Category: Surgery

Heart Stents – What is Their Life Expectancy?

How long does a stent last?

This question troubles all those who had stent(s).

Well, here is the shortest answer: stent is for life. In other words, stent is permanent.

Stents are made up of metal. Usually, today’s stents are drug eluting. Stent is coated with anti clotting drug. When it’s placed within an artery the coated drug dissolves over several years. Therefore, you need not worry about stent’s life. But you need to worry whether the stent is functioning properly.

Therefore, the question you must ask is:

How Can I Get the Most Benefit from Stent?

Your body considers stent as alien. After stent is placed, blood will rush to clot over a stent. Hence, it is necessary to take anti clotting drugs like Clopidogrel. Aspirin is obvious. You will be prescribed Clopidogrel for months or a year but Aspirin is for your life.

Sometimes, stents damage inner artery walls.

Finally, within years stent will get blocked. In such cases, your doctor will either recommend another stent procedure or bypass.

Therefore, after a stent procedure, ensure to take prescribed medicines. Most important of all eat healthy and exercise regularly.

A stent procedure is no guarantee that you won’t have another block.

Note: This article discusses stents made up of metals. 

How to Care for Your Heart After Bypass Surgery

After Bypass, the responsibility is yours. You need to work towards healing and getting back to normal life. Usually it takes 6 to 8 weeks. Your doctor must already have given a plan. However, we have  provided some crucial points which will help in getting your health back.

Making Lists:

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As soon as you settle at home do these things:

  1. Have a separate file for all instructions the medical team gave you. It is usually on how to care for yourself.
  2. Note the list of contacts (doctors and family member) incase you need them in emergency. Doctors and hospital emergency contact numbers must be listed. In case, you have any doubts, you can clarify calling these numbers.
  3. Have a Medicine Kit. This medicine must be different from previous ones. It must contain only medications intended after your Bypass surgery.
  4. Have your insurance card in your wallet. In case of emergency it will come in handy.

Taking Care of Incision:

Incisions are common in surgeries. In bypass there are two types:

  1. Traditional incisions and
  2. Minimal Invasive incisions

Traditional incisions are done when open heart surgery is performed. The sternum (middle of your chest) is split open to reveal your heart. After completion of surgery, it is stichted together using sternal wires. The outer incision (your skin) is either stitched traditionally/internally stitched or glued.

Image showing Sternum and Incision
Image showing Sternum and Incision

In Minimally invasive methods small incision is made which do not interfere with sternum.

 Care for Incisions while bathing:

It is okay to bath. However, do not soak in tub. Wash incisions daily with mild soap. Do not use soap directly on incisions. Use soap water to gently rub on incision. After bathing pat dry. The scab on your chest will fall off within a month. Until that time do not use lotion or ointment.

While showering turn your back towards the spray. If you can’t stand get a shower stool. Ask someone to get you in and out of shower till you regain strength.

Signs of Infection:

If you notice any of below infection signs call your doctor:

  1. Swelling on Oozing from incision
  2. Edges of incision pulling apart
  3. Warm feeling over the incision area
  4. Redness around incision
  5. Fever higher than 100F

Other signs (which are not infection) to note are:

  1. when your breastbone moves inside
  2. when you hear a pop or crack while you move.

Coping with Swelling Legs

If a vein was taken from your leg then it will swell occasionally. The swelling is caused due to improper blood supply (since a vein was taken). Here are some tips to cope with leg swelling:

  1. Wear white support stockings daily. Remove it in evenings. Continue until swelling stops
  2. Do not cross your legs.
  3. Whether you are sitting or sleeping rest your legs a little higher. Use pillows while sleeping and another couch while sitting.
  4. Walk daily for increased circulation.

Watching Your Weight

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After surgery some people experience fluid retention. This is caused by improper heart or kidney function. Check your weight daily to eliminate the possibility of fluid retention.

Things to do Daily:

  1. Check your weight daily. Use a digital scale.
  2. Record your weight.
  3. Take the record with you when visiting your doctor.

If you see 3 lb or more increased weight within 2 days let your doctor know immediately.

Activities – Do’s and Don’ts

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First two months after bypass surgery are crucial. The sternum won’t heal like other bones. It is held together by a strong wire. It will only heal if it’s in place constantly. If you do any strenuous activity there are chances of sternum edges being shifted.

Some Do’s and Don’ts:

  1. Do not drive. You can travel as passenger
  2. Do not life weights greater than 5 lb. These include children and trashes.
  3. Do not stand in one place longer than 15 minutes.
  4. Do not push or pull heavy items.
  5. Walk slowly everyday.

Approximately it take 2 months till you can return to your normal lifestyle. Talk with your doctor before regaining normal activities.

Some Tips on Exercising After Bypass Surgery

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Here are some tips to exercise after surgery:

  • Walk daily. Take short walks throughout the day. Do not over exert yourself.
  • Stop immediately if you experience pain or discomfort
  • Have someone walk with you
  • Increase your walking distance daily or weekly
  • Climb the stair slowly, each step at a time.

Changing Your Lifestyle After Bypass Surgery

Surgery alone won’t help. You need lifestyle changes. But the most important ones are below:

  1. Stop Smoking. If you never smoked, congrats!
  2. Reduce your alcohol intake. If possible, avoid altogether.
  3. Eat a healthy balanced meal.
  4. Exercise regularly.

How is Coronary Bypass Surgery Done & When?

Coronary artery bypass surgery is done using a healthy blood vessel to substitute damaged artery. When plaques build along the inner walls of arteries they restrict blood flow. A bypass surgery is done to bring the blood flow back to normal.

When is Coronary Artery Bypass Surgery Recommended?

This entirely depends on your situation. You, can have angioplasty as alternative. Then again, you need to talk with your doctor.

However, here are some common cases where Bypass Surgery is preferred:

  1. Previously you had Angiplasty and it didn’t work.
  2. The artery is severly damaged and it won’t survive a stent.
  3. Previously placed stent gets blocked, increasing the chance of heart attack.

Depending upon your situation cause will differ.

How is Coronary Artery Bypass Surgery Performed?

You will receive a general anesthesia and become unconsious. An incision is made in the middle of chest. Rib cage is then opened up exposing the heart.

A healthy blood vessel usually from leg is taken.

By now, Heart Lung machine is connected. The machine will pump oxygenated blood throughout your body.

The healthy blood vessel is implanted in such a way that blood flow instead of passing through damaged artery passes through the new vessel.

Surgeons check the functioning of newly placed blood vessel. If everything is alright then you are stitched up.

Risks involved?

Here are some risks which can arise after surgery:

  1. Heart Attack
  2. Bleeding
  3. Blood Clot
  4. Chest Pain
  5. Memory loss (usually temporary)
  6. Infection at incision point
  7. kidney failure
  8. Reaction to General Anesthesia

What are the Alternatives?

There are three main alternatives to Bypass Surgery. They are:

Enhanced External Counterpulsation:

In Enhanced External Counterpulsation therapy blood pressure cuffs are used. They are tied at your lower limbs. When the heart relaxes a compression is sent electronically. The compression increases blood flow to the heart. The increased blood flow provides sufficient blood flow to the heart. As time passes, the heart starts developing branches of arteries to cope with increased blood flow. This new branch of arteries act as natural bypass for damaged arteries.

Angioplasty:

Angioplasty involves using a balloon to compress the plaque and stents to keep the arteries from blocking again. This is most popular alternative for Bypass sugeries. For more infomarion on how Angioplasty is done please read this article on Angioplasty.

Medication:

Medicines too are used to unblock arteries. However, if you depend only on medicine the dosages are strong and you need to follow strict diet for significant changes. Usually, you are put on cholesterol lowering drugs along with other drugs.

Talk with your cardiologist for alternatives and their respective risks. Choose the one with more benefit to less risk ratio.

Note: No matter what alternative you choose your diet is most important. Even after a Bypass Surgery it’s vital to eat healthy diet.

Coronary Angioplasty: How and When is it Done

After an Angiogram, depending upon the lesion Angioplasty is recommended. It is also advised in cases of emergency like after a Heart Attack.

Angioplasty is fairly an easy procedure. It takes anywhere between 20 minutes to 2 hours. In some cases it can take more than 2 hours.

Before Angioplasty:

If your doctor has advised for Angioplasty then a general health check up and blood test is done. Theses are done to ensure your body is operable. After everything is found normal green signal is given.

Before Angioplasty, you are not supposed to eat for 6 to 7 hours. Regarding medication, you can take them normally until the previous day of Angioplasty procedure. Any further information, depending upon your health, your cardiologist will advise.

Angioplasty Procedure:

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Angioplasty is done in a catheterization lab. You will be asked to lie on an X-ray table. A heart monitor and IV line is fitted. Local anesthesia is used to numb your skin.

An incision is made under your groin. A sheath (small tube) is inserted into the artery to keep it open. Within this sheath a catheter is passed through your artery into left or right coronary artery guided through X-ray imaging.

A thin wire with a ballon at its tip is passed through the catheter. The wire is further guided towards blockage and ballon is inflated and then deflated. This causes the lesion (plaque) to be squashed. The procedure might be repeated for several times.

Ballon is inflated for 20 to 30 seconds. During this period you will miss or have an extra heart beat. Mild pain in the chest is also normal. If you feel uncomfortable, tell your cardiologist.

When procedure is finished, the wire, catheter and sheath are removed. the incision is closed through pressure or plug.

After Angioplasty:

Usually you will stay overnight after procedure. After you are discharged the necessary advice for your recovery is provided.

The incision will be sore for few days. If you notice bleeding rush to the hospital and let your cardiologist or General physician know.

You shouldn’t drive within the recovery period. Heavy weight lifting and strenuous work is prohibited until you recover completely.

Stents:

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Stent (wire-mesh tube) maybe recommended. In this case, the stent is placed above the ballon and inflated. After ballon is deflated the stent keeps the artery open.

There are two types of Stents:

  1. Bare Metal and
  2. Drug-eluting

Bare Metal Stents:

This type of stent has no coating. Once in place it helps the artery to heal asap. However, the problem is that these type of stent get blocked again. Bare metal stent are viewed as foreign agents and immune system attacks it creating a block within the artery. To avoid this problem Drug-eluting stents are used.

Drug-eluting Stents:

This type of stents are coated with medication. After being placed within the artery, coated medication gets dissolved over a period of time which prevents any immune system attack and further blocking. The only downside is that coronary arteries do not heal asap.

Today 70% of cardiologists use Drug-eluting stents. You can discuss with your cardiologist and depending on the risk and beneficial factor choose type of stent.