ANGIOPLASTY

General Information

DEFINITION--Angio = blood vessel; plasty = surgical shaping or alteration of. In this procedure, a catheter with an inflatable balloon tip is inserted into a blocked or partially blocked coronary artery.

BODY PARTS INVOLVED--Coronary arteries (the blood vessels that supply nourishment to the heart muscle).

REASONS FOR SURGERY--To remove a block or partial block of a coronary artery.

SURGICAL RISK INCREASES WITH

• Obesity; smoking.
• Excess alcohol consumption.
• Use of drugs such as: antihypertensives; muscle relaxants; tranquilizers; sleep inducers; insulin; sedatives; beta-adrenergic blockers; or cortisone.
• Use of mind-altering drugs.
• Angina (for more than 1 year).
• Calcification of blood vessels.

What To Expect

WHO OPERATES--Cardiologist or cardiothoracic surgeon.

WHERE PERFORMED--Hospital.

DIAGNOSTIC TESTS

• Before surgery: Heart catheterization with x-ray and fluoroscopic examinations.
• During surgery: X-rays after injection of dye through the catheter into various parts of the heart.

ANESTHESIA--Local, with standby general anesthesia.

DESCRIPTION OF OPERATION

• The cardiac balloon catheter is inserted into an artery in the arm or leg. Fluoroscopy provides guidance for the catheter to pass through the artery to the heart.
• Blood-pressure readings are taken, and the heart's ability to pump blood is tested.
• The catheter is guided into the coronary-artery system. Fluoroscopy allows identification of any disease in the coronary arteries.
• The catheter is passed through the occlusion, the balloon is inflated, and the occlusion is compressed, allowing blood to flow through once again.
• When all examinations have been completed, the catheter balloon is withdrawn, and the artery is compressed until bleeding stops.
• The skin is closed with several sutures, which usually can be removed about 1 week after surgery.

POSSIBLE COMPLICATIONS

• Break or rupture in the dilated artery lining.
• Dislodged plaque that escapes suction.
• Coronary spasm.
• Chemical irritation from dye used in x-ray studies.

AVERAGE HOSPITAL STAY--3 to 4 days.

PROBABLE OUTCOME--Removal of blockage in occluded coronary artery.

Postoperative Care

GENERAL MEASURES

• No smoking.
• A hard ridge should form along the incision in the arm or leg. As it heals, the ridge will recede gradually.
• Use a warm compress to relieve incisional pain.
• Discoloration under the skin where the catheter was inserted should disappear in 2 weeks.
• Bathe and shower as usual. You may wash the incision gently with mild unscented soap.
• Between showers, keep the wound dry with a bandage for the first 2 or 3 days after surgery. If a bandage gets wet, change it promptly.
• If the wound bleeds during the first 24 hours after surgery, press a clean tissue or cloth to it for 10 to 15 minutes continuously.

† You may use non--prescription drugs, such as acetaminophen, for minor pain. Avoid aspirin.

† To help recovery and aid your well--

being, resume daily activities, including work, as soon as possible. This procedure requires much less time for recovery than coronary bypass surgery.

• Avoid vigorous exercise for 2 weeks after surgery. > Resume driving 2 days after returning home.

DIET---As directed by your doctor

Call Your Doctor If

† You experience sudden or severe chest pain.

• Pain, swelling, redness, drainage or bleeding increases in the surgical area.
• You develop signs of infection: headache, muscle aches, dizziness or a general ill feeling and fever.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.