Patient Care – Adult cardiac, endovascular, and thoracic aortic surgeryPatient information & resources

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Balloon angioplasty: Angioplasty is a medical procedure in which a balloon is used to open narrowed or blocked blood vessels of the heart (coronary arteries). It is not considered to be a type of surgery. See also cardiac catheterization and angiogram.
Alternative Names:
Balloon angioplasty; Coronary angioplasty; Coronary artery angioplasty; Cardiac angioplasty; PTCA; Percutaneous transluminal coronary angioplasty; Heart artery dilatation
Description:
Fat and cholesterol can accumulate on the inside of arteries and form
deposits called plaque. This disease process is called atherosclerosis.
The arteries that supply blood to the heart itself (called the coronary
arteries) can be narrowed or blocked by this accumulation.

If the blockage is not too severe, a balloon catheter may be used to
open the heart artery as an alternative to open heart surgery. The
catheter is a small, hollow, flexible tube that has a balloon near the
end of it.
The procedure starts with the patient lying on a padded table. Local
pain medicine is given, and the catheters are then inserted in an artery
(usually near the groin). The patient is awake for the procedure, but
pain medicine can be given as needed.
The heart and heart arteries are then visualized by using X-rays and
dye, and blockages in the heart vessels are identified. A balloon
catheter is then inserted in or near the blockage and inflated, thus
widening or opening the blocked vessel and restoring adequate blood flow
to the heart muscle.
Occassionally, blood thinning medicines are also given to prevent
formation of a blood clot. In almost all cases, a device called a stent
is also placed at the site of narrowing or blockage in order to keep the
artery open. A common type of stent is made of self-expanding, stainless
steel mesh.

Indications: Angioplasty may be performed to treat:

Persistent chest pain (angina)
Blockage of one or more coronary arteries
Residual obstruction in a coronary artery during or after a heart
attack

Risks: The risks for any anesthesia include reactions to
medications and
problems breathing. Bleeding and infection are risks for any surgery.

Additional risks may include:

Complete obstruction of blood flow to an area of the heart (a small
risk, less than 1%; a heart surgery team is on standby)
Damage to a valve or blood vessel
Stroke
Arrhythmia
Bleeding in the groin (or other catheter access site)
Kidney failure
Allergic reaction to the X-ray dye
Death

Expectations after surgery: This procedure greatly improves 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 result is relief from chest pain, and 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
recurrenct narrowing can be expected in 17-25% of cases over a 6 month
period. However, this recurrent narrowing may or may not require a
repeat procedure.

Patients should diet, exercise, abstain from smoking, and reduce stress
in order to lower the chances of recurrence. The physician may prescribe
a medication, such as statin, to help lower the patient’s cholesterol.

If the arteries are not sufficiently widened by angioplasty or the
blockages are too severe to be treated by angioplasty, heart surgery
(CABG surgery) may be recommended.

Convalescence: The average hospital stay is less than 2 days, and
often, an overnight hospital stay is not required at all. Patients are
generally able to walk within 6 hours after the procedure. Complete
recovery takes a week or less.