Practice makes perfect? by Dr. Iain Corness

Published : January 12, 2010 :: 11:01:52 [ 1,014 views ]

I asked our Heart Center the other day, just how many stents they had placed in blocked coronary arteries in 2009. The answer was 182. Approximately that number of people died in Thailand in 2009 from the H1N1 swine flu and the news was treated like an unnatural disaster. So as opposed to the H1N1 figures, I suppose we could say we ‘saved’ 182 people in 2009.

Actually, it is not too outrageous a claim. Blockage of the coronary arteries produces heart attacks, ‘starving’ of the heart muscle and ultimately death. Stents placed in the coronary arteries allow the blood to flow again and the heart muscle can again function normally.

Of course, you have to demonstrate that there are blockages to begin with, and we can predict this in many ways. People with angina, or having a positive Exercise Stress Test or positive 64-Slice CT, and/or having raised cholesterol levels gives us a high degree of clinical suspicion, and from there the next step is a coronary angiogram, where we can actually show which arteries are blocked and exactly where in the artery.

This is done by introducing a catheter into the arterial system, generally from the groin, and under direct (real time) fluoroscopic vision the cardiologist can guide the catheter right into the coronary arteries themselves. There, by injecting a contrast medium, the blockages are demonstrated. After this, balloon angioplasty (stretching the artery where it is blocked) can be done and then a stent placed inside to keep the artery open.

This is very much exacting use of today’s current technology, and it is reassuring to know that 182 were carried out in 2009, plus many in previous years.

After all, practice does make perfect!

Should you wish to enquire about our courses or other information, please email us at inquiry@bph.co.th