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Providing Non-Invasive Cardiovascular Treatments

Angioplasty/PTCA

This is an invasive procedure done in a hospital setting. It relieves narrowing and obstruction of the arteries to the muscle of the heart (coronary arteries). This procedure is also known as PTCA, which stands for percutaneous transluminal coronary angioplasty, or PCI, which stands for percutaneous coronary intervention.

How Does it Work?

During this procedure, a small catheter is inserted into an artery in the arm or groin and then advanced to the narrowing artery. Contrast (dye) is injected into the artery for X-ray images. The balloon is inflated for about one minute to enlarge the artery.

This allows the plaques to compress and enlarge the opening of the coronary artery. The balloon is then deflated and removed from the body.

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What to Expect

  • 1 Before the angioplasty, you will first undergo cardiac catheterization. This will allow your doctor to determine if angioplasty is the best treatment for you.
  • 2 The angioplasty procedure usually takes from thirty minutes to two hours.
  • 3 Most patients are monitored overnight in the hospital before leaving.
  • 4 For one or two weeks after the procedure, you are advised not to lift anything heavier than 20 pounds or perform vigorous exertion.
  • 5 Your doctor will follow up with you a week after the angioplasty to determine if you are ready to resume your normal activities.

Cardiac Catheterization

Cardiac catheterization is an invasive procedure that allows cardiologists the ability to take direct angiograms (pictures) of the arteries around the heart (coronary arteries) and measure the pressure within the heart and check the valves and strength of the heart. It is done in an outpatient setting at the hospital. It is a safe test done every day.

However, any time you enter the body, there is a risk, just like taking a shower carries a risk. While the procedure is 99.9% safe and the risks are small, they are significant, and this is why we do not suggest this test unless we feel the benefits significantly outweigh the risks.

The major risks include bleeding, infection, impaired kidney function, heart attack, allergic reaction, and death.

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What to Expect

  • 1 Normally, you will go to the hospital and check in two hours prior to the test. You will have had nothing to eat or drink after midnight unless the office has said differently. You will take your medication with a small sip of water the morning of the test. You will have discussed with the office about any blood thinners you are taking.
  • 2 You will have been informed about the test, all questions you will have will be answered, and then you will sign an informed consent.
  • 3 Pre-procedure testing will be done and you will be prepped for the test.
  • 4 An IV will be started and light sedation will be given.
  • 5 Normal procedure will be to use the right groin for access to the artery system, although at times an alternative approach may be used.
  • 6 Your groin will be numbed with Novocain.
  • 7 A needle will be used to gain access to the artery.
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  • 8 A sheath will be placed which will act as a door for equipment inside and out of your body.
  • 9 X-rays will be used to place tiny tubes in the arteries and dye injected, and X-ray pictures of each artery will be recorded. A catheter will be placed across the aortic valve (doorway into the heart), and pressure will be recorded and dye injected to look at the strength of the heart.
  • 10 After the catheterization, all equipment will be removed and either pressure or a device will be placed into the artery to seal the hole created by needle puncture.
  • 11 You will spend several hours at the hospital for observation, and then you will be discharged.
  • 12 Total procedure time is approximately one hour, although this may change depending upon what is encountered during the procedure.
  • 13 This is the best test available to get hard data about the state of your arteries.

Stent Placement

A stent is made up of stainless steel wire mesh which is left in place in the coronary arteries by means of PTCA. This process is used to enhance long-term results in preventing Coronary Artery Bypass (CABG).

Some stents are “medicated,” which means they are coated with medications that help prevent the formation of plaque, which reduces the rate of restenosis (reoccurrence of the blockage) in the artery.