Pinpoint incisions to achieve big results. That’s the approach cardiologists are taking today to correct heart disease. Interventional techniques have become the standard of care for many heart problems. Here’s an overview:
ANGIOPLASTY
Before. Surgeons performed a sternotomy, making a long incision to access the heart by splitting the breastbone and prying open the rib cage.
Now. A miniature catheter is threaded to the obstructed heart vessel through a needle puncture in the groin. Then a hot-dog shaped balloon is advanced through the catheter to the blockage. Here it’s inflated, pushing plaque aside and opening the artery.
STENTS
Before. There was no method to keep newly opened arteries from collapsing if they were predisposed to do so.
Now. Tiny wire-mesh tubes called stents are threaded to the site of the blockage using balloon angioplasty. Then they’re expanded and locked into place, forming a framework that holds the artery open. Some stents penetrate the plaque, while others compress it.
ATHERECTOMY
Before. Open-chest surgery was necessary to access clogged arteries.
Now. When stents or angioplasty aren’t appropriate, doctors may use lasers and tiny rotating or stationary blades to destroy the plaque blocking an artery. An angiojet—a tool that uses pressure to destroy clots—may also be used. All is done through a needle puncture in the groin.
