In current medicine, there is an increasing tendency to solve problems in the least aggressive way possible, making patients have a better and easier recovery.
In some cases of heart disease, heart surgery is still essential and the results are getting better. There are, however, a series of cardiological problems that a few years ago had surgery as their only solution and can now be treated differently. Interventional hemodynamic techniques are capable of treating various cardiological diseases using catheters, without the need to operate.
Among the diseases that we can most often resolve by catheters is coronary heart disease. The use of angioplasty and stent implantation has led to a revolution in the treatment of these diseases. Cardiac treatment hospitals in India can also use hemodynamic techniques in some congenital diseases. Among them coarctation of the aorta or interatrial communication or the patent foramen ovale. These lesions can be treated by balloon dilation in the case of coarctation or by closing the orifice of the interatrial communication or the oval foramen with a device that is placed through the femoral vein.
Another large group of diseases that we can treat in hemodynamic cabinets are some valvulopathies. Among them, aortic stenosis, a very common disease in elderly people who can benefit from the implantation of a transcateter prosthesis. This last procedure is consolidated as the technique of choice to treat aortic stenosis in elderly people or with other health problems that cause the surgery to have a significant risk.
All these procedures require a highly qualified medical team. Each case must be carefully individualized, and the cardiology team, composed of the clinical cardiologist, the hemodynamic-interventional cardiologist, the cardiac surgeon, and the cardiac imaging experts must decide the technique to be used. There is no doubt that patients treated in this way benefit from a shorter hospital stay and avoid all discomfort arising from surgical intervention.
The treatment of the valves
Interventional cardiology is also moving towards the treatment of valves. Up to five years ago, it was not conceivable that a heart valve could be replaced without opening the chest. Today, however, we can do it, for example in the case of aortic stenosis, a disease typical of the elderly, especially after the age of seventy. Intervening with an open heart on an 85-year-old patient carries a very high risk, today we do this surgery by going through the leg and implanting a new valve inside the old one.
To do this, cardiac treatment hospitals in Indiacarry out deep sedation and the intervention uses an echo transesophageal control: that is, an ultrasound is introduced into the oesophagus to see the heart and position the valve well. It is a huge step forward and this technique will be used in the future also in younger patients.
Today's stents then not only keep the artery open but thanks to the drug they are covered with, they prevent the plaque from being reformed inside the artery after some time, which happened with the old stents. In this way, we are able to treat 90-95% of the arterial diseases of the heart with great success and low risks, we think that bypass is now reserved for a small group of patients.