CORONARY ANGIOPLASTY

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Katherine Flowers
5 years ago
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1 CORONARY ANGIOPLASTY

What is Coronary Angioplasty? Coronary angioplasty is a procedure to remove the obstruction caused by plaque or fatty build up on the inner walls of the arteries to your heart.

2 What is Coronary Angioplasty? Coronary angioplasty is a procedure to remove the obstruction caused by plaque or fatty build up on the inner walls of the arteries to your heart. It improves the blood flow to the heart without the need for heart surgery, relieves chest pain (angina) and minimises damage to the heart muscle from heart attack. It commonly involves insertion of a coronary stent which is a metal tube or spring coil that is passed into the part of the artery using a miniature balloon. Blocked Lumen in Branch of Left Coronary Artery Anterior Infarct Coronary angioplasty is not suitable for all blocked or narrowed arteries; your doctor will discuss your individual options and risks.

What is Coronary Stent Insertion? Coronary stent insertion is a procedure often used instead of surgery to treat narrowed or blocked coronary arteries.

3 What is Coronary Stent Insertion? Coronary stent insertion is a procedure often used instead of surgery to treat narrowed or blocked coronary arteries. The procedure is performed in a Cardiac Catheterisation Laboratory using local anaesthetic. Once the local anaesthetic is administered, a fine tube or catheter is inserted into the artery in the groin or arm. The tube is pushed carefully into the affected part of the artery. A tiny wire is passed down the coronary artery so that a small balloon can be passed over it and into the part that is narrowed or blocked. 2 A clear lumen allows unrestricted bloodflow Build-up of plaque within the lumen allows partial bloodflow Total blockage of blood flow within the artery

4 The artery is opened by blowing up the balloon with fluid; the balloon then presses against the material blocking the artery and pushes it away. During the procedure the following may occur: The coronary artery may be split or damaged The artery may become narrowed against the balloon as it goes down The artery may become blocked again If any of these occur, a stent or stents may be used. A stent is a metal tube or spring coil that is passed into the part of the artery using a balloon. When the stent is in place the balloon is removed. Stenting is a fairly common procedure; in fact, over 70 percent of coronary angioplasty procedures also include stenting. 3

5 After the procedure, drugs will be prescribed to reduce your risk of blood clotting and blocking the stents. Most commonly Clopidogrel is used for up to four weeks or longer with a small daily dose of Aspirin to be taken for the rest of your life. What anaesthetic will I have? The procedure is usually performed using a local anaesthetic to numb the area. If you have any concerns, please speak to your doctor. What are the risks? The risks of coronary angioplasty and stent insertion depend on: Your level of coronary artery disease How well your heart is pumping How healthy your other organs are Your general health 4 The risks increase if you have had previous bypass surgery.

6 Please see listed below some of the more serious risks of coronary angioplasty and stent insertion. These are a guide only and please note that these are not the only risks associated with the procedure. Less than 1 in people Skin injury from radiation, can cause reddening of the skin. 5 1 in 1000 people A major reaction to the X-ray dye, which may cause a severe reaction such as asthma, shock and convulsions. Death in extremely rare cases - about 1 in to injections. A higher lifetime risk from X-ray exposure. Stroke, which can cause paralysis and long term disability. 1 in 200 people Emergency surgery to re-open the coronary artery. 1 in 100 people The stent may suddenly close within the first month. It is more likely to occur if blood thinning tablets are stopped prematurely. This can cause angina or heart attack. It may be treated with another angioplasty, or at worse, with surgery. A heart attack. Tear or perforation of the coronary artery or bleeding. A bad reaction to the drugs. The heart may not beat with a proper rhythm, which will need urgent treatment.

7 Minor allergic reaction to dye. Loss of kidney function due to the dye. Damage to the blood vessel at the groin puncture site. If this happens, you may have a longer stay in hospital. 1 in 20 people Major bruising or swelling at the groin puncture site. 1 in 5 people The stent can narrow or scar. This can cause angina. This is usually treated with another angioplasty, or at worse, with surgery. There are now special types of stents (known as drug eluting stents) that can stop the artery from narrowing again. Before your procedure Before your procedure you may have several tests including an ECG, blood tests and chest X-ray. You will be asked not to eat or drink for 6 hours before the procedure and we request that you have a thorough shower on the morning of your procedure. You will be asked a series of questions regarding your general health and requested to sign a consent form. 6 Medicines Please continue to take any prescribed medicines, including Aspirin and Clopidrogel during your fasting period or as instructed by your doctor. If you are on diabetic medicine or on Warfarin and have not been given any special instructions by your doctor, please contact the staff at the Department of Cardiac Science and Critical Care, Fortis Clinique Darné.

8 Please bring all your current medicines, doctor s letters and any recent X-rays and blood test results with you to the hospital. If you develop a cold, flu or illness prior to your procedure, please contact your doctor. If there is any possibility that you may be pregnant, please let your doctor know. What to wear We recommend that you wear casual, comfortable and loose fitting clothes. Please leave all jewellery, any other valuables and large sums of money at home. 7 How is a Coronary Angioplasty done? Coronary angioplasty is performed only after you have undergone a coronary angiography. On some occasions, coronary angioplasty can immediately follow a coronary angiography. The procedure is hence initially similar to coronary angiography. For more information on coronary angiography, please refer to our coronary angiography information brochure. Depending on the coronary angiogram, your cardiologist may place a coronary stent during coronary angioplasty or use a balloon to dilate your blocked artery.

Sample right Coronary Angioplasty images Narrowed right Coronary Artery After your procedure Stent deployed to open narrowed right Coronary Artery Right Coronary Artery stent deployment

You will then be moved to the Intensive and Coronary Care Unit where your heart rhythm and blood pressure will be monitored, and the site where the catheter was inserted will be checked

You may need to lie flat for several hours on your bed depending on the site used for the angioplasty.

9 Sample right Coronary Angioplasty images Narrowed right Coronary Artery After your procedure Stent deployed to open narrowed right Coronary Artery Right Coronary Artery stent deployment Once your procedure is completed you will be transferred from the Cardiac Catheterisation Lab to your bed where it will be necessary for you to lie flat. You will then be moved to the Intensive and Coronary Care Unit where your heart rhythm and blood pressure will be monitored, and the site where the catheter was inserted will be checked frequently. You could be asked to remain in bed for several hours until the catheter is removed. The staff will aid and advise you on how to care for your wound site. You may need to lie flat for several hours on your bed depending on the site used for the angioplasty. Mild chest discomfort is common immediately following a stent procedure but should fade within 1 to 2 hours. Although this is a normal side effect it is important for you to inform a staff member immediately. Your medicine may need to be changed. You will be informed why, and instructed on what it is for and when to take them. 8

10 Later your doctor will visit you to discuss: Your discharge and follow up management Your medicines Any questions you may have 9 Going home When you are ready to go home, you will receive information about: How much exercise you can do What medicines you need to take When you should follow up with your doctor There is a possibility of the artery blocking again within the first few months after angioplasty. It is important to report any recurrent or unusual symptoms to your doctor. You can help reduce the risk of developing further coronary artery disease by reducing certain risk factors for heart disease. For more information about reducing the risks please speak to your doctor. You should arrange for somebody to be available to drive you home from the hospital on the day of your discharge. You and your carer will receive information on care of your wound prior to discharge. You should avoid strenuous activity for 48 hours and return to your normal healthy diet.

11 Your doctor will let you know which activities can be resumed and when. It is important for you to follow all of your doctor s instructions to ensure a safe and speedy recovery. Further questions If you have any questions or concerns about your coronary angiogram procedure or further treatment, please do not hesitate to contact the staff at Fortis Clinique Darné on (+230)

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CORONARY ANGIOGRAPHY

CORONARY ANGIOGRAPHY What is Coronary Angiography? A coronary angiography is a remarkable type of diagnostic procedure that allows doctors to use an X-ray camera outside your body to see how blood circulates