Backgrounder:
Glossary of frequently used medical terminology relating to
cardiac surgery
Atherectomy
A procedure for opening coronary arteries blocked by plaque — the build-up
of cholesterol and other fatty substances in the inner lining of an artery.
Coronary Atherectomy uses a laser catheter or a rotating "shaver."
Cardiac Catheterization
A thin plastic tube, called a catheter, is guided through an artery or vein in
the arm or leg and into the heart and the coronary arteries in the heart. The
test can measure blood pressure and how much oxygen is in the blood and
also provide other information about the pumping ability of the heart muscle
or for treatment. See also Coronary Angiography, Percutaneous
Translumninal Coronary Angioplasty (PTCA).
Cardiomyopathy
A serious disease in which the heart muscle becomes inflamed and doesn't
work as well as it should. Cardiomyopathy can be classified as primary or
secondary. Primary cardiomyopathy cannot be attributed to a specific cause,
such as hypertension, heart valve disease, artery diseases or congenital heart
defects. Secondary cardiomyopathy is due to specific causes and is often
associated with diseases involving other organs as well as the heart. There
are three principal types of cardiomyopathy — dilated, hypertrophic and
restrictive. Dilated (congestive) is the most common form of
cardiomyopathy.
Congestive Heart
Failure
A condition in which the heart cannot pump enough blood to meet the needs
of the body's other organs. Also known as heart failure.
Coronary Angiography
When a catheter is used to inject dye into the coronary arteries. Also called
coronary arteriography.
Coronary Arteries
The reservoirs that supply blood to the heart muscle.
Coronary Artery
Bypass Surgery
Also known as CABG
(Coronary Artery Bypass
Graft)
Surgery done to reroute, or "bypass," blood around clogged arteries and
improve the supply of blood and oxygen to the heart. Arteries chosen for
bypass surgery are often clogged by the buildup over time of fat, cholesterol
and other substances. During bypass surgery, surgeons take a blood vessel
from another part of the body and construct a detour around the blocked part
of the coronary artery. A pump oxygenator (heart/lung machine) is used for
nearly all coronary bypass graft operations.
Determination of Need
(DoN)
The Commonwealth of Massachusetts requires hospitals to file
Determination of Need (DoN) applications in order to perform some medical
procedures, such as cardiac surgery, and operate certain high-tech
equipment. The Massachusetts Department of Public Health considers open
heart surgery to be "a statewide resource" and therefore regulates where it
can be offered. In the past, only tertiary academic-based medical centers
have been approved to perform open heart surgery. Southcoast is seeking to
become one of the first community hospitals authorized to perform cardiac
surgery under new regulations passed into law in July 2000.
Minimally Invasive
Direct Coronary Artery
Bypass Grafting
(MIDCABG)
The goal of MIDCABG is to avoid using the heart/lung machine. It's
performed while the patient's heart is still beating and is intended for use
when only one or two arteries will be bypassed. MIDCABG uses a
combination of small holes, or "ports," in the patient's chest and a small
incision made directly over the coronary artery to be bypassed. The cardiac
surgeon usually detaches an artery from inside the chest wall and re-attaches
it to the clogged coronary artery. The surgeon views and performs the
attachment directly, so the artery to be bypassed must be right under the
incision.
Myocardial infarction
or "Heart Attack"
Heart attacks result from coronary heart disease (CHD) — blood vessel
disease in the heart. A heart attack occurs when the blood supply to part of
the heart muscle itself — the myocardium — is severely reduced or stopped.
Open Heart Surgery
Open heart surgery is performed on the heart while the bloodstream is
diverted through a heart/lung machine. The surgery includes heart valve
replacements, coronary artery bypass graft (CABG) surgeries, heart
transplants and other open heart procedures.
Percutaneous
Transluminal Coronary
Angioplasty (PTCA)
A procedure known as coronary artery balloon dilation, or balloon
angioplasty. PTCA is a procedure used to dilate (widen) narrowed arteries.
A doctor inserts a catheter with a deflated balloon at its tip into the narrowed
part of the artery. Then the balloon is inflated, compressing the plaque and
enlarging the inner diameter of the blood vessel so blood can flow more
easily. Then the balloon is deflated and the catheter removed. It is a less
traumatic and less expensive alternative to bypass surgery for some patients
with coronary artery disease.
Stent Procedure
A procedure using a wire mesh tube, called a stent, to prop open an artery
that has recently been cleared using angioplasty.
References:
American Heart Association 1999, Heart and Stroke A-Z Guide.
The American Medical Association, Encyclopedia of Medicine, Random House, 1989.
Weaver, Litwin, Martin, Use of Direct Angioplasty for Treatment of Patients with Acute Myocardial Infarction
in Hospitals With and Without On-Site Surgery, Circulation: 1993 [part 1]: 2067-2075.
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