Inside Jeremy Clarkson underwent emergency heart surgery as Grand Tour star reveals ‘s*** week’ as his DOG also goes under the knife

by Mia de Graaf, American health editor

Stents keep the arteries open to help improve blood flow to the heart and relieve chest pain.

Former chairman of the American Heart AssociationDr. Sidney Smith, MD, told DailyMail.com how stents work and when they are placed.

HOW IS THE PROCEDURE CARRIED OUT?

A stent is a wire mesh tube that supports open arteries.

To open the narrowed artery, the surgeon can perform a so-called angioplasty.

This involves making a small incision in a patient’s arm or leg, through which a wire with a deflated balloon attached to it is guided to the coronary arteries.

In some cases, this is all that is needed to break the blockage, without the need for permanent vein openers to be placed.

However, surgeons sometimes place a stent to keep the arteries open.

The stent surrounds the balloon and expands when it is inflated.

After the balloon is deflated and removed, the stent remains permanently in the artery.

HOW COMMON IS IT?

Angioplasties are becoming more common in the United States and Mexico due to the rising number of heart problems.

And stents are becoming increasingly common in angioplasty patients, as it is very common for the arteries to narrow again if nothing is placed (this is known as restenosis and occurs in about a third of cases).

CAN IT BE PERFORMED DAYS OR WEEKS AFTER A HEART ATTACK?

Yes, depending on the type of heart attack.

There are two types of blockages: a STEMI (which is a complete blockage) and an NSTEMI (a partial blockage).

STEMI stands for ‘ST-elevation myocardial infarction’, which means the patient has had changes in cardiac enzymes and changes in cardiac electrical activity, as seen on an ECG scan.

A non-STEMI heart attack, or NSTEMI heart attack, is less urgent. It means they have had enzyme changes, but no changes on their ECG.

“A STEMI is a very large, severe heart attack in which a patient comes into the emergency room and the artery is completely blocked, and needs to be opened immediately and the stent placed,” says Dr. Smith, professor of medicine, cardiology, School of Medicine of the University of North Carolina, explained.

‘That is the patient who will be operated on immediately.’

‘In other cases, the patient may have a non-STEMI. They may have chest pain and come to hospital with changes in enzymes, but no changes in their ECG (electrical activity of the heart). The need is not urgent. Stents are placed, but it could also be days later.’

WHY SHOULD A PATIENT RECEIVE MORE THAN ONE STENT AT A TIME?

It depends on how many blockages they had, or how many blood vessels were affected.

“The decision to place stents in the coronary arteries is based on the number of significant blockages present there,” Dr. Smith explains.

‘Three is not unusual. Sometimes you only put one, sometimes two or three – it all depends.

‘Stents are placed where there is a significant blockage. There may have been two or three ships involved, or three blockades in one ship. That would justify three stents.’

He adds that the amount of blockages has nothing to do with the severity of the heart attack, or whether it would be a STEMI or NSTEMI.

HOW IS THE RECOVERY?

Patients treated for chest pain can usually go home the same day of surgery. Patients are often advised to avoid strenuous activities and driving for at least a week.

But Dr. Smith said it depends on each patient, especially whether they have other underlying health conditions.

“It depends on how well their heart is pumping,” Dr. Smith said.

‘Patients can often go home within 24 hours, usually for cardiac rehabilitation.’

As for the patient taking a transatlantic flight, Dr. Smith said this would have to be decided on a case-by-case basis.

“It depends on how they are doing and how long the flight is,” he said.

• Any reader who thinks he or she has had, or has had, a heart attack should never self-diagnose. Always call 911 if you think you are having a heart attack. The paramedics in your ambulance will guide you to the right hospital based on your location