PTCA

1. Percutaneous Transluminal Coronary Angioplasty (PTCA) Coronary Artery Bypass Graft (CABG) By Theodoros Adoni 1151

2. Is performed to open blocked or narrowed coronary arteries caused by coronary artery disease (CAD) and to restore arterial blood flow to the heart tissue without open heart surgery Greek word ‘ αγγείο’ = vessel and ‘ πλαστός ’ = moulded Percutaneous Transluminal Coronary Angioplasty (PTCA)

3. Causes Coronary artery disease (CAD) occurs when fatty deposits called plaque build up inside the coronary arteries Factors: Smoking High amounts of certain fats and cholesterol in the blood High blood pressure High amounts of sugar in the blood due to insulin resistance or diabetes

4. Symptoms - Chest pain (angina pectoris) - due to lack of oxygen - Difficulty breathing or shortness of breath - Sweating or “cold sweat” - Fullness, indigestion, or choking feeling (may feel like “heartburn”) - Nausea or vomiting - Dyspnea - Excessive fatigue

5. PTCA Procedure A special catheter is inserted into the coronary artery to be treated in the femoral artery in the groin First a guide wire is inserted and then a catheter which injects a dye

6. This catheter has a tiny balloon as its tip The balloon is inflated once the catheter has been placed into the narrowed area of the coronary artery The inflation of the balloon compresses the fatty tissue in the artery and makes a larger opening inside the artery for improved blood flow PTCA Procedure – Balloon

7. PTCA Procedure – Stent Placement Is a procedure used in PTCA A tiny, expandable metal coil (stent) is inserted into the newly opened area of the artery to help keep the artery from narrowing or closing again

8. PTCA Risks of the Procedure Bleeding at the catheter insertion site (usually groin) - Blood clots or damage to the blood vessels at the insertion site - Blood clot within the vessel treated by PTCA/stent - Infection at the catheter insertion site Cardiac arrhythmia - Chest pain or discomfort - Rupture of the coronary artery

9. PTCA Procedure monitoring Fluoroscopy (a special type of x-ray that obtains real- time moving images) assists the physician in the location of blockages in the coronary arteries as the contrast dye moves through the arteries.

10. Coronary artery bypass graft (CABG) p atients with severe narrowing or blockage of the left main coronary artery CABG is used over angioplasty when… patients with disease involving two or three coronary arteries are generally considered for bypass surgery

11. Coronary artery bypass graft A segment of a healthy blood vessel from another part in the body is taken and make a detour around the blocked part of the coronary artery Vessels are used: - Internal thoracic artery - Saphenous vein - Radial artery

12. CABG procedure -Incision is made in chest wall (sternotomy) -B ypass grafts are harvested -I n the case of "off-pump" surgery, the surgeon places devices to stabilize the heart - I n the case is "on-pump", surgeon connects heart lung machine to patient and delivers cardioplegia to stop the heart

13. One end of each graft is sewn on to the coronary arteries beyond the blockages and the other end is attached to the aorta.

14. - Internal defibrillator paddles used to induce pulse

15. The End