Heart treatments and procedures Ngā rongoā me pokenga manawa
Some heart conditions need major surgery such as heart bypass and valve surgery. Many other heart problems can be treated with non-surgical or less invasive procedures.
Major heart surgery
The most common types of heart surgery are:
- heart bypass surgery
- heart valve replacement.
If you need heart surgery, you will be referred to a heart surgeon, also called a cardiothoracic surgeon.
It is normal to have some pain and discomfort after heart surgery.
Heart bypass surgery
Heart bypass surgery moves a blood vessel from another part of your body to replace a blocked or narrowed artery (blood vessel) in your heart muscle. It is also called coronary artery bypass graft surgery (CABG).
When the blood vessels that supply the heart muscle are blocked or narrowed, it can cause angina (chest pains) or heart attacks.
Heart valve replacement
Your heart has 4 chambers and 4 valves (the aortic, pulmonary, mitral and tricuspid valves). These valves keep the blood flowing in one direction.
Sometimes heart valves are too tight and do not open easily enough (called stenosis). Sometimes they are too floppy, which allows blood to flow in the wrong direction (regurgitation).
Heart valve problems can affect how your heart works and can cause symptoms like:
- shortness of breath
- swollen ankles
- chest pain.
Heart valve problems can even make you collapse.
Your cardiologist (heart specialist) will usually monitor any heart valve problems over time using echo tests (echocardiograms). Your valves may eventually need to be repaired or replaced.
Cardioversion
Cardioversion can restore your heart rhythm to normal by applying a small electric shock to your chest. It is carried out under a general anaesthetic — a medicine that makes you 'go to sleep' while the procedure is carried out.
Pacemakers
A pacemaker monitors and treats heart rhythm problems, reducing the risks that go with them. The pacemaker is implanted during a surgical procedure. You will not be completely anaesthetised but you will be sedated and given a local anaesthetic to numb the area.
Angioplasty and heart stents
During an angioplasty, a long, flexible tube (a catheter) is put into the blood vessels around your heart. A tiny balloon at the end of the tube is inflated in the area where you have a narrowed artery or vein. This opens up the blockage. Using the same catheter, a stent, or small mesh tube, is then placed in the area to keep your blood vessel open.
This procedure helps to restore blood flow to the area of your heart that was affected by the blockage.
Angioplasties are used as treatment if you have a heart attack or angina.
Defibrillators
An implantable cardiac defibrillator (ICD) is a device that monitors, treats and reduces the risks of fast, abnormal heart rhythm problems.
The ICD is implanted during a surgical procedure. You will not be fully anaesthetised but you will be sedated and given a local anaesthetic to numb the area.
Ablation therapy
Radiofrequency ablation is a treatment that can help to correct heart rhythm problems (also called arrhythmias).
Using x-rays to guide the process, a cardiologist (heart doctor) puts 3 to 5 long wires into your heart, inserting them through your groin and passing them through your blood vessels. Energy is passed through the wires to create tiny scars in the heart. These scars block any faulty electrical signals and stop your heart rhythm problems.
Radiofrequency ablation takes 1 to 3 hours. It is a low risk treatment that is usually very successful. You will not be completely anaesthetised but you will be sedated and given a local anaesthetic to numb the area.
Radiofrequency ablation is sometimes used to treat atrial fibrillation.
Transcatheter aortic valve implantation
Transcatheter aortic valve replacement (or transcatheter aortic valve implantation, TAVI) is a way of putting in a new heart valve without taking out the old one. A new expandable valve is placed inside your old, damaged valve.
The procedure is done using a tube passed to your heart through a blood vessel without opening up your chest.