Coronary angioplasty: One step away from bypass surgery

Coronary angioplasty is a procedure used to open blocked or narrowed coronary arteries, in order to restore blood flow to the heart muscle.

Basically, the doctor expands narrow blood vessel with the balloon and a stent, attached to the catheter.

It is mostly used in emergency rooms as well as in situations when a doctor concludes that heart medications are insufficient and the patient is suitable candidate which can benefit from balloon angioplasty.

USES

Since procedure restores blood flow to the heart muscle, it can be used to treat:

  • Coronary artery (heart) disease
  • Chest pain
  • Heart attack (used in emergency rooms)

When heart function is weak or there is severe case of coronary heart disease, bypass surgery is usually a better option.

ADVANTAGES

In comparison to coronary bypass surgery, there are several advantages associated with coronary angioplasty:

  • Shorter recovery time
  • Requires only local anesthesia (you won't be asleep during procedure)
  • It is simpler procedure, unlike open heart surgery

RISKS

Although it is considered relatively safe, especially in comparison to coronary bypass surgery, there are some risks involved. They may include:

  • Bleeding
  • Infection
  • Rupture of coronary blood vessel which may require open heart surgery
  • Blockade of blood vessel where the catheter was inserted
  • Heart damage or heart attack
  • Formation of small blood clots which can cause stroke
  • Allergic reaction to contrast material
  • Arrhythmia or angina (harmless palpitations and chest pain are to be expected as the balloon expands but they disappear after it deflates)

HOW TO PREPARE FOR THE PROCEDURE

The doctor will give you precise instructions.

  • You may need to shave your groins before the procedure
  • Stop taking or adjust the intake of drugs or supplements you might be taking, especially if you are diabetic or you might be taking blood thinners
  • Restrain yourself from eating or drinking, at least 6 hours before the procedure
  • Sign a consent form
  • Perform additional tests, before going through with
    coronary angioplasty

WHAT TO EXPECT DURING PROCEDURE

After you lay on the bed, the doctor will use coronary angiography, in order to find the location and to asses the extent of blockages in the coronary arteries.

Also, a small incision will have to be made, usually in the upper thigh or the arm, to insert a catheter into the artery. After that, contrast agent is injected through the catheter.

As it flows through the coronary arteries, X-ray pictures are taken. Since contrast agent is visible on the X-ray, it shows the location and the size of blockages.

When the extend of damage has been determined, another catheter with a balloon at its tip is inserted and positioned were the blockages are located.

Also, small wiry tube, called stent, is wrapped around deflated balloon catheter. Then, balloon is inflated which pushes the plaque, while expanding the stent thereby improving blood flow.

Although stent opens the artery, it also reduces the risk from narrowing of the artery, in the future. Some stents contain medicine which can be slowly released into the bloodstream, when needed.

If coronary angioplasty is preformed on just one part of the artery, then whole procedure lasts about 30 minutes. However, if numerous stens need to be implanted on other parts of the artery, then whole procedure may last up to few hours.

WHAT TO EXPECT AFTER PROCEDURE

You usually need to stay in hospital overnight for observation. When you go home, it is strongly advised that you avoid lifting heavy objects or any intense activities until small wound, where the catheter was inserted, heals completely.

Since you aren't allowed to drive any vehicle for a week, after the procedure, you should ask someone to drive you home.

Sometimes plaque can form within the stent over the next few months or years, by causing the same problems. However, this kind of risk is greatly reduced, due to advancements in medicine.

Following coronary angioplasty, bruise may form where the catheter was inserted. Although it is not dangerous, it can be sore for a few days.





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