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| SURGERIES OF THE HEART |
Carotid Artery Endarterectomy
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Carotid Artery Endarterectomy is a surgical procedure to remove fatty deposits, also called Atherosclerotic plaques, from the carotid artery. This artery travels through the neck and carries oxygen-rich blood to the brain.
REASONS FOR THE PROCEDURE
To help prevent stroke and transient ischemic attacks (TIAs) by restoring adequate blood flow to the brain. TIAs happen when the blood supply to the brain is temporarily blocked. People with TIAs have symptoms of a stroke, but unlike a completed stroke, these symptoms resolve within 24 hours. TIAs are considered a “warning sign” of an increased risk of stroke. People with severe blockages in their carotid arteries, especially those who have already had a stroke or a TIA, can benefit from carotid endarterectomy.
RISK FACTORS FOR COMPLICATIONS DURING THE PROCEDURE
* The degree of blockage in your carotid artery
* Gender
* Diabetes
* The type of stroke symptoms one had
* Blockage of the carotid artery on the opposite side of the neck
BEFORE THE PROCEDURE
The doctor will likely do the following:
* Blood and urine samples
* Electrocardiogram (ECG, EKG) – a test that records the heart's activity by measuring electrical currents through the heart muscle.
* Arteriogram – a type of x-ray in which a contrast material or dye is injected into the arteries to make them more visible.
* Ultrasound – a test that uses sound waves to examine the carotid arteries.
* Magnetic resonance angiography (MRA) scan – a test that uses magnetic waves, along with a paramagnetic contrast agent, to make pictures of arteries inside of the body.
In the days before the procedure:
* The patient will probably continue to take all major medications until the day of the surgery.
* The night before, eat a light meal and do not eat or drink anything after midnight.
PROCEDURE
The patient will have to lie flat, with a roll placed under the shoulder, and head turned to the side. The surgeon makes an incision along the right or left side of the neck from just behind the ear to a point above the breastbone. The carotid artery is identified, clamps are temporarily placed above and below the plaque, and the artery is opened. In some cases, a shunt, which serves as a "bypass," is used to maintain blood flow.
The artery is cleaned of plaque. When all plaque has been removed, the artery is sewn back together and the clamps (and shunt, if used) are removed. The surgeon may need to remove a section of the carotid artery and sew in either an artificial graft or a segment of vein to replace it. The neck incision is closed with stitches.
AFTER PROCEDURE
The surgeon may do an arteriogram of the carotid artery to ensure that there are no complications, such as blood clots or narrowing. The patient may be given a medication to help prevent blood clotting.
TIME TAKEN FOR THE PROCEDURE
2-4 hours
POSSIBLE COMPLICATIONS
* Heart attack
* Stroke
* High blood pressure (hypertension) or low blood pressure (hypotension)
* Blockage of carotid artery due to a blood clot (embolism)
* Possibility of nerve injury in the neck, resulting in weakness in the voice box or tongue muscles, which may affect speech.
* Facial muscle paralysis (rare)
* Bleeding in the brain (rare)
* Earlobe numbness on the side where the carotid was repaired
* Infection
* Death.
POSTOPERATIVE CARE
* Keep the neck straight, and keep the head of the bed elevated during recovery.
* Take medications as prescribed by the doctor. These may include anticoagulants to prevent blood clots, as well as prescription and nonprescription pain relievers.
* Resume the daily activities as soon as possible.
* Do not drive for three weeks after surgery.
* Avoid vigorous exercise for six weeks after surgery.
* Make dietary changes to help prevent a recurrence of plaque build-up. These include eating a diet low in saturated fat and high in fruits, vegetables,grains , and fish.
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| Last Modified :
Monday, May 11, 2009 |
Compiled and edited by the Editorial team and
approved by Expert panel of h4heart.com
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