The circulatory system carries vital oxygen, water, nutrients and hormones through our bodies. Your heart is a muscle that keeps this system running and acts like a pump to move blood throughout your body. The coronary arteries are major blood vessels that supply your heart with blood, oxygen and nutrients. The heart needs a constant supply of oxygenated blood in order to function properly.
What is Coronary Artery Disease?
Coronary artery disease (CAD) is a common form of heart disease. It occurs when the arteries to the heart become narrowed or blocked with a buildup of fatty deposits and other substances. This buildup is also known as plaque.
This narrowing of the artery, also called stenosis, restricts blood flow, depriving the heart muscle of needed oxygen and nutrients.
A normal coronary artery with normal blood flow
A coronary artery narrowed by plaque with restricted blood flow
Symptoms of Coronary Artery Disease
Coronary artery disease can develop over time and symptoms may not be noticed until the blockage is severe and life-threatening.
Typical symptoms include:
- Chest discomfort or pain, also known as angina
- Shortness of breath
- Extreme fatigue with exertion
- Nausea or vomiting
- Heavy sweating
- Swelling in your feet
- Pain in the jaw or neck
- Pain in your shoulder or arm
Women may experience atypical chest pain. The pain may be fleeting or sharp, and noticed in the abdomen, back or arm. They are also more likely to experience nausea, back or jaw pain.
There are several ways your doctor may treat coronary artery disease. Treatments include lifestyle changes, medication and minimally invasive or surgical procedures.
For some patients, coronary artery disease can be treated using a minimally invasive surgical procedure called percutaneous coronary intervention (PCI). This procedure can be used to open blocked arteries.
The procedure is performed under local anesthesia in the cardiac catheterization lab by a specialized cardiologist and a team of cardiovascular nurses and technicians.
Some patients will need coronary artery bypass graft (CABG) surgery. The surgery involves implanting a segment of a healthy vessel (taken from another part of the patient’s body) from the aorta to the coronary artery beyond the blockage site. This provides a new route for the blood to flow around a blocked artery.
There are several types of interventions that may be used during PCI, including:
A specialized catheter with a small balloon is guided over a wire to the location of the narrowed artery. Once in place, the balloon is inflated to compress the plaque against the artery wall, opening the artery and increasing blood flow to the heart.
Stents are used to reduce blockages or narrowing. The stent is a small, expandable metal-mesh tube that is mounted on a balloon catheter and delivered over a wire into the narrowed coronary artery. Once in place, the balloon is inflated. The stent expands to the size of the artery, holding the artery open. The balloon is then deflated and removed while the stent stays in place permanently. Over several weeks, your artery heals around the stent.
Drug-Eluting Stents (DES)
Some stents also have a medicated coating that is slowly released (eluted) over time to help prevent the overgrowth of tissue on the artery wall. This helps the artery remain smooth and open, ensuring good blood flow. Depending on individual patient characteristics, a doctor may use a drug-eluting stent (DES). A DES is generally more effective than bare metal stents in keeping the artery open over time.
A new class of treatment, bioadaptors also have a medicated coating and are implanted similar to a DES. However, after the artery heals, the bioadaptor design allows the artery to move more naturally and resume its normal function. The bioadaptor design also allows the artery to naturally expand over time and maintain the size of the opening while the disease continues to progress. The result is continued good blood flow.
DynamX™ Coronary Bioadaptor System
An Innovation in Coronary Intervention
The DynamX Coronary Bioadaptor System is designed to treat blocked coronary arteries and deliver superior outcomes.
It is easily implanted and initially functions like a traditional drug-eluting stent while your coronary artery heals.
Over six months, a bioresorbable coating (similar to dissolving sutures) on the DynamX Bioadaptor resorbs. This allows its unique couplers to safely disengage. This permits the bioadaptor to move more naturally with the artery wall in response to the needs for more oxygen demanded by your heart (such as during exercise). It also gradually expands with the artery to accommodate any new plaque buildup, maintaining the diameter of the treated area for good blood flow over time.
Traditional stents are rigid and prevent arteries from moving and functioning normally. Stent rigidity also prevents the artery from growing over time. This causes blood flow to decrease as the disease naturally continues to progress. Unlike traditional stents, the DynamX Bioadaptor is designed with additional features to overcome these limitations.
What to Expect for Your Procedure
Before the procedure
Your doctor will instruct you on how to prepare for the bioadaptor implantation procedure prior to your admission to the hospital. Your doctor may ask you to take aspirin and other prescribed medications for several days before the procedure. You may receive medication for relaxation prior to the procedure.
During the procedure
During the procedure, you will have to lie flat on your back. You will remain awake, allowing you to follow your cardiologist’s instructions (e.g. “breathe deeply”). Devices will monitor your heart rate and blood pressure.
- Your doctor will use local anesthesia at the catheter insertion site.
- A thin plastic tube called a sheath will be inserted into your artery, from the inside of your upper thigh or inside of your forearm. The tube is guided over a wire to the arteries surrounding your heart.
- A small amount of contrast material is injected through the catheter to allow imaging as it moves through the heart’s chambers, valves and major vessels. Your doctor will be able to see the exact location of the blockage.
- Your doctor will position the bioadaptor at the treatment site, inflate the balloon and deploy the device. The balloon will be removed and blood flow resumes, leaving the bioadaptor in place to support the re-opened artery.
- The procedure generally lasts 1.5 – 2 hours.
Recovery and post procedure
The amount of time you stay in the hospital may vary dependent on whether complications arise during the procedure and how well the catheter insertion site is healing. Some people may be released the same day and some people may stay overnight and return home the following day.
After you leave the hospital, you will be instructed to take medications, including those to reduce the risk of future blood clots. It is important to take medications regularly as prescribed and notify your doctor of any side effects or concerns. Note: Do not stop taking your medications unless you are asked to stop by your cardiologist.
Continue following your doctor’s instructions when you return home, keep your implant card handy and let your doctor know about any changes in lifestyle you make during your recovery period. Note: Contact your doctor or the hospital immediately if you experience pain, bleeding, discomfort or changes such as severity or frequency in angina symptoms (chest pain).
Potential Risks and Complications
Use of the DynamX Bioadaptor carries the same risks as those associated with standard stent placements. Talk with your cardiologist about potential risks and complications that may occur during or after placement of the bioadaptor.
Elixir Medical does not provide medical advice, diagnosis or treatment. The content of these website pages is for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always follow the advice of your physician or other qualified health care provider and consult them with any questions you may have regarding a medical condition.