Centers of Excellence in Interventional Cardiology and Radiology

INTERVENTIONAL CARDIOLOGY

Coronary angioplasty

We HAVE MOST OF ROMANIA renowned cardiologists

Our center has saved the lives of over 4,500 patients in the last 4 years

The most modern equipped angiography room , an exceptional medical team

The first centre in our country that performs fully bioresorbable implants

Only 24 hours hospitalization

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Generalities

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Coronary angiography is a specialized procedure in which x ray pictures are taken of your heart arteries (the coronary arteries) to see if they are narrowed or blocked. It is an important test, used when your doctor suspects or knows that you have coronary heart disease.

Indications

Coronary angiography can be used to help diagnose a number of heart conditions, including:

  • heart attack – a serious medical emergency where the heart’s blood supply is suddenly blocked, usually by a blood clot
  • angina – a dull, heavy or tight chest pain caused by a restriction in the heart’s blood supply due to a build-up of fatty substances (atheroma) in the walls of the coronary arteries (the arteries that supply blood to the heart)

Coronary angiography is considered to be the ‘gold standard’ method of diagnosing coronary artery disease. Coronary angiography is also used during certain treatments. For example, it may be used if you need to have:1

  • a coronary angioplasty or percutaneous coronary intervention (PCI)– this is a procedure to widen blocked or narrowed coronary arteries
  • a coronary artery bypass graft (CABG) – surgery to divert blood around narrow or clogged arteries and improve blood flow to the heart
  • heart valve surgery or intervention – the valves are structures inside the heart that control blood flow within and through the organ

Procedure

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The team responsible for your care includes a cardiologist (heart specialist), nurse, and cardiac technician. The procedure is carried out in a catheterisation laboratory in one of our center of excellence.

Before having the procedure, you should tell your cardiologist if you have any allergies and if you are taking any medication, either for a heart problem or another medical condition. You will be told whether to continue taking your medication or if you need to stop. You should not stop taking prescribed medication unless you are advised to do so. Occasionally, you may also be asked not to eat or drink anything for six hours before the procedure.
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Anaesthetic
The procedure will be carried out under local anaesthetic and you may also be given the option of having a sedative. Sedatives are a type of mild anaesthetic (painkilling medication) used during minor painful or unpleasant procedures. If you are sedated, you will feel sleepy and relaxed but remain awake and have enough awareness to respond to instructions. For example, you may be asked to take a deep breath and hold it at certain points during the procedure.

Monitoring your heart

Throughout the procedure, you will be attached to an electrocardiogram (ECG) machine. An ECG records your heart’s rhythms and electrical activity. A number of electrodes (small metallic discs) are placed on your arms, legs and chest. The electrodes are connected to a machine that records the electrical signals of each heartbeat.

The procedure

Provided that you do not need to have a further procedure, such as a balloon angioplasty (see the Coronary Angioplasty section on our website), coronary angiography should take about half an hour.

Below is a step-by-step guide to what you can expect during the procedure. The healthcare professionals who are with you will explain what is happening.

  • After entering the catheterisation laboratory you will be asked to lie on a special table. If the catheter is being inserted into your groin, your groin may be shaved and will be cleansed with antiseptic fluid.
  • You will be covered with a sterile sheet and given an injection of local anaesthetic to numb the skin of your groin or arm, so the procedure should not be painful.
  • The catheter will be inserted through a fine tube called a sheath.
  • The catheter will be moved through your blood vessels and into your heart using X-ray guidance.
  • A small amount of special dye called contrast medium will be injected through the catheter and the pressure in your heart will be measured.
  • As the dye is injected, you may feel a hot flushing sensation that passes quickly. You may experience a warm sensation in your groin that feels as if you have wet yourself. You may also have a metallic taste in your mouth. This is nothing to worry about and you will be warned when to expect it.
  • You will not feel the catheter being guided through your blood vessels. However, you may be aware of the odd missed or extra heartbeat.
  • A series of X-ray images will be taken of your heart and the blood vessels around it. These are called angiograms and will be stored digitally (on a computer).
  • In certain circumstances – for example, if your arteries are blocked, your cardiologist may decide to carry out a balloon angioplasty (an interventional procedure to widen blocked arteries). This will be carried out immediately and will add about an extra hour to the procedure. This should usually have been discussed with you beforehand, unless it is required as an emergency procedure.
  • After the procedure is complete, the catheter will be removed.
  • If the catheter was inserted into your groin, the nurse or cardiologist may apply pressure to the entry site for about 10 minutes to stop any bleeding.
  • Alternatively, a number of different plugs or clips may be used to seal or close up the wound.
  • If the catheter was inserted through your arm, a tight dressing will be applied for around two to three hours.

Is it painful?

No. The whole procedure is carried out under local anesthesia, the patient being conscious during the whole duration of the procedure.

How long does it take?

The procedure takes about 30 -45 minute and is performed in the cardiac catheterization laboratory but the procedure may take about 1 – 2 hour if the coronary angioplasty its made.

Risks

Coronary angiography is generally considered to be a safe procedure. However, as with all medical procedures, there are some associated risks.Potential risks of coronary angiography include:

  • bleeding under the skin at the wound site (haematoma) – this should improve after a few days but contact your doctor if you are concerned
  • bruising – it is common to have a bruise in your groin or arm afterwards
  • allergy to the contrast dye used – this is rare but you should discuss any allergies that you have with your cardiologist (heart specialist) before having the procedure

Serious complications

In very rare cases, more serious complications of coronary angiography can occur. These include:

  • heart attack – a serious medical emergency where the heart’s blood supply is suddenly blocked, usually by a blood clot
  • stroke – a serious medical condition that occurs when the blood supply to the brain is interrupted
  • damage to the artery in the arm or groin in which the catheter was inserted, with possible impairment of circulation to the limb
  • deterioration in kidney function
  • tissue damage from X-rays if the procedure is prolonged
  • death

The risk of a serious complication occurring is estimated to be around 2 in 1,000. It is usually the result of serious underlying heart disease. Our cardiologist will discuss the risks with you before you have the procedure.

Before procedure

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Before having the procedure, you should tell your cardiologist if you have any allergies and if you are taking any medication, either for a heart problem or another medical condition. You will be told whether to continue taking your medication or if you need to stop. You should not stop taking prescribed medication unless you are advised to do so. Occasionally, you may also be asked not to eat or drink anything for six hours before the procedure.

After procedure

After having coronary angiography, you will usually be able to leave hospital the next day, after a period of rest and observation.

If the catheter was inserted into your groin, a nurse may apply pressure for 5-10 minutes to stop the bleeding after the catheter and sheath have been removed from the artery. Sometimes, the doctor carrying out the procedure will insert a special stitch or other closure device. In this case, it will not be necessary to press on the artery.

If the catheter was inserted into your arm, a small pressurised cuff may be placed around your arm and pressure will gradually be decreased over the course of several hours. A nurse will check whether there is any bleeding at the point where the catheter was inserted. If the catheter was inserted into your arm, you should be able to sit up straight away and you may be able to walk around soon afterwards. If the catheter was inserted into your groin, you will be asked to lie flat after any bleeding has stopped.

Most people are fine the day after having the procedure, although you may feel a bit tired afterwards and the wound site is likely to be tender for up to a week. Any bruising may last for several weeks. However, you should seek immediate medical attention if swelling at the site of your wound gets worse, or if you experience excessive bleeding or circulation problems to a limb.

The advice listed below may help with your recovery.

  • Avoid having a hot bath for three to four days until the wound site has healed. You can still take a shower.
  • Remove the plaster from your groin the day after the procedure. Gently clean the site with mild soap and water and dry it thoroughly before applying a new plaster. Change the plaster daily until your skin has healed.
  • Contact your doctor if you experience any redness at the wound site that is warm to touch, or if you have a high temperature, rash, numbness or pain in your leg when walking.
  • Do not drive for 24 hours.
  • Avoid playing sport, excessive activity or lifting anything heavier than 5kg (11lb) for two to three days.

Important!

Find out the cost for this procedure!

Or
you can contact us!

Call Center
031 9300

Within our centres of excellence, both the patient and his/her doctor can choose the interventional cardiologist from our reputable team. As soon as a procedure is performed, the patient will receive a written report and a CD containing recorded images of the intervention, and the doctor is informed about his/her patient’s health status.

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