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Heart artery dilation Description:
Fat and cholesterol accumulates on the inside of arteries ( atherosclerosis ). The small arteries of the heart muscle (the coronary arteries) can be narrowed or blocked by this accumulation. If the narrowing is small, it may be treated with a balloon catheter rather than major surgery. This is a a small, hollow, flexible tube that has a balloon near the end of it.
While the patient is awake and pain-free (local anesthesia), the catheter is inserted into an artery at the top of the leg (the femoral artery). X-ray pictures are taken to view the catheter as it is passed up the artery, into the aorta, and into the blocked coronary artery. The small balloon at the end of the catheter is inflated and widens the area of the blockage, restoring adequate blood flow through the artery to the heart muscle.
Rarely, a device called a stent may be placed. This is a small tube that is placed within the coronary artery to keep the vessel open. One type is made of self-expanding, stainless steel mesh. (A stent may also be used after coronary artery bypass graft surgery.)
Indications:
The indications for heart artery dilatation are:
What to Expect After:
This procedure can greatly improve the blood flow through the coronary arteries and to the heart tissue in about 90% of patients and may eliminate the need for coronary artery bypass surgery ( CABG ). The outcome is relief from chest pain symptoms and an improved exercise capacity. In 2 out of 3 cases, the procedure is considered successful with complete elimination of the narrowing or blockage.
This procedure treats the condition but does not cure the cause and recurrences happen in 1 out of 5 cases. Patients should consider diet, exercise, and stress reduction measures.
If adequate widening of the narrowing is not accomplished, heart surgery ( coronary artery bypass graft surgery, also called a CABG) may be recommended.
Convalescence:
The average hospital stay is less than 3 days and sometimes hospital stay is not required. Complete recovery takes a week or less.
Risks:
Risks for any anesthesia are: Risks for any surgery are: Additional risks include: - complete obstruction of blood flow to an area of the heart (a small risk, less than 3%; a heart surgery team is on standby)
- damage to a valve or blood vessel
- blood clot
Cost:
The costs of any surgery varies significantly between surgeons, medical facilities, and regions of the country. Patients who are younger, sicker, or need more extensive surgery will require more intensive and expensive treatment.
Surgery charges can be separated into five parts: 1) the surgeon's fee, 2) the anesthesiologist's fee, 3) the hospital charges, which includes nursing care and the operating room, 4) the medications, and 5) additional charges.
1. Surgeon's fee: approximately $1,500
2. Anesthesiologist's fee: averages $350 to $400 per hour
3. Hospital charges: basic rate averages $1,500 to $1,800 per day (more for the intensive care unit (ICU) or private rooms)
4. Medication charges: $200 to $400
5. Additional charges: assisting surgeon, treatment of complications, diagnostic procedures (such as blood or X-ray exams), medical supplies, or equipment use.
Insurance coverage for surgery expenses depends on many factors and should be explored for each individual instance.
Picture:
P0094.pctCardiac catheterization
Cardiac catheterization is used to study the various functions of the heart. Using different techniques, the coronary arteries can be viewed by injecting dye or opened using balloon angioplasty. The oxygen concentration can be measured across the valves and walls (septa) of the heart and pressures within each chamber of the heart and across the valves can be measured. The technique can even be performed in small, newborn infants.
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