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The National Cardiothoracic Centre (NCTC) of the Korle Bu Teaching Hospital has successfully carried out a ground-breaking heart surgery without opening the chest of the patient. The one-hour coronary stenting surgery on a 50-year-old Nigerian could have taken five hours if the heart surgeons had used the normal open-heart procedure. Coronary stenting surgery A coronary stenting surgery involves placing a tube in the coronary arteries which supply the heart with blood to keep the arteries open in the treatment of coronary heart disease; the most common type of heart disease that leads to heart attacks. A stent is a tiny, expandable mesh tube made of medical-grade stainless steel or cobalt alloy metal. Three doctors, led by the Director of the NCC, Dr Lawrence Agyemang Sereboe, performed the surgery on Mr Muhammed Diggol from Kano State, Nigeria, who was diagnosed of severe heart pains which made it difficult for him to breathe properly. Other members of the team were Dr Abdul-Samed Tanko, Head of the Cardiology Unit, and Dr Martin Adu Adade, a cardiologist. Press briefing Dr Sereboe told newsmen in Accra yesterday that although the coronary stenting surgery was being practised, the absence of trained medical personnel had made it difficult for the procedure to be used for patients in Ghana. �Now we have experienced and trained medical personnel available and patients with early heart-related diseases can seek treatment without having to travel outside the shores of Ghana,� he said. Dr Sereboe said until the introduction of the coronary stenting surgery, patients suffering from heart diseases underwent surgical operations which took about five hours. �But now that the new procedure is available, it will take only one hour for an operation,� he added. Dr Sereboe also noted that the new procedure was used to treat patients suffering from coronary artery diseases (CAD). Coronary artery diseases Coronary artery disease, also known as atherosclerotic heart disease or coronary heart disease, is the most common type of heart disease and cause of heart attacks. It is caused by plaque building up on the inner walls of the arteries of the heart, which narrows the arteries and reduces blood flow to the heart. While the symptoms and signs of CAD are seen in the advanced stage of the disease, most individuals with CAD show no evidence of the disease for decades as the disease progresses, until the first symptom, often a "sudden" heart attack, finally manifests itself. Symptoms of coronary heart disease include angina (characteristic chest pain on exertion) and decreased exercise tolerance. The narrowing of arteries increases with age, smoking, high blood cholesterol, diabetes, high blood pressure, and is more common in men and those who have close relatives with CAD. Other causes include coronary vasospasm (a spasm of the blood vessels of the heart, which is usually called Prinzmetal's Angina). Cost of the operation Dr Sereboe said treatment of the condition was about 5,000 euros. �A patient needs about $25,000 for similar operations to be conducted if he or she is to travel outside the country,� he added. The cost of an open-heart surgery is about 10,000 euros, making the coronary stenting surgery cheaper. Government support Dr Sereboe also said although the NCC had medical personnel to undertake heart operations, �we need government support in terms of the provision of facilities to enhance the work of the medical personnel�. The Stent Procedure Explaining how the procedure worked, the Head of the Cardiology Unit of NCC, Dr Abdul-Samed Tanko, said the stent was mounted on a tiny balloon that was placed inside a coronary artery to push back plaque and restore blood flow. �After the plaque is compressed against the arterial wall, the stent is fully expanded into position, acting as miniature �scaffolding� for the artery. The balloon is then deflated and removed, and the stent is left in the patient�s coronary artery to help keep the blood vessel open,� he said. For some patients, it may be necessary to place more than one stent in the coronary artery, depending on the length of the blockage.