Medical Tests & Procedures Archive

Comparisons have produced mixed results, but the heyday for both procedures (especially bypass) may be winding down.

Yes, it's an oversimplification, but at one level, coronary artery disease is a plumbing problem. The coronary arteries supply the heart with blood. When they get gunked up with atherosclerotic plaque, not enough blood can get through. If the blockage isn't too bad, the result is angina, the pain caused by a heart working with an inadequate blood supply. If the blockage is bigger or the plaque ruptures, the result can be a heart attack, the death of heart tissue that was suddenly starved for blood and oxygen.

The first robotic surgery was performed in the mid-1980s. Now thousands of operations are being done with the assistance of robots. A better term might be robotic instrumentation because, ultimately, there's always a human surgeon with his or her hands on the controls.

Even without robots, a lot of surgery is less hands-on than it used to be. For decades, surgeons have been doing many common abdominal operations with laparoscopes — tube-like instruments with video cameras on the ends — and long-handled surgical instruments. Surgeons watch magnified images on video monitors to see what they are doing so they can guide the surgical instruments.

The aorta is the largest artery in the body; it's also the strongest. But size and strength are not enough to protect this crucial blood vessel; in fact, the aorta is one of the body's most vulnerable arteries.

Although many things can go wrong with the aorta, the most common is an aneurysm; it's an unfamiliar term, but it's a well-chosen name based on the ancient Greek word that means "to widen."

Understand the risks and limitations before embarking on this last-ditch option.

An operation that changes how the stomach and intestines digest food has been hailed as a potential lifesaver for people who are severely overweight. It can dramatically improve blood sugar, lower blood pressure and cholesterol, lessen sleep apnea (a dangerous pattern of breath holding during sleep), and improve heart function. But these benefits, which accrue only with a lifelong commitment to healthy eating and exercise, must be balanced against possible risks.

Q. My doctor told me I have pericardial effusion. I know it has something to do with fluid in the heart. Can you tell me more?

A. Pericardial effusion is the medical term for a buildup of fluid inside the sac that surrounds the heart. This sac, called the pericardium, protects the heart, helps hold it in shape, and prevents it from expanding too much when blood volume increases.

Q. I think I may have cataracts. I heard somewhere that they need to be ripe before I get surgery. Is that true?

A. The lens of the eye is normally clear and has a consistency that is a bit stiffer than Jell-O. A cataract is a clouding of the lens caused by degradation and clumping of various proteins in the tissue. When that happens, the lens also gets stiffer, and in extreme cases, a lens can get as hard as a rock.

Whether the check-up should include an electrocardiogram is an unanswered question.

Sports, and the physical fitness needed to participate in them, provide an extra layer of cardiovascular protection by strengthening the heart, improving the lungs, and making arteries more supple. Sometimes, though, something goes horribly wrong and an athlete suddenly dies while engaged in his or her sport.

Not everyone needs an overnight hospital stay after this artery-opening procedure.

Artery-opening angioplasty is an amazing procedure. It lets a doctor restore blood flow to hard-working heart muscle without having to cut into the chest or split the rib cage. Assuming all goes well, the recovery time is minimal and the only physical reminder of the procedure is a half-inch scar at the top of one leg.

Treating enlarged leg veins can improve their appearance and reduce the risk of swelling, aching, and other problems.

If you have varicose veins — those dark blue or purple leg veins that bulge above the skin's surface — you may dread wearing beachwear and other clothes that expose your legs. With summer just a few months away, this may be a good time to do something about that. But it's not just a cosmetic consideration. Varicose veins can cause pain and discomfort and even, in rare cases, bleeding leg sores. Treating enlarged leg veins can relieve discomfort and prevent complications.

Same-day angioplasty feasible, safe

Patel M, Kim M, Karajgikar R, et al. Outcomes of patients discharged the same day following percutaneous coronary intervention. JACC Cardiovascular Interventions 2010; 3:851-8.

Chambers CE, Dehmer GJ, Cox DA, et al. Defining the length of stay following percutaneous coronary intervention: an expert consensus document from the Society for Cardiovascular Angiography and Interventions. Endorsed by the American College of Cardiology Foundation. Catheterization and Cardiovascular Interventions 2009; 73:847-58.