Cardiovascular disease jumped to the top of the list of causes of death in China several years ago, and the population of patients with coronary heart disease is huge, with significant harm and often the culprit of “premature death”. Interventional therapy is currently one of the most important treatments for coronary heart disease. 1.Does the onset of coronary heart disease have anything to do with age? Coronary heart disease in the narrow sense refers to the disease caused by the narrowing of blood vessels due to atherosclerosis of coronary arteries. Atherosclerosis begins to appear in its earliest form in the 20s, and only begins to cause disease as it accumulates over time in middle and old age, but in recent years, probably due to some bad habits and underlying diseases including hypertension and diabetes that affect more patients, coronary heart disease patients are getting younger and younger. 2, coronary heart disease has a specific high prevalence of people? This is called the susceptible population of coronary heart disease, epidemiology has been relatively clear, including “three high” (high blood pressure, high blood pressure, high blood sugar), bad habits (lack of exercise, abdominal obesity, smoking, etc.) and genetic factors (family early onset of coronary heart disease), etc., will make the incidence of coronary heart disease is greatly increased. 3.What are the methods of surgical treatment for coronary heart disease? If coronary artery disease involves surgical treatment, there are generally two situations: First, an acute event occurs, which is called “acute coronary syndrome” in professional terminology, and this situation can make the patient rapidly become dangerous and life-threatening if it is serious. The second is when the patient has reached a significant degree of coronary stenosis that induces ischemic symptoms, such as typical angina pectoris. These two conditions force the patient to opt for surgical treatment. The surgical treatment of coronary artery disease is divided into medical and surgical means, and nowadays the more carried out is the medical interventional treatment, and there is a more traditional and longer history of surgical bypass surgery. 4.What is stenting for coronary artery disease? Stenting (percutaneous intervention) is a technique that has been developed and matured in the last 20 years or so to correct stenosis or blockage of the coronary arteries in the heart. Simply put, the procedure of cardiac stenting treatment involves puncturing a blood vessel, thereby delivering a catheter to the opening of the coronary artery, using a special delivery system to deliver the stent to the site of the stenosis for release, and finally withdrawing the catheter to end the procedure. Of course, not all interventions involve the placement of stents, but there are also balloon dilatation (including drug balloons), as well as other techniques such as rotational laparoscopy and laser ablation. 5.Stents are foreign bodies and will be rejected, so they cannot be installed? This is also a problem that many patients, including their families, worry about and are concerned about. The early stent is a kind of stainless steel called 316, and now many manufacturers have also developed alloy stent as a kind of metal stent material. A simple analogy can be understood, after the fracture to do internal fixation, need a plate, no one seems to question this plate implanted in the body will be rejection, although this probability from the medical point of view is not absolutely no. The probability of our body developing allergies to metals is very, very small. In clinical practice, there is no clear evidence of a typical allergic or rejection reaction caused by metal in a patient after stent implantation. In addition, when it comes to rejection, the word “rejection” is more often used in organ transplantation, that is, when you implanted another person’s tissue or organ, because the body’s histocompatibility will produce rejection, which is actually two concepts and we say that the implantation into the body is a certain metal or artificial parts. 6.Do I need to install the new biodegradable stent (BVS)? Biodegradable stents (BVS) are currently a very hot research area in the field of cardiovascular intervention. Since it is a research hotspot, it means that it is not yet mature enough to reach every patient. 2011, the US FDA approved the first absorbable stent to be marketed, but there are clinical trials of domestic and foreign absorbable stents, including our domestic clinical trials, and the clinical data we have got so far in Europe and other regions do not support that biodegradable stents can completely replace the more mature drug-coated stents. The characteristics of BVS are: first, it is highly case selective and not all patients are suitable for implantation; second, its surgical procedure is more complicated than the existing stent implantation process. 7, the body can be installed up to 5 stents, any more will “fail”? This is also a question we often hear in clinical practice. Many patients and family members will be more torn about the number, you have 3, I have 2, then I am better than you. Or some say more than how many is ineffective. In fact, in terms of caliber, the smallest stent is 2.25mm stent, to the largest 4mm stent, and if it is short, there is 8mm, and the longest is 38mm stent. So it has different specifications and sizes, and the length of the patient’s lesion is diffuse or limited, which varies greatly from person to person. From the point of view of receiving interventional treatment, it is only necessary to consider that I choose this treatment, to know the pros and cons, and eventually to cover these segments that are necessary to implant stents well through the doctor’s judgment, and the lumen will be restored to the normal diameter. But because of the wide variety of patients and different types of lesions, doctors do not simply obsess about how many must be used to solve the problem. In terms of prognosis, if you implant a lot of stents, I can only say that the lesion is really too diffuse and too long, which is determined by the pathological characteristics, not how many stents to determine your prognosis. 8, installed stent can not be strenuous exercise, or you exercise, it “move”? The purpose of medical treatment is to prolong the life of patients, and to improve their quality of life. If we look at it from the perspective of severe stenosis of coronary heart disease, when your blood vessel is severely stenosed, even if you have no significant symptoms, in fact you are in a relatively dangerous state, through our active treatment, so that his lumen has returned to the normal diameter, blood flow a smooth, the distal myocardium to restore the normal blood supply, at this time from the heart function, your problematic organs have been repaired, more should You should not feel psychologically that I am a patient, or that I have implanted a foreign body with great pressure for me, and that I cannot do this or that from now on, and the quality of life is greatly affected, which is completely contrary to the original intention of our medical treatment. 9. Do I have to take medicine every day if I have a stent, but not if I don’t? We can say that we do not need to be particularly negative after the stent is installed, but should face life more positively. Many patients simply understand that our treatment is one or the other, either conservative treatment with medication or aggressive treatment with surgery, either one or the other, which is a very big misunderstanding and will greatly reduce our ultimate efficacy. Regardless of the treatment option chosen, medication is the root of all treatment. On this basis, if your condition dictates that you must choose surgical treatment, then preoperative and postoperative medication and long-term postoperative follow-up remain fundamental, which is absolutely non-contradictory and non-exclusive. So here also need to appeal, remind the general public, if there is such a friend or relative around, you must repeatedly influence him to convince him that drug therapy is fundamental and cornerstone for the treatment of coronary heart disease. In addition, coronary heart disease, like hypertension and diabetes, is a disease that cannot be cured by current science and technology and medical treatment, and is a lifelong disease, so its treatment is also lifelong. 10.What do I need to pay attention to in terms of diet after stenting? This question can be interpreted as whether the diet structure of any patient diagnosed with coronary heart disease needs attention. The stent is just a treatment tool and will not have a huge impact on your life and make you take a different path. But if a diagnosis of coronary heart disease is confirmed especially in patients with comorbid underlying diseases such as hypertension need a low salt diet, diabetes needs to restrict carbohydrate intake and hyperlipidemia patients need a low fat diet. So we need to plan our lifestyle and restrict our diet wisely, but we should not choke on a disease that makes our life just a single medication and turn into a medicine jar, making our life uninteresting. Follow the diet of your own underlying disease is fine, do not need to pay extra attention to something because of the stent. 11.Can’t I do MRI with a stent? All the stents on the market can resist MRI detection, and even in extreme cases, it is safe to do MRI on the same day when the stent is installed today. The reason for this concern is based on two issues. Many people think that the stent is metal and MRI will suck out the stent and will produce displacement. The second problem is that the metal will generate heat under the strong magnetic field and will burn the patient. However, as we have explained earlier, the stent is propped up on the surface of the inner wall of the blood vessel, and it is very firmly integrated with the inner wall of the blood vessel, so the magnetic field of MRI will not produce any displacement for the stent which is weakly magnetic or non-magnetic itself. On the other hand, we should not forget that the temperature of 1℃ is in the pipeline with rapid blood flow, and your heat will be taken away at any time. So based on these details of the examination, we know that the stent implantation, MRI detection is safe for you for life, and the pacemaker is completely different. 12.Can I travel by airplane with a stent installed and will there be an electromagnetic reaction? If the magnetic resonance is such an artificially loaded high-intensity magnetic field for the stent, no problem will occur, not to mention the airplane ride. But some patients may have such a memory that when we go to some big airports, they will mark out that if a patient who has been implanted with a pacemaker has to go through this channel, otherwise it will call every time you go through the security gate, but the security personnel can’t find out because you have a big piece of metal implanted in your body, which is a pacemaker. That’s why some foreign airports even ask patients to show their pacemaker’s warranty card, which represents the pacemaker’s identification and proves that you are not carrying dangerous goods but have a pacemaker implanted. But the stent is a very low metal content device, not to mention the implantation of one or two stents, or even more than one, you go in and out of the security gate will not have an alarm sound, this we can rest assured. 13.Does the stent have a life span and what is the general warranty period? This is a question extended by the pacemaker, because pacemakers have a warranty card, and the national mandatory requirement is now 5-6 years, because the battery of the pacemaker has a power limit. But the stent is a metal mesh, so there is no problem of battery power or other electromagnetic reaction changes in the body after implantation. In a sense, the stent can work indefinitely in the body because it is a metal; but on the other hand, it has a finite lifetime in terms of the progression of coronary heart disease. How to understand it, the stent is implanted, because it is a skeleton network, this stage may protect you from the progression of the disease again or restenosis for eight to ten years, but this vessel is so long, does atherosclerosis occur in other parts, resulting in the reduction of the lumen area of the vessel? Actually, it has little to do with this stent and has to do with the underlying disease of the patient. If the stenosis occurs again in this stent segment, we can remedy it again by dilation, cutting, or even implanting another stent. Therefore, the lifespan of stent is closely related to the rate of progression of coronary artery disease of the patient, which varies from person to person and cannot be generalized. 14.What are the advantages of stent implantation compared to surgical heart surgery? Bypass has a long history and is more classic, but with the rise of medical interventions, the number of bypass patients may be somewhat affected. If you make a simple choice and tell the patient about the risks of your surgery, the healing of the surgery may be similar, one is minimally invasive to do a very small puncture to fix everything, and the other way to do it is to open the chest, even if it is a small incision, one of about ten centimeters. The difference in the size of these two types of incisions will induce patients, and many patients may choose to do minimally invasive interventions, and do small harm to the treatment plan. Therefore, in this regard, the efficacy is not disadvantageous. These characteristics determine that patients will tend to choose this option because of the small trauma, fast recovery and convenient application, which can even be carried out in many hospitals of not very high level in China. 15.Is interventional therapy applicable to all patients with coronary heart disease? For all unstable coronary artery disease, we call it acute coronary syndrome, and such patients should actively seek coronary angiography and then decide whether to implant stents. However, for the other type of patients with stable coronary artery disease, there are clear studies at home and abroad proving that there is little difference between stent implantation and conservative treatment with oral medication in terms of long-term prognosis and life expectancy. So at this point it can be tailored to the patient’s condition. If this patient’s symptoms are exertional angina, which are significant, then the choice between conservative or interventional treatment with drugs can be made by the patient with good communication between the patient and the physician and cannot be generalized. It should be repeatedly emphasized that for unstable coronary artery disease, especially for patients who have been clearly diagnosed with acute myocardial infarction, it is necessary to conduct wide publicity so that our patients, including their family members, can have a correct attitude toward interventional treatment and must try to trust the doctor when you are in such a dangerous situation and leave your treatment to a professional doctor who can help you because in acute heart attack Because in front of such a special and highly lethal disease, we repeatedly emphasize: “Time is heart muscle, time is life”.