Patient Health InfoCoronary Angioplasty (PTCA)
Coronary angioplasty or PTCA (percutaneous transluminal coronary angioplasty) is an invasive treatment performed in the catheterization laboratory. The cardiologist uses a catheter with a tiny balloon at the tip to open blockage in the coronary artery. Inflating the balloon packs the blockage against the artery wall. It does not remove the blockage. Preparation Your care and activities before angioplasty will be similar to what happens before cardiac catheterization. After you and your physician have discussed the procedure, you will be asked to sign a consent form. Please read it carefully and ask any questions you have. Do not eat or drink anything after midnight the night before the procedure. An intravenous needle will be placed in your arm. Blood may be drawn for laboratory tests, a chest x-ray and electrocardiogram will be taken and you will receive medication to help you relax. A surgeon, perfusionist, operating room and staff will be available if needed. If your cardiologist determines the angioplasty was unsuccessful and may result in heart muscle damage, you may be taken directly to surgery.
The Procedure
The length of time required to perform a PTCA varies. You will be awake, but sedated and comfortable. The cardiologist and catheterization lab staff will explain each step of the procedure. If you have questions at any time, please ask.
The area of the insertion will be scrubbed. You will be covered with sterile sheets and the area will be numbed with a local anesthetic. You will feel pressure during the procedure but you should not feel any pain.
The cardiologist will place an introduces into a blood vessel from a site in your groin area or arm. The guide catheter passes through the introduces to the aorta and into the coronary arteries. A deflated balloon catheter will be inserted through the guide catheter to the point of the blockage.
The balloon will be slowly inflated and deflated. As the balloon inflates, the blood flow to the artery will be temporarily blocked and you may feel some chest discomfort. As the balloon deflates, the pain should subside. If it continues, please tell the cardiologist, nurse or technician.
When the artery appears to have been successfully opened, the balloon catheter will be removed and a contrast solution injected into the guide catheter. This allows the cardiologist to determine whether the blockage has been reduced. If the blood flow is restored, the procedure is considered a success.
Following the Procedure
The introducer in your groin area or arm may remain in place for a number of hours while you remain in bed in the Coronary Intensive Care Unit. You will be asked to lie flat during this time and a small ankle restraint may be positioned to remind you to keep your leg straight.
Please report any chest pains, shortness of breath, nausea or back pain to your nurse. Medication can relieve your discomfort. Please also report any sudden pain, a coolness or numbness in your leg, or any warm, sticky or wet feelings at the insertion site. Your blood pressure, pulses in your feet and groin area or arm, and the insertion site will be monitored often.
You will continue to receive intravenous fluids and you will be encouraged to drink fluids to help flush the contrast solution from your kidneys.
With your physician's orders, a nurse will remove the introducer and maintain direct pressure over the insertion area until the bleeding has stopped. A five-pound sandbag and dressing may be applied.
As soon as you are able to get out of bed, you will be transferred to a telemetry unit in the hospital where your condition will continue to be monitored. A nurse will assist you when you feel ready to get out of bed. You may feel or lightheaded.
How long you remain in the hospital will be determined by the amount of heart damage you have experienced. If there is none, you will be discharged the following day. If you experienced a heart attack prior to the procedure, you will remain in the hospital a few more days.
Generally, you will undergo a stress test before leaving the hospital. You may continue to have a bruise, swelling and tenderness at the insertion site. Avoid lifting anything over 10 pounds for a week after the procedure.