Bypass graft angioplasty and stenting! Dr Binoy John (2016) скачать в хорошем качестве

Bypass graft angioplasty and stenting! Dr Binoy John (2016)

WHAT TO DO IF BLOCKS OCCUR AFTER BYPASS SURGERY? SAPHENOUS VEIN BYPASS GRAFT ANGIOPLASTY! BY-PASS GRAFT ANGIOPLASTY OF THE SVG! Saphenous vein grafts (SVG) are veins harvested from one's legs and used in Coronary artery Bypass Graft (CABG) surgeries. ​Contrary to popular belief, ​SVGs have a rather high attrition rate ​with a​ 30% chance ​o​f blocks occurring in the first one year​ itself​ after ​By-pass ​surgery​. If identified early, before they become 100% occluded​ or blocked​, these can be angioplastied and stented.​ To detect the blocks before they become 100%, a very close and frequent follow-up is warranted. Once they become 100% blocked vein grafts cannot be opened. Saphenous vein graft angioplasty is complex and very different from angioplasty of the coronary arteries. This is because the fatty-atheromatous debris in the​ vein grafts are heavy and if dislodged can flow and occlude (embolize) the arteries and their small branches, thus causing a phenomenon and complication called No-flow or slow-flow phenomenon, which can cause on-table heart-attacks! To prevent this embolization, SVG angioplasty requires a distal protection device (DPD) which are very fine nets placed deep in the vein beyond the blocks, to trap the fatty debris from flowing down and occluding the arteries. ​The following is a video of a SVG angioplasty I performed recently with a SPIDER FX filter device deployed beyond the block. After deploying the SPIDER FX DPD, I performed the balloon dilatation of the block and thereafter placed a stent and completed the angioplasty and stenting. Thereafter I removed the Spider Fx DPD by catheter occlusion to get an excellent result and flow! DR BINOY JOHN MD DM (CARDIOLOGY) FACC FESC FCSI FAPSIC FSCAI Dr Binoy John is a cardiologist practicing in Chennai and was awarded the title of Best interventional cardiologist of Tamil Nadu @ Vigyan Bhawan, New Delhi in 2020 Facebook@ Binoy John Dr​