Q&A: Big deal when having heart and chest surgery
On 29 Nov 2020 at 11:20 a.m.
Technology for Cardiothoracic Surgery by Dr. Phuwadon Thitiwaraporn, Head of Heart and Thoracic Surgery Center Charoenkrung Pracharak Hospital
Head of Cardiovascular Surgery Center Charoenkrung Pracharak Hospital Relieve questions about modern medical technology in treatment. Along with revealing the situation of heart disease and heart surgery statistics
Each year, people die from non-communicable diseases. Non-Communicable Disease (NCD) accounts for 41 million people, representing 60-70 percent of all deaths worldwide. Where the number one cause of death in this group Is cardiovascular disease For Thailand as well According to the latest 2018 statistics from the Ministry of Public Health, our country has the number 1 deaths from cardiovascular disease, 72 percent of all deaths. And tends to increase every year due to both internal and external factors such as cigarette, dust pollution Consuming a diet full of bad fats Inactivity and chronic conditions that are not treated or controlled enough Like diabetes High blood pressure High blood fat Kidney failure / degenerative diseases, etc.
Although there is currently a stimulus Campaign to promote health Prevent various diseases From both the public and private sectors such as the Ministry of Public Health Thai Heart Foundation The Association of Cardiologists of Thailand And at the same time, there are more measures to take care of this group of patients. Both from providing more comprehensive access to services for patients There are networks and management of referral systems in acute ischemic heart disease. Giving the patient access to the necessary drugs And care for heart disease patients who have to be operated on But still caring for the patients in this group Especially heart disease that requires surgery Still considered to be very scarce
Charoenkrung Pracharak Hospital It is the first and only hospital in the medical bureau. Bangkok (Which has 11 hospitals in the office) that are capable of providing comprehensive care for heart disease patients. Both taking care of heart disease, heart attack, heart arrhythmia by giving drugs and electrocautery. Heart physical therapy Color injection and belt walk And heart surgery Both coronary artery disease By performing bypass surgery Heart valve replacement or repair surgery Arterial aneurysm surgery, both surgical and stent surgery. Primary congenital heart surgery in children Using a heart support (ExtraCorporeal Membrane Oxygenator, ECMO), etc. Charoenkrung Pracharak Hospital has performed surgery for the fifth year and has a higher trend. By the way of the Charoenkrung Pracharak Hospital Receive help from a medical teacher Experienced person Both from Chulalongkorn Hospital and Siriraj Hospital Including a team of medical professors in various fields to help in case the surgery is complicated. Which has always made the surgery successful
According to the statistics of heart surgery from the Association of Cardiologists of Thailand in 2018, it was found that coronary artery bypass surgery (CABG) is the number 1 heart surgery and tends to increase every year. By 57 increments % Over the past 10 years (from 3,790 to 5,970 / year), heart surgery was not as horrible as many people imagine. Nowadays, different technologies are used to help improve surgery. In terms of faster recovery, smaller wounds, fewer complications. After surgery, patients begin to realize 1-2 hours and can eat in 8-12 hours. The average hospital stay period is 5-7 days if there are no complications. After the patient starts awake and sits, the physical therapy team will take care of it. Teach exercises to help the body and heart recover as quickly as possible. After that, the cardiac physiotherapy team will arrange for the patient to walk on the treadmill or ride a bicycle to restore the fitness of the heart.
Bangkok Medical Center Therefore, the development plan in Charoenkrung Pracharak Hospital was established to be a tertiary service center specialized in heart and lung disease to be able to provide a full range of services. And developed into a network of referral treatment network center and the first and only tertiary medical center in the medical bureau Bangkok (Which has 11 hospitals in the office) that are capable of providing comprehensive care for heart disease patients. Who perform the service Diagnose and care for patients with heart disease and Unified blood vessels Has modern technology and medical equipment Supervised by a team of expert medical teachers in each field And medical personnel with expertise and high experience It is also the center of knowledge to disseminate to People and society The center consists of The various disciplines involved are the Disciplines of Cardiothoracic Surgery. Department of Cardiovascular Medicine And the field of cardiovascular anesthesiology
From such situation Indicating that the illness is increasing every year And a threat to health, the center realizes the importance of such problems Therefore, a campaign to communicate awareness about disease, violence, prevention and actively cooperate in risk mitigation operations. Will make the target people healthy Have a better quality of life Which people have questions about modern medical technology in treatment, the answers are as follows
1.Which is better compared with bypass surgery?
Present coronary artery disease If symptoms are not more, 1-2 or 3 uncomplicated stenosis, stent therapy. May not be different But in stenting patients will have a faster recovery time. The wound is less painful. However, bypass treatment. Still the main treatment in patients with multiple sclerosis Although the balloon stenosis treatment and new types of stenting Also known as a Drug Eluting Stent, it is effective, but a stent into the previously narrowed artery is more easily followed by a recurrent stenosis, ie in patients with uncomplicated or complicated hepatic impairment. Calculated as a score called a low Syntax Score, the results of 5-8 years of treatment may not differ. But if the patient has difficult or complicated 3 stenosis of the blood vessels or the patient with low heart function. Diseases such as diabetes are combined with the use of two arteries from both chest cavity and arm artery. Inevitably gives better treatment results In particular, the rate of repeated stenosis in the 10-year period is much less. And the chance of dying Or have to admit with heart disease is much less
2. Endoscopic heart surgery is a small incision or not?
Heart surgery is performed by using a camera. And surgery to make the incision smaller However, the incision is smaller. Back is not a smaller surgery But it is a more complicated surgery. Both planning and dissection Use of modern tools And the surgeon’s expertise Currently, major surgical treatment is the standard. But the surgeon tends to make a smaller incision. Both from the original wound Halve the size Or change the way to the heart through the chest cavity Instead of entering the front of the heart By what the heart surgeon The first consideration is safety and treatment outcome. It must not be less than standard surgery. Which has begun to operate with some small incisions And it is in the beginning to choose a surgical method that is suitable and safe for the patient is important.
3. Can aorta (Aorta) stent be placed through the groin?
Current treatment of bulging aorta Or torn some position Stent therapy Were taken to treat more patients Due to open surgery There can be many complications; however, a stent is not yet possible in all forms of tearing. Open surgery If the operation works well Patients will not have to come back for frequent computed tomography in the future by the Charoen Krung Hospital. Both open, stent and mixed surgery were considered and performed, known as Hybrid Operation.
4. What is the difference between open lung surgery and laparoscopy?
Today endoscopic surgery In particular, the single incision surgery gave very good results, ie the wound was smaller, recovered quickly and returned home quickly. On the side of removing all necrosis And the treatment result is as good as open surgery In addition, less than one lung resection, also known as Sublobar Resection, is currently in patients who cannot tolerate whole lobe resection. It began to be used in early cancer.
5. In addition to dissecting the heart, heart valves, aorta and lungs Does the hospital have other types of surgery?
Charoenkrung Pracharak Hospital Ready with heart Both pediatric and adult hearts are supervised in the field of bypass surgery using and without artificial heart lung machines. Surgery to repair or replace heart valves Dissecting open artery or stenting Lung surgery, both endoscopic 1, small or open incision, and some types of congenital heart surgery It starts with care from planning and talking before surgery. Appointment with a cardiologist to explain heart rehabilitation Standard surgery With 2 – 3 heart surgeons in every surgery After the operation, there is a team of care in the ICU with modern equipment. And finally, the physical team will make an appointment to walk the belt to check the performance of the Vo2 Max measurement so that the patient can return to her health and live better.
Finally, I want the Thai people to take care of their health and close ones. Along with treatment if you already have heart disease Because heart disease is not as scary as we are concerned, the Heart and Chest Surgery Center Charoenkrung Pracharak Hospital Inviting interested people to join the public seminar In the public education project On “Technology for Cardiovascular Surgery” on Tuesday, December 15, 2020 from 9:00 a.m. to 12:00 p.m., Meeting Room Udom Sangvaranayana, 23rd Floor, 72nd Anniversary of the Great Queen, Charoenkrung Pracharak Hospital. Interested persons can seek advice and check heart waves. It’s free To register for the event, call 062-416-4536 or donate to build a hybrid heart surgery room at Charoenkrung Pracharak Hospital Foundation Office. For heart surgery room Telephone number 02-289-7368 or via website www.ckphosp.go.th