Percutaneous Coronary Intervention What Is Coronary Angioplasty (PTCA)?
Coronary angioplasty (Percutaneous Transluminal Coronary Angioplasty) is a medical procedure used to open narrowed or clogged blood vessels of the heart. A thin balloon is threaded through a blood vessel in the groin or arm into a heart (coronary) artery. The balloon is inflated to compress the blockage and stretch the artery open.
Why Do I Need Angioplasty (PTCA)?
Angioplasty is used if you have coronary artery disease (CAD) to:
Relieve chest pain caused by reduced blood flow to the heart
Minimize damage to the heart muscle during a heart attack , which occurs when blood flow is totally cut off to an area of the heart
CAD develops over time as fatty deposits, called plaque, build up on the inside walls of the coronary arteries. The built up of plaque narrows the arteries, reducing the flow of blood to the heart. This is called atherosclerosis .
How Do I Get Ready For My Angioplasty?
It is important that you do not eat or drink anything 12 hours before the scheduled time of your examination. You may have a small amount of water with any medications you need to take. Be sure to ask your doctor if you have any questions about eating or drinking before your examination.
Prior to your angioplasty you will be visited by our Consultant Cardiologist who will explain the procedure to you. At that time you should ask any questions you may have about the angioplasty. If you have any allergies or problems with medications or think you might be pregnant and allergic to X-ray dye, iodine, or shellfish, it is important to let your doctor know as soon as possible. You will be asked to sign a special form giving the doctor permission to perform the angioplasty.
Everyone having an angioplasty will have blood tests done prior to the procedure. Your groin will also be shaved on one or both sides where the doctor will insert the catheter. Sometimes the arm may also be prepared in this way. You could be asked to remove your jewelry and dentures if any. You will be asked to put on a hospital gown. It is advisable to go to the bathroom to empty your bladder before you leave your room. While this examination is being done, your family can wait in one of the hospital waiting areas.
What Happens When I Get To The Cardiovascular Catheterization Laboratory?
In the Cardiovascular Catheterization Laboratory (CVL) you will see plenty of special equipment. The staff will position you on the procedure table and begin to prepare you for the procedure. This includes monitoring of your heart and blood pressure. If you do not already have an IV (intravenous) line, the nurse will insert one so that you can receive fluids and medication during the procedure.
The doctor will use the IV line to give you fluids and medications. The medications are given to relax you and prevent blood clots. The rest of your preparation includes:
Staff in the lab will place ECG electrodes on your chest to monitor your heart continuously during the procedure.
Cleaning the shaved area to make it germ free.
Numbing the area (the numbing medicine may sting as it is going in).
What Is An Angioplasty Like?
Once you are comfortable, the doctor will begin the procedure:
A small cut is made in your groin or arm. The doctor threads a very fine catheter or tube through a blood vessel to the area of the coronary artery that is blocked.
A small amount of dye is injected into the tube. An x-ray is taken so that your doctor will be able to see the coronary arteries, valves, and chambers of your heart.
Once the blockage is reached, your doctor will inflate the balloon attached to the tube. The balloon will widen the artery to increase the flow of blood to the heart muscle.
A special device may be used to remove some of the plaque from the wall of the artery.
A stent is usually placed at the site to keep the artery open. The stent remains in place forever.
When the doctor finishes, the inner catheter and other devices are removed from the blood vessel. The outer catheter may remain in place, or if a closure device is used, all tubes will be removed.
Recovering
After the procedure, you will be moved to the Intensive Care Unit where:
You will need to lie flat in bed. Do not bend your legs. You will need to lie flat longer if no closure device is used. If the angioplasty was performed in your arm, you do not need to lie flat.
When the catheter is removed later, pressure will be applied to the site.
You will have to lie still for about 4 - 6 hours to allow the punctured site in your leg to seal completely.
Afterward, you may walk with assistance.
As you recover, the nurses will check:
Your heart rate and blood pressure.
Your groin or arm for bleeding.
The place where the tube was inserted may feel sore or tender. This may last for about one week.
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