Atherosclerosis is the most common cause of death in every civilized country. It is caused by a narrowing of the arteries by a waxy substance in the vessel wall called "plaque" comprises cholesterol, fatty compounds, calcium, and coagulating substance called fibrin. As more plaque, the artery narrows, preventing blood flow. Also a break of this plate can cause a clot occurs and to close sharply leaving the artery that supplies blood circulation territory. This disease in the arteries of the heart, causes angina when blood flow is insufficient or if the plaque ruptures, acute vessel obstruction causing a myocardial infarction or heart attack.
Medications may be used to improve the symptoms but not cleaned yet these clogged arteries and a very narrow coronary artery may need other treatments to reduce the risk of a heart attack. One option is to do a percutaneous coronary intervention, such as balloon angioplasty or stenting.
In order to know where the lesions are, if there is one or many, we must first perform a cardiac catheterization or coronary angiography and then if the procedure is feasible,Angioplasty with or without stent.
WHAT IS A CORONARIOGRAPHY?
The catheterization cardiologists perform in a special room like a theater that features monitoring pressure and electrocardiogram and a special X-ray system that allows viewing and recording of the obtained images. It is done in awake patient but sedated puncture an artery in the arm or groin under local anesthesia. Catheters (tubes very thin, long and flexible plastic) through the arteries to the heart are entered using fluoroscopic control and once there is injected to opacify the coronary vessels and see the number, severity and characteristics of obstructions.
WHAT IS A BALLOON CORONARY ANGIOPLASTY?
The Balloon angioplasty is performed using a similar diagnosis but with a small ball or balloon at the tip (balloon catheter) catheter. The ball is brought to the blockage and inflated to compress at a controlled atheromatous plaque against the artery wall pressure. The main problem is that sometimes a few hours the elasticity of the wall may cause the vessel again shut.
WHAT IS ANGIOPLASTY WITH STENTING?
The stent is a tubular wire mesh. VA folded outside the ball, so that when the balloon catheter is inflated the stent is left in the wall acting as a support or scaffold to keep the vessel open once dilated so that normalizes completely blood flow in the disappearance of angina.
The stent is left in the wall and in some weeks endothelium lining the vessel being built.
Some stents are coated with a drug that is slowly and continuously released into the artery that prevents clogging again with scar tissue after angioplasty. These stents is known as drug-eluting.
- Arrival to the Consultation Clinic with Interventional Cardiologist for:
- Clinical evaluation and confirmation of the need
- Explanation of the intervention
- Signed informed consent
- Performing analytical Electrocardiogram and Time: 60 minutes
- Hospitalization in the Clinic at 13 hours.
- Fasting for 4 hours before
- Single room with companion
- Patient preparation
- Intervention at 17 hours
- Begin walking
- Overall assessment and the puncture site after hospital discharged.
- Transfer to Hotel
- Visit the cardiologist and final discharged
Does it hurt to try?
It is not painful. You may notice some stinging sensation when the local anesthetic is placed on the site where it is to be performed. Sometimes when injecting the contrast feeling very temporary heat throughout the body is felt. Other times, the delay or put the stent may notice a slight pain in the chest like that usually has, but very temporary
Why not make me sleep?
The test is not painful and you suffer heart is preferable not to perform anesthesia. You will be given prior to a medication you are calm and in case you get nervous it will put the right treatment for it is nearly asleep and feel no discomfort. I am allergic to the contrast.
Can I let me?
It is not an absolute contraindication. In these cases it is prepared with a medication before and during the process to avoid these allergic reactions.
Are there alternatives?
Angioplasty is one of the treatments available for this disease. The other two possibilities is to continue with medical treatment or surgery with placement of coronary bypass Medical treatment is appropriate when symptoms well controlled and no data of risk that may suffer a serious heart attack. But if he continues to upset or tests indicate a significant risk of having a heart attack must resort to angioplasty or bypass surgery. Coronary bypass is a surgery in which an artery or vein of a healthy body is connected or grafted to the coronary artery beyond the blockage where it is, so that the blood goes round to prevent the blockage of coronary artery. In this way the circulation of the heart is improved. Angioplasty has several advantages compared with coronary bypass surgery. These include the following:
- It does not require open heart surgery.
- It does not require general anesthesia (ie, it is not necessary to give the patient medicine to be asleep during the surgery).
- The recovery time is shorter.
However, angioplasty is not suitable for everyone. For some people, CABG might be a better alternative. The best treatment for you depends on many factors. The cardiologist will consider before recommending one treatment or another.
What are the risks of coronary angioplasty?
Coronary angioplasty is a common medical procedure. Serious complications are rare. However, there may be, no matter how careful you are the doctor or how well you perform the procedure. The complications of angioplasty are the following:
- Discomfort and bleeding at the catheter insertion site.
- Damage to blood vessels due to the catheters.
- Allergic to the dye used during angioplasty reaction.
- Arrhythmia (altered heart rate). Need for a coronary bypass or coronary bypass during surgery (this occurs in less than 1 percent of patients). It may occur if an artery becomes blocked more instead of cleared.
- Damage to the kidneys from the contrast medium used during angioplasty.
- Heart attack (I suffer from 1 to 2 percent of patients).
- Stroke (occurs in less than 1 percent of patients).
Sometimes during angioplasty may be pain in the chest because the balloon temporarily prevents blood circulation to the heart. As with any intervention that has to do with the heart, complications can sometimes be fatal. However, this is rare in coronary angioplasty. Less than 2 percent of individuals undergoing angioplasty die during surgery.
When I can get back to doing my normal life?
Most people recover from angioplasty and return to work the following week after leaving the hospital. The next day you can now walk safely and in 2-3 days you can perform a virtually normal physical activity. If is necessary to take all the medication you are told.
What should I do so that I do not happen again?
Although angioplasty eliminates the symptoms of the disease and removes blockages, does not cure the disease. You have oredisposición to clogged arteries. Lest happen again should eliminate the risk factors that produced it. When making changes in lifestyle contributes to the treatment of coronary disease and the good results of angioplasty are maintained. Ask your doctor what the risk factors predispose to coronary heart disease and what changes to make in your lifestyle. Changes in lifestyle can be to make changes in diet, quitting smoking, staying active, lose weight and reduce stress.