Medical Tests & Procedures Archive

Articles

Radial artery grafts prove durable

In coronary artery bypass grafting (CABG), the internal mammary (or thoracic) artery is the graft of choice for bypassing blockages in the main coronary artery, because it tends to remain open and functioning well for many years.

Choosing a heart surgeon

The way public data are presented may influence your choice.

If you're shopping for a car, it's easy to find information on gas mileage, repair rate, and other factors of interest to consumers. Moreover, it's possible to compare models in order to find which one is most likely to meet your needs. Can you do the same with heart surgeons?

Breakthrough: Robotic surgery

How robots are transforming minimally invasive surgical procedures.

In an operating room at Brigham and Women's Hospital in Boston, Dr. Colleen Feltmate performs a hysterectomy on a woman with uterine cancer. As Dr. Feltmate operates, she doesn't stand next to the patient, but in front of a monitor and console. The hands holding the instruments are not her own—they belong to a robot.

Robot-assisted techniques are the next generation in minimally invasive surgery. Surgeons can now perform laparoscopic procedures with the assistance of remotely controlled instruments attached to a robot's arms. At Brigham and Women's (BWH)—and at other hospitals around the country—doctors are using robots to do everything from removing uterine fibroids (myomectomy) to cutting out kidney tumors (radical and partial nephrectomy).

Should you have stenting or bypass surgery?

Many factors go into your physician's recommendation.

When fatty plaques threaten to obstruct the coronary arteries, there are two options for restoring blood flow (otherwise known as revascularization): open the blockages with a balloon (angioplasty), followed by the placement of a stent; or bypass the blockages with coronary artery bypass grafting (CABG).

Balloon angioplasty can open a narrowed artery, and the stent (an expandable wire mesh cylinder) can hold it open. Angioplasty and stenting is a minimally invasive, nonsurgical procedure with less postoperative pain, a shorter hospital stay, and faster recovery than CABG. So it's no surprise that its popularity has soared. But despite these advantages, it's not the best choice for everyone. Now that thousands of stents have been implanted, cardiologists better understand the long-term effects of the procedure and can make an informed decision about which treatment might be best for each individual.

Bariatric surgery reduces type 2 diabetes risk in obese individuals

Bariatric surgery may significantly reduce a person's odds of developing type 2 diabetes. This stomach procedure that restricts food intake may reduce the long-term incidence of type 2 diabetes in obese individuals.

Treatments for heart failure

Many therapies can be effective, but care must be individualized.

Modern treatments for heart disease have saved many people. Some of them, however, now live with heart failure—a heart that does not function well. Blood from the body is constantly returning to the heart and then being pumped out to the body. A "failing" heart either resists the inflow of blood, struggles to pump it out, or both.

Carotid stenosis treatments compared

Both surgical and nonsurgical options can prevent stroke.

The same process that causes obstructions in the heart's arteries can block the carotid arteries in the neck, a disease known as carotid stenosis. If these interfere with blood flow, a stroke can occur.

Symptoms of pending stroke (see box) usually require treatment to reduce the risk. One option calls for opening the artery and removing the plaque—a surgical procedure known as endarterectomy. A less-invasive option, called carotid stenting, involves inserting a catheter into an artery in the groin, advancing it to the carotid artery, opening the blockage with a balloon, and leaving behind a wire cage (or stent) to hold the artery open.

New ways to treat varicose veins

Simple procedures can eliminate the condition.

Varicose veins are more than just unsightly. They raise your risk of skin ulcers and superficial blood clots if left untreated. Fortunately, there have been some real breakthroughs in treatment in recent years. "Treatment used to be very involved, requiring general anesthesia and a trip to the operating room, but now it's just an office procedure," says Dr. Sherry Scovell, a vascular surgeon and instructor in surgery at Harvard Medical School.

Varicose veins

Blood flows forward in normal veins (1), but blood pools in varicose veins (2).

The promise of a total artificial heart

Advanced device buys time until a transplant can be performed.

Like other people with advanced heart failure, Jim Carelli, Jr., suffered from severe shortness of breath and fatigue. With a heart unable to pump a sufficient amount of blood to his organs, his kidneys began to fail, and he swelled with fluid. He needed a heart transplant, or he would die.

Drug-eluting stents being misused

Many people who don't need a drug-eluting stent during angioplasty get one anyway. More appropriate use would save $200 million a year in the cost of the stents plus the medications that must be taken afterwards.

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