Take heed of your heart

Heart disease is the leading cause of death globally, and is likely to remain so. In Singapore alone, about 15 people die from cardiovascular disease.

Businessman Dino Sidek almost contributed to that statistic.

In the year 2000, he had two artificial tubes inserted into his body to open up his narrowed arteries. Feeling good, he returned to an indulgent lifestyle shortly after the successful heart surgery. Ten years down the road, he was shocked to find out that the main artery to his heart was 80% blocked. He could have died if not operated on in time.

While some heart diseases can be treated by making lifestyle changes, medication or undergoing procedures, there are certain heart diseases such as heart valve disorders and hole in the heart which requires surgery as a form of treatment.

Dr Eugene Sim, cardiothoracic surgeon from Mount Elizabeth Hospital, shares with us the various types of surgery:

Open heart surgery, where the heart is literally opened to allow for surgery on its internal structure, is generally a safe operation in the hands of a skilled specialist. Of course, there is always a small chance the patient may die during operation, or suffer stroke, kidney failure, infection or heart failure after the surgery.

Heart bypass surgery is needed when one suffers severe blockages in the blood vessels which cannot be treated with stenting (insertion of artificial tubes) or ballooning. Depending on the location of the blockage, this surgery may be a safer option.

Blockages in the heart are typically caused by plaque, which is a build-up of fat, cholesterol or other substances. Built-up plaque can slow down or stop blood flow through the heart's blood vessels, leading to chest pain or heart attack.

A heart bypass surgery is so named as it involves creation of a blood vessel to bypass the blockages caused by the built-up plaque, allowing blood to flow to the heart. This process is done by harvesting veins or arteries from the leg, arm or chest and sewn onto the blocked heart arteries using very fine thread.

In most cases, the patient's heart will be stopped temporarily and a heart-lung machine will take over the basic functions while the doctors perform the grafting of harvested vessels onto the blocked arteries. In other instances where the risk of using the machine is high, the heart is allowed to continue beating during the surgery. This special technique is also known as beating heart or off-pump surgery. This technique has the additional benefit of reducing risk of stroke in high risk patients.

For Mr Dino's situation, Dr Sim constructed four bypasses to get around to the arteries to bring about normal blood flow to his heart. Due to the severity of the situation, the beating heart technique was employed.

Endoscopic vein harvesting is a new way to graft blood vessels. A small incision is made on the body, through which a telescopic device is inserted to allow surgeons to see and harvest the vessels they need. Prior to this technique, surgeons had to make long incisions to harvest the vessels.

Endoscopic vein harvesting and off-pump surgeries have shown to reduce hospital stays and allow faster recovery in patients, especially for diabetic patients where healing could be a problem.

Although bypass surgery improves blood supply to the heart, it doesn't cure the underlying heart disease. The results and long term outcome of the surgery still boils down to the patient's commitment in adopting a healthy lifestyle and consumption of medication as directed.

Take care of your heart
Leading a healthy lifestyle is the best defence against heart diseases. This includes refraining from smoking, adopting a healthy, low cholesterol diet, controlling blood pressure and maintaining a healthy weight, preferably though exercise. Regular screening is one of the best ways to detect problems such as a narrowed artery, which can lead to heart attacks. It is best that any heart disease is detected and treated early.

Publication of article by courtesy of Parkway Health