What you need to know about:

Heart Balloon Coronary Angioplasty

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Recovery Period:
1 night in hospital
Permanence:
Depends on patient condition.
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Time it takes:
1-2 hours
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Anesthetize:
General anesthesia

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Overview of

Heart Balloon Coronary Angioplasty

in Thailand

Coronary angioplasty, also called percutaneous coronary intervention [PCI] or balloon angioplasty, is a procedure used to open clogged heart arteries. Angioplasty uses a tiny balloon catheter that is inserted in a blocked blood vessel to help widen it and improve blood flow to your heart. Angioplasty is often combined with the placement of a small wire mesh tube called a stent. The stent helps prop the artery open, decreasing its chance of narrowing again. Most stents are coated with medication to help keep your artery open (drug-eluting stents). Rarely, bare-metal stents may be used. Angioplasty can improve symptoms of blocked arteries, such as chest pain and shortness of breath. Angioplasty is also often used during a heart attack to quickly open a blocked artery and reduce the amount of damage to your heart.

Goals of

Heart Balloon Coronary Angioplasty

Angioplasty is used to treat the buildup of fatty plaques in your heart's blood vessels. This buildup is a type of heart disease known as atherosclerosis. Angioplasty may be a treatment option for you if:  -You have tried medications or lifestyle changes but these have not improved your heart health. -You have chest pain (angina) that is worsening. -You have a heart attack. Angioplasty can quickly open a blocked artery, reducing damage to your heart. -Angioplasty isn't for everyone. Depending on the extent of your heart disease and your overall health, your doctor may determine that coronary artery bypass surgery is a better option than angioplasty for you.  You may need coronary artery bypass surgery if:  -The main artery that brings blood to the left side of your heart is narrow -Your heart muscle is weak -You have diabetes and multiple severe blockages in your arteries -In coronary artery bypass surgery, the blocked part of your artery is bypassed using a healthy blood vessel from another part of your body.

Price of

Heart Balloon Coronary Angioplasty

Average Cost

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Pros and cons of

Heart Balloon Coronary Angioplasty

Pros

-Reduced chances of operative complications from coronary artery bypass surgery that uses a vessel from another part of the body. Since bypass surgery is open-heart surgery which is performed under general anesthesia, it is most often reserved for cases of multiple narrowed coronary arteries.

-A faster recovery time with a shorter hospital stay (only 1-2 days). Patient can return to daily life and activities quicker.

-The procedure can be performed several times in case that narrowed vessels might happen again in the future.

Cons

-Some arterial blockage characteristics do not allow balloon angioplasty and stent placement to be suitably performed.

-Chances to develop re-narrowing of the treated artery (restenosis) due to natural proliferation and healing process of the body.

How It Works:

Heart Balloon Coronary Angioplasty

Balloon Angioplasty generally takes 1 to 2 hours. The patient is awake for the procedure but local anesthesia is used and pain medication can be given as needed. During the procedure the surgeon will insert a small balloon catheter into an artery in the groin or arm and advance it toward the narrowing in the coronary artery. The balloon is then inflated to enlarge the narrowing in the artery. In some cases, a stent of wire mesh inflates with the balloon and is left behind to support the artery walls.

Preparation before

Heart Balloon Coronary Angioplasty

Pre - treatment

Before a scheduled angioplasty, your doctor will review your medical history and do a physical exam. You may need to have some routine tests, including a chest X-ray, electrocardiogram and blood tests, before your procedure. Your doctor will also perform an imaging test called a coronary angiogram to see if the arteries to your heart are blocked and if they can be treated with angioplasty. If your doctor finds a blockage during your coronary angiogram, it's possible he or she may decide to perform angioplasty and stenting immediately after the angiogram while your heart is still catheterized. Your doctor will give you instructions to help you prepare. -Your doctor may instruct you to adjust or stop taking certain medications before angioplasty, such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs) or blood thinners. Be sure to tell your doctor about all medications you take, including herbal supplements. -Usually, you'll need to stop eating or drinking six to eight hours before an angiography. -Take approved medications with only small sips of water on the morning of your procedure. -Gather all of your medications to take to the hospital with you, including nitroglycerin, if you take it. -Arrange for transportation home. Angioplasty usually requires an overnight hospital stay, and you won't be able to drive yourself home the next day.

Recovery after

Heart Balloon Coronary Angioplasty

Post - treatment

If you had a nonemergency procedure, you'll probably remain at the hospital overnight while your heart is monitored and your medications are adjusted. You generally should be able to return to work or your normal routine the week after angioplasty. When you return home, drink plenty of fluids to help flush your body of the contrast dye. Avoid strenuous exercise and lifting heavy objects for at least a day afterward. Ask your doctor or nurse about other restrictions in activity. Your doctor will most likely put you on blood-thinning medications inlcuding; aspirin and clopidogrel (Plavix), prasugrel (Effient) or similar medications. Most people who have undergone angioplasty with or without stent placement will need to take aspirin indefinitely. Those who have had stent placement will need a blood-thinning medication, such as clopidogrel, for six months to a year. If you have any questions or if you need any other type of surgery, talk to your cardiologist before stopping any of these medications.

Risks & side effects

As with any surgery, there are risks, including the possibility of:  -Complications associated with anesthesia, including respiratory or cardiac malfunction -Infection -Bleeding in the groin (or other catheter access site) -Complete obstruction of blood flow to an area of the heart (a small risk, less than 1%) -Damage to a valve or blood vessel -Stroke -Arrhythmia -Kidney failure -Allergic reaction to X-ray contrast  Balloon Angioplasty treats the condition, but does not cure the cause of narrowed arteries. Recurrent narrowing can be expected in up to a quarter of cases over a 6 month period. This recurrent narrowing may or may not require a repeat procedure.   Risks can be reduced by following the physician's instructions before and after surgery.

FAQs:

Heart Balloon Coronary Angioplasty

What are the benefits of a coronary angioplasty?

In most cases, the blood flow through the coronary arteries improves after an angioplasty. Many people find their symptoms get significantly better and they're able to do more than they could before the procedure.  If you've had a heart attack, an angioplasty can increase your chances of surviving more than clot-busting medication (thrombolysis). The procedure can also reduce your chances of having another heart attack in the future.

How safe is a coronary angioplasty?

A coronary angioplasty is 1 of the most common types of treatment for the heart.  Coronary angioplasties are most commonly performed in people aged 65 or older, as they're more likely to have heart disease.  As the procedure doesn't involve making major incisions in the body, it's usually carried out safely in most people. Doctors refer to this as a minimally invasive form of treatment.  The risk of serious complications from a coronary angioplasty is generally small, but this depends on factors such as: age, general health, and your history of heart attacks.

How long does the procedure take?

Angioplasties do not take much time. It takes 1 hour at the most, however, the patient needs another 12 to 16 hours for recovery. The patient usually stays for a night in the hospital and goes home the following day.

What is a stent?

A stent is a small, mesh-like device made of metal. When a stent is placed inside of a coronary artery, it acts as a support or scaffold, keeping the vessel open. By keeping the vessel open, the stent helps to improve blood flow to the heart muscle and reduce the pain of angina. Stent procedures are usually used along with balloon angioplasty. In fact, about 80% of patients who have balloon angioplasty will have a stent placed as well.  Just like with balloon angioplasty, doctors are now using stents in many other parts of the body—not just the heart. Stents can also be placed in the carotid arteries in the neck, in the aorta, and in the peripheral arteries in the legs.

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Hein Htoo
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Butree Chalanupap
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