Heart Angioplasty Surgery in Noida, Delhi Ncr, India

Overview

Coronary Angioplasty, also known as Percutaneous Transluminal Coronary Angioplasty (PTCA), is a minimally invasive procedure that treats narrow or blocked coronary arteries caused by plaque buildup. This procedure aims to improve blood flow to the heart, alleviating symptoms such as chest pain (angina) and preventing heart attacks (myocardial infarction).

• Procedure Type: Minimally invasive
• Speciality: Cardiology
• Body Location: The heart
• Alternate Name: Percutaneous Transluminal Coronary Angioplasty (PTCA)

Who is a Candidate for Angioplasty Surgery?

Angioplasties are usually performed for:

• Individuals diagnosed with significant blockages in their coronary arteries causing symptoms or limiting daily activities.
• Individuals in good general health without other medical conditions that may increase the procedure’s risks.
• Emergency treatment during a heart attack.
• Preventing future heart attacks.

Preparation for Coronary Angioplasty

• The doctor will review the patient’s medical history, allergies, and medications.
• A physical exam and diagnostic tests like blood tests, angiograms, exercise stress tests, and cardiac catheterisation may be performed.
• Quit smoking before the procedure and avoid smoking for six weeks after.
• Adjust or stop certain medications as advised by the doctor.
• Detailed instructions will be provided by the care team.

How Coronary Angioplasty is Performed

1. Anaesthesia: Administered to the patient.
2. Catheter Insertion: A catheter, a thin and flexible tube, is inserted through a small incision, usually in the groin or arm, and guided to the blockage site in the coronary artery using X-ray imaging or fluoroscopy.
3. Balloon Inflation: A small balloon attached to the catheter is inflated to widen the blocked area of the coronary artery.
4. Stent Placement: A stent (metal mesh device) may be placed to keep the artery open and prevent recurrence of the blockage. The balloon is inflated to expand the stent, then deflated and removed.
5. Closure: The catheter is removed, the incision is closed with surgical glue or sutures, and a bandage is applied.

Risk Factors Associated with Coronary Angioplasty

• Anaesthesia-related complications
• Damage to blood vessels
• Damage to the heart
• Persistent narrowing of the blood vessel
• Blood clots
• Poor wound healing

Recovery After Coronary Angioplasty Surgery

• Recovery can take 4-6 weeks, depending on general health and lifestyle.
• Avoid lifting heavy objects, strenuous activities, and operating heavy machinery.
• Pain medication will be provided for comfort during healing.
• Regular follow-up appointments are essential to monitor for any complications.
• Engage in doctor-approved exercises after recovery.
• Take all prescribed medications on time to ensure proper recovery.

Frequently Asked Questions

What is the difference between an angioplasty and a stent?

Angioplasty and stenting are often performed together to treat blocked blood vessels. Angioplasty involves opening a blocked blood vessel using a small balloon that is inflated to widen the artery. A stent is a small mesh-like device inserted into the blood vessel to keep it open after angioplasty. The stent supports the blood vessel, reducing the risk of restenosis (re-narrowing of the blood vessel).

What are the risks of an angioplasty?

Coronary angioplasty is a common medical procedure but carries some risks, including:

• Bleeding, especially at the catheter insertion site.
• Damage to blood vessels: From the catheter or balloon.
• Allergic reactions may occur due to the dye used during the procedure.
• Arrhythmias: Abnormal heart rhythms.
• Emergency coronary artery bypass grafting: If angioplasty is unsuccessful.
• Kidney damage: This can occur due to the contrast dye used during the procedure.
• Heart attack: Though rare, it can occur during the procedure.
• Stroke: Due to blood clots dislodged during the procedure.

Complications are rare, with less than two percent of people dying during angioplasty. Risks are higher in individuals aged 75 and older, those with kidney disease or diabetes, those with poor heart function, and those with extensive heart disease and blockages.

What is the life expectancy after angioplasty?

Life expectancy after angioplasty depends on several factors, including the patient’s lifestyle, overall health, and the severity of the blockage. Adopting a heart-healthy lifestyle with regular exercise, a balanced diet, and avoiding smoking can significantly improve long-term outcomes.

How many stents can one person have?

The number of stents a person can have varies based on their specific medical situation. Multiple stents may be required to treat multiple blockages in different blood vessels. The cardiologist will assess the patient’s needs and decide on the number of stents to place.

Can angioplasty be done twice?

Yes, angioplasty can be repeated if necessary. Repeat angioplasty may be needed due to restenosis (re-narrowing of the blood vessel) or the development of new blockages. The procedure can be performed multiple times depending on the patient’s condition and medical needs.

How many years does a stent last?

The longevity of a stent can vary, but most are designed to provide long-term support for the blood vessel. Factors influencing the lifespan of a stent include the type of stent used, the location of the stent in the blood vessel, and the individual’s overall health. Regular follow-ups with a cardiologist and maintaining a healthy lifestyle are crucial for the long-term success of stent placement.

Types of Heart Angioplasty Surgery

Heart angioplasty surgery can be performed in various ways:

• Balloon Angioplasty: Involves using a small balloon at the tip of the catheter, inserted near the narrowed or blocked area of the coronary artery. The balloon inflates, compressing the blockage against the artery walls, increasing blood flow to the heart.
• Balloon Angioplasty with Stenting: A stent, a small metal mesh tube, is inserted into the narrowed artery using a balloon catheter. The stent is expanded to fit the artery, and the balloon is removed while the stent remains to support the artery.
• Drug-Eluting Stents (DES): Stents that release medication at the implantation site to reduce the risk of restenosis. Though there is a potential risk of blood clots, it is generally managed with medications post-procedure.
• Rotablation (Percutaneous Transluminal Rotational Atherectomy or PTRA): Uses a special catheter with a diamond-coated tip to grind away plaque in the arteries. The microscopic particles are safely washed away in the bloodstream and filtered out by the spleen and liver.
• Cutting Balloon: A catheter with small blades and a balloon tip. The blades clean the plaque as the balloon inflates, compressing fat deposits into the artery. This is useful for treating blockages caused by previously used stents.

Post-Procedure Care

• Hospitalization for at least a day to monitor the heart and adjust medications.
• Refrain from engaging in strenuous exercise or heavy lifting for several days.
• Stay hydrated to flush the contrast dye used during the procedure.
• Consult a doctor if experiencing:
  • Bleeding or swelling at the catheter insertion site
  • Discomfort in the catheter insertion area
  • Signs of infection (drainage, fever, redness, or swelling)
  • Sudden changes in temperature or color of the arm or leg used during the procedure
  • Weakness or dizziness when getting up
  • Shortness of breath or chest pain

Medication and Lifestyle Recommendations

• Take blood-thinning medications such as clopidogrel and aspirin as prescribed. Patients with a stent replacement may need these medications for a year or longer.
• Follow pre- and post-procedure routines diligently.
• Maintain a healthy lifestyle by incorporating regular exercise, a balanced diet, and refraining from smoking.

When is Heart Angioplasty Surgery Required?

Heart angioplasty surgery treats atherosclerosis, a condition where fatty plaques build up in the heart’s blood vessels. Angioplasty is suggested when:

• Medications and lifestyle changes are insufficient to improve heart health.
• The heart muscle is weak, or the main artery to the left side of the heart is narrow.
• Multiple blockages are present, for which coronary artery bypass surgery may be recommended.

Angioplasty can also be an emergency treatment right after a heart attack, significantly increasing survival chances.

Diagnosis Before Heart Angioplasty Surgery

• Typically involves blood tests and an electrocardiogram.
• Multiple appointments may be needed.
• Fasting is required the night before the tests.
• Inform the doctor of any allergic reactions.
• The procedure is usually performed while the patient is awake but relaxed with medication.

Post-Surgery Expectations

Heart angioplasty improves blood flow to the heart, reducing chest pain from angina. However, it does not cure heart disease. Patients must maintain a healthy lifestyle, including:

• Regular exercises as advised by the cardiologist
• Maintaining a healthy weight
• Manage conditions such as high blood pressure and diabetes effectively.
• Quitting smoking
• Achieving a low LDL cholesterol level

Stent Heart Angioplasty Surgery

A stent is a wire-mesh tube supporting the coronary artery. The angioplasty procedure involves placing a balloon catheter over a guide wire to insert the stent into the blocked artery. The balloon is inflated, expanding the stent around the artery, and then deflated and removed while the stent remains.

• Duration: 30 minutes to 2 hours, depending on the case.
• Hospital Stay: Same-day discharge for angina patients; longer stay for heart attack patients until stabilized.

Last Update: Reviewed by Dr. (Prof.) Purshotam Lal, Chairman – Metro Group of Hospitals & Director – Interventional Cardiology on 22 June 2024.