Treatment Of Heart Disease - Coronary Artery Surgery, Heart Transplant

Coronary artery disease, where arteries in the heart narrowed, is now the problem which takes most of the cardiac surgeon's time. The current surgical technique, called coronary artery bypass grafting, uses segments of vein taken from the leg. One end of the vein is then attached to the aorta above the aortic valve, and the other to a coronary artery beyond the narrowing. Although simple in principle, this technique requires considerable expertise, but 80 to 85 per cent of patients can expect total or substantial relief of angina after this operation. This surgery is reserved for people whose angina cannot be controlled by medical therapy and whose life-style is significantly affected by it; how much they are affected by the angina varies with age and, perhaps, occupation. It is unclear, though, if this operation usually prolongs life itself by avoidance of coronary ruction and myocardial infarction (heart attacks). Where it is clear that benefit is derived from surgery is when severe narrowings exist in each of the three main arteries of the heart or perhaps in the left main coronary artery. For this reason, those under 50 years old known to have coronary disease (usually because they have had heart attacks), but without subsequent symptoms, may be advised to undergo coronary arteriography, with a possible view surgery.