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Heart Disease Procedures -- Angioplasty

Clip Number: 33 of 41
Presentation: Common Heart Conditions, Tests, and Procedures
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Reviewed By: Arthur Schoenstadt, MD
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Cardiac catheterization with angioplasty is a procedure that allows your doctor to study the condition of your heart, including the muscle, valves, and arteries. It can also be used to open blocked coronary arteries and improve blood and oxygen flow to the heart without surgery.
To begin a cardiac catheterization with angioplasty, the doctor chooses an artery for the catheter entry site. Most commonly, an artery in the groin area of the leg is used. However, an artery in the bend of the elbow may also be used.
Once the area is numb the doctor will insert an introducer, which is a thin plastic tube, into the artery. Through this, a guidewire is lowered in the artery and a catheter, a small flexible tube, is inserted over the wire and carefully advanced to the heart, through the aorta, and to the coronary arteries.
The catheter movement is viewed on an xray screen.
Once the catheter reaches the coronary arteries, dye is injected into them. This special dye shows up on the x-ray screen and allows the doctor to see the blockages that may be present. The doctor will repeat the injection of dye several times, looking at the arteries from many different angles.
After the arteries have been examined, the catheter will be redirected to the left ventricle. This is to test how the ventricle is contracting and if the valves are functioning properly.
If the doctor injects the dye and locates a blockage, he or she will prepare for the balloon angioplasty. During angioplasty the doctor inserts a special balloon-tipped catheter into the artery and guides it to the blockage. Once the balloon catheter is correctly placed, it is inflated and deflated several times. With a successful angioplasty the blockage is squeezed outward against the wall of the artery and bloodflow is restored.
Depending on the specifics of the blockage, the doctor may place a stent in the artery. It will look something like this. The stent is an expandable device that is mounted on a balloon catheter. The stent and balloon are advanced to the blockage area and the stent is expanded into place. A stent supports the artery and helps it remain open for a longer period of time. After stent placement, the body will grow tissue over the stent to help maintain its position. The stent will not move around.
The procedure usually takes from 1 to 3 hours, but this varies from patient to patient. Once the procedure is complete, the doctor will take out the catheter but the introducer may remain in the artery. The doctor leaves the introducer in place for a period of time in case signs of artery reclosure are encountered, or, happen.

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