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Angioplasty with stents offers good-and fast-results for patients with coronary-artery disease
Today, patients with coronary heart disease need not have their chests opened to unblock blood vessels
and to get the heart working well again. Now, all it takes is a small puncture near the groin, balloons, fine
wires, X-ray, and flexible steel mesh tubes-or stents, which are no bigger than an ordinary pen.
Bypass surgery has been the most common form of therapy for coronary-artery disease (CAD) since
the late 1970s. In the next decade, percutaneous transluminal coronary angioplasty was introduced, using
only balloons to restore the patency of the artery.
Though many would opt to have a bypass, angioplasties with stents are also getting more common in
the Philippines, says Dr. Edwin Dizon, an interventional cardiologist from the Cardinal Santos Medical
Center and Philippine Heart Center (PHC). Angioplasty is recommended for single- and double-vessel
disease. On the other hand, a bypass is more appropriate if three coronary arteries are affected. "But
there are some patients who would not want to undergo a major surgery, so they usually request for a
multi-vessel angioplasty" he adds.
For Cecille Pelayo, professor and head of the Law and Tax department of the University of the East in
Caloocan, angioplasty was the best option. She just had three stents placed in her heart in February this
year at PHC. Busy with her teaching workload and other social activities, she had stopped exercising and
neglected her diet. Six months prior to her operation, she started having chest heaviness, easy
fatigability, and shortness of breath. When Dizon found three blocked arteries and recommended an
open-heart surgery, she hesitated, fearing the complications of such a major procedure. Not wanting to
take any chances, she immediately decided to undergo angioplasty.
Fast-tracked angioplasty
In less than an hour, Pelayo's heart is as good as new. She was awake during the whole procedure
and even watched the monitor. "It's just like having an angiogram," she says. Later in the ICU, she started
sending text messages to all her friends that she had just come out of surgery. "When friends visited me
in the ward, I was on a chair chatting with them, and not lying on the bed as they expected," she shares.
Now that there's marked improvement in her health, Pelayo is not taking anything for granted, though
she may have some difficulty adjusting to some limits in activity and diet, with a drastic lifestyle overhaul
in the works. Three months from now, if there are no complications, she will resume her normal routine,
which includes ballroom dancing. For now, she takes it easy as she goes about her classes.
After the surgery, aspirin and other drugs are given for 15 to 30 days to prevent clots. Unlike bypass
patients who have a recovery period of six to eight weeks, most angioplasty patients can work after a
week. Yet Dizon cautions his patients to first avoid vigorous activities, such as jogging, to prevent
hematoma of the puncture site at the femoral area.
"The success rate is usually more than 90 percent, except for totally occluded lesions," Dizon says.
"Experience of the surgeon counts, as angioplasty is a highly technical procedure."
Besides angioplasty, Pelayo believes that divine providence saved her from the wrath of heart disease
that claimed the lives of her father and two brothers. "For me, this procedure is better," she says, "but the
success of the procedure relies on what you will do with your life. Kailangang sundin mo 'yung doctor
mo."
Whether one chooses a bypass or angioplasty, efforts at keeping a healthy lifestyle will keep the heart
going. M