Increasingly recommended for those with minimum blockages and low complications, angioplasties are now the standard of care for those with coronary artery disease. As the cardiologist may have already explained to you, this minimally invasive surgery has the surgeon thread a stent bearing balloon catheter through a blood vessel in your groin or arm till it reaches the blocked artery. The balloon is then inflated to push the plaque to the sides of the artery and the stent is put in place. The balloon is then deflated and removed and a bandage or groin sheath is put in place to prevent the patient from bleeding out. The other alternative is open-heart surgery or Coronary Artery Bypass Grafting where arteries from one’s arms or legs are grafted on to the existing coronary arteries. As this surgery is more invasive and requires a longer rehabilitation time, it is advocated only for cases where there are multiple or severe blockages or other complications are present.

Recovery after your procedure

The road to recovery after your angioplasty or bypass surgery can be long and at times frustrating. However, with a little precaution and care, one can improve their recovery process and sometimes even speed it up. Remember, self-care is critical after your procedure.

  1. Pain management: Dealing with the mental and physical after-effects of angioplasty or bypass can be aggravated by poor pain management. Therefore, staying on top your pain management schedule is vital for your recovery. Remember to regularly take your pain medication if so advised by your cardiac surgeon at the appointed times. Alleviating your pain can also help speed up the healing process.

  1. Get enough sleep: The old adage that sleep is the best medicine holds for those who have undergone bypass or angioplasty. It may be difficult to fall asleep in the first few days or weeks after your procedure, but there are some things that you can try to get the optimum amount of shut-eye. Things, like staying on top of your pain medications and avoiding caffeine in the evenings, can go a long way in helping you relax.

      1. Seek help: Experiencing a cardiac event can be a traumatic event for even the strongest people. It is quite normal to find yourself feeling vulnerable, anxious or depressed. If your feelings don’t go away or start affecting your day to day life, then it is best to consult a psychologist.

      1. Go to rehab: Going to a properly designed and comprehensive rehab programme can do wonders for your recovery process. So sign up for one if available.

      1. Remember that your journey is unique: Undergoing a major surgery or procedure is a life-changing event. It is best to be patient and focus on your journey and milestones instead of focusing on someone else’s. Depending on your situation it may take you six months or even a year to fully recover from your procedure. Be patient.

      1. Exercise and modify your lifestyle: Surgery won’t cut down your risks of getting another blockage or experiencing another cardiac event. Exercise and modified dietary and lifestyle habits are the only things that can reduce your chances.

      1. Avoid smoking and limit your alcohol intake.

A point to note at this point is that an angioplasty is not a complete cure. Blockages may still occur if the proper precautions like following your doctor’s dietary and exercise recommendations are not followed. A diet rich in fruits, vegetables, whole grains, nuts, etc and low in salt, sugar and oil is the one to follow. Medications like blood-thinners, statins that lower lipids and hypertension drugs should be consumed as per advice and not discontinued at whim. Smoking should be cut out of your life and include a daily exercise regimen of minimum 30 minutes instead. This will help manage your weight and other co-morbid conditions like hypertension, diabetes and high cholesterol too. A happy heart is a healthy one so keep stress at bay by taking up new hobbies and activities; these will elevate your mood and help your recovery process too. Last, but not least, don’t forget your regular check-ups with your cardiologist.

Undergoing a cardiac procedure is a huge event in one’s life. Taking the right precautions and care is a vital step towards one’s recovery and healthier life.

We have all heard the story. A relative or an acquaintance experiences chest pain and immediately rushes to the hospital only to find out that it was severe gas. A more morbid one has the relative ignore the chest pain as gas till it intensifies and upon being rushed to the hospital is found to have suffered a severe heart attack. All these stories underscore the symptomatic similarity between heartburn and heart attack but the truth is that while both are chest pains; they do differ in how they manifest and in symptoms. In fact, 50% of heartburns are mistaken for heart attacks in Emergency Rooms. 

So what does one do when faced with debilitating chest pain? The first thing to do is calm down and figure out one’s symptoms.

Classic symptoms of heartburn are:

  1. A burning sensation in the breastbone or lower part of the chest or in the upper part of the stomach 
  • Radiating pain towards your throat instead of shoulders and arms
  • Feeling of regurgitation or food coming back into your mouth or a bitter taste.
  • Worsening pain when lying in a prone position
  • Occurring after a heavy meal

Heart attacks, on the other hand, exhibit the following symptoms:

  1. Chest pain that feels like pressure, squeezing, tightness or heaviness
  2. The pain comes in waves and continues only for a few minutes at a time
  3. Felt in the central or central left of the chest and radiates to the arms, neck, jaw or back
  4. Accompanied by cold sweat, shortness of breath, nausea, vomiting, fatigue and dizziness.

It is advisable to rush to the doctor if these symptoms occur for more than 15 minutes. Unfortunately, not all heart attacks are accompanied by symptoms or if present are mild. Sometimes heart pain is not always a heart attack but simple heart pain or angina. In any case, any pain that is accompanied by the above symptoms warrants an immediate visit to the hospital.

The first hour after a heart attack is crucial for long term recovery and better outcomes. 

Think you have had a heart attack? There are some things that you should do at home before rushing to the hospital or while waiting for the ambulance. They are:

  1. Immediately consume aspirin, unless allergic to the same. This will thin your blood and prevent further clotting.
  • If prescribed, then take a dose of nitroglycerin
  • Ask someone knowledgeable with CPR to begin the same and start chest compressions
  • Use an Automatic External Defibrillator (AED) if one is available on hand.

While these methods may better your chances of survival and long term recovery in case of a heart attack, they will not prevent one. The best ways to prevent a heart attack are:

  1. Avoiding smoking, both firsthand and secondhand
  2. Keeping your BP and cholesterol levels under control. This can be accomplished with dietary and lifestyle changes. Consult your doctor if you require medications for the same and remember to take them regularly.
  3. Go for regular health check-ups as the factors that contribute to heart disease, like high BP, cholesterol etc are usually asymptomatic in the early stages.
  4. Include regular physical activity. Even something as light as 30 minutes of walking, 5 times a week can go a long way in improving and maintaining your cardiac health while also keeping your weight in check.
  5. Reduce stress and take up hobbies that help you relieve the stress of your work and personal life.
  6. Consume alcohol only in moderate quantities.

Maintaining a healthy lifestyle is not only important for your cardiac health, but it is also a great way to prevent heartburn as well. Be aware of your body and don’t hesitate to go to the hospital if you are feeling any severe chest pain or accompanying symptoms. After all, it is better to be safe than sorry.

Your heart has four valves that pumps the blood throughout the body. These four valves work relentlessly to ensure blood supply to all the organs in the body. But sometimes as time passes, the usual wear and tear sets in causing the main valve, called the aortic valve in the heart to be blocked.

Once blocked it becomes very difficult for the heart to pump the adequate amount of blood required by the body resulting in breathlessness, chest-pains and finally heart attacks.

The patient needs to undergo valve replacement surgery to solve/treat this disease. Usually, valve replacements are done through open-heart surgery wherein a new tissue or mechanical prosthetic valve is inserted in the place of the diseased valve.

Open heart surgery is an invasive procedure with a very long recovery period. This can be a difficult challenge for patients, especially elderly patients.

But there is an alternate method to open heart surgery which is less invasive and has a shorter recovery period. It’s called a TAVI.

A TAVI or Transcatheter Aortic Valve Replacement (TAVR) technique is a life-saving treatment modality for patients who are unwilling or are high risk patients to undergo an open heart surgery.

This minimally aggressive procedure includes positioning a novel artificial valve over the diseased native valve of the patient through a catheter introduced through the patient’s large artery located in the groin (femoral artery).

This procedure can thus be done through small openings and hence result in quicker recovery post procedure enabling the patients to go back to their normal lives.

To know more about the procedure, visit your cardiologist today.

The after effects of finding out that one has a coronary artery blockage can be extremely stressful for both the patient and their families. Coming to terms with one’s illness while dealing with various tests, paperwork and hospitalization are just some things to deal with in the short term. Add to this the thought of what lies next, and the situation becomes quite stressful. Fortunately, the ultimate decision regarding the course of therapy rests entirely with the cardiologist. Depending upon various factors the patient may only be asked to make lifestyle modifications to put them on the path to recovery. However, patients with major blockages in their arteries must necessarily undergo either a Coronary Artery Bypass Grafting or an angioplasty.

Bypass: Coronary Artery Bypass Grafting or CABG involves cutting the patient’s chest open, putting them on a bypass machine that will act as their temporary heart. The surgeon then grafts new arteries from either the arms or the legs on to the blocked arteries. This is an invasive method which requires a long recovery period, thus advocated for complex cases with multiple blockages and complications.

Angioplasty: This is a minimally invasive option that requires less recovery time than a bypass. In this procedure, the cardiologist threads a thin catheter through a blood vessel in one’s arm or groin and inserts a balloon and stent through it. This balloon is inflated once it reaches the blocked area, pushing the plaque to the sides, widening the artery and putting the stent in place. Stents are a wire mesh implant that is made of either metal or polymer, with the latter material gaining more favour these days. Drug-Eluting Stents or DESs are part of the new generation of stents which are rapidly becoming the standard of care. These stents are coated with drugs that prevent clots and are designed to dissolve after a set number of years, thus allowing the artery to recover on its own.

What factors will a cardiologist consider while deciding on the best course of treatment?
Deciding on the best course of action is completely your cardiologist’s prerogative and should be made after proper consultation only. One thing to keep in mind is that not all blockages require surgical intervention. Some minor blockages may simply require lifestyle changes and medicines. These medicines decrease the risk of further plaque accumulation, stabilize the plaque, prevent its breakage and thus prevent total occlusion of the vessel. However, no two patients are the same and what will work for one may not work for the other; therefore individualized treatments are a must. The presence of co-morbid conditions like diabetes, high blood pressure etc, are also major factors that help your cardiologist make the final decision. As mentioned earlier surgery is the only option for major blocks. No matter the course of treatment, medications are a must.

Will my stent completely reduce my chances of getting a heart attack in the long-term?
No option provides a 100% guarantee of preventing heart attacks in the long term. Even stents can experience blockage over time. This occurs when the scar tissue starts to grow around the stent as the artery heals. This phenomenon is most commonly experienced with Bare Metal Stents or BMSs. Drug-Eluting Stents, which are the current standard of care, helps prevent such situations. This is done by coating the outer layer of the stent with a drug that prevents clots. These stents also dissolve after a certain number of years, thus allowing the artery to return to its normal curvature and dilation. No matter the type of stent, one will need to continue taking blood thinners to prevent the recurrence of clots over the course of one’s lifetime.

Experiencing a cardiac event can be terrifying for anyone. However, having a good knowledge of what to expect can reduce the fear and stress to a certain extent. So discuss all your doubts and fears with your cardiologist, no matter how insignificant or trivial they may seem. It may make all the difference to your post-procedure recovery process!

Getting a hip implant is a huge boon for those whose lives have been significantly affected by hip trauma and arthritis. Millions of patients across the world have undergone this surgery and found a new lease on life. However, as with any surgery, apprehensions remain. Will it work for me or my loved ones? Will they or I be able to go back to our normal routines again? What are hip implants made of? While the previous two questions and many more have been or will be covered in our other blogs, this blog will focus on the last question, “What are hip implants made of?”

After all, a hip implant is likely to last for the patient for the next 15-20 years, which is a significant part of one’s life. Having a thorough knowledge of the entire process takes the fear of the unknown out of the picture, and helps the patient approach their surgery with an open mind.

So the question you must be asking yourself is that “Is a hip implant really necessary?” The answer to that differs from case to case. A THR is only recommended if the patient suffers from chronic hip pain that hinders their daily activities and is unabated by non-invasive therapies like weight reduction, physical therapy, and painkillers. Another factor that is considered is, if pain affects the patient’s ability to sleep.

So what will a Total Hip Replacement procedure entail?

In simple terms, a Total Hip Replacement procedure will consist of the following steps:

  • The damaged ball of the hip joint is taken out and replaced with a metallic stem and is placed into the femur’s hollow center. This stem can be either cemented or press-fit into the bone.
  • A ceramic or metal ball is then positioned on the stem’s upper part. This serves as the replacement for the worn-out femoral head.
  • The damaged cartilage surface of the socket is replaced and held in place with cement or screws.
  • Finally, a metal or plastic spacer is positioned between the new implants to facilitate a smooth and frictionless movement.

To know more, click:  (Video link)

The final decision of which implant to use rests on the orthopedic surgeon.

However, the selection will take into account one’s level of activity, weight, age, lifestyle factors and most importantly, the extent of damage and the optimal fit. Each implant is different in its own way and thus, surgeons prefer to rely on 1-2 styles and brands depending on their practice and experience.

What makes for a good implant?

While each surgeon has their own reasons for preferring one implant over another, what they all look for in an implant are that it should:

Help the patient regain their usual activities and movement

Have expected durability of 15 to 20 years

Should have a good track record of minimum 5-10 years in Total Hip Replacement use

Meets the patient’s unique requirements and needs

A brand or a style that is familiar to them.

Depending on the patient’s need the surgeon may choose a press-fit or cemented implant.

Cemented Implant: The artificial implant is stuck to the natural bone with a quick drying cement.

Press-fit Implants: The preferred standard of care presently, press-fit implants allows the natural bone to grow and hold the implant in place.                                                                         

What constitutes a hip implant?

While the natural hip joint has only two components, the ball and the socket, a Total Hip Replacement implant has four different parts.

1) Acetabular component (socket)– This is the part that makes up the socket portion of the new hip. The cup-shaped component is fit into the patient’s resurfaced socket. In traditional hip implants, this component is composed of metal but there are a few implants whose acetabular component is made of ceramic or a combination of plastic and metal.

2) Acetabular liner: This high-grade polymer or plastic liner fits into the acetabulum and permits the ball to glide normally in the socket.

3) Ball: This is the other main component of the hip joint and fits directly into the new plastic socket. The ball in a normal hip is the upper end of the femur. In an implant, the ball is attached to femur with the use of a femoral stem. Balls can be manufactured from metal, plastic, ceramic or even a combination of these materials. They come in different sizes and shapes to fit different patients.

4) Femoral stem: This is the part that attaches the ball to the femur.  This component is especially important as it supports the entire joint. Usually made of a porous metal, the stem allows natural bone growth and facilitates attachment to this piece and replaces the thighbone.                                         

What the implants made of?

Total Hip Replacement implants are composed of high-grade plastic polymers, metal, ceramic or a combination of them all. The femoral stem is usually made of titanium, titanium-cobalt alloy, stainless steel, cobalt-chromium alloy or other metallic alloys. The other components, on the other hand, can be composed of either metals, plastic or ceramic material or even a combination of these materials. The reason these metals are chosen is that they have been proven to be both strong yet flexible enough to allow regular movement. These materials also do not cause immune reactions in the patient’s body.

Depending on their composition, implants can be categorized as:

1. Metal on Metal/MOM in which both the ball and socket components are metallic in nature.

2. Polyethylene and Metal on Polyethylene (MOP): When the socket is made of plastic/polyethylene and the ball is metallic, it is termed as MOP.

3. Ceramic on Metal (COM), Ceramic on Polyethylene (COP) and Ceramic on Ceramic (COC): These are rare compositions and not preferred by many surgeons. These are usually used for patients who are allergic to metals.

Which material is better?

When it comes to implants, no material is significantly better than the other. The choice depends on surgeons and their assessment of their patient’s needs. For the longest time metal on metal Total Hip Replacement implants were thought to be the best. All this changed in 2010 with the Depuy metal implant debacle where it was found that the implants came with a high risk of metal poisoning. Many surgeons prefer titanium implants as they have a long record of proven effectiveness.  As of now, metal on plastic and ceramic implants are the standards of care. The former is more preferred for aged patients, while the latter is more suitable for younger, more active patients.

When it comes to choosing the best material, both have their own pros and cons. While ceramic does not get as worn out as metal or plastic, they can develop cracks or break suddenly. However, these problems have been ironed out in the newer generation of implants that show fewer incidences like these. The main issue restricting the use of ceramic implants is that compared to metallic implants, fewer long-term clinical outcomes with ceramic implants are published.

It is normal to be a little apprehensive when faced with the prospect of having something semi-permanent implanted in one’s body. But the truth is that there is little to worry about. Total Hip Replacement is a common surgery with high rates of success. So go out there and get ready to get back on your feet!