Dialysis is a very important and life-saving procedure. It is performed to replace kidney function in case of renal failure. Wastes and extra fluids in the blood are filtered out during this process. To be able to perform Dialysis, the connection between the patient s bloodstream and the equipment for performing Dialysis (dialyzer) outside the body is established. This connection is created through Dialysis Access Surgery. It is a type of Vascular Surgery which forms the vascular opening for access during Dialysis. Thus, Dialysis Access Surgery is the lifeline for the survival of the patient.

Types of Vascular Access for Dialysis- 
There are three types of Vascular Access for Dialysis: Arteriovenous (AV) Fistula, Arteriovenous (AV) Graft, and Venous Catheter.

  Arteriovenous (AV) fistula is a surgical connection of an artery to a vein. An AV fistula is usually placed in the upper arm or in the forearm. It causes extra blood to flow into vein making it grow large. A larger vein hence provides easy access to blood vessels. An AV fistula is preferred over other methods as it lasts longer than other methods of access and provides a good flow of blood. Moreover, it is less prone to infection and blood clots than other methods. Before an AV Surgery, a Vessel Mapping Test is sometimes performed for assessing the blood vessels most suitable for Dialysis. An AV fistula is performed under local anaesthesia and requires two to three months for maturation before hemodialysis. If it fails to mature, the procedure is repeated.

  Arteriovenous (AV) graft is performed when AV fistula fails to mature. It is hence the second most preferred choice for long-lasting access to vascular tissues for Dialysis. An AV graft is a looped plastic tube which establishes a connection between an artery and a vein. Like AV fistula, AV graft is also performed under local anaesthesia. It is slightly more difficult to maintain than an AV fistula.

  A venous catheter is used for short- term hemodialysis. It is a tube which is inserted into chest, neck, leg, or near groin for vascular access. After exiting the body, the tube splits into two halves. In the case where a renal disease has made quick progression leaving little or no time for the AV fistula or AV graft to mature, a venous catheter is used to establish the required vascular connection. This procedure is also performed under local anaesthesia. It is a tool for emergencies but is not suited for long- term use. It can cause narrow vein due to an infection,
scarring, or blood clot. If long- term venous catheter is used, it is tunnelled under the skin which has fewer problems associated with it and is more comfortable. 

How to Care for a Vascular Access?
  Get checked for infections and other problems before each hemodialysis session;
  Use the operated site for access only for the intended use;
  Always keep the access clean;
  Prevent cutting or bumping the access;
  Check for thrill/ vibration in the access and inform the doctor if any;
  Do not put pressure on the access site;
  Do not put blood pressure cuff around the access arm;
  Do not wear jewellery or tight-fitting garments over the site;
  Do not lift a weight.

Take Away-
Vascular Surgery for Dialysis is performed to provide vascular access for the procedure. AV fistula is the most preferred type followed by an AV graft. A venous catheter is recommended to be used only in case of an emergency when there is not much time left for the other two options to mature.

Vascular Surgery - Can It Help For Dialysis?

An unhealthy diet is an absolute no in daily life to remain healthy, fit and without any disease. Unhealthy diets fail to give the body the correct amounts and varieties of proteins and nutrients for a maximum proper health.
Too many intakes of calories lead to an unhealthy diet, which also increases blood pressure. It leads to a very poor calorie ratio-to-nutrient that leads to gain weight and also leads to malnutrition along with various health problems. Unhealthy diets cause chronic disease, hypertension, cancer, diabetes, osteoporosis and cardiovascular disease.
Therefore, unhealthy eating habits should be avoided and strongly abandoned.

Why Avoid Unhealthy Diet?

It causes obesity. Increased intake of nutrient-dense foods like fruits, sugar, processed carbohydrates and animal fat leads to obesity.
Nutrient deficiency is another harmful effect of following an unhealthy diet.
Illness is another factor. Poor intake of nutrition leads to diseases like heart disease, diabetes, and cancer. Lack of calcium weakens the bones, lack of vitamin A and C suppress the body immune system leaving a person vulnerable to diseases.
Increases the risk of coronary artery disease as unhealthy diet contributes to building up of plaque in the coronary arteries which can cause heart attacks.
Coronary Heart Disease - A Serious Issue!
It is a disease which leads to plaque building inside the coronary arteries, which supply rich oxygen blood to the human heart muscle. Over time the plaques either hardened or get ruptured and hardened plaque restricts the coronary arteries, which reduce the oxygen flow to the heart. On the other hand, if the plaque is ruptured blood is formed on its surface which also narrows the coronary artery and restricts the blood flow. And if the blood flow is blocked or reduced, then it might lead to Angina and heart attacks leading to loss of life. Angina causes chest pain it can also cause pain in the neck, back or arms. It is a state where one gets a feeling of indigestion.

Outlook
Changes in lifestyle, eating habits, intake of medicines and its procedures helps to prevent this disease. These steps can also reduce the chances of health problems. Therefore, a proper healthy diet is a must in a person s routine because it serves as one of the links to coronary heart diseases. In order to live long, live healthily and live happily one needs to adopt a good eating habit, take care of the medicines they intake, certain input time of exercise, change the monotonous lifestyle to lessen down the chances of their occurrence. Adopting healthy food habits also enables the body to fight against diseases and infections, reducing the rate of illness. It also reduces stress and provides a good healthy and happy life.

Unhealthy Diet - How It Is Related With Coronory Heart Disease?

Angioplasty is the procedure of opening a coronary artery blockage with the help of wire balloon and stent. This procedure is done to open the blocked coronary arteries if they are causing symptoms or acute heart attacks.

HOW IT IS DONE?

The procedure is usually done in local anaesthesia. A wrist artery (radial) or a groin artery (femoral) is used to gain access to the coronary artery as is done in angiography. A hollow tube called a catheter is passed upto heart artery and through this, a guidewire is passed across the blockage and over this wire balloon is passed and blockage dilated.

After this balloon is removed and the metallic stent is passed over this wire. The stent is then inflated and it takes its shape of the hollow tube so that the flow in the coronary artery is restored.

WHAT ARE INDICATIONS OF ANGIOPLASTY AND STENTING:

An acute Heart attack is the most definite indication of angioplasty and stenting. At the time of the heart attack, there is an urgent need to restore the blood flow of block coronary artery which is usually not possible with medicines alone. Angioplasty is the most effective and definite way of opening the artery urgently in such situation.

SHOULD ALL BLOCKAGES BE OPENED UP BY ANGIOPLASTY AND STENTING?

NO, all blockages do not warrant this procedure. There is some amount of risk involved in the angioplasty procedure itself. When the risk of blockage is considered more than the risk of opening the artery then the procedure is indicated. Patients who are doing good on medicines may be followed up without angioplasty.

All About Angioplasty!

Coronary artery blockage is the most common heart disease and also causes of premature death in the present era. Comparatively, male sex is more prone to the Arterial Blockages than females. Heart muscles need a regular blood supply, oxygen molecules and nutrients to function properly. Heart muscles need a regular blood supply, oxygen molecules and nutrients to function properly. Coronary arteries are those which supply blood to the heart muscles, any blockage in the coronary arteries causes decreases the supply of blood to the heart muscles. Coronary artery blockage is caused due to the build-up of the cells, fat and cholesterol which is called as plaque, which leads to lack of blood supply to the heart muscles.

When the person is active and takes too much stress, the heart needs, even more, blood supply, but when the coronary artery is blocked then there will be a lack of blood supply to heart muscles, such a condition is known as ischemic heart disease. Common symptoms of ischemic heart disease are

Irregular heart rhythm

Shortness of the breath

Angina pain

Tightness in chest

These symptoms take time to appear, but with the gradual decrease in oxygen supplied by the blood the muscles of the heart can get damaged, sometimes even permanently and that is what happens in a heart attack. If someone is suffering from ischemia since long, then it can lead to irregular heartbeat and heart failure.

Tests conducted for detecting coronary artery disease:

Electrocardiogram

Exercise Stress

Nuclear Scan Test

Stress Thallium Test

Cardiac Catheterization

You doctor based on your medical history and symptoms will refer a particular test.

Treatments

If the coronary artery disease is diagnosed, then there are a number of ways it can be treated including lifestyle changes, medication, procedure or surgery

Lifestyle changes: It includes daily exercise, changes in the diet and strictly no smoking

Medication: In the allopathic system of medicine, medication can only help treat the symptoms of blocked coronary arteries, it cannot fix them.

Ayurvedic Approach: The way of understanding of medoroga prakarana according to yogaratnakara and other acharyas are unique. Even stoulya and medoroga is caused due to medo vruddi. Our acharya explains stoulya prakarana and medo roga prakarana in separately. It indicates that Stoulya includes fatty deposition in the adipose tissue. Likewise Medo roga including fat molecules and plasma cholesterol in the blood. Due to the more quantity of the fat molecules and plasma cholesterol in the blood, it can cause several disorders including coronary artery blockage, gallbladder stones, PCOD, Hypothyroidism, X-syndrome etc.

Clinically sometimes a person may be lean but can suffer from coronary artery disease or gallbladder stones, hypercholesterolemia, higher plasma cholesterol levels. Sometimes, we can t find these conditions in obese persons, but they are more at risk of suffering from these problems.

Ayurvedic Medication:

Line of treatment:

Hrudya vati 1000mg 2 times a day before food can be helpful

Anarsha Kshara 3 pinch before food.

Sukha virechana Churna 1tsb after food will surely help

Note:

At the plaque formation stage in arteries and before the thrombus (blood clot) formation, plasma cholesterol management is required and for this Hrudya vati is highly recommended
With the help of above mentioned ayurvedic medicines, we can easily treat coronary artery blockage of 10 to 100%, without any stent or bypass surgery
Anupana: Water, Honey or Ghrutha
Other indications

Prevention of heart attack

Increased blood cholesterol (Lipid Profile Abnormalities)

Gall Bladder Stones

PCOD

Hypothyroidism

Metabolic X-Syndrome.

Conclusion

Coronary artery Blockage is caused due to Medo Vruddi in the blood that may accumulate in the coronary artery vessels. And, will eventually cause ischemia in the heart muscles i.e. craving of the oxygen supply to the heart muscles. That may produce the symptom like irregular heart rhythm, shortness of the breath, angina. After that, it may lead to thrombus formation and can cause myocardial infarction.

Serological Study: Sometimes 100% blockage with cholesterol, fat molecules and cells i.e. Plaque may not show any symptoms, but sometimes even 20-30% of blockage can show all the symptoms. So in the higher cholesterol level or in the hypercholesterolemia conditions and in the early stages of the Plaque formation, one should take medication.

Scientific study:- By observing different scholar s scientific study of all the ingredients of Hrudya vati with respect to regularization of cholesterol level and break down of Plaque formation, we concluded that Hrudya Vati is the drug of choice for the coronary artery blockages.

Animal experiment: Also for further study we conducted an animal experiment on mice in Govt M-Pharma College Bangalore. Experiment result shows serum cholesterol level becomes normal. So that it can prevent the coronary blockage, and reverse the coronary artery blockages.

Clinical study: Through the Clinical study we observed that at the stage of plaque formation in the coronary artery and other arteries can be removed permanently that is 100% by advising Hrudya Vati. 

No need to go for any stunt or bypass operation. With this medication can clear the pathway of the blood vessels, also prevents the blockages & heart attack. In case, there is a family history of heart attack and your blood cholesterol is high, it is advisable that you take at least one course of Hrudya vati, once a year. So, everyone must try to understand the condition of the coronary artery blockage and prevent further complications based on the evidence.

Ayurvedic Treatment For Coronary Artery Blockage Without Surgery!

The coronary arteries supply the heart with oxygen-enriched blood and nutrients. If these arteries become damaged or diseased; they could cause Coronary artery disease or CAD. Plaque deposits on the walls of the arteries are the most common cause of this disease. This plaque is usually the result of high cholesterol levels. As the plaque builds up, the passage of blood flow is reduced. This reduces the amount of blood that reaches the heart. In cases of a complete blockage, CAD can even cause a heart attack. Because of its slow progression, this disease is often not diagnosed until it reaches a dangerous stage. However, it can be prevented and treated if diagnosed in time.

In the early stages of CAD, symptoms are not very noticeable. Symptoms become visible only when blood flow to the heart reduces and the heart has to pump harder than normal. The most common symptoms experienced include:

Chest Pain: This is also referred to as angina. It may feel like a tightening of the chest or pressure on the chest as though someone is pressing against it. This type of chest pain may be triggered by emotional or physical stress. It is usually relieved within a few minutes of stopping the activity. Women may experience this pain as a sharp, fleeting pain in the back, arm or neck.
Breathlessness: When the heart does not receive enough blood, it has to work harder to pump blood through the body. This may be translated to breathlessness of shortness of breath when performing any type of physical activity. It can also cause extreme fatigue.
Heart Attack: A heart attack is the most severe symptom of coronary artery disease. This is caused by the complete blockage of a coronary artery. A heart attack can occur without any symptoms or be preceded by slight symptoms. The signs of an impending heart attack include pain in the chest and shoulder, shortness of breath and extreme sweating. The chest pain may also travel to the lower jaw. These symptoms are more pronounced in men as compared to women. Women have a higher tendency of experiencing atypical signs such as extreme fatigue.
Other symptoms that might indicate coronary artery disease are dizziness, nausea and an irregular heartbeat. The good news is that this disease can be prevented. Staying physically active, maintaining a healthy weight, reducing stress and eating a low fat and low salt diet can help reduce the risk of CAD.

Coronary Artery Disease (CAD) - What Are The Symptoms?

The heart pumps pure blood to all parts of the body through a network of arteries. These are thicker in the beginning and become finer and thinner as they reach the various organs. These arteries are lined by a layer of epithelial tissues and as blood flows through them, the heavier cholesterol / fat molecules settle down along the walls. 


This attracts more and more fat molecules to settle down.  This is known as atherosclerosis (hardening of the arteries). Over a period of time, the vessels circumference reduces and the blood supply to the target organ reduces. This impacts proper functioning of these organs and when this happens to the major organs like the heart, kidney or the brain, conditions like stroke or thrombosis or heart attack can occur.


This condition, known as coronary artery disease, is becoming a major cause of deaths.  While that is the bad news, the good news is that it is largely lifestyle dependent, and if steps are taken, it can be prevented, and in the early stages, the damage completely reversed.


Preventive measures: 
1. Diet: A low-fat, high-fiber, heart-healthy diet consisting of Omega-3 fatty acids is recommended by doctors, especially to people who are prone to develop heart disease.  This also requires reduced salt, increased unsaturated fats, reduced triglycerides and reduced sugar.  Include loads of fresh fruits and vegetables, whole grains, nuts and seeds and fish oils. Include multivitamins or other supplements after checking with your doctor.


2. Exercise:  Regular exercise in any form increases the efficiency of the circulatory system, keeps the cholesterol levels in check and helps in blood pressure management.  Exercise in any form is advisable, based on individual preference. A moderate physical activity of 30 to 45 minutes per day is advisable.


3. Smoking: This is one of the major risk factors for smoking, and quitting or controlling smoking is one of the best methods to prevent coronary artery disease.


4. Alcohol consumption:  While moderate alcohol consumption is believed to be healthy for the heart, excessive alcohol consumption is a strict no-no.  Binge drinking especially is shown to cause heart attacks.


5. Weight management: Check with your doctor on what is ideal BMI for you and work out a plan to keep your weight under check.


6. Regular medications: If you are on blood pressure or diabetes medications, ensure you do not miss them.  Keep a constant check to ensure your readings are managed well. 


7. Watch out:  Ask your doctor if there are specific symptoms that you need to watch out and seek medical support if you see any of them.


Coronary disease is not treatable fully, but can be prevented and managed effectively to improve the overall quality of life.

Coronary Artery Disease - 7 Ways You Can Prevent it 

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