What Is Reperfusion Therapy?

Reperfusion therapy is a type of treatment wherein blood is immediately reintroduced to the heart after the patient has suffered from myocardial infarction, or heart attack in layman’s term. In this way, the heart is also supplied with oxygen, and further damage to the muscle is prevented. There are typically three types of reperfusion therapy: coronary artery bypass, percutaneous coronary intervention (PCI), and thrombolytic therapy.

The main principle behind reperfusion therapy is to open up any blockages in the arteries, whether by medication or by a cardiac surgery. Among the three types, the thrombolytic therapy specifically uses “clot-busting” medication in order to disperse blood clots formed by plasma and other protein cells. It is often administered to the patient intravenously and is most effective when given as early as possible after symptoms are experienced, preferably no later than 12 hours. There are some contraindications, however, that prohibit patients from choosing thrombolytic therapy, such as a recent stroke or a diagnosis of uncontrolled hypertension. This is because the drugs typically thin the blood and can induce bleeding.

Another type of reperfusion therapy is the coronary artery bypass, a surgical procedure often done to reduce symptoms of angina, wherein the coronary arteries are blocked. Typically, a surgeon harvests a blood vessel from either the leg or the arm, and surgically grafts it to the blocked artery by suturing. This technique does not really “unclog” any blocked arteries, but rather redirects or “bypasses” the blood flow by introducing a more spacious passageway. A coronary artery bypass is often done as an “open-heart” surgery that creates an incision in the chest, exposing the heart. Surgeons, however, have developed other methods that can use a coin-sized hole to operate on the heart.

Another type of reperfusion therapy is the PCI, or more commonly known as the angioplasty. This is often selected if the arterial blockage is caused by high levels of cholesterol that thicken the arterial wall. The procedure begins with inserting a very thin wire through the narrowed vessel, and then a small tube called a catheter is inserted, with a fine wire mesh wrapped over it. Once the catheter is in place, a small balloon inside it is inflated, which reopens and widens the arterial opening. The catheter and the thin wire are extracted, but the wire mesh remains inside.

Reperfusion therapy is one of the treatments for patients suffering from or at risk of having a heart attack. It can raise a patient’s chances of survival by 50%, and improve his quality of life. In order to choose the most suitable type of reperfusion therapy, the patient must be examined through an electrocardiogram (ECG) and should seek the expertise of his cardiologist.