Text for the Angioplasty Brochure

(the first part of this file is the text designed to support the medical art in the first two columns of the brochure's "outside")

 

What is an Angioplasty?

Angioplasty is a remarkable type of procedure that allows doctors to open clogged arteries in the walls of your heart without performing surgery! Instead, a fine tube is guided up to your heart through a small incision, usually made at the very top of your leg. A miniature balloon is guided through the tube, and then inflated. When the balloon expands, it pushes back the plaque blocking your artery, improving the blood circulation to your heart muscle once again.

[drawing of the heart

in the first column]

Heart Anatomy

Your heart is your body's hardest-working muscle, working every minute to pump blood throughout your body. Like any muscle, the heart needs a constant supply of oxygen and nutrients. These reach the heart walls via the three coronary arteries - the two branches you see on the drawing above, plus one on the back side. In spite of all the blood rushing through your heart every minute, your heart muscle can starve when any of the three coronary arteries become too clogged.

[drawing of three blood vessels

at the top of the second column]

Unfortunately, clogged coronary arteries are not uncommon - over 7 million Americans have this condition, known as coronary heart disease (CHD).

The Procedure:

During angioplasty a miniature balloon is fed through your arteries right to the place in your heart wall where earlier tests determined that there was a blockage. Once the balloon is in place, it is inflated and deflated, sometimes a few times. This action pushes back the plaque blocking the coronary vessel, improving blood flow to that portion of the heart muscle.

Unfortunately, the benefits of angioplasty are sometimes temporary. Blockages do reform, sometimes quickly. Depending on where your blockages are, Dr. Welby may decide to place one or more stents in the arteries of your heart. A stent is a miniature wire shape, smaller than the spring in a pen. The stent acts like a brace, helping keep the plaque that's been pushed out of the way from collapsing back down and re-blocking your artery.

[drawing of the stented

vessel at the bottom of

the second column]

(the following is the text provided to help you with the brochure's "inside")

 

Before Your Angioplasty:

Although angioplasty is not surgery, your pre-procedure guidelines are important:

  • Do not eat or drink anything after midnight the night before your procedure.

  • Usually you can continue to take your regular medications, even the morning of the procedure. Let us know what medications you're on, so that we can advise you of any adjustments you'll need to make.

  • The morning of the procedure, swallow approved medications with just a sip or two of water.

  • Since you will not be allowed to drive yourself home when you check out, arrange for transportation to and from our facility.

Please be on time for your appointment, since there's lots to do. After completing a few last-minute forms, it will be time to change into a hospital gown. Then we will take an electrocardiogram, and a chest X-ray. We will draw a small sample of your blood, for lab tests, and we'll place an IV in your arm. The area where the catheter will be inserted may be shaved, to reduce the risk of infection. As we're about to go to the lab, we'll add a medication to your IV that will help you to relax.

During the Procedure:

Dr. Welby will join us in the lab. Although you'll feel groggy, you will be awake, and able to speak with him.

The large machine hanging from the ceiling is the X-ray camera. What makes this machine unique is that, instead of a single snapshot, like a traditional X-ray, this machine takes pictures continuously. These pictures are displayed on the monitors next to you, and in the adjoining room. These monitors will be Dr. Welby's eyes, as he works inside the walls of your heart.

The procedure begins with a very small incision, where your leg joins your torso. A small tube, called an introducing sheath, is placed in the incision. Through this hollow tube, another hollow tube, called a catheter, is threaded into your artery system. Soon the catheter is at the heart. Although blood is constantly circulating through the heart; the heart itself is nourished just by the blood that makes it through the three coronary arteries. Watching on the TV monitor, Dr. Welby will carefully guide the catheter until it is actually inside the coronary artery that is blocked. X-ray dye will be released. On the monitor, the delicate vessels that feed the heart wall will stand out, much like a river with many small streams leading from it. Your partial blockage will show as an unusually narrow section of the river. With the dye outlining the blockage, Dr. Welby will feed a second smaller catheter, with a balloon tip, through the first catheter. When the balloon is in place, in the narrowed area, it is inflated. This action pushes aside the plaque blocking the coronary vessel, and improves blood flow to that portion of the heart muscle.

This procedure will be repeated for other blockages that have been found in your coronary arteries.

Depending on the location of a blockage, stents may also be used. Stents are miniature wire frames that are worked into place after the first balloon has pushed back the blockage. Once in place, a second balloon inside the stent is inflated, and the stent is pushed into place, acting as a scaffold to hold open the vessel. Stents can't be used everywhere, but where they will fit, they can be very useful in keeping the plaque that's been pushed out of the way from collapsing back down and re-blocking your vessel.

After Your Procedure:

When your angioplasty is done, you will be wheeled to a special recovery room. Since coronary blockages can reform suddenly, the introducing sheath that was placed in your leg may be left there for a number of hours after your procedure. You will need to lie quietly and keep your leg still so that the healing process can begin. When the introducing sheath is removed, a piece of tape will be placed over the cut, and a weight may be placed on the area to keep it from bleeding. Although you'll need to stay in bed, you'll be able to eat and drink, and visitors are allowed. We will keep you on the IV, so that fluids and special medications can be administered. Expect that you'll be released the following day.

Your Recovery:

Take it easy at first. Although you should feel well-enough to return to desk-work a day or two after you're released, avoid lifting or straining for at least a week. If you're feeling uncomfortable, take Tylenol (Acetaminophen).

For the first few days, if you feel that you're about to cough or sneeze, put gentle pressure where the incision was, to keep the wound from reopening..

During the healing process, if something happens, and you do begin bleeding from your wound, put pressure on it, and call us. If we're not available, be safe, and get to an emergency room.

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