Coronary Angioplasty

Coronary Angioplasty

Coronary Angioplasty

A coronary angioplasty (AN-jee-o-plas-tee) is a procedure performed to treat narrowed or blocked coronary arteries. During the procedure, your blocked artery is widened with a balloon (angioplasty), usually followed by insterting a stent (a small wire mesh tube) to help keep the artery open.

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Why do I need a coronary angioplasty?

Following your coronary angiogram, depending on your symptoms, anatomy of the blood vessels identified with narrowings, and considering your preferences, the doctor may offer you coronary angioplasty to improve the blood supply to your heart because you have had:

  • Heart attack or at risk of having a heart attack
  •  Symptoms of coronary artery narrowing such as chest pain or shortness of breath, affecting your quality of life
  • Shortness of breath due to heart muscle impairment
  • New diagnosis of heart failure
  • A congenital heart defect
  • Abnormal results from a heart stress test showing significant part of your heart muscle at risk.

An alternative decision could be to recommend a coronary artery bypass operation or to intensity medical treatment.

Risks and complications

Most procedures performed on your heart and blood vessels carry some risks. However, major complications are very rare (less than 1 in 1000). Potential complications and risks include infection, kidney damage, excessive bleeding, injury to the catheterised artery, stroke, heart attack and allergic reactions to the dye or medications used during the procedure.

Serious complications from coronary angioplasty are also rare (less than 1:1000). However, they include heart attack, kidney problems from the dye, coronary artery damage, arrhythmia, stroke and death.

How long does it take?

In the majority of cases, coronary angioplasty takes approximately 30 minutes to an hour to complete.

Do I need to prepare for coronary angioplasty?

You’ll need to do certain things in preparation for your coronary angioplasty:

  • Have a blood test (kidney test and full blood count) four weeks prior to your procedure
  • Do not drink alcohol or smoke for six to eight hours before the procedure
  • Do not drink any clear fluids two hours before the procedure – for example, water, black tea
  • Talk to your doctor about your regular medications – find out if any needs to be stopped before your procedure (NB: This is especially important if you are diabetic or on blood-thinning medications)
  • Organise someone to drive you home – after your procedure

Please note, the procedure is performed as an in-patient. You will usually be admitted to a day procedure unit, where you will be cared for by an experienced team of care-givers. You will be asked to remove any jewellery and slip into a hospital gown.

What happens during a coronary angioplasty?

Your angioplasty procedure will be performed in a hospital operating room. You will lie down on a narrow table and will be awake throughout the procedure. Your doctor will offer sedation to help relax you. During the procedure, your medical team will:

  • Shave your groin area – if required
  • Give you a local anaesthetic – to numb the entry point (groin or wrist)
  • Carefully place a guidewire into your artery – which is moved up towards your heart
  • Inject dye into your artery – you may feel a brief flushing or warm sensation when this happens
  • Take x-rays as the dye moves through the blood vessels – this indicates where there may be narrowing or blockages in the arteries
  • Push the catheter (with a tiny balloon at the end) over the guidewire. The balloon is then inflated and deflated, widening the blocked artery. Once the artery is stretched, they may insert a stent to keep the artery open. Then, they will deflate the balloon and remove the catheter.
What happens next?

Your doctor will explain to you the details of the angioplasty procedure immediately after completing the procedure. He will then inform your family doctor of the details of the procedure.

You’ll be moved to the recovery room or ward to rest. You may have slight tenderness, discomfort and bruising for up to two weeks. You’ll be kept in hospital for monitoring, and encouraged to drink lots of water to help flush the dye away. Providing you’re well enough, you will go home either the same day or the next day.

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