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Science
CASE NOTES
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Tuesday 21:00-21:30
Repeat Wednesday 16:30
Dr Mark Porter gives listeners the low-down on what the medical profession does and doesn't know. Each week an expert in the studio tackles a particular topic and there are reports from around the UK on the health of the nation - and the NHS.
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LISTEN AGAINListen 30 min
Listen to 20 September
PRESENTER
DR MARK PORTER
Dr Mark Porter
PROGRAMME DETAILS
Tuesday 20 September 2005
Surgeons perform heart surgery

Full programme transcript >>

Coronary Artery Surgery

Every year more than a quarter of a million people in the UK have a heart attack and some 150,000 of them die.

In this episode of Case Notes Dr Mark Porter reports on the latest approaches to preventing deaths from heart attacks.

He'll be discussing these treatments with his studio guest, leading cardiologist Dr Kevin Beatt.

Angioplasty

Someone who's suffered a heart attack is often given a course of drugs to break down the clots in their arteries, then an angioplasty to open up the blood vessels.

In an angioplasty, a tiny balloon is introduced through the groin into the clogged up vessels; the balloon is then inflated and keeps the vessels open.

So that the blood vessel doesn't become blocked again, a tiny stent - made of a fine metal mesh - can be left inside the artery. 

Nowadays the stent is often coated with drugs - a so-called eluting stent - to reduce the likelihood of unwanted clots.

Molly Bentley reports from University of California Department of Medicine, where an angioplasty is regularly carried out as soon as a heart attack occurs. 

Doctors there have found that the prognosis for patients who receive a 'primary angioplasty' in this way is better than those taking clot-busting drugs.

A pilot project is now running in several hospitals in the UK and Mark finds out about its progress. .

Cardiac bypass surgery

If the coronary artery disease is more severe patients may need cardiac bypass surgery.

In this operation the surgeon grafts blood vessels - usually from the legs - around the blockage to restore the blood flow to the heart.

Recuperation from this major surgery can take several months.

We sit in on a cadiac bypass operation at the Royal Brompton Hospital in London. 

Mark finds out how doctors decide which patients are suitable for this procedure, and why the number of operations carried out each year is decreasing in favour of angioplasty.

Preventing surgery

Mark will also be asking how successful we have been at preventing heart attacks.

A low dose of aspirin has been shown to reduce the chance of someone having a second heart attack, but is there any evidence that aspirin can prevent a first attack?

Mark talks to Dr Colin Baigent of the Clinical Trial Service Unit at Oxford University about who should be regularly taking aspirin, and who shouldn't.
 
One of the main risks is bleeding in the stomach: aspirin can cause stomach ulcers and potentially life-threatening bleeding, so the risk of this must be weighed up against the potential risk of a heart attack or stroke.

These risks are particularly difficult to assess in older people (over 70) and no one should take aspirin without consulting their doctor first.
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