Endovascular Therapy

Endovascular therapy – in recent years the method of minimally invasive cardiac surgery has developed greatly. In this case the surgery is performed through a very small incision and it eliminates the use of the heart and lung machine:

1. Radiofrequency ablation – it is performed using special catheters – electrode probes inserted into the cavity of the heart through a puncture on the skin to burn out the pathologic parts by means of high-frequency generator (radiofrequencies). Radiofrequency ablation is used in paroxysmal supraventricular tachycardia and cardiac fibrillation treatment. The effectiveness of this method has been repeatedly proven by clinical trials and its practical application in cardiology and arrhythmology;
   
   
2. Coronary angioplasty – this procedure is performed under local anesthesia. During angioplasty a special catheter is inserted into the artery in the thigh or arm and passed to the narrow part of the vessel which causes blood flow disturbance. Such catheter has a balloon which expands when air is pumped into it and, thus, it opens the lumen of the vessel. The size of the balloon is chosen in accordance with the size of the affected vessel and the length of its narrowed part. The restoration of the normal blood flow is confirmed by the introduction of the contrast medium and repeated X-ray photography – control coronary angiography. However, the effect of this procedure does not last long –the damaged atherosclerotic plaque is eventually replaced with a new one, and the speed with which the unpleasant symptoms return depends on lots of other factors and on whether the patient keeps a diet to limit his cholesterol level;
   
   
3. Stent angioplasty – it is one of the sparing surgical procedures which are used to dilate coronary vessels. It implies the insertion of a special catheter into the vessel through which a device widening its lumen is delivered to the narrowed part of the vessel. In most cases such surgery allows restoration of a normal blood flow. However, this method has some limitations, thus, if the narrowed part of the vessel is too long or it is located in the hard-to-reach place, then stent angioplasty is impossible due to the high risk to life, and coronary artery bypass surgery should be considered.
   
   
4. Balloon valvuloplasty – it is used to eliminate aortic valve stenosis in children. It is a sparing surgery during which a special catheter with a balloon is passed to the valve through the vessels (usually through femoral aorta). When the catheter reaches the required destination, air is supplied through this catheter and the balloon is inflated increasing in size and moving apart the stenosed aortic valve. After such manipulation most patients report significant improvement in health. The procedure is performed in a specialized operating room under X-ray and ultrasound scanning control.