| SURGERIES OF THE HEART |
Coronary Angioplasty
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OTHER NAMES OF THE PROCEDURE
Balloon Angioplasty, Percutanous Transluminal Coronary Angioplasty [PTCA], Percutaneous Coronary Revascularization
Balloon Angioplasty is the insertion of a catheter carrying a balloon, through an artery in the groin or arm, into a blocked artery in the heart. The balloon is quickly inflated and deflated to open the artery to allow blood flow.
REASONS FOR THE PROCEDURE
The main reason for the procedure is to open a blocked artery in the heart to allow more normal blood flow through that artery.
RISK FACTORS FOR COMPLICATIONS DURING THE PROCEDURE
* Allergies to medications, shellfish, or x-ray dye
* Obesity
* Smoking
* Bleeding disorder
* Age: 60 or older
* Recent Pneumonia
* Recent Heart Attack
* Diabetes
* Kidney Disease
* Angina
* Hardening of blood vessels
BEFORE THE PROCEDURE
The patient may be asked by the doctor to likely undergo the following:
* Blood tests, especially if you are taking certain medications (high blood pressure pills, blood thinners, heart medications)
* Electrocardiogram(ECG,EKG) – a test that records the heart's activity by measuring electrical currents through the heart muscle.
* Chest X-ray
And in the days before the surgery -
* The night before, eat a light meal and do not eat or drink anything after midnight.
* You may be asked to shower the morning of your procedure, and you may be given special antibacterial soap to use.
* Arrange for a ride to and from the procedure.
* Arrange for help at home after returning from the hospital.
DURING THE PROCEDURE
The patient is given the following during the surgery -
* IV fluids
* Fluoroscopy/X-rays
* Heart rhythm monitoring
* Sedation
* Local Anesthesia
* Possibly the blood thinner heparin to decrease the risk of blood clots
* Pulse oximetry to monitor blood oxygen levels
PROCEDURE
The area of the groin or arm where the catheter will be inserted is shaved, cleaned, and numbed with local anesthetic. The doctor inserts a needle into the artery, and a wire is passed through the needle. The wire is guided through the arterial system until it reaches the blocked artery in the heart. Next, a soft, flexible catheter tube is slipped over the wire and threaded up to the blockage.
This procedure is monitored using a continuous x-ray image called Fluoroscopy. Dye can be injected through the catheter into the arteries of the heart to better visualize the arteries and the blockages. Once the blockage is reached, a small balloon at the tip of the catheter is rapidly inflated and deflated, stretching the artery open. The deflated balloon, catheter, and wire are then removed, and a bandage is placed over the groin or arm area. Depending on the size and location of the blockage, your doctor may insert a small mesh tube, called a Stent (a metallic scaffold that is inserted into a vessel to prevent its narrowing), in the newly opened area to prevent the artery from narrowing in the future.
AFTER THE PROCEDURE
If the catheter was inserted through the groin, the patient will need to lie flat on the back, keeping the leg still for about six hours after the procedure. One may have a sandbag placed over the area in the groin where the catheter was inserted to put pressure on the artery and prevent bleeding. If the catheter was inserted in the arm, the patient will be required to keep the arm straight using an arm board.
TIME TAKEN FOR THE PROCEDURE
Upto 3 hours
POSTOPERATIVE CARE
* The patient may be sent home on blood thinning therapy, either aspirin or another medication, such as warfarin or agents that inhibit platelets clumping (eg, Plavix).
* To minimize pain and soreness, the patient can place ice at the insertion area for 15-20 minutes each hour, for the first two days. After this time, switch to a heating pad or hot water bottle.
* To lower the risk of recurrent blockages in the coronary arteries and further heart disease, make lifestyle changes, including eating a healthier diet, exercising regularly, and managing stress.
* One may need to undergo periodic stress tests to monitor for any early-on recurrent blockages.
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| Last Modified :
Monday, May 11, 2009 |
Compiled and edited by the Editorial team and
approved by Expert panel of h4heart.com
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