Cardiac fixes problems with the heart surgically. A lot of heart surgeries performed annually in Israel, is one of the most advanced branches of medicine.
These surgical procedures are performed to both adults and children. But this material is considered the treatment of adults mostly.
The most commonly performed coronary artery bypass grafting (CABG), During which the bypass is created by constriction shunts. Doctors use a vein or artery of the body. New Way provides full restoration of blood flow to the heart muscle. CABG eases pain in the chest and reduces the likelihood of a heart attack.
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Cardiac surgery in Israel includes the following operations:
- Restoration or replacement of heart valves that control the flow of blood through the heart.
- The introduction into the body of special devices that help control heart rate, or support function and blood flow.
- Reconstruction of abnormal or get damaged heart segments.
- Replacement of damaged heart healthy donor organs.
heart surgery in Israel is performed using several approaches.
- Traditional surgery, also referred to as open-heart surgery, performed by opening the thorax. Made incision the sternum (or simply opening the upper part). the patient's heart is connected to the device "artificial heart-lung machine." Hardware pumping blood to the body. This allows the surgeon to carry out the necessary manipulations.
- Another type of surgery - surgery on the beating heart. Also used an open access, but the heart is not stopped, the device "artificial heart-lung" is not applicable. Such operations are limited to CABG.
- At the moment there is a possibility of surgeons make small incisions between the ribs in order to carry out certain types of surgical procedures on the heart. Dissection of the sternum is not carried out, to get to the heart. It organosberegatelny approach. The device "artificial heart-lung" can be used or not.
New methods of surgical interventions reduce risk and accelerate the subsequent rehabilitation. The studies comparing these types of heart surgery with traditional open surgery. The obtained results will help physicians make the best choice for every patient.
Results of heart operations in Israel are often very high - reduces the manifestations of the disease, improving quality of life and increase the chances of survival.
Rates of heart operations
The cost of heart surgery depends on the type of surgery, approach (cavity, minimally invasive, robotic), cardiac surgery services (title, experience and so forth.).
Yet, how much heart surgery in Israel?
- The implantation of a cardioverter-defibrillator - 11 $ 500 excluding the cost of the device.
- Endarterectomy Carotid - 30 000 - 40 000 $.
- Operation on replacement and reconstruction of the heart valves - 49 000 $.
- Coronary stenting - $ 17,900.
- Stenting of the carotid arteries - $ 15,000.
What do heart surgery in Israel?
coronary artery bypass grafting
type of surgery, which is performed most often. CABG improves blood flow to the heart. The main indication is coronary heart disease (CHD). Inside the coronary arteries, the main function of which - the supply of oxygen-rich blood, body gradually accumulate atherosclerotic layers.
Over time, they harden, and this may lead to rupture. There is a narrowing of the arteries, decreases the blood flow to the heart. All this can cause pain or discomfort known as angina pectoris.
If part of the layers off, a blood clot may form on its surface. It is capable of partially or completely block the flow of blood through the coronary artery. This is the most common cause of heart attack.
During CABG used healthy artery or vein from the patient's body, they bind or prizhivlyayut to the narrowed coronary artery. It creates a shunt - a new way of bypassing the blocked area of the artery.
CABG - coronary heart disease is not the only way to therapy. Also used successfully coronary angioplasty. While the catheter with a balloon on the end of the procedure are introduced into the blood vessel and lead to blocked or narrowed coronary arteries. Reaching the required area, the balloon is inflated, compressing the layers and extending opening. Blood supply is restored. During this procedure, a stent may be placed in the coronary artery, it helps to keep it open. Stent - a small mesh tube-shaped supports inside the artery wall.
If they can be applied and CABG, and angioplasty, the physician will decide which option is the best.
Transmyocardial laser revascularization (TMLR) in cardiac Israel
This surgery is used in angina. To her turn, when other therapies do not bring the proper result. For example, if a procedure was performed CABG, repeat bypass surgery is not possible, TMLR - can be considered as an option. In some cases, revascularization combined with CABG.
If only TMLR performed, the procedure can be performed through a small opening in the chest. In the course of its implementation, the surgeon uses lasers to create small channels through the heart muscle and in the lower left heart chamber (left ventricle).
It does not fully know how to clean revascularization angina. Surgery can promote the growth of new tiny blood vessels. Oxygenated blood flows through the vessels into the heart muscle, facilitating angina.
Replacement or repair of cardiac valves - heart surgery in Israel
When a healthy heart blood flows only in one direction through the valve. They are in a certain way is opened and closed when the organ pumping blood.
Valves have plates that are opened, allowing blood flow from the heart chamber to the other, or in the artery, and prevent blood from flowing back.
Heart surgery is performed to fix the records that do not open as wide as they should. This happens when they become stiff or is their thickening, or they are connected. As a result - an insufficient amount of blood through the valve.
Heart surgery is also done to fix the records that do not close tightly. This problem can lead to backflow of blood - back to the chambers of the heart, not in the artery, as it should be.
To solve these problems, surgeons repair or replace the valve with an artificial or biological. Recent fabrics made from pig, cow or human material is used, they can also have artificial parts.
To restore the mitral valve, which is too narrow, the cardiologist inserts the catheter with the balloon at an end through a large blood vessel and leads it to the heart. He end of the catheter is placed inside the valve. Then the balloon is inflated, which extends the valve, allowing increased blood flow. This approach - less invasive than open heart surgery.
The researchers also are testing new ways to use catheters in other types of operations on the valves.
- For example, catheters are treated with the aim to place the clips on the flaps of the mitral valve, to keep them in place.
- Catheters can be used to replace a failed aortic valve. For this procedure, a catheter is introduced into the artery in the groin (the top of the thighs) and lead to the heart.
- In some cases, the surgeon may make a small incision in the chest and in the left ventricle. The catheter will be put into the heart through a small hole.
The catheter has a deflated balloon on the end with a folded valve replacement around it. The balloon is used to expand the new valve.
Currently, surgery for valve replacement is performed traditionally for the treatment of healthy people. However, the use of the catheter may be a life safer option for patients when to hold open-heart surgery on - is very risky.
implantation of pacemakers and kardiodifibrillyatorov , "Labyrinth"
Arrhythmia - a whole spectrum of cardiac rhythm disorders, it can be speeded up, delayed or irregular.
For the most part arrhythmias do not cause serious harm, but some can be life-threatening. In this state the heart loses its ability to pump enough blood to the body. The lack of blood flow can damage the brain, heart or other organs.
Drug treatment - is the first line therapy. If the drugs do not help, your doctor may recommend surgery on the heart of Israel. It can be implanted pacemaker or kardiodifibrillyator.
Pacemaker - a small device that is implanted under the skin in the chest or abdomen. appliance wire connects to the camera of the heart. The pacemaker uses low-energy electrical discharges, to control heart rhythm. Most of these devices are equipped with a sensor that triggers the device only when the rhythm becomes abnormal.
Cardioverter defibrillator - a small device that is implanted in the same way as a pacemaker. Wires connected to his heart. The device checks the heartbeat for dangerous arrhythmias. If it detects that sends electric shock to restore the rhythm.
Another way to treatment of arrhythmia is called "labyrinth". During heart surgery in Israel, the surgeon creates a new channel for the electrical signals passing through the body. For this type of surgery treated for atrial fibrillation, a serious type of arrhythmia that occurs most frequently.
Simpler and less invasive procedures are also used to treat atrial fibrillation. They employ heat or extreme cold, to prevent abnormal signals.
aneurysm treatment at Assuta
An aneurysm is a bulge in the wall of failure artery or the heart muscle, such balloon. It occurs when the wall is weakened. Blood pressure causes these bulges.
Over time, the aneurysm may grow and burst, causing dangerous, often fatal internal bleeding. Aneurysm lead to the rupture of one or more layers of the arterial wall. The gap provokes bleeding inside or along the fibers of the artery wall. Aneurysm removed surgically.
This is an operation in which the diseased organ donor is replaced by a deceased person. In some instances, also performed artificial heart transplant on waiting time on the list for a transplant. The main indication is the end-stage heart failure. The only treatment that will help a transplant.
Implantation of an artificial heart ventricle in cardiac Israel
VAD - a mechanical pump that supports heart function and blood flow when a weakened body. The physician may recommend this arrangement in heart failure, where there is no response to treatment or patient waits organ transplantation. VAD can be used a short time or a few months or even years, depending on the situation.
Surgical approaches in heart surgery in Israel
Surgeons use a variety of approaches in the surgery:
- open-heart surgery;
- without the use of the device "artificial heart-lung machine";
- minimally invasive.
Choice is due to the existing problems of the patient, general health and other factors.
Open heart surgery
It is any kind of surgery during which the surgeon makes a large incision in the chest to open it and make the necessary manipulations on the heart. The term "open" refers to the chest, not the heart.
After dissection of the patient's breastbone is connected to the device "artificial heart-lung machine." He takes over the function of the heart, pumping blood. This allows the surgeon to work with the body.
Open-heart surgery is used for bypass surgery, valve repair or replacement, the treatment of atrial fibrillation, heart transplants, artificial ventricles or artificial hearts.
Cardiac surgery without the device "artificial heart-lung"
This approach is used in CABG. The sternum is cut, the chest is opened, but the heart is not stopped, the device "artificial heart-lung" is not used.
This operation is not suitable for all patients. The doctor will determine whether it is one for the particular case of disease. It will examine the existing problems, age, general health and other factors that could affect the surgery.
In the course of such operations on the heart surgeon in Israel performing small incisions in the chest between the ribs. Such an approach may or may not use the device "artificial heart-lung machine."
Organosberegatelnuyu surgery is used to perform a bypass operation or an operation called "labyrinth". Also, when the restoration or replacement of heart valves, during installation of pacemakers and defibrillators kadioverterov, when extracting a vein or artery of the body with a view to use as shunt during CABG.
One type of minimally invasive surgery, which is becoming more common - robotic surgery. The doctor uses a computer to control the surgical instruments with thin handles. Instruments are inserted through small incisions in the chest. It provides high accuracy and a number of other advantages.
Who needs a heart surgery?
Cardiac surgery in Israel solves many heart problems. For example, with the help of the following disorders are treated:
- congestive heart failure and ischemic heart disease;
- eliminate heart valves that do not function, and replace them with others;
- establish control abnormal heart rhythm;
- implanted the special equipment;
- replace damaged heart healthy.
If other therapies, such as lifestyle changes, medications and medical procedures - do not give the desired effect on heart surgery in Israel becomes your goal.
Preparation for heart surgery in Israel
First with the patient in the clinic Assuta operates cardiology and cardiac surgery, who will make a decision as to whether surgery is needed. Cardiologist provides diagnosis and treatment of heart disease, a heart surgeon specializes in the surgical treatment of pathologies of the cardiovascular system.
These doctors will communicate with the patient, collect anamnesis, will appoint tests to learn more about the general health and heart disease. The results obtained are to be discussed with the patient and help to take the right decision.
Doctors collect the following information:
- About heart disease and its symptoms.
- On the conducted earlier treatments - operations, medications and procedures.
- About family history.
- The presence of other heart problems - diabetes, or high blood pressure.
- On the age and general health.
blood tests will be assigned - full and biochemical (cholesterol test), a number of others - on request.
diagnostic task - to learn more about the state of the heart, to determine whether heart surgery and its kind is needed. The following types of inspections may be carried out:
- ECG (electrocardiogram) visualizes organ damage due to ischemia, as well as previous or current symptoms of heart attack.
- Stress test is performed during physical exertion, or using drugs that increase the heart rate. Measured blood pressure and ECG is performed. other tests can be performed.
- Echocardiography studies the functioning of the heart chambers and valves, finds areas of poor blood supply to the heart, arising in connection with this problem body injury.
- Coronagraph examines the inner surface of the coronary arteries using a contrast agent and X-rays. For the introduction of contrast is performed cardiac catheterization. X-ray records, as a contrast extends through the arteries. This test helps to find the lock and contraction that can cause a heart attack.
- Aortic angiography shows the location and size of the aneurysm of the aorta.
- Chest X-ray creates pictures of internal structures - the heart, lungs and blood vessels.
- Computed tomography of the heart using X-ray equipment to create a clear and detailed images of the body. Sometimes used contrast agent, is injected into the vein during scanning. It allows you to select the coronary arteries more clearly. This so-called CT angiography. It can show narrowing of the arteries or an aneurysm, find problems with the heart and valves.
- Cardiac MRI - safe and non-invasive test that uses magnets, radio waves and a computer to the formation of still and moving images of the heart and major blood vessels. MRI visualizes the structure and function of the heart, can show the size and location of the aneurysm.
Surgery Assuta to be carefully planned with the doctors. The patient interacts with a team of doctors, which are introduced in the course explain the operation passes. Also tell us what training is required.
They may be performed a number of tests -. Electrocardiogram, chest X-ray, blood tests, etc. It is possible, is assigned a dropper for administering fluids and drugs.
shaving operated zones (if necessary), the use of special means of reducing the risk of infections, etc. - adequate preparation of the patient will be carried out.
Before surgery, the patient will move into the operating room, give anesthesia.
What to expect during heart surgery in Israel?
In surgical interventions involved a team of experts, in addition to the cardiac surgeons, other doctors and nurses. The duration determined by the type operation. CABG - the most frequently performed, grafting takes about three to six hours.
The traditional open-heart surgery
During such surgery, general anesthesia is used, the doctor checks the heartbeat, blood pressure, oxygen levels and breathing.
Injected through the throat into the lungs breathing tube and connect it to a ventilator.
The surgeon makes a cut from 15 to 21 cm in the center of the chest, cut the sternum and opening the chest to reach the heart.
The patient is given blood thinners to prevent clotting. The device "artificial heart-lung" is connected to the heart, it provides the body with blood.
To stop the heart, the patient is given medication as soon as connect AIC. The tubes are placed in the heart, the blood entered into the machine. The device "artificial heart-lung machine" removes carbon dioxide from the blood, add oxygen and blood is pumped back into the body.
After connecting the unit surgeon begins to work on the problem. At the end of the operation the blood flow to the heart is reduced, the body begins to function independently. Sometimes use a mild electric shock to restart the heart.
Once it starts beating, the surgeon removes the tubes and stops the AIC. The patient is given a drug that promotes blood clotting.
To close the sternum using a special wire that remains in the body. After srastetsja sternum, it will be as strong as before the transaction.
Stitches or staples are used to close the skin incision. Breathing tube is removed when the patient himself begins to breathe.
Surgery on a beating heart
Surgery like traditional surgery open heart, the chest bone is opened to access the heart. However, the body does not stop and the device "artificial heart-lung" is not connected.
The heart is stabilized by a mechanical device, after which the surgeon performs the necessary manipulations. The Authority will continue to pump blood.
Minimally invasive surgery
The surgeon performs a small incision in the chest, between the ribs. They may be of 5 to 8 cm. After operating tools are inserted, one of which is equipped with a small camera on the end, allowing the physician to see inside the operated surface.
Some types of minimally invasive operations using AIC, others - no.
Rehabilitation after heart surgery in Israel
Day or the patient can spend in intensive care, depending on the type of operation performed. With a dropper, installed in the chest or arm, the body enters the liquid while the patient is not able to drink on their own.
Supplies supplemental oxygen through a mask or nasal catheter (cannula).
After the patient is transferred to a regular room. Doctors and nurses Assuta Hospital provide thorough and careful maintenance - check the pulse, blood pressure, breathing, state cuts.
Recovering in a house
People react differently to the surgery. The process of rehabilitation after heart surgery depends on the existing problems, and surgical intervention. A doctor at Assuta will give detailed information on the following issues:
- Care for the healing incisions.
- Signs of potential complications.
- How to cope with the effects of surgery.
The patient will receive detailed information on the implementation of the various appointments for drugs and situations that require immediate medical attention.
Possible consequences of surgery - this is normal. These may include:
- pain in the muscles and chest;
- loss of appetite;
- trouble sleeping;
- mood swings and depression.
On the recovery process is influenced by:
- type of heart surgery;
- general state of health prior to surgery;
- any complications after surgery.
The doctor will inform when we can go back to everyday life - work, driving, physical activity.
It includes medical checkups. During these visits, the patient can undergo the following tests:
- blood tests;
- echocardiogram or stress test.
Surveys show how the heart works.
After certain types of heart surgery need to take blood-thinning medications. The doctor conducts routine tests to ensure that the patient receives the right amount of medication.
What are the risks of cardiac surgery?
Heart surgery - is the risk, even if the results of surgery are often excellent. Possible unwanted effects include:
- infection, fever, swelling and other symptoms of inflammation;
- reactions to medications used for anesthesia;
- damage to the heart tissue, kidney, liver and lung;
- stroke, which can lead to short-term or irreversible damage;
- fatal (heart surgery is dangerous to the lives of people who were very sick before surgery).
Memory loss and other disorders - problems with concentration, mental confusion - may occur in some people. These problems mostly occur in the elderly and women. Condition often improves during the 6- 12 months after surgery.
In general, the risk of complications increases if heart surgery is done in an emergency situation (such as during a heart attack). Also, the presence of other diseases such as diabetes, kidney disease, lung disease and peripheral arteries.