Cardiology & Cardiovascular Diseases and Treatments in Turkey

Cardiology is the branch of medicine that deals with the study, diagnosis, and treatment of disorders of the heart and blood vessels. This field includes medical conditions such as heart disease, heart attacks, and arrhythmias, as well as preventative measures to maintain a healthy cardiovascular system. Cardiologists are specialized physicians who have received training in diagnosing and treating these conditions using various methods such as medication, lifestyle changes, and surgical interventions.

Angiography

Angiography is a medical imaging technique used to visualize the inside of blood vessels and organs of the body, particularly in the cardiovascular system. It involves injecting a contrast dye into the bloodstream and then using X-rays or other imaging technologies to capture detailed images of the blood vessels.

Purpose

Diagnosis: To identify blockages, narrowing, or abnormalities in blood vessels.

Guidance: Helps guide treatment decisions, such as angioplasty or bypass surgery.

Types

Coronary Angiography: Focuses on the coronary arteries to assess heart conditions.

Cerebral Angiography: Visualizes blood vessels in the brain.

Peripheral Angiography: Examines arteries in the limbs.

Pulmonary Angiography: Looks at blood vessels in the lungs.

Procedure;

Preparation: Patients may need to fast for several hours before the procedure.

Contrast Injection: A catheter is inserted into a blood vessel (often in the groin or wrist) and guided to the area of interest. A contrast dye is injected.

Imaging: X-ray images are taken to visualize the flow of the dye through the blood vessels.

Assessment: Radiologists or cardiologists analyze the images for any abnormalities.

Coronary Angioplasty PTCA

Coronary angioplasty, also known as percutaneous transluminal coronary angioplasty (PTCA), is a minimally invasive procedure used to treat narrowing or blockages of the coronary arteries. Here are some key points about the procedure:

Purpose: To improve blood flow to the heart muscle in patients with coronary artery disease (CAD).

Indications: Often recommended for patients with significant blockages that cause angina (chest pain) or increase the risk of heart attacks.

Preparation: The patient is usually given a sedative and local anesthesia.

Access: A catheter is inserted through a small incision, typically in the wrist or groin.

Navigation: The catheter is guided through the blood vessels to the site of the blockage in the coronary artery.

Balloon Inflation: A small balloon at the tip of the catheter is inflated at the site of the blockage, compressing the plaque against the artery walls.

Stenting (if necessary): A stent (a small mesh tube) may be placed to keep the artery open after balloon inflation.

Completion: The catheter is removed, and the incision site is closed.

Coronary Artery Bypass (CABG)

Coronary artery bypass grafting (CABG) is a surgical procedure used to treat coronary artery disease (CAD) by improving blood flow to the heart. Here’s an overview:

Revascularization: To bypass blocked or narrowed coronary arteries and restore blood flow to the heart muscle.

Symptom Relief: Helps alleviate symptoms such as chest pain (angina) and shortness of breath.

Prevent Heart Attacks: Reduces the risk of heart attacks in patients with significant blockages.

Indications

Severe Blockages: Often recommended for patients with multiple blocked arteries or left main coronary artery disease.

Failed Angioplasty: May be necessary if angioplasty and stenting are not successful or suitable.

Procedure

Preparation: Patients are placed under general anesthesia.

Access: A surgeon makes an incision in the chest to access the heart. This may involve splitting the breastbone (sternotomy).

Graft Placement: A healthy blood vessel (graft) is taken from another part of the body (often the leg, arm, or chest) and attached to the coronary arteries, bypassing the blocked sections.

Heart-Lung Machine: In many cases, a heart-lung machine is used to take over the heart’s pumping function during surgery.

Closure: After the grafts are in place, the heart is restarted, and the chest is closed up.

Types of Grafts

Saphenous Vein Graft: Taken from the leg.

Internal Mammary Artery Graft: Taken from the chest wall.

Radial Artery Graft: Taken from the arm.

Pacemaker Implantation

Pacemaker implantation is a medical procedure used to treat certain heart conditions, particularly those that involve irregular heartbeats (arrhythmias). Here’s an overview:

Regulate Heart Rhythm: A pacemaker helps control abnormal heart rhythms by sending electrical signals to the heart to maintain a normal heartbeat.

Treat Bradycardia: It is commonly used for patients with bradycardia, where the heart beats too slowly.

Types of Pacemakers

Single-Chamber Pacemaker: Monitors and paces one chamber of the heart (usually the right ventricle).

Dual-Chamber Pacemaker: Monitors and paces both the atrium and ventricle, coordinating their contractions.

Biventricular Pacemaker: Used for cardiac resynchronization therapy, pacing both ventricles to improve heart function in heart failure patients.

Preparation: The patient is placed under local anesthesia and mild sedation.

Access: A small incision is made, typically below the collarbone, to access the subclavian vein.

Lead Placement: One or more leads (thin wires) are threaded through the vein into the heart. The leads are attached to the heart muscle to deliver electrical impulses.

Heart Valve Surgeries

Heart valve operations involve surgical procedures to repair or replace damaged or diseased heart valves. There are four valves in the heart – the mitral, aortic, tricuspid, and pulmonary valves – and these can be affected by conditions such as stenosis (narrowing) or regurgitation (leakage).

Valve repair involves techniques to fix the existing valve, while valve replacement involves removing the damaged valve and replacing it with a mechanical or biological prosthetic valve.

Surgical options for heart valve operations include open-heart surgery, minimally invasive surgery, and transcatheter procedures. The choice of procedure depends on factors such as the type and severity of the valve disease, overall health of the patient, and other individual considerations.

Overview of Heart Valve Operations

Common Conditions Treated

Stenosis: Narrowing of the valve, which restricts blood flow.

Regurgitation: Leakage of the valve, causing blood to flow backward.

Prolapse: Bulging of the valve leaflets into the heart chamber.

Types of Heart Valve Surgeries

Valve Repair

Procedure: Involves reconstructing the existing valve to improve its function.

Techniques: May include reshaping the valve, reinforcing it with rings, or repairing the leaflets.

Benefits: Preserves the patient’s own valve, potentially reducing the need for long-term anticoagulation.

Valve Replacement

Procedure: The damaged valve is removed and replaced with a new valve.

Types of Replacement Valves:

Mechanical Valves: Made from durable materials; require lifelong anticoagulation.

Biological Valves: Made from animal tissues; may not last as long but generally do not require long-term anticoagulation.

Commonly Replaced Valves:

Aortic valve

Mitral valve

Pulmonary valve

Tricuspid valve

Surgical Approaches

Open-Heart Surgery

Description: Involves a sternotomy (opening the chest) to access the heart.

Recovery: Longer recovery time, typically several weeks in the hospital.

Minimally Invasive Surgery

Description: Performed through smaller incisions using specialized instruments.

Benefits: Often results in less pain, shorter hospital stays, and quicker recovery times.

Transcatheter Aortic Valve Replacement (TAVR)

Pediatric Heart Surgeries

Pediatric heart surgeries are procedures performed to correct congenital or acquired heart defects in children. Here’s an overview of some common types of pediatric heart surgeries:

Common Conditions Treated

Congenital Heart Defects: Structural problems present at birth, such as:

Atrial Septal Defect (ASD)

Ventricular Septal Defect (VSD)

Tetralogy of Fallot

Coarctation of the Aorta

Transposition of the Great Arteries

Acquired Heart Conditions: Issues that develop over time, such as:

Rheumatic heart disease

Infective endocarditis

Common Surgical Procedures

Atrial Septal Defect (ASD) Repair

Procedure: Closing the hole between the heart’s atria using stitches or a patch.

Purpose: To prevent blood from flowing abnormally between the chambers.

Ventricular Septal Defect (VSD) Repair

Procedure: Similar to ASD repair, but involves the ventricular septum.

Purpose: To correct the flow of blood between the ventricles.

Tetralogy of Fallot Repair

Procedure: Involves multiple repairs, including closing a VSD and relieving obstruction to blood flow.

Purpose: To improve oxygenated blood flow to the body.

Coarctation of the Aorta Repair

Procedure: Narrowed section of the aorta is removed or widened.

Purpose: To restore normal blood flow to the lower body.

Transposition of the Great Arteries (TGA) Repair

Benefits;

Improved Heart Function: Correcting structural defects can significantly enhance heart function.

Increased Life Expectancy: Many children with congenital heart defects can lead normal, healthy lives after surgery.

Symptom Relief: Reduces symptoms such as fatigue, difficulty breathing, and poor growth.