Coronary angiography is a procedure that uses a special dye (contrast material) and X-rays to see how blood flows through the arteries in your heart. Cardiac angiography is also known as Heart Angiography or Coronary Angiogram.

Who should undergo CT coronary angiography?

• Asymptomatic patient with a family history of coronary artery disease.
• Patients with high-risk factors.
• Prior to non-coronary surgery in the adult population, e.g. pre-ASD repair, pre-valvular repair, and pre-tumor surgery.
• Follow up for post CABG.
• Atypical chest pain with a doubtful coronary origin.
• Evaluation of coronary anomalies.
• Assessment of cardiac neoplasm.
• Assessment of stent potency.
• Detection and characterization of congenital heart disease.
• Diagnosis of pericardial disease.
• Non-conclusive stress tests.

A hole in the wall between the two upper collecting chambers (ASD) or between the two bottom pumping chambers (VSD) can cause problems.

The severity of the symptoms depends on the size and the location of the defect and can range from no symptoms at all to severe heart failure. Heart failure in a baby results in poor feedings and poor weight gain. In older children, heart failure may cause decreased exercise tolerance and shortness of breath.

Depending on their size and location, septal defects may close by themselves. The cardiologist will likely wait a while before recommending surgical treatment to see if that happens naturally.

In cases involving larger holes and severe symptoms, however, treatment with surgery or catheter closure with a device will be needed.

The surgical treatment for ASDs and VSDs is open-heart surgery. The heart is stopped and opened, and the hole is closed with a patch made of a synthetic material like Dacron or a patch of the pericardium (the thick sac that surrounds the heart). Complications are minimal and the length of stay in the hospital is about 5 days.

Angioplasty is a medical procedure to open narrowed or blocked blood vessels of the heart called the coronary arteries. Angioplasty is not considered to be a type of surgery.

It’s sometimes called percutaneous transluminal coronary angioplasty (PTCA) and percutaneous coronary intervention (PCI). Angioplasty is also used in other parts of the body, usually to treat peripheral artery disease.

When is Coronary Angioplasty Recommended?

Angioplasty may be used to improve symptoms of coronary artery disease (CAD) such as angina and shortness of breath. Angina is a form of chest pain or discomfort that occurs when an area of the heart muscle is deprived of enough oxygen-rich blood. Angina may feel like pressure or squeezing in the chest. The pain also may occur in the shoulders, arms, jaw, neck, or back. Angina can feel like indigestion.

Coronary Angioplasty Success Rate :

More than 9 in 10 coronary angioplasty procedures are successful at relieving angina. However, the use of coronary angioplasty is not possible with all people with angina. The reason for this is in some cases there are too many narrowed sections in the coronary arteries. Or, the sections that are narrowed are too long or too narrow for coronary angioplasty.

In some other cases, it is not possible to stretch the narrowed artery. This occurs in about 1 in 20 cases where coronary angioplasty is tried. An alternative treatment of coronary artery bypass grafting may then be an option to treat angina. Bypass grafting involves involving major surgery hence most patients feel that it was worth trying a coronary angioplasty first.

In heart valve surgery, one or more valves are repaired or replaced, depending on the condition of the valve. The decision to either repair or replace the valve can be taken only during surgery and not before. Your surgeon will discuss with you the options and any other procedures you may need.

• Valve Repair: A ring may be sewn around the opening of the valve to tighten it. Other parts of the valve may be cut, shortened, separated, or made stronger to help the valve open and close right.
• Valve Replacement: If a valve cannot be repaired, it may be replaced with a prosthetic valve. Two kinds of prosthetic heart valves are available: mechanical and biological.

Minimally Invasive Heart Valve Surgery :

Heart valve surgery can also be done through the minimally invasive method. However, a total evaluation of your condition is required before determining if you are a candidate for this method. Minimally invasive heart valve surgery has significant advantages over the traditional method like faster recovery, lesser pain, and less visible scarring.

Benefits of Heart Valve Surgery :

You will slowly be able to participate in normal activities again, though the recovery time varies from patient to patient. Recovery depends on your overall strength. The problems that the old, damaged valve caused will no longer occur and the new heart valve will help your heart function better.

Heart bypass surgery is the colloquial name for coronary artery bypass surgery or coronary artery bypass graft surgery (CABG – often pronounced ‘cabbage’).

Heart bypass surgery is done to treat coronary artery disease – the condition in which the arteries that supply blood and oxygen to the heart harden and thicken.

But coronary artery bypass surgery is not to be taken lightly. Doctors recommend it only when lifestyle changes and medicines don’t work.

Benefits of Heart Bypass Surgery :

Most CABG patients have a good prognosis, provided they are committed to the cardiac rehabilitation program. You can look forward to the following benefits from heart bypass surgery:

• Improvement in quality of life and decrease in angina (chest pain) and other symptoms of CAD.
• You will be able to adopt a more active lifestyle.
• The better pumping action of the heart.
• Lower chances of a heart attack.
• Better chances of survival.

The main pumping compartment of the heart (left ventricle) is connected with the main artery that supplies oxygen-rich blood to your body. The aortic valve is situated between the aorta and the left ventricle and its job is to stop the backflow of the oxygen-rich blood into the left ventricle.

Likewise, the mitral valve is situated between the left chambers of the heart, the left atrium and the left ventricle. This valve functions as a unidirectional router of the blood coming from the left atrium to the left ventricle.

For Aortic Valve:

• Aortic Valve Regurgitation: This is the condition when the blood flows backward through the aortic valve into the left ventricle every time the chamber expands, which is the direct opposite condition of a working aortic valve allowing the only one-way direction of the blood to the aorta.
• Aortic Valve Stenosis: This is the phenomenon where the aortic valve has become constricted or has been obstructed by some kind of block that takes more force into pumping blood into the aorta.
• Structural Issues: There may be some inborn structural problems that cause the blood to flow properly into each of the sites. The aortic valve may not have enough tissue flaps, the valve may be of wrong shape or size, and it may also be possible to not have an opening for the flow of blood to occur properly. This condition is known as atresia.

A pacemaker is a small device that is implanted under the skin (most often in the shoulder area just under the collarbone) it sends electrical signals to start or regulate a slow heartbeat. Some are permanent (internal) and some are temporary (external). They can replace a defective natural pacemaker or blocked pathway.

Pacemakers can be surgically placed into the chest (a permanent pacemaker) through a small incision, or they can be worn outside the body (a temporary pacemaker) and attached to the heart through a wire that is threaded through a neck vein. Temporary pacemakers are used only while a person is in the hospital.

Types of Pacemakers :-

There are several kinds of permanent pacemakers, each designed to meet a different need. They include : -

• Demand pacemakers, which monitor the heart rate and discharge electricity only when the heart rate falls below a > programmed minimum or misses a beat.
• Fixed-rate pacemakers, which discharge a steady stream of electrical impulses, regardless of the underlying heart rate.
• Rate-responsive pacemakers, which monitor various physical changes in the body (e.g., respiration, physical activity) and change the rate of discharge accordingly.

There are two basic types of pacemakers: -

• Single-chamber pacemakers stimulate one chamber of the heart, either an atrium or more often a ventricle.
• Dual-chamber pacemakers send electrical impulses to both the atrium and the ventricle and pace both chambers. A dual-chamber pacemaker synchronizes the rhythm of the atria and ventricles in a pattern that closely resembles the natural heartbeat. Dual-chamber pacemakers are usually used to treat a slow heart rate.