Modern medicine has various methods of treatment for heart disease, and one of them - stenting conducted in myocardial infarction. Rehabilitation after myocardial infarction and stent allows you to save a positive result and prevent the occurrence of complications after surgery.
Indications and contraindications
Stand - is ultra-thin design, reminiscent of spring. It is set inside the vessel into the lumen of the coronary artery. When it increases the expansion clearance to provide normal blood flow. Stenting in Myocardial shown in the following cases:
- with blocked coronary arteries (such as in myocardial and after);
- by narrowing the one or more vessels, which leads to malfunction of the heart;
- under restrictions in the cardiovascular system that glitch in the bloodstream, creating pain in the chest, do not disappear with drug taking;
- in the presence of acute coronary syndrome.
The operation is not a number of contraindications, but before it is performed by a physician compares the effectiveness of surgery and other treatments for myocardial infarction. If stenting can be replaced by drug therapy or other operations, so often do. Stand installation is desirable to replace other methods of treatment in the following cases:
- if the operation is carried out soon, in which possible strong bleeding;
- if the patient is at an age when the establishment of the stand is not desirable (to 22 or elderly persons);
- if there is a ban on antiplatelet therapy.
types of stands
Stenting in myocardial infarction can be conducted using various types of stands:
- BMS-boards made from metal. They more often lead to another narrowing of blood vessels and heart complications. Every third patient, with which operations were used BSM-stands diagnosed repeated narrowing of the arteries.
- DES impregnated with drugs that are beginning to be released after the installation of the stand, thus preventing fusion of the connective tissue. Re-narrowing of heart arteries when they have a rare, but there is a high risk of thrombosis.
- Bioengineering boards coated with antibodies that have an impact on endothelial cells and attracting them to itself, thus reducing the risk of thrombosis.
- Biodegradable stands in myocardial gradually dissolve in the body after installation and contained in these drug is released and does not narrow the vessels.
- Stands with double coating are the most expensive, but at the same time the most effective. They combine the advantages of all DES and bioengineered plants. Forecasts when establishing purely optimistic.
How is the procedure
Stenting in Myocardial carried out in several stages. The first is to prepare for the operation. In order to avoid the negative consequences of the patient should:
- stop taking anticoagulants for 3 days prior to stenting, that there was no bleeding;
- suspend the reception of insulin or medication to lower blood sugar levels in a few days;
- do not eat or drink for 8 hours before surgery;
- shave the groin area.
Also, the patient undergoes an electrocardiograph and a number of other studies.
Stenting is performed using angiography, which reproduces what is happening during the operation. The patient lies on his back, his chest and limbs are connected to the electrocardiograph and the forearm installed catheter for permanent venous access.
Regardless of a massive heart attack, the patient is conscious throughout the procedure. intravenously strong sedative will be put to him, that he was at peace, a little drowsy, but able to communicate with the surgeon. Conducted interference in the groin area or in the forearm area, where the main artery.
Stenting is as follows:
- a zone on which the operation is carried out, decontaminated;
- a local anesthetic is administered artery to needle penetration was imperceptible by the patient;
- is introduced into the needle lumen conductor after the needle is retracted;
- catheter which provides penetration tool;
- through a catheter introduced into one, but smaller, and there is a stand in the folded state;
- Stand slowly fed to the right place;
- after the stand reaches the desired location, the balloon is inflated it to atherosclerotic plaque was pressed to the walls of the arteries;
- catheter is removed and the insertion site greatly compressed for 20 minutes, after the bandage.
recovery period
After stenting in myocardial infarction patient in intensive care placed where doctors are watching his condition, blood pressure and heart work. If the femoral artery, the patient requires bed rest has been involved with the operation. Leg should be kept at rest for 6 hours. The first hour after surgery the patient is observed every minute. If the artery was sealed with, then the patient will rest for a few hours less than the standard squeezing.
If the heart vessels stenting was performed at the radial artery, the need for bed rest determined by the attending physician. Sitting position can occupy immediately after the operation, unless there are specific recommendations from the surgeon. Start walking, you can only after 4 hours.
Patients undergoing stenting after myocardial need to take a lot of liquid, as introduced into the body a contrast agent. With frequent urination reagent will be displayed quickly.
After discharge from the hospital, you need to continue to recover at home. An important step in restoring a therapeutic exercise, the beginning of which is consistent with the doctor.
In moderate exercise therapy of the disease can begin as early as day 3 of the stent after a heart attack. Each increase of the load on the body is measured blood pressure. With a sharp increase in the load level indicators should be reduced.
Rehabilitation after stenting includes power correction. Reduced calorie food, the patient restricts itself to the flour, sweet, fatty, too salty and sharp products, be sure to increase the amount of fluid, and meals are becoming more frequent, but the portions at the same time decrease. The basis of the diet should be the following products:
- lean meat;
- fresh fruits and vegetables;
- homemade compotes and juices with no added sugar;
- rye bread or bran;
- fish;
- boiled eggs;
- milk products.
In the early days, doctors recommend to use only frayed food that does not require chewing.
During the recovery period after a heart attack and stenting patient may not perform all the housework, depending on the severity of the disease. Avoid the awkward position of the body and fatigue. Sex life can begin after 1.5 months after surgery. It is necessary to keep a number of nitroglycerin. Before the act can not take alcohol, energy drink and bathe in the hot tub.
