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Minimally invasive procedure to open blocked heart(coronary) arteries and help restore blood supply to the heart. A catheter is inserted in an artery in the groin(Femoral artery) and it is guided to the affected, narrow and blocked coronary(Heart) artery. The catheter has a balloon at its tip which is inflated and deflated multiple times inside the narrowed coronary artery, to open it up and compress the plaque against the wall of the artery.During the procedure, before putting the catheter in the coronary or heart artery, dye is injected and a series of x rays are taken to clearly view the coronary artery which is narrowed.
Once through with the insertion of catheter in the Coronary(heart) artery, Xrays(Coronary angiogram) are repeated to ensure the successful opening of the affected artery and when confirmed, the catheter is removed. A stent may be placed in the affected artery to keep it open.
This procedure restores the blood supply to the heart.
Q1. What is the duration of the PTCA(Angioplasty) procedure?
A1. PTCA procedure usually takes 1 to 2 hours.
Q2. Where is PTCA (Angioplasty) carried out?
A2. Angioplasty is carried out in the Cardiac Catheterization Lab.
Q3 What are Coronary arteries?
A3 Coronary arteries are the blood vessels that supply blood rich in Oxygen to the heart. Coronary term is used in reference to the heart or related to heart. It is derived from a Latin word "Corona" which means a "Crown", these blood vessels encircle the heart like a crown.
Q4 What is CAD(Coronary Artery Disease)?
A4 CAD or CHD(Coronary heart disease) is one of the most common heart problem that can severely compromise the function of the heart. CAD involves the stiffening and narrowing of the blood vessels supplying oxygen rich blood to the heart due to a condition called "Atherosclerosis". As a result the blood supply to the heart is compromised thereby depriving heart its nutrition by way of blood. It can manifest as symptoms such as chest pain or even heart attacks,heart failure, disorder of heart beat rhythm(Arrhythmia) in worse cases.
Q5 What is Cardiac Catheterization?
A5 Cardiac Catheterization is a medical procedure employed for not only diagnosing but also treating certain heart problems. Here, a catheter is used,which is a thin, flexible tube, to reach to the heart. It is inserted in a blood vessel present in the groin,arm or neck initially and guided right into the heart. A dye may be used to clearly view the diseased coronary arteries, in the xrays. This procedure is performed by heart specialists(Interventional Cardiologists).
Q6 What is Atherosclerosis?
A6 Atherosclerosis is a medical condition in which the walls of blood vessels(arteries) become thick, hard and stiff due to the accumulation of plaque(cholesterol,other fatty deposits,waste product of cells,calcium and blood clotting protein-Fibrin) on their inner lining. High blood pressure, High amount of bad cholesterol,Diabetes,family history are its usual causes. Atherosclerosis is a slow progressive disease.
Q7 What is a Stent?
A7 A small expandable tube shaped device usually made up of network of metal wires(Mesh).
It is placed inside the narrowed and blocked segment of the coronary artery for good, to provide firm support and keep it open thereby improving blood flow to the heart muscle. Most of the patients who undergo Balloon Angioplasty(PTCA or PCI) will have a stent also placed at that time.
Drug eluting stents (DES)are the ones that are coated with a medicine that is slowly released to prevent the blocking of the artery again.
Q8 What is meant by wrist angioplasty?
A8 When catheter is introduced into the body in order to access the heart for either diagnostic or therapeutic(treatment) purposes, through radial artery in the wrist instead of conventional approach of insertion of the catheter through femoral artery in the groin, the procedure is referred to as Wrist Angioplasty. It is a minimally invasive procedure carried out by Interventional cardiologist.
Q9 What can I expect after completion of the procedure?
A9 There are certain things that may be expected after the completion of the Angioplasty procedure. They are
Drink plenty of fluids to flush out the dye that was injected in your body prior to the procedure.
Catheter insertion site should be kept dry for initial 24 to 48 hrs.
Keep lying in supine position(lying on your back) for few hours. However, if the radial artery was used for insertion of catheter, you may be allowed to walk immediately post procedure. Usually, patient can walk within 6 hrs and recovery takes place within a week. It is important to mention here that walking on a levelled surface for short distances for initial 2 to 3 days is fine. However, climbing up or downstairs should be restricted to not more than 2 times per day for initial 2 to 3 days post procedure. Please follow the instructions of your treating doctor, well customized as per your requirement, regarding the same.
Keep away from lifting heavy stuff for first few days. Generally when the catheter is inserted through groin(femoral artery) restrict yourself from indulging in any sexual activity,driving, playing sports,squatting for first 2 to 5 days. Again, follow your treating doctor's instructions regarding resumption of the above activities specially individualized as per your condition and requirement.
Resumption of your work depends on the nature of your work. If your work involves only light activity, you can resume it in 2 to 3 days otherwise consult your doctor who will guide you better regarding the appropriate time for resumption keeping your safety in his/her mind.
In case of wrist angioplasty, wherein the catheter woill be inserted through radial artery in the arm, you will be asked to keep away from lifting anything beyond 4 to 4.5Kgs and also, make sure that you do not pull or push something heavy or twist your arm in any way.
Advice regarding how often the dressing needs to be changed and when to come for review.
Pressure bandage will be applied over the catheter insertion site to prevent bleeding.
Q10 When do I need to call my doctor after the procedure?
A10 You need to immediately contact your doctor under the following conditions:
These are the usual conditions for which you need to contact your doctor. However, if you feel any sort of doubt or discomfort you are free to contact your doctor for alleviation of your apprehensions and clarify your doubts. Your doctor would be glad to pacify all your concerns.
Most affordable cost coupled with quality.
World class hospitals with state of the art infrastructure.
No waiting period
Globally trained Cardiologists with decades of experience in carrying out the procedure with competence and ease.
Compassionate staff to look after
Hospitals accredited with international organizations such as JCI(Joint commission International) for quality standards.
Language no barrier. English speaking people and if required, translators are available for your convenience
Most economical accommodation available at a walking distance from the hospital. Wide range of options starting from guest house, service appartments to five star hotels, best suited to your budget and choice.
Good flight connectivity
India has a diverse and rich cultural heritage. You can witness its beauty and uniqueness. It offers most conducive environment for recuperation.
Dr Naresh Trehan
MBBS, Diplomat(American Board of Cardiac Surgery),Diplomat(ABS)
Chairman and Managing Director,Heart Institute, Division of Cardiothoracic and Vascular Surgery)
Medanta,The Medicity,Gurgaon, Delhi-NCR
Dr Ganesh K. Mani
MBBS. MS, M.Ch (Cardiothoracic Surgery)
Chairman, Cardiothoracic and Vascular Surgery
Max Smart Super Specialty Hospital, Saket, New Delhi
Dr Manoj Luthra
MBBS,MS(General Surgery),DNB(General Surgery), MCh(Cardiac Surgery)
Ex Senior registrar,Cardiac surgery(NHS,UK)
Fellowship in coronary artery surgery at Royal Prince Alfred Hospital (Sydney,Australia
Visiting fellowship in cardiac transplantation from Cleveland Heart Clinic,USA.
Saket, New Delhi
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