tailieunhanh - Ebook Tarascon pocket cardiology: Part 2

(BQ) Part 2 book "Tarascon pocket cardiology" presents the following contents: Cardiovascular therapeutics (coronary revascularization, pacemaker therapy, cardiac resynchronization for heart failure, implantable defibrillator therapy,.), supplement - bedside procedures (central venous catheterization, arterial line placement, right heart catheterization,.). | SECTION III CARDIOVASCULAR THERAPEUTICS 27 CORONARY REVASCULARIZATION60 INTRODUCTION Coronary revascularization is the process of restoring blood flow oxygen and nutrients to the essential myocardium. The method of and indications for coronary revascularization are complex and often debated topics. The basic goals of coronary revascularization include the following three items 1 Improve clinical symptoms 2 Improve long-term survival 3 Attempt to decrease the incidence of nonfatal outcomes such as myocardial infarction congestive heart failure and malignant arrhythmias There are three common methods for approaching coronary revascularization Percutaneous coronary intervention PCI is a generic term referring to any therapeutic procedure directed at treating the narrowed stenotic segments in coronary arteries using a combination of balloon angioplasty and stent implantation coronary atherectomy or thrombectomy. Coronary artery bypass surgery CABG is a surgical procedure directed at bypassing the stenotic coronary artery segments using vessels harvested from other places in the body loWer extremity veins or thoracic abdominal arterial grafts . Fibrinolysis in the setting of ST-Elevation myocardial infarction STEMI . PERCUTANEOUS CORONARY INTERVENTION PCI involves repair of the artery by advancing equipment over a coronary guide wire that has been advanced past a blockage in the artery. PTCA percutanous transluminal coronary intervention angioplasty is when balloon inflation crushes the coronary plaque against the walls of the vessel restoring blood flow to the downstream myocardium. Advanced adjunctive techniques are utilized for specific clinical scenarios and lesions subsets. Such devices include Rotational diamond tipped drill or laser atherectomy for calcified noncompliant vessels Manual or mechanical thrombectomy for large thrombus burden Protection devices utilized in saphenous vein grafts to capture debris liberated during PCI avoiding embolization downstream 0