JAKAYA KIKWETE CARDIAC INSTITUTE (JKCI)

Cardiac Surgeries

What is Coronary Angioplasty?

Coronary Angioplasty is also known as PCI (Percutaneous Coronary Intervention) or PTCA (Percutaneous Transluminal Coronary Angioplasty). It is an endovascular procedure performed to open blocked or narrowed arteries of the heart. This further helps in improvement of blood flow to the heart muscles.

What happens during the Procedure?

During an angioplasty, the doctor inserts a catheter is into one of arteries through an incision in the groin area, wrist or arm of the patient.

This is further guided to the affected coronary artery using a continuous x - ray video. When the catheter reaches its place, a thin wire is guided down the length of the diseased coronary artery, over which stent with balloon around it is inflated to widen the artery, squeezing fatty deposits against the artery wall. This helps the blood flow through it more freely when the deflated balloon is removed.

Like in the case of most other procedures, the treating doctor asks not to eat or drink a certain number of hours before procedure, or often nothing after midnight the night before.

The procedure usually takes 30 mins to 2 hours after which patient is kept under observation. It requires 1 to 2 days of hospital stay. Patient needs to avoid heavy lifting, tiring activities and driving for at least a week after discharge from the hospital. PCI is typically performed by interventional cardiologist.

Types of Coronary Angioplasty

Balloon Angioplasty

Coronary Stenting

Coronary Atherectomy

Laser Angioplasty

(*** The major difference between these is the type of instruments used for the procedure).

Balloon Angioplasty: This is performed by passing a thin tube,or catheter, into an artery. , after which the catheter is moved skillfully into the diseased artery and a balloon at the tip of the catheter is expanded. This balloon then pushes against the plaque in the wall of the artery and squashes it, thus widening the artery.

Coronary Stenting: In this method, stents (small and expandable metal devices) are used. During the procedure, stent of choice is inserted by a catheter into the diseased artery after the angioplasty procedure is complete and then it is left there to help keep the artery from closing again. Stents are now mostly used in combination with balloon angioplasty as this is a better option in most of the cases. Stents are of following kinds:

Bare Metal Stent: In certain cases, coronary arteries treated with balloon angioplasty tend to get affected by restenosis. To solves this problem, the first generation of stents was developed initially. These were called bare metal stents. Although these stents almost reduced the risk of the artery collapsing, they only modestly eliminated the risk of restenosis. Quite a few numberof all coronary arteries treated with bare-metal stents would get closed again, usually within around six months.

Drug Eluting Stent: To resolve this problem, doctors came up with stents which were coated with antiproliferative drugs that intervened the process of restenosis. These are called drug-eluting stents. These stents dramatically reduced the rate of restenosis and thus the need of repeat procedures.

Bioresorbable, biodegradable, or bioabsorbable stent: These stents serve the same purpose as the other two mentioned above, but they are manufactured from a material that may dissolve or be absorbed in the body, leaving no permanent implant and thus preventing the following problems:

Development of stent thrombosis after placement of bare metal stent or drug eluting stent;

the remaining rate of restenosis.

Coronary Atherectomy : This procedure is started in a similar way to balloon angioplasty, but instead of balloon, special instruments are used to cut the plaques away. It is most useful in cases where the blockages are inaccessible for balloon angioplasty or are too calcified (hardened).

Laser Angioplasty: This procedure too is similar to balloon angioplasty, but instead of catheter with balloon at its tip, one with laser at the tip is used. The laser is first guided to the blocked artery, then it is used to destroy the plaque by vaporizing it into gaseous particles, layer by layer. This technique is not used as frequently as other angioplasty procedures.

What happens Post Procedure?

The site where catheter was inserted is checked for bleeding and swelling. Also, the heart rate and blood pressure are monitored. Usually, patients are given medication that relaxes them to protect the arteries against any kind of involuntary muscular contraction

Patient is asked to lie down straight to make sure there is no discomfort or bleeding at the site of catheter insertion.

After few hours of observation in the cardiac care unit, patient gets shifted to the ward. And depending upon medical condition, he or she may get discharged from hospital next day.

Treating doctor may prescribe aspirin or other medicine in order to prevent the risk of blood clot in the artery. This also helps in reducing the risk of blood clots likely to get formed in and around the stent.

After getting back home, please check the area where the catheter was inserted. It is expect to have some bruising and tenderness, but if there is any redness or swelling, or if the bruising gets worse, kindly contact the treating doctor.

Patient is advised to avoid heavy weight lifting or vigorous activities for few days after the procedure.

Diet For Angioplasty Patients

A heart healthy diet helps in the recovery process. It is essential that you adhere to the diet chart provided by your health care provider/dietician. It is suggestive to follow a personalized diet plan that includes specific food for heart patients. You are advised to eat small meals throughout the day.

Following are a few heart healthy diet tips that you can discuss with your doctor and nutritionist

Limit your fat intake with a low fat diet, but don't abolish fats altogether. Variety is essential.

Your daily diet should include plenty of fresh fruits and vegetables.

Skinless chicken and lean meats like fish and are healthy if taken in small/medium servings only.

Simply consume low fat varieties of milk and yogurt, and keep away from egg yolk although egg whites are fine.

Significantly reduce your intake of products that are caffeinated and avoid all alcoholic beverages.

Reduce your intake of sugar rich refined foods like chocolates, cakes, and biscuits.

Also, Cut down on your salt intake as much as possible for you.

Patient Testimonials

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Happy kids after successfully surgeries

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