Coronary artery disease
Cardiologists at the nationally ranked Duke Heart Center are leaders in the diagnosis and treatment of coronary artery disease. With clinic locations throughout the Triangle, including Raleigh, we identify coronary heart disease at its earliest stage, and use lifestyle changes, as well as medical and surgical techniques to prevent serious complications like heart attack. If you have advanced coronary artery disease, our cardiologists and surgeons use the latest techniques to open narrowed or blocked coronary arteries and improve your condition. We routinely perform successful heart bypass surgery on people who have been told their blockages are too complex to bypass. Our goal is to restore normal blood flow to your heart and return you to your normal activities.
Expert prevention and treatment of coronary artery disease
Your coronary arteries supply blood, oxygen and nutrients to your heart. Coronary heart disease develops when the arteries become narrowed or blocked by a buildup of plaque. Over time, the disruption of blood flow may cause chest pain, also known as angina, and shortness of breath. As it progresses, coronary artery disease may lead to heart attack and seriously damage your heart muscle.
Our goal is to identify coronary artery disease at the earliest possible stage. We engage you in an active prevention and treatment program to manage your coronary artery disease and prevent heart attack from occurring. If your disease is advanced, we have the skill and expertise to perform successful heart bypass surgery using minimally invasive and open heart surgery techniques. We routinely treat people with multiple and complex blocked arteries. And, our involvement in clinical trials means you gain access to the most advanced therapies for coronary artery disease before they become widely available.
Choose a Duke heart clinic for your coronary artery disease treatment because we offer:
- Top-ranked care. U.S. News and World Report ranks Duke Heart Center 5th in the nation, based on our patients’ survival rates, the number of procedures we perform and the quality of our support services.
- Better outcomes for heart bypass surgery. Our cardiac surgeons have performed more than 20,000 heart bypass surgeries to date, and achieve survival rates that are consistently higher than the national average. We perform heart bypass surgery, also known as coronary artery bypass grafting, on high risk patients, as well as patients with complex conditions involving multiple blockages or blockages in difficult-to-reach locations.
- Ongoing clinical trials. You may be eligible to participate in studies investigating new therapies for coronary artery disease. Currently we are exploring the use of stents made of biodegradable material, which open blocked arteries, and stem cell therapy which may aid in the growth of blood vessels and alleviate chest pain known as angina.
- High volume heart catheterization program. We perform more than 12,000 diagnostic catheterization procedures and 3,000 interventional catheterizations each year. Our research in angioplasty, also known as percutaneous coronary intervention (PCI), identifies the best time to use PCI to open blocked arteries, and the most appropriate candidates for the procedure.
- Minimally invasive options. Whenever possible, we use small incisions to remove or harvest veins from one part of the body during bypass surgery. Your surgeon uses the harvested veins to bypass, or create a new pathway around the blocked vein. This method can reduce pain and scarring associated with surgery that requires larger incision. It may also shorten your recovery period.
- Personalized risk factor management program. We offer one-on-one exercise and nutrition counseling, high blood pressure management and more through our cardiac prevention and rehabilitation program.
CORONARY ARTERY DISEASE
Our cardiac prevention and rehabilitation program gives you access to medically supervised exercise programs, nutrition and weight loss counseling, high blood pressure management to help you manage coronary heart disease and return to normal activities.
Statins, antihypertensives, aspirin and nitroglycerin may be recommended to help you lower your blood pressure, prevent blood clotting and improve blood flow to reduce chest pain.
Inflatable cuffs are placed on the lower limbs to compress the blood vessels and improve the flow of oxygen-rich blood to the heart. Successive treatments are used to alleviate angina or chest pain.
Also known as percutaneous coronary intervention. Restores blood flow to the heart quickly. A balloon-tipped catheter is threaded through a blood vessel to reach the heart. The balloon is opened and a metal mesh tube or stent is used to open the artery and restore blood flow. Our specialists have extensive experience using advanced angioplasty techniques to tunnel through an artery that is almost completely blocked -- a condition called chronic total occlusion -- and restore blood flow.
Also known as coronary artery bypass grafting (CABG). Implants veins taken from elsewhere in the body to reroute blood flow around a blocked artery. Depending on your condition, heart bypass surgery is performed through a large chest incision or through smaller incisions through which robotic tools may be used to enhance surgeons’ visualization and ability to access the heart. The minimally invasive methods often result in less scarring, less blood loss and a faster recovery. In both open heart surgery and minimally invasive methods, a heart-lung bypass machine, or pump, may be used to still the heart while maintaining blood flow through the body. Your surgeon will choose the procedure that is most appropriate for you.
When appropriate, interventional cardiologists and surgeons work together in our hybrid operating room to perform multiple procedures. This shortens the procedure time, and helps you recover faster.
CORONARY ARTERY DISEASE
To determine whether the coronary arteries are narrowed or blocked by plaque build-up, we use a variety of advanced technologies, including:
Radio waves, magnets and a computer create still and moving images of the heart and vessels to show details of the heart structure, function and blood flow.
Small electrodes are placed on the skin to record the heart’s electrical impulses to evaluate heart muscle damage and whether the heart is getting enough oxygen. When an ECG is performed while you walk on a treadmill or ride a bike, it measures the heart’s function during exertion, and is called a stress test.
Contrast agent is injected into your arm and a CT scan produces highly detailed 3-D images of your coronary arteries.
3-D images of the heart and arteries are created after a radioactive substance is injected into your blood vessels.
Interventional cardiologists guide a catheter through a small incision to your heart. Contrast dye and X-rays are used to capture images inside the heart, coronary artery and blood vessels. Determines the extent of disease and pinpoints the location of blocked arteries.