Also known as coronary artery bypass grafting or surgical myocardial revascularization, it is used to treat an obstruction in the irrigation of the coronary arteries usually caused by atheroma, through which a portion of another vein is taken, and one end is attached to the aorta artery to provide blood supply and the other end is attached to the to the coronary sector that is beyond the obstruction.
The most common symptom of coronary atherosclerosis is angina pectoris. When it occurs gradually, the cardiologist can request a nuclear medicine study called SPECT where the extent and severity of the disease can be observed. Catheterization provides the diagnosis where the location, number and type of obstruction can be determined and the type of treatment can be defined.
Bypass surgery is recommended for the following:
Obstruction of the trunk of the left coronary artery.
Proximal obstruction of two or three epicardial arteries (right, circumflex or anterior descending coronary artery).
Obstruction of the proximal left anterior descending artery where a coronary angioplasty is impossible to perform.
Before surgery, patients are required to undergo a physical examination to detect coexisting illnesses. Different laboratory, physical, radiographic and other studies are also carried out to prevent complications and plan a strategy in the event of an accompanying disease. Patient control during surgery has been improved by the development of electromedicine; the anesthesiologist will continuously monitor your vital signs and anesthetic depth.
The internal mammary artery, which is located in the thorax, is commonly used to replace obstructed arteries; it does not have a vital function. The radial artery, which is extracted from the arm, is also used. For bridges, it is necessary to enter the chest by median sternotomy (large incision through the sternum). This method is safe and allows the surgeon to perform complex procedures. Bridges can be performed with or without extracorporeal circulation depending on the complexity of the procedure and the characteristics of the individual patient.
The patient spends the first 24 hours in cardiovascular recovery, and then, he spends the 2nd and 3rd day in the intensive care unit. The patient is transferred to intermediate care where he spends the 4th and the 5th day. The patient is usually discharged starting from the 6th day.
Heart valves are located in the outlets of the four chambers of the heart. Their function is to prevent blood from flowing backwards. With the different contractions of the heart, its four chambers contract in a certain sequence to pump blood in one direction and irrigate it to the rest of the body.
In some cases one or more valves stop working properly causing congenital heart valve disease (a person is born with this deficiency), endocarditis (a valve has been irreversibly damaged by inflammation inside the heart), valve stenosis (a valve becomes narrower and causes insufficient flow), valve insufficiency (valve hardens and ceases to be flexible, so it does not close properly).
When these deficiencies become more serious, the patient will feel fatigue, shortness of breath and have limited ability to walk, climb stairs, exercise and, generally, to resist fatigue. The solution is to repair or implant artificial valves, for which the patient must undergo open heart surgery to replace heart valves.
Varicose veins is a disease that affects the leg veins due to several factors. Veins become enlarged and painful causing blood circulation problems that can be very harmful to the health in addition to being unattractive. Varicose veins are formed by a malfunction of the valves in the leg veins that help blood to flow to the heart.
People that suffer from varicose veins have heavy legs, cramps, itching and even severe pain. One in ten people suffer from varicose veins, being more common in women, especially as a result of pregnancy and hormones.
Venocentro is the first medical institution in El Salvador engaged in the diagnosis and treatment of varicose veins and conditions of the veins. They have specialized in providing the best treatment for each type of vein. They have the latest and most advanced laser equipment for veins with state-of-the-art technology, according to the most stringent international standards, as well as Endolaser surgery and Ohmic Thermolysis.
The technology that is used is:
Innovative computer system for color Doppler Diagnosis, which takes an accurate mapping of all the diseased veins to obtain an image of the entire venous system of the lower limbs.
YAG laser 1064 is the most powerful, skin-friendly laser equipment for spider vein removal. It penetrates up to 5 mm into the skin and is ideal for thin red or purple veins with a 1 to 2 mm. diameter. 4-5 sessions are usually required with an interval of 2 weeks between each session and the treatment can be combined with sclerotherapy and the Spider.
What is the post-laser treatment care?
Avoid sun exposure of the treated area for 14 days to prevent blemishes or scars.
Moisturize the treated area with Aloe Vera moisturizing creams two or three times a day.
Avoid scratching to reduce the risk of marks, infections and/or deep scars, small or micro scabs (if they appear).
Biolitec 1470 Endolaser Surgery. Of German origin, it is the latest and most widely used technology for surgery of large varicose veins due to its effectiveness (98%) to remove them without damaging the surrounding fat tissues and skin.
The procedure is performed under local anesthesia in the operating room. The vein is punctured using Doppler ultrasound and laser thermal energy. The Biolitec technology doesn’t leave hematoma marks but a small bruising and post-operative pain, discomfort and swelling are minimal so the patient returns home the same day.
The aesthetic result is optimal with a 3-5 day recovery and return to daily activities. You can control the pain with oral medications and your legs will look better a few days after the procedure.
During the recovery, elastic stockings must be worn for five days after the bandages are removed as indicated by your doctor. Elevate your legs for 15 minutes every 6 hours for the first week. Walk every day after the first day, starting with 20 minutes daily and increase the time as the discomfort allows you to. Avoid strenuous exercise or heavy lifting or spending too much time standing up during the first 14 days. Avoid hot baths, saunas, hot tubs, swimming in pools and high-temperature environments.
Risks and Complications
Although risks and possible complications of endovenous laser ablation are very unlikely, the following must be reported:
Swelling and numbness of the skin are common but must be reported if they persist after a week.
Signs of infection in treated areas, increasing pain, redness and/or fever.
Skin burns or blisters.
Formation of a blood clot in a deep vein.
The Ecleris Spider equipment is a selective thermo-coagulator that generates great heat by radio frequency and is used to remove thin 1mm spider veins and laser-resistant spider veins.
The Ohmic Thermolysis cannot be used in:
Patients with heart pacemakers.
Patients with skin infection, open wounds or post-shaving irritation dermatitis.