artery disease is damage to the heart caused by the narrowing or blockage of these arteries. It commonly presents as ANGINA PECTORIS or acute myocardial infarction (see HEART, DISEASES OF).... coronary arteries
A treatment for a stenosed (restricted) coronary artery (see ARTERIES). A balloon-tipped catheter (see CATHETERS) is passed through an incision in the skin of the chest into the artery of the HEART that has developed stenosis (narrowing). The balloon is aligned with the stenosed section and then in?ated to dilate the coronary artery and allow the blood to ?ow more freely.... percutaneous transluminal coronary angioplasty
This artery arises from the brachial artery at the level of the neck of the radius. It passes down the forearm to the wrist, where it is easily palpated laterally. It then winds around the wrist to the palm of the hand to supply the ?ngers. (See ARTERIES.)... radial artery
A branch of the external carotid artery that is the main vessel supplying blood to the temple and scalp.... temporal artery
The artery that runs down the inner side of the upper arm, between the armpit and the elbow.... brachial artery
A specialist ward for the care of acutely ill patients who may be suffering, or who have suffered, a myocardial infarction (heart attack) or another serious cardiovascular disorder.... coronary care unit
A major blood vessel that supplies oxygenated blood to the leg. The femoral artery is formed in the pelvis from the iliac artery (the terminal branch of the aorta). It then runs from the groin, down in front of the thigh, and passes behind the knee to become the popliteal artery, which branches again to supply the lower leg.... femoral artery
The cause of: coronary occlusion, coronary blockage, coronary thrombosis. A heart attack occurs when a coronary artery becomes blocked by swellings composed, among other things, of cholesterol. Such swellings may obstruct the flow of blood leading to a blood clot (thrombus). Cholesterol is a major cause of CHD.
Coronary thrombosis is more common in the West because of its preference for animal fats; whereas in the East fats usually take the form of vegetable oils – corn, sunflower seed, sesame, etc. Fatty deposits (atheroma) form in the wall of the coronary artery, obstructing blood-flow. Vessels narrowed by atheroma and by contact with calcium and other salts become hard and brittle (arterio-sclerosis) and are easily blocked. Robbed of oxygen and nutrients heart muscle dies and is replaced by inelastic fibrous (scar) tissue which robs the heart of its maximum performance.
Severe pain and collapse follow a blockage. Where only a small branch of the coronary arterial tree is affected recovery is possible. Cause of the pain is lack of oxygen (Vitamin E). Incidence is highest among women over 40 who smoke excessively and who take The Pill.
The first warning sign is breathlessness and anginal pain behind the breastbone which radiates to arms and neck. Sensation as if the chest is held in a vice. First-line agent to improve flow of blood – Cactus.
For cholesterol control target the liver. Coffee is a minor risk factor.
Measuring hair calcium levels is said to predict those at risk of coronary heart disease. Low hair concentrations may be linked with poor calcium metabolism, high aortic calcium build-up and the formation of plagues. (Dr Allan MacPherson, nutritionist, Scottish Agricultural College, Ayr, Scotland)
Evidence has been advanced that a diagonal ear lobe crease may be a predictor for coronary heart disease. (American Journal of Cardiology, Dec. 1992)
Tooth decay is linked to an increased risk of coronary heart disease and mortality, particularly in young men. (Dr Frank De Stefano, Marshfield Medical Research Foundation, Wisconsin, USA) Treatment. Urgency. Send for doctor or suitably qualified practitioner. Absolute bedrest for 3 weeks followed by 3 months convalescence. Thereafter: adapt lifestyle to slower tempo and avoid undue exertion. Stop smoking. Adequate exercise. Watch weight.
Cardiotonics: Motherwort, Hawthorn, Mistletoe, Rosemary. Ephedra, Lily of the Valley, Broom.
Cardiac vasodilators relax tension on the vessels by increasing capacity of the arteries to carry more blood. Others contain complex glycosides that stimulate or relax the heart at its work. Garlic is strongly recommended as a preventative of CHD.
Hawthorn, vasodilator and anti-hypertensive, is reputed to dissolve deposits in thickened and sclerotic arteries BHP (1983). It is believed to regulate the balance of lipids (body fats) one of which is cholesterol.
Serenity tea. Equal parts: Motherwort, Lemon Balm, Hawthorn leaves or flowers. 1 heaped teaspoon to each cup boiling water; infuse 5-15 minutes; 1 cup freely.
Decoction. Combine equal parts: Broom, Lily of the Valley, Hawthorn. 1-2 teaspoons to each cup water gently simmered 20 minutes. Half-1 cup freely.
Tablets/capsules. Hawthorn, Motherwort, Cactus, Mistletoe, Garlic.
Practitioner. Formula. Hawthorn 20ml; Lily of the Valley 10ml; Pulsatilla 5ml; Stone root 5ml; Barberry 5ml. Tincture Capsicum 1ml. Dose: Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: 1 teaspoon. Tinctures: 2 teaspoons. Thrice daily in water or honey.
Prevention: Vitamin E – 400iu daily.
Diet. See: DIET – HEART AND CIRCULATION.
Supplements. Daily. Vitamin C, 2g. Vitamin E possesses anti-clotting properties, 400iu. Broad spectrum multivitamin and mineral including chromium, magnesium selenium, zinc, copper.
Acute condition. Strict bed-rest; regulate bowels; avoid excessive physical and mental exertion. Meditation and relaxation techniques dramatically reduce coronary risk. ... coronary heart disease
Blockage of an artery supplying blood to the retina, most commonly due to thrombosis or embolism, The disorder can result in permanent blindness or loss of part of the field of vision, depending on the artery affected and whether or not the condition can be treated quickly enough.... retinal artery occlusion
When coronary arteries, narrowed by disease, cannot supply the heart muscle with su?cient blood, the cardiac circulation may be improved by grafting a section of vein from the leg to bypass the obstruction. Around 10,000 people in the United Kingdom have this operation annually and the results are usually good. It is a major procedure that lasts several hours and requires the heart to be stopped temporarily, with blood circulation and oxygenation taken over by a HEART-LUNG MACHINE.... coronary artery vein bypass grafting (cavbg)
A specialised hospital unit equipped and sta?ed to provide intensive care (see INTENSIVE THERAPY UNIT (ITU)) for patients who have had severe heart attacks or undergone surgery on the heart.... coronary care unit (ccu)
A narrowed or blocked coronary artery (see ARTERIES) can compromise the blood supply to the heart muscle (see HEART, DISEASES OF). A supportive tube or stent passed into each affected artery can restore the blood supply. The stent has a HEPARIN coating to stop blood clots from forming. Since it was ?rst performed in 1987, intracoronary stents have cut the reblockage rate from one in three patients who have had coronary ANGIOPLASTY to fewer than one in ten in cases where a stent was used with angioplasty.... intracoronary artery stenting
a combination of angina (unstable or stable), non-S–T elevation *myocardial infarction (NSTEMI), and S–T elevation myocardial infarction (STEMI). It implies the presence of coronary artery disease.... acute coronary syndrome
an artery in the base of the brain, formed by the union of the two vertebral arteries. It extends from the lower to the upper border of the pons Varolii and then divides to form the two posterior cerebral arteries.... basilar artery
see innominate artery.... brachiocephalic artery
n. a surgical procedure to divert the flow of blood or other fluid from one anatomical structure to another; a *shunt. A bypass can be temporary or permanent and is commonly performed in the treatment of cardiac and gastrointestinal disorders. See also cardiopulmonary bypass; coronary artery bypass graft.... bypass
(carotid stenosis) narrowing of the carotid artery, which reduces the supply of blood to the brain and is a cause of strokes. It is treated by surgical excision or bypass of the narrowed segment (see also endarterectomy) or by inserting a *stent into the carotid artery.... carotid artery stenosis
Procedures to bypass the blockage or narrowing of an artery or vein or any part of the digestive system. Arteries can become blocked or narrowed in atherosclerosis. Obstructions can be bypassed using sections of healthy artery or vein from elsewhere in the body or using synthetic tubing. Veins are bypassed most often in patients with diseases of the liver that cause portal hypertension and bleeding oesophageal varices. This kind of bypass is called a shunt. Intestinal bypasses are employed most commonly in patients with cancer in which tumour growth is too extensive to be removed. An obstructed bile duct can be bypassed by constructing a new opening into the digestive tract. (See also coronary artery bypass.)... bypass operations
an X-ray technique for examination of the coronary arteries, often taken to also include examination of the chambers of the heart. A catheter is introduced via the radial artery at the wrist or the femoral artery at the groin and manipulated into the heart under X-ray control. *Contrast medium is then injected to outline the ventricles and coronary arteries. Digital video images are recorded during contrast-medium injection. Coronary angiography is used to diagnose cardiac disease, specifically narrowing or blockage in the coronary arteries, and plan treatment by surgery or radiological interventional techniques (see coronary artery bypass graft; percutaneous coronary intervention). It has now largely been replaced by CT coronary angiography.... coronary angiography
(CABG) *coronary revascularization in which a segment of a coronary artery narrowed by atheroma is bypassed by an *autologous section of healthy saphenous vein or internal mammary artery at *thoracotomy. The improved blood flow resulting from one or more such grafts relieves *angina pectoris and reduces the risk of *myocardial infarction. Recently developed techniques of *minimally invasive surgery have enabled the operation to be performed without the need for thoracotomy.... coronary artery bypass graft
the restoration of blood flow to ischaemic heart muscle (see ischaemia) by *coronary angioplasty and *stenting or by a *coronary artery bypass graft.... coronary revascularization
the terminal branch of an artery, which does not communicate with other branches. The tissue it supplies is therefore probably completely dependent on it for its blood supply.... end artery
any of several procedures of *bariatric surgery that allow food to bypass parts of the gut in order to reduce absorption of nutrients and calories. Such operations often lead to greater weight loss than restrictive procedures, such as *gastric banding and *stomach stapling, but there are significant long-term complications relating to chronic malabsorption and patients must remain under long-term specialist follow-up.... gastric bypass surgery
a fetal artery lying in the *hyaloid canal of the eye and supplying the lens.... hyaloid artery
(brachiocephalic artery) a short artery originating as the first large branch of the *aortic arch, passing upwards to the right, and ending at the lower neck near the right sternoclavicular joint. Here it divides into the right common carotid and the right subclavian arteries.... innominate artery
(PCI) treatment of coronary artery disease delivered by cardiac *catheterization. This usually means *coronary angioplasty followed by insertion of a coronary *stent, but also includes more specialized procedures, such as rotational *atherectomy (rotablation). Primary PCI refers to the use of PCI as the first-line treatment to relieve coronary obstruction in S-T elevation *myocardial infarction, rather than *thrombolysis. Rescue PCI is used in the event of unsuccessful thrombolysis.... percutaneous coronary intervention
the artery that conveys blood from the heart to the lungs for oxygenation: the only artery in the body containing deoxygenated blood. It leaves the right ventricle and passes upwards for 5 cm before dividing into two, one branch going to each lung. Within the lungs each pulmonary artery divides into many fine branches, which end in capillaries in the alveolar walls. See also pulmonary circulation.... pulmonary artery
either of two large arteries arising from the abdominal aorta and supplying the kidneys. Each renal artery divides into an anterior and a posterior branch before entering the kidney.... renal artery
either of two arteries that originate from the abdominal aorta and travel downwards to supply the testes.... spermatic artery
(SPA) a surgical procedure to identify and occlude the sphenopalatine artery in the nose using endoscopic surgery. It is used in the treatment of severe epistaxis (nosebleed).... sphenopalatine artery ligation
either of two arteries supplying blood to the neck and arms. The right subclavian artery branches from the innominate artery; the left subclavian arises directly from the aortic arch.... subclavian artery
a branch of the brachial artery arising at the elbow and running deep within the muscles of the medial side of the forearm. It passes into the palm of the hand, where it unites with the arch of the radial artery and gives off branches to the hand and fingers.... ulnar artery
a method of embolizing the uterine artery under radiodiagnostic control (see embolization). It has been successful in controlling postpartum haemorrhage and can also be used in treating fibroids, correcting arterial or venous malformations of the genital tract, and terminating abdominal and cervical pregnancies.... uterine artery embolization
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