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| Balloon angioplasty |
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Surgical index |
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Heart Artery Dilation |
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angioplasty of the heart; balloon angioplasty; coronary angioplasty; coronary artery angioplasty; percutaneous transluminal coronary angioplasty; PTCA |
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Cardiac catheterization
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| A procedure to open narrowed (stenosis) or blocked (obstructed) blood vessels (coronary arteries) of the heart muscle (myocardium). See also cardiac catheterization and angiogram. |
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The coronary arteries supply blood to the heart muscle.
Next Indications
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| Description |
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Fat and cholesterol accumulates on the inside of arteries (atherosclerosis). The small arteries of the heart muscle (the coronary arteries) can be narrowed or blocked by this accumulation. If the narrowing is small, it may be treated with a balloon catheter rather than major surgery. This is a a small, hollow, flexible tube that has a balloon near the end of it.
While the patient is awake and pain-free (local anesthesia), the catheter is inserted into an artery at the top of the leg (the femoral artery). X-ray pictures are taken to view the catheter as it is passed up the artery, into the aorta, and into the blocked coronary artery. The small balloon at the end of the catheter is inflated and widens the area of the blockage, restoring adequate blood flow through the artery to the heart muscle.
Rarely, a device called a stent may be placed. This is a small tube that is placed within the coronary artery to keep the vessel open. One type is made of self-expanding, stainless steel mesh. (A stent may also be used after coronary artery bypass graft surgery.) |
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Indications |
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The indications for heart artery dilatation are: |
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persistent chest pain (angina)
blockage of only one or two coronary arteries |
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Cardiac catheterization |
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Coronary artery stent
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Cardiac catheterization is used to study the various functions of the heart. Using different techniques, the coronary arteries can be viewed by injecting dye or opened using balloon angioplasty. The oxygen concentration can be measured across the valves and walls (septa) of the heart and pressures within each chamber of the heart and across the valves can be measured. The technique can even be performed in small, newborn infants.
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Cardiac arteriogram
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Risks |
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Risks for any anesthesia are: |
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reactions to medications
problems breathing |
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Risks for any surgery are: |
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bleeding
infection |
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| Additional risks include: |
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complete obstruction of blood flow to an area of the heart (a small risk, less than 3%; a heart surgery team is on standby)
damage to a valve or blood vessel
blood clot |
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Expectations After Surgery |
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This procedure can greatly improve the blood flow through the coronary arteries and to the heart tissue in about 90% of patients and may eliminate the need for coronary artery bypass surgery (CABG). The outcome is relief from chest pain symptoms and an improved exercise capacity. In 2 out of 3 cases, the procedure is considered successful with complete elimination of the narrowing or blockage.
This procedure treats the condition but does not cure the cause and recurrences happen in 1 out of 5 cases. Patients should consider diet, exercise, and stress reduction measures.
If adequate widening of the narrowing is not accomplished, heart surgery (coronary artery bypass graft surgery, also called a CABG) may be recommended. |
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Convalescence |
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The average hospital stay is less than 3 days and sometimes hospital stay is not required. Complete recovery takes a week or less.
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Heart bypass surgery |
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bypass surgery - heart; CABG; coronary artery bypass graft |
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Definition |
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Heart bypass surgery (coronary artery bypass graft) is done to relieve blockages of the blood vessels of the heart muscle. Vein grafts are connected above and below the blockage to allow adequate blood flow to the heart muscle. |
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Description |
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The heart muscle (myocardium) works constantly and requires oxygen-rich blood, delivered through small arteries (called the coronary arteries). When fats and cholesterols accumulate inside the small coronary arteries (atherosclerosis), there is less room for blood to flow. When the heart muscle cannot receive adequate blood supply through the arteries, heart pain (angina) or heart attack (myocardial infarction) occurs. Coronary bypass surgery is used to bypass the blockage and restore adequate blood flow to the heart muscle.
Coronary bypass surgery is an open heart surgery (the chest is opened, but not the heart itself). It is done through an opening through the breast bone (sternum). While one surgeon is working on the chest, another surgeon works on taking a length of vein (for the bypass) through a long incision along the inside of the lower leg. The vein is sewn in above and below the blockage in the coronary artery.
Although the heart itself is not "opened", the heart-lung bypass machine is used to re-route the blood from the heart while the surgery is being done to provide adequate circulation to the brain and other vital organs.
Rarely, a device called a stent may be placed. This is a small tube that is placed within the coronary artery to keep the grafted vessel open. One type, called an intraluminal coronary artery stent, is made of self-expanding, stainless steel mesh. |
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| Indications |
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Coronary artery bypass is recommended when one or more coronary arteries are seriously blocked and blood supply to the heart muscle is insufficient. Several tests will be done to identify the cause of the chest pain (angina), such as blood tests and X-ray studies (angiograms).
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Risks |
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Risks for any anesthesia are: |
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reactions to medications
problems breathing |
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Risks for any surgery are: |
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bleeding
infection |
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| Additional risks of coronary artery bypass surgery include: |
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blood clots
brain damage
death |
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| Expectations After Surgery |
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| Every year a half million Americans have coronary bypass surgery to relieve symptoms and prolong their lives. |
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| Convalescence |
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After the operation, the patient will spend 7 to 10 days in the hospital, the first 2 or 3 days in an intensive-care unit (ICU). Heart functions will be monitored. The full benefits from the operation may not be ascertained until 3 to 6 months after surgery. Sexual activities may be resumed 3 to 4 weeks after surgery. All activities that do not cause fatigue are permitted, and the patient is kept from attempting too much too soon.
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| The information provided herein should not be used for diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions |
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