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Cardiac Angioplasty and Stenting

The heart is a muscle, fed by arteries called coronary arteries that supply the muscle with oxygen. During a heart attack, one of these coronary arteries becomes blocked, depriving the muscle of oxygen and causing the heart attack symptoms people generally report. As the heart muscle is deprived of oxygen, the cells that make up the muscle begin to die.

Muscle is lost by the minute during a heart attack, and if blood is not restored to the heart quickly, it can lead to irreversible damage to the heart and, sometimes, even death. Limiting damage to the hard requires opening the blocked coronary artery to restore the flow of oxygen-rich blood to the cells of the heart muscle. To do this, Tanner uses a procedure called cardiac angioplasty.

What is angioplasty and stenting?

Angioplasty is used to reopen an area where your artery is blocked. Your doctor can open up your artery to allow blood to flow better by using a tube called a catheter that has an inflatable, small, sausage-shaped balloon at his tip. Angioplasty is much less invasive than surgery. You will receive a relaxing medicine (sedative) through an intravenous line (“IV”), and you will be given a local anesthetic to numb the area—usually the groin or arm—where the catheter will be inserted.

By using X-ray images, your doctor can look at the size of the coronary artery and choose the appropriate type of balloon catheter and wire. The guide wire is an extremely thin wire with a flexible tip. During angioplasty, the wire is inserted through the catheter and into the artery. The tip of the wire is then guided across the blockage and beyond it. The wire serves as a guide for the catheter and balloon, which is navigated and positioned across the blockage, where the balloon is inflated to open the blockage and restore blood flow.

The same technique is used for stenting. A stent is a small tube made of wire mesh, which is left in the artery to keep the artery open and improve blood flow.

Angioplasty and stenting can also be used to treat other vascular conditions, such as peripheral artery disease (PAD).

Blockages in the coronary arteries can be caused by high levels of cholesterol, which turns into plaque and lines the walls of arteries, causing them to narrow or become blocked over time. The surface of the plaque in the artery may also rupture, causing a blood clot to form and leading to a heart attack.

The name of the game is time. It’s essential that blood flow be restored to the heart as quickly as possible. In the past, patients had to be transported to hospitals in Atlanta for this procedure, losing valuable minutes as their hearts deteriorated without oxygen. Now, angioplasty is available much closer to home for west Georgia residents.

According to the American College of Cardiology (ACC), a patient should receive angioplasty within at least 90 minutes of arriving at the hospital (called door-to-balloon time). The national average time from when a patient enters the hospital doors to undergoing the procedure is estimated at 120 minutes; at Tanner Medical Center/Carrollton, the average time is faster than ACC guidelines and much faster than the national average. View our Quality information.

A visitor experiencing a heart attack and arriving at any of Tanner’s 24-hour emergency departments will activate Tanner’s Heart Alert system. The patient will immediately receive appropriate care before he or she is transferred to Tanner Medical Center/Carrollton, where specially-trained and qualified physicians, nurses and technologists will oversee their care.

Why is your doctor suggesting or performing angioplasty or stenting?

Your doctor may order an angioplasty and/or stenting procedure for several reasons, including:

  • You have had a heart attack due to a blockage.
  • You are experiencing chest pain, which is determined to be caused by a blockage.
  • You have had a stress or other test which revealed a build up of plaque lining the wall of an artery.

How do I prepare?

Do not eat or drink after midnight. Medicines prescribed by your doctor may be taken with sips of water. If the procedure is scheduled for the afternoon, you may be allowed to have an early liquid breakfast (juice, tea, brother, water, etc.) prior to 7 a.m. You will need to stay overnight.

How long does it take?

The procedure can take anywhere from 30 minutes to an hour.

What to expect after catheterization for angioplasty or stenting

Minor bruising and a small lump or knot (smaller than a quarter) at the insertion site are normal and expected after a catheterization. This should go away in two-to-six weeks. Check the site occasionally for oozing, swelling or enlarging lump/knot. This is an indication that you are bleeding internally or externally. If this occurs, your physician should be called immediately and you should lay down flat and have someone apply firm pressure on and above the puncture site for 15 to 20 minutes.

Should swelling and bleeding continue as you press, you need to reposition the point of pressure slightly and follow any further instructions your physician has given you. If bleeding persists, you should call 911.

The soreness and bruising should disappear within two weeks. It is normal for the site to feel tender for about a week.

Patients should:

  • Avoid strenuous activity for at least 48 hours.
  • Drink plenty of liquids for several hours after the test to prevent dehydration and help flush the dye out of your body.

Care of your incision:

  • After the procedure, wait 24 hours before showering. Remove the hospital dressing while showering.
  • Gently clean the site using warm, soapy water. Dry thoroughly.
  • Cover the site with a bandage or dressing that covers the entire site
  • Keep the dressing clean and dry to prevent infection. If the bandage becomes wet, remove that one and place a new one.
  • Do not put ointments, oils or lotions on the catheterization site.
  • Do not take baths in a tub (or swim in a pool) for the first seven days.
  • Inspect the site daily.
  • If a closure device was used, please follow the instructions provided.

Call 911 or go to the emergency department of the nearest hospital if you develop:

  • Chest pain
  • Increased shortness of breath
  • Dizziness, trouble speaking or swallowing
  • Loss of feeling in the leg or foot on the side of the catheterization
  • Increased swelling in the groin or leg
  • Unusual groin pain or pain in your right/left leg
  • A redness, swelling, warmth or discharge at the catheter insertion site
  • A fever
  • Bleeding that does not stop after 10 minutes of applying firm pressure directly to the incision

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