What is cardiac angioplasty?

Coronary artery disease, or hardening of the arteries, is the most common form of heart disease in the United States. It can coexist with other forms of heart disease such as a weakened heart muscle or diseases of the heart valves.

Cardiac catheterization is a diagnostic procedure that provides your doctor with precise information about your particular heart condition, allowing much more individualized treatment.

The results of your cardiac catheterization may indicate that you have a narrowed artery that can be opened by angioplasty and/or stenting.

Angioplasty is sometimes referred to as PCTA - percutaneous transluminal coronary angioplasty, or balloon angioplasty. It is a non-surgical way to treat artery buildup (atherosclerosis). Angioplasty is commonly performed with stenting, in which a balloon is used to expand a metal sleeve inside the artery.

What do angioplasty and stenting do?

Angioplasty is a non-surgical treatment designed to open clogged arteries. This procedure is done after the doctor has seen the angiogram (picture) that shows where the arteries are blocked. Angioplasty, with or without stenting, opens the arteries to restore blood flow.

What should I expect?

Several routine tests are done before the angioplasty:

  • EKG (electrocardiogram)
  • Blood test
  • Medical history and exam
  • Chest x-ray

You will receive specific instructions about the food you may have. Generally, you will be allowed nothing to eat or drink six or eight hours before the procedure.

Some suggestions to help you prepare:

  • Pack a small bag of overnight clothing and for the next day.
  • Do not bring any valuables.
  • Bring a list of your medications (with exact names and dosages).
  • Arrange for someone to drive you home.
  • Be sure to mention if you are allergic to x-ray dyes or shellfish, and if you have problems taking aspirin or blood thinners.
  • Empty your bladder for your own comfort.
  • You may wear dentures, hearing aids, or glasses.

What happens the day of the angioplasty?

The procedure is done in a catheterization laboratory. It begins with a thin, flexible tube (the catheter) which the physician inserts through a sheath (previously inserted) in your arm or leg and maneuvers toward your heart.

A non-toxic dye is injected to make it possible for the physician to visualize the coronary arteries. In addition, blood pressure recordings may be made in the various chambers of your heart, and valve function can be examined. Pictures will be taken with specialized cameras.

When the blockage is located, a balloon catheter is placed in the narrowed artery and slowly inflated to press the fatty deposits against the artery walls. This allows the blood to flow more freely to the heart muscle.

In many cases, superior results can be obtained if the cardiologist inserts a stent into the area of the blockage and expands it with a balloon. A stent is an expandable wire mesh tube, sized to fit your artery. Once in place, a stent can provide a better channel for blood to flow through the artery, with a better long-term result.

What happens after the angioplasty?

You will be asked to drink plenty of fluids to help flush the dye contrast out of your system. Later, when the sheath is removed, a sandbag or pressure bandage will be placed on the insertion site to prevent bleeding. You will remain lying down for several hours.

What can I do when I return home?

Avoid heavy lifting and do only light activities for a few days. Call your doctor if:

  • The insertion site bleed.
  • You feel chest pain or discomfort.
  • Your arm or leg (at the insertion site) feels numb or cold.
  • The bruising or swelling gets worse or increases.
  • If you have a fever, or signs of infection (redness or oozing) appear at the insertion site.
  • Any other unusual symptoms.

How will I feel after the angioplasty?

Your doctor will talk to you about the amount of improvement in the artery opening and the possibility of your symptoms returning, medications, restrictions, and changes in daily habits to reduce the risk of more arteries narrowing. You'll also be told when to return for follow-up visits.

What are the risks?

There can be some risk involved with certain diagnostic procedures. In most cases they are relatively minor. Please ask your doctor to discuss the risks and benefits so that you are fully informed about any tests you may have.

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