慢性 总计 闭塞

迹象 & 症状

不像急性或突发性堵塞, 什么通常会导致心脏病发作, cto是随着时间发展的. When you have a CTO, your heart is receiving less blood – and therefore less oxygen – than normal. But you may not notice a problem because blood is still reaching your heart through open arteries or through new tiny blood vessels that the heart develops in response to the CTO – as a detour around it. For many people, 症状 show up only during exercise or exertion. 这些包括:

• 胸部疼痛
• 乏力
• 呼吸急促（气促）
• 运动能力下降或不能运动
• 心跳异常(心律失常)

Risk factors for CTO are mostly the same as for coronary artery disease. 它们包括:

• 家族病史
• 超重或肥胖
• 高血胆固醇
• 高血压
• 体育锻炼不足
• 心脏病发作史
• 搭桥手术史

诊断

用于诊断CTO的主要测试是 冠状动脉造影. 导管(细), flexible tube) is threaded through a blood vessel in the wrist or groin to an artery in the heart; then a harmless dye that shows up well on X-rays is injected through the catheter. The images reveal blocked arteries as well as how well the heart muscle and valves are functioning.

Our providers review your angiogram results and tailor a treatment plan to your condition and needs. You will then have a clinic visit – either in person or by video – in which we discuss the recommended treatment, 包括其风险, 好处和期望.

治疗

The goal of treating CTO is to restore blood flow through the coronary arteries and relieve 症状. Appropriate treatment depends on how much the condition is affecting the heart – and consequently, 病人.

如果你没有感到不适或症状, we may recommend managing your condition through medications, such as drugs that lower cholesterol or blood pressure. But if 症状 develop, or if your condition is already advanced, we offer two procedures:

• 冠状动脉旁路移植术 (CABG). 在这个开胸手术中, the surgeon takes a section of healthy artery or vein from elsewhere in your body and grafts (connects) it to the blocked artery. One end is attached above the CTO and one end below, 为血液绕过堵塞提供了一条途径. CABG手术后, patients typically spend one to two days in intensive care and another three to five days in the hospital before going home. Generally, it takes six to 12 weeks to fully recover.
• 经皮冠状动脉介入治疗 (PCI). This minimally invasive procedure to open blocked arteries is performed by an interventional cardiologist. With 病人 under sedation (rather than general anesthesia), the doctor makes a small incision in the wrist or upper leg and – guided by imaging – threads a catheter carrying a tiny balloon and a stent (a mesh tube) through blood vessels until it reaches the CTO. Special instruments conveyed by the catheter are used to break up or push through the blockage. The balloon is then inflated to compress the plaque against the artery walls and the stent is placed to help keep the artery open. Most stents now come coated with timed-release drugs that prevent the growth of scar tissue, helping to ensure good blood flow and reduce the need for further treatment. 整个过程需要三到六个小时, depending on the degree of difficulty in reaching and removing the particular CTO.

病人 usually spend one night in the hospital for observation after PCI. Most experience immediate relief from 症状 and are able to resume normal activity within a few days. A follow-up visit will be scheduled for 14 to 30 days after the procedure.