Coronary Angioplasty

What you should know

Coronary angioplasty is a procedure to open arteries in your heart that are clogged with plaque. Plaque is a mixture of fat and cholesterol. When your arteries are clogged, your heart may not get enough blood. This could lead to angina (chest pain), heart disease, or a heart attack.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

• The dye used during angioplasty may cause an allergic reaction or kidney problems. Fluid could build up in your lungs and cause trouble breathing. An artery in your heart could become completely closed or have a spasm. If this happens, your heart will not get enough blood. This could cause chest pain or a heart attack. You might need heart surgery right away to bypass (go around) the artery.
  
  
• You may get a blood clot in your leg or arm. The clot may travel to your heart or brain and cause life-threatening problems, such as a heart attack or stroke. Your arteries could become blocked again, and you may need another angioplasty or heart surgery. If you do not have this procedure, plaque may continue to build up in your arteries, and you may have a heart attack.

Getting Ready

The week before your procedure:

• Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.
  
  
• Contrast dye will be used during your procedure to help caregivers see your heart better. Tell the caregiver if you have ever had an allergic reaction to contrast dye.
  
  
• You may need blood tests before your procedure. Talk to your caregiver about these or other tests you may need. Write down the date, time and location for each test.
  
  
• Ask someone to drive you home when you leave the hospital. Do not drive yourself home.
  
  
• Write down the correct date, time, and location of your procedure.
  
  
• You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

The day before your procedure:

• Ask caregivers about directions for eating and drinking.
  
  

The day of your procedure:

• Ask your caregiver before taking any medicine on the day of your procedure. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring a list of all the medicines you take, or your pill bottles, with you to the hospital.
  
  

Treatment

What will happen:

• You may be given medicine in your IV to help you relax or make you drowsy. You may also get medicine called local anesthesia that will numb the area where the catheter will be placed. You will be awake during the procedure so that your caregivers can give you instructions. You may be asked to cough, hold your breath, or to tell them how you feel during the procedure.
  
  
• A catheter (long, thin tube with an empty balloon on the end) is put into an artery, usually in your groin. The catheter is gently threaded up to your heart and into the blocked artery. Caregivers will use x-rays and dye to find the place where the artery is blocked. You may feel warm as the dye is put into the catheter. Caregivers may do more than one of the following to open your arteries:
  
  
  • Inflate a balloon-tipped catheter: Caregivers inflate a tiny balloon on the tip of the catheter. The inflated balloon pushes the plaque against the artery walls. This opens them up and helps more blood flow to your heart.
    
    
  • Vaporize plaque with a laser light: Caregivers may vaporize (melt away) some of the plaque with a laser light.
    
    
  • Put in a stent: A stent is a tiny mesh tube or coil. Caregivers may put a stent in your artery to keep plaque from building up again.
    
    
  • Shave away plaque: Caregivers may use a catheter with a shaver or tiny drill tip to remove plaque from the arteries. Plaque may be suctioned away after it is shaved or drilled off the sides of the artery.

After your procedure:

The catheter will be taken out of the artery and a tight pressure bandage will be put on the area. Caregivers will put pressure on the bandage with a sandbag to stop the bleeding. You may have a collagen plug or stitches to stop the bleeding. You will need to lie still and flat for 4 to 6 hours or longer after the procedure to prevent bleeding. Do not get out of bed until your caregiver says it is okay.