Coronary Angioplasty :

Indications for Coronary angioplasty / Who needs a coronary angioplasty?

Angioplasty is preferred over CABG ( Coronary artery bypass grafting) when there is less severe narrowing of the arteries , an emergency and additionally it also is preferred in patients with low syntax score ,high stroke risk and comorbidities like sever pulmonary disease.

Constant blood supply is necessary for the heart to function normally any condition that restricts or reduces blood supply or flow to the heart might need a Coronary angioplasty . Such conditions include :

Coronary artery disease : It is a condition where the arteries become narrowed and hardened due to the buildup of Plaque ( made up fat or cholesterol) This condition ( the build of plaque ) is called as Atherosclerosis and can occur in different places of your body , including your heart leading to Coronary artery disease .

Angina : Angina is defined as chest pain due to restricted or decreased blood flow to the heart . Angina can be treated with medications, In severe cases when the medications are not effective one might need a coronary angioplasty to improve the blood flow or supply .

Heart attack : It is often used as an emergency treatment for Heart attack . Heart attack is condition when there is a block reducing blood flow and oxygen supply to the heart.

Investigations before the procedure

The patient is subjected to certain examinations before appearing for the surgery to make sure if the operation is possible . Patient may have to undergo blood tests and a general health check up to ensure if they are suitable candidates for the surgery. An angiogram is done as a pre operative assessment to locate the block before angioplasty. In certain cases angioplasty is performed in conjunction with angiogram as the part of the same procedure.

Coronary angioplasty Procedure

A coronary angioplasty procedure may last upto 30 minutes to 2 hours depending upon the patient ‘s condition . This procedure is carried out in a special room called catheter lab mostly under local anesthesia . The surgeon proceeds to make small incisions in the groin, wrist or arm of the patient , a thin flexible tube called catheter will be inserted through the artery into the heart guided by the x-rays to locate the block or constricted area. Once the narrowed or blocked artery is located a thin wire with a small sausage-shaped balloon is passed along the catheter, the balloon is then inflated to widen the narrowed artery, squashing fatty deposits against the artery wall in order to enhance the blood flow .If a stent is being inserted, it will be fitted onto the balloon and opens up when the balloon is inflated. The stent will be left inside the artery while balloon is deflated and removed , once the balloon is removed the surgeon confirms if the artery is wide enough to allow blood to flow through easily .

What is a stent ?

A stent is a short, wire mesh tube that acts like a scaffold that aids in keeping an artery open . There are 2 main types of stent:

• Bare metal (uncoated) stent
• Drug-eluting stent – coated with medication that reduces the risk of the artery becoming blocked again

After the procedure

After the procedure the patient is shifted to the room and monitored by the paramedical staff . The patient requires 2 to 6 hours of bed rest immediately after the procedure depending on the severity of the condition.

Hospital stay : Depending on the severity of the condition the hospital stay varies. In majority of the cases you may be put under observation for 24 hours that requires mostly an overnight stay in the hospital on the contrary the patient is expected to stay longer if angioplasty was done as an emergency procedure.

Precautions after angioplasty procedure

It is crucial to follow all the instructions given by your health care team. Some of things to keep in mind are:

• Avoid participating in any strenuous activities or lifting anything heavy
• Monitor your insertion site( the site where the catheter tube is inserted) look for bleeding, unusual pain, swelling, abnormal discoloration
• Avoid participating in sexual activity for few weeks after the procedure
• Avoid swimming or using bath tub after the procedure
• Take all the medications properly as prescribed by the specialist.
• Refrain from bathing immediately after procedure it is important that you keep your insertion area dry and clean .

Recovery after coronary angioplasty

Recovery from the procedure may be influenced by various factors . Generally 1 to 2 weeks period is expected to recover and resume to normal activities , But in individuals who had an emergency angioplasty might take several weeks to months to resume to routine.

After care

• Cardiac rehabilitation : The patient might be recommended for a personalized program of exercise and education that involves exercise training, emotional support and education about a heart-healthy lifestyle in order to improve the heart condition .
• Inculcate healthy eating habits ( Balanced and more nutritious food)
• Exercise regularly ( include walking as a mandate in your routine)
• Reduce stress
• Quit smoking and alcohol consumption
• Control cholesterol, blood pressure and blood sugar.
• Maintain a healthy weight .

Complications of coronary angioplasty

Coronary angioplasty does not hold any potential complications but the risk of complications may be influenced by factors like age , over all health condition , and emergency condition for instance heart attack

• Stent stenosis is defined as a gradual re narrowing of the arteries after the procedure ( stenting). The main cause of this complication is due to the regrowth of the tissue at the treatment site or recurrent atherosclerosis.
• Bleeding at the insertion site (usually the groin, wrist, or arm)
• Infection at the catheter insertion site
• Blood clot or damage to the blood vessel from the catheter
• Chest pain or discomfort
• Allergic reaction to the contrast dye used
• Blood clot within the treated blood vessel
• Abnormal heart rhythms
• Heart attack
• Rupture of the coronary artery or complete closing of the coronary artery, needing open-heart surgery

Consequences of Delaying Coronary Angioplasty Surgery

Delaying a Coronary angioplasty surgery can have significant consequences . This medical procedure aims to enhance the blood flow to the heart . Prompt treatment is necessary to prevent further complications and reduce the risk of heart damage.

Facilities required for coronary angioplasty?

• Coronary angioplasty is carried out in a cath lab , rather than in an operating theatre.
• This room is equipped with x-ray imaging equipment,a radiographic table, one or two x-ray tubes, and a video monitor.
• This procedure also uses sheath ,a balloon catheter, stent and guide wire.

How to choose a surgeon and hospital for Coronary Angioplasty?

When selecting a surgeon for a coronary angioplasty, there are various aspects to consider. The cardiac surgeon's experience, training, certification, positive reviews and references are essential factors to consider. It advisable to to choose a Hospital that is well-equipped with state-of-the-art technology and is easily approachable to minimize travel time. It is better to consider the experiences of individuals who have undergone treatment for particular a condition while making decisions about treatment or surgery options as it can fetch you a better out outcome.

Skedoc assists you to find information related to Best cardiologists and best hospitals/ clinics . It also ease the process of selecting the right doctor for right advise.