|
|
-
-
-
An Introduction
-
-
More premature deaths are caused by coronary artery disease than any other
disease process in North America. Coronary artery disease is the narrowing
or obstruction of the vessels that supply blood and oxygen to the heart
muscle. This narrowing is caused by fatty deposits (plaque) on the walls
of the arteries. These fatty deposits gradually build up and can cause
a marked reduction of blood and oxygen to the heart. If the blood flow
is significantly reduced, some form of medical treatment becomes necessary.
Your doctor has recommended that you have PTCA (also known as 'balloon
treatment') to correct the narrowing in your artery(ies).
-
P -percutaneous ; meaning access to the blood vessel is made
through the skin
T - transluminal; meaning the procedure is performed within the
blood vessel
C - coronary; identifying that the coronary artery is being treated
A - angioplasty; meaning “to remodel” the interior of the blood
vessel with balloon inflation
If agreed upon in advance by you and your physician, the cardiac catheterization
procedure and PTA are done together. This is an added convenience for you
as it shortens your hospital stay by one day.
PROCEDURE
DAY 1 --ADMISSION, EVALUATION, AND ANGIOPLASTY PROCEDURE
-
You will first undergo a thorough evaluation by your physician. Any questions
you still have before your procedure begins can be answered at this time.
You will not be permitted any food or beverages after midnight. This is
to prevent nausea during the procedure. If you are a diabetic, you will
be given special instructions.
-
Your groin area will be washed and shaved in preparation for the PTCA.
-
-
To provide a route for medications, an intravenous line will be started
in your arm this morning.
-
To help you relax you will be given medication prior to leaving for the
angioplasty laboratory. You will remain awake, but slightly drowsy. If
family or friends are with you, they will wait in the waiting room near
the catheterization laboratory. The length of the procedure depends on
the complexity of each individual’s situation, but in general, the duration
is 1-3 hours. You will be placed on an x-ray table upon your arrival in
the lab. It is the same type of room in which you had your cardiac catheterization.
Heart monitoring equipment will be placed on your arms and legs, and you
may be given oxygen to breathe.
-
-
You will be given certain medications through the intravenous line, and
periodically medication will be given to relax you and decrease any restlessness.
Remember, you must still be able to talk and follow directions. All personnel
in the lab will be wearing surgical attire. You will be covered by sterile
sheets. and so will some of the equipment. Your groin will be cleansed
with an antiseptic (might be cold) and then numbed with an anesthetic.
You will feel the sting of the needle, but then your groin will feel quite
numb.
-
The angioplasty catheter (balloon-tipped) is inserted at the numb area,
and advanced to your heart, using x-ray to guide it. When the balloon is
inflated at the point of the blockage, you may feel chest pressure, or
discomfort, and this is normal. It will subside when the balloon is deflated.
You may also feel your heart thump or skip, feel flushed, or have a headache.
All these sensations are normal. Always, however, let your doctor know
exactly how you feel during the entire procedure. You will be asked, at
times, to hold your breath for a few seconds. You may also be asked to
cough -- try your best to cough forcefully, as you are instructed.
-
-
Following the procedure, the catheter will be removed and firm pressure
applied for about 20 minutes. Then a pressure bandage is applied and a
small sandbag placed over it. This is to assure proper healing of the artery.
Pain medication is available to you every few hours after the procedure.
Please let your nurse know of any pain or discomfort you may feel at any
time. After the procedure, you will be moved to a recovery area for a short
time, and then taken to your room where your heart can be monitored. You
will be able to eat as soon as you wish after the procedure. Nurses will
closely monitor your vital signs and general well being. They will also
frequently check the groin area and dressing. A small, flexible catheter
is routinely left in the groin for 12-24 hours after the procedure. This
allows quick access for a catheter should an emergency situation arise.
Because of the catheter, you will be required to remain in bed and keep
your leg immobilized.
-
DAY 2 -- DISCHARGE HOME
-
This day is basically for rest, recuperation, and a gradual return to your
activities. You will see your doctor the morning of discharge. You will
also see his nurse who will go over medications, activities, and follow-up
care. You will receive prescriptions for medicines you will need. You will
usually undergo a low-level stress test at the Heart Center, very shortly
after your discharge. You will be informed by the doctor or nurse when
this will be. This stress test will help determine the extent of the success
of your PTA (by showing blood flow to your heart muscle). It also serves
as a basis of guidance for your future exercise program.
POSSIBLE COMPLICATIONS AND RISK
-
No invasive procedure occurs without a certain amount of potential risk
and complications. The incidence of complications is low, but nonetheless,
you need to be aware what they can be.
-
You are followed closely by your doctor and nurses, precisely for the reason
that if any of these complications arise, corrective action can be taken
immediately.
-
Severe bruising/bleeding into the groin area of the procedure leg.
-
Changes in your heart rhythm.
-
Allergic reaction to the dye or to other medications used.
-
A tear in the lining of the artery which is being dilated.
-
Possibility of a heart attack during or following inflation of the balloon.
(you are given strong blood thinners to minimize this risk.)
-
Possibility of a blood clot in the artery in which the catheter is inserted.
(If this occurs, surgical removal may be required.)
FOLLOW-UP CARE
-
Periodic follow-up with your personal physician is quite important. It
is important for you to realize that by angioplasty (PTA), your immediate
problem has been taken care of, but it does not cure coronary artery disease.
-
In some patients, re-closure of the artery may occur. If this happens,
your original symptoms will return, or your stress test will be abnormal.
-
If you have chest discomfort, stop your activity, sit or lie down,
and take nitroglycerine, as instructed. If it does not go away after 3
nitros, in a 15 minute period, DO NOT DELAY SEEKING MEDICAL ATTENTION.
Either call your doctor, or go to an emergency room.
|
