ABSTRACT
Coronary artery and valve disease (see Chapter 29) remain major causes of UK mortality, especially among older people. ST elevation myocardial infarction (STEMI, also called ST elevation acute coronary syndrome – STE-ACS) should be treated by urgent transfer for primary percutaneous coronary intervention (pPCI) (Antman et al., 2008; di Mario et al., 2008). With other cardiac disease, when drug therapies cannot support cardiac failure, percutaneous intervention or open-heart surgery may be needed either to repair or replace damaged tissue. Outcomes (survival and quality of life) for both are good, and have been for many years. Percutaneous and open surgery may be used to repair or bypass occluded coronary arteries or repair valves. This chapter also describes heart transplants. Intra-aortic balloon pumps and ventricular assist devices (means to support failing hearts) are described in Chapter 31. Immediate post-procedure nursing care largely follows from actual and potential problems created by procedures.
