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 Angina Treatment
Enhanced External Counterpulsation (EECP) therapy is a noninvasive, outpatient therapy used in the
treatment of ischemic cardiovascular diseases, currently used to manage chronic stable angina and heart
failure. The therapy increases blood flow and oxygen supply to the heart muscle and other organs and
decreases the heart's workload and need for oxygen while also improving function of the endothelium,
the inner lining of blood vessels throughout the body, lessening resistance to blood flow. These
actions reduce or eliminate symptoms of angina and heart failure, and improve the quality of life for
thousands of people worldwide. For details about Kettering's EECP program, call (937) 395-8366.
Space-Age Technology helps angina patients.
 Carotid Artery Stenting
No sooner had the FDA and Medicare approved carotid artery stenting, than Kettering Medical Center did the first procedure in the south Dayton area. M. Niranjan Reddy, MD, and Raja Nazir, MD performed the stenting in June, 2005 on an elderly gentleman who had previous history of carotid surgery which was high risk. "He's doing very well," said Reddy.
Reddy explained the procedure is for patients with severe stenosis and at high risk for carotid surgery. A relatively new endovascular treatment, carotid stenting can be a better option for some patients.
The procedure uses a stent to open partially blocked arteries and to hold the plaque against the artery wall. An embolic protection device is also used to help catch pieces of plaque or debris that can be released during the procedure and lead to a stroke.
The SAPHIRE and ARCHER trials indicated that carotid artery stenting is a safe and equal alternative to carotid endarterectomy. It is done with a catheter-based approach from the groin after the embolic protection device has been placed. The physician maneuvers the stent on a catheter into the vessel and positions the stent across the narrowed area in the carotid artery.
The procedure can be done by interventional cardiologists, interventional radiologists and vascular surgeons who have passed the FDA training program.
 Catheter Ablation for Atrial Fibrillation
In 2003, Kettering Medical Center became the first hospital in southwestern Ohio to perform catheter ablation for atrial fibrillation. Since then, electrophysiologist Dr. K. Baig has performed close to 50 of these procedures with a success rate of 75 percent and no complications. Candidates for this procedure, which essentially cauterizes the cells in the heart which are causing the fibrillation, have either exceptionally fast, slow or irregular heart rhythms.
Atrial fibrillation is a fast and irregular heart rhythm. It carries an increased risk of mortality with it. Most patients experience a poor quality of life and functional status. The drug-based treatment has the risk of severe side effects and increase mortality. In the last seven years catheter-based ablation has proven to be effective and safe in bringing the rhythm back to normal. The procedure has also shown it improves the quality and length of life.
The procedure is performed under general anesthesia in the Electro Physiology (EP) lab. The catheters are inserted through the veins in the groin and neck. No surgical incisions are made. At the end of the procedure, the catheters are removed and the patient has simple bandages at the puncture sites. There is a four-hour bed rest following the procedure.
Kettering Medical Center boasts the most experienced nursing team in the EP lab. The procedure also utilizes the most cutting-edge and innovative technology currently available. This includes state-of-art 3-D intracardia and 3-D CT scanning of the heart chambers, intracardiac echocardiography and a variety of ablation catheters.
 Coronary Angioplasty
Coronary angioplasty is a non-surgical procedure that relieves symptoms of coronary artery disease
(commonly known as heart pain or angina) by improving blood flow to a region of your heart that is
not getting enough blood and oxygen. During the angioplasty procedure a thin flexible tube (catheter)
with a balloon at the tip, is inserted into an artery in your heart where the blood vessel is narrowed.
The balloon is then inflated in a effort to widen the blood vessel to allow more blood to flow through.
 Coronary Artery Bypass Surgery
Coronary artery bypass surgery creates a new pathway around one or more blockages in the arteries that
feed the heart with blood and oxygen, thus allowing oxygen rich blood to again be supplied to areas of
heart that were lacking. In most cases, a healthy blood vessel is taken from another part of your body
and surgically placed on the heart to create the new pathway. This new pathway is commonly known as a
graft. The graft is usually taken from inside the chest wall, the legs or the arms.
 Coronary Atherectomy
Coronary atherectomy (also known as rotoblator) is a non-surgical procedure that relieves symptoms of
coronary artery disease (commonly known as heart pain or angina) by improving blood flow to a region of
your heart that is not getting enough blood and oxygen. During the atherectomy procedure a thin
flexible tube (catheter) carrying a special cutting or sanding device gently shaves the inside of the
blood vessel at the location of a blockage. The shaved particles are then vacuumed into the catheter
and removed.
 Coronary Stents
A coronary stent is a small metal coil or mesh tube that is placed in a narrowed coronary artery
(blood vessel that feeds the heart with blood and oxygen) in an effort to improve blood flow to a
region of the heart muscle. The stent is placed in the narrowed blood vessel through a long, thin
tube (catheter) and it remains in place to permanently hold the vessel open.
 Heart Valve Replacement / Repair
Your heart valves are doorways that open and close to direct blood to flow as it is pumped between the
upper and lower heart chambers. When heart valve disease occurs, the valve may not open all of the
way (stenosis). When this occurs less blood is circulated with each heart beat. Valvular disease can
also involve problems with complete valve closure (insufficiency). When this occurs the blood may leak
in a backward direction. With either of these abnormalities the heart must work harder to circulate
blood and oxygen to the body tissues. Both problems can be corrected with surgery.
During valve repair surgery, stenosis can be repaired by cutting or separating parts of the valve to
allow more blood to flow through. Valvular insufficiency can be repaired by strengthening or shortening
parts of the valve. If the valve cannot be repaired it can be replaced with a tissue valve taken from a
cow, a pig, or another human. Valves can also be replaced with mechanical manmade materials.
 Implantable Cardioverter Defibrillator
The implantable cardioverter defibrillator (ICD) is a device that is placed in your body to help
control your heart rhythm. The ICD is a small, lightweight device that keeps track of your heart
rhythm. The ICD generator is surgically implanted under the skin at the left shoulder, below the
collar bone, or on the left side of the abdomen at the bottom of the rib cage. Electrode wires are
then threaded into the heart to enable the ICD to track and record your heart rhythm. If a
life-threatening heart rhythm occurs the ICD will send an electric shock to your heart to return it
to a normal rhythm.
KICKSTARTERS
Kickstarters is a support group for patients with an Implantable Cardioverter-Defibrillator (ICD).
This group offers an informal meeting with ICD patients, their families, Kettering Medical Center
clinical staff, plus one of the electrophysiology doctors. The goals are to provide an opportunity to
share personal experiences, answer questions or concerns, and keep you up to date on new developments
in ICD therapy.
 Pacemaker
A pacemaker is a small electronic device that helps the electrical system in your heart to send electrical signals at the right speed. Problems with the heart's electrical system can make your heart beat slow or uneven. When this happens you may have dizziness, shortness of breath, fatigue, or fainting spells. These symptoms are most likely to occur when you are doing an activity.
The pacemaker is surgically implanted under the skin at the left shoulder, below the collar bone. Electrode wires are then threaded into the heart to enable the pacemaker to track and record your heart rate. When the heart rate is too slow, the pacemaker generates signals to simulate the heart to beat at the right pace.
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