Medicine is developing at a rapid pace, but few fields have seen the innovation and progress experienced in the care and treatment of heart disease.
Indeed heart specialists are now able to detect and treat heart problems at very early stages optimising care and avoiding irreversible heart muscle damage.
Whether it is spotting a defect at the scanning stage, or the interventional widening of an artery to re-establish full blood flow and avert possible problems in later Iife, the role of the cardiologist and the heart surgeon have undergone major changes over the last ten years.
“Technologies such as catheters, balloons and stents to allow cardiologists to repair or widen coronary arteries by a minimally invasive procedure called coronary angioplasty are unrecognisable from ten years ago,” explained Dr Tim Kinnaird, a consultant cardiologist at Spire Cardiff Hospital.
“Like all technologies, down-sizing means that in most cases, the heart arteries can be reached through the wrist rather than the groin. This allows us to carry out a less invasive procedure that usually means most procedures can now be carried out on a day-case basis.”
Dr Kinnaird, who trained in coronary angioplasty at the London Chest Hospital and the Washington Hospital Centre in the United States, discussed the developments in cardiac medicine meaning it was possible to treat more and more complex heart artery narrowings with balloons and stents, reducing the need for more invasive surgery such as heart bypasses.
“The stents themselves are developing all the time. In the past they were made of stainless steel and were more difficult to insert with less certain results. However the development of newer alloys such as cobalt chromium have improved the ability to place them in the heart and also the results afterwards.
“Additionally stents are now coated with drugs that further improve the long term outcomes and the need for further procedures. But that isn’t all.
“A further major area of research currently in the development of dissolvable stents. Work is being carried out on magnesium stents and stents made from plant fibres that actually slowly dissolve after about three years once its work is done. This means, theoretically, that the artery can ultimately be returned to normal..”
There have also been major developments in catheter technology that allow cardiologists to either image the inside of the heart arteries using infra-red or ultrasound technology, or use a catheter with a pressure sensor that can actually measure the blood pressure either side of an artery blockage.
“This takes away any of the ‘guesswork’ that might have previously been relied upon when deciding whether an artery narrowing needed treatment or not,” explained Dr Kinnaird.
The ability to mend or replace damaged heart valves using minimally invasive procedures via catheter based technology is another major area of development in cardiology with surgeons and cardiologists now able to repair or replace major heart valves – such as the aortic or mitral – under local anaesthesia.
“Such ground-breaking work in the field of interventional cardiology means that many patients who previously needed major open heart surgery can now be treated successfully and reliably using minimally invasive procedures under local anaesthesia on a day-case basis. Interventional cardiology – spotting and treating the heart problem early in its development – is, in my opinion, leading to people living healthier and more active lives.
“Of course it’s also crucially important that patients taking steps to help themselves – stopping smoking, a healthier diet, more exercise – to improve their heart health. But when there is a problem that needs medical intervention then cardiologists like myself as well as heart surgeons, have never been better equipped to deal with these problems.”
For more information on treatments available visit the South Wales Heart Centre at www.spirehealthcare.