Preparation
An interventional cardiac catheterization is also referred to as coronary angioplasty, balloon angioplasty, or percutaneous transluminal coronary angioplasty (PTCA). This therapy also includes the procedure of implanting a stent across a coronary artery blockage. During this inpatient procedure, narrowed or blocked coronary arteries are opened, restoring blood flow to the heart muscle and correcting critical problems caused by coronary artery disease. This therapy is administered using fluoroscopy. Fluoroscopy is a special x-ray technique that captures and stores real-time images.

If you need this procedure, Dr. Moore will likely refer you to a trusted, experienced, board-certified cardiologist or cardiothoracic surgeon at Indian River Medical Center.

The physician performing the procedure will provide you with specific preparation instructions, which may include:

• Informing the physician of all medications
• Obtaining pre-procedure blood work
• Abstaining from eating or drinking after midnight the evening prior to the procedure

Procedure
Once you have registered, changed into a hospital gown, and been situated in a bed, you'll receive an intravenous (IV) line that will be used to give you fluids. The IV also will administer a mild sedative that will help you relax during the procedure. The sedative is generally given about 30 minutes prior to the procedure. You'll still be awake and somewhat responsive during the procedure, but many patients find they don't remember much afterwards. You may also be administered a blood thinning medication (usually heparin) to prevent blood clots during the procedure. Electrodes will be attached to your chest to monitor your heart, and a cuff will be placed on your arm to monitor your blood pressure.

Once the sedative has taken effect, a sheath is inserted into an artery in your groin or arm. A local numbing anesthetic will be applied to the insertion site so you won't feel a great deal of discomfort. Next, a long thin hollow tube with a special balloon tip that can be inflated will be inserted into the sheath. This tube is called a balloon catheter. Using a fluoroscopy x-ray machine, the cardiologist will guide the catheter to your heart. Once the catheter has reached your heart, the cardiologist will inject a contrast material, so the blocked vessel(s) can be located. The balloon catheter will be guided in or near blocked arteries and then inflated. When the inflation occurs, the blocked or narrowed vessel will open and blood flow will be restored. You may feel pressure in your chest during the balloon inflation. If you do, inform your physician.

Once the artery is opened, the cardiologist will implant a stent at the precise location that the artery was narrowed or blocked. A stent is a device that holds the artery open and prevents a problem called restenosis. Restenosis occurs when the artery re-narrows or re-closes. A number of advances in stent technology have been made in recent years, reducing the occurrence of restenosis.

The entire angioplasty procedure generally takes one to two hours. Infrequently, the physician discovers during this procedure that angioplasty is not an appropriate solution and the patient needs immediate open-heart or coronary artery bypass graft (CABG) surgery.

Post-procedure
Following the procedure, you'll be moved to a special recovery room or cardiac care unit. The introducing sheath will be removed and pressure will be applied to this site. If your groin was used, you will be required to lie flat on your back for six to 10 hours after the sheath is removed. Some patients find the reclined position is uncomfortable for their backs. If you experience back pain, tell the nurse and/or your physician.

The nurse and cardiac care team will continue to monitor your heart and the insertion site. Blood work will also be done to measure your anticoagulation levels. You will be released from the hospital one to five days following the procedure, and your activity level may be restricted. Follow all post-hospital instructions that the physician and nurses provide.

A follow-up appointment with Dr. Moore is generally scheduled so he can continue to monitor your recovery and progress.