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Angioplasty
In
coronary angioplasty (also called percutaneous
transluminal coronary angioplasty, or PTCA), a
tube called an inducer catheter, or sheath, is
inserted into the femoral artery in your groin.
A dye is used so that the narrowed artery can
be viewed on a TV screen, or monitor. Through
the sheath, a thin tube with a balloon at the
tip is carefully threaded to the area of narrowing
in your coronary artery. Once it is in place,
the balloon is inflated for several seconds. As
the balloon fills, it splits and compresses the
fatty material in the artery wall. The opening
of the artery is enlarged to allow blood to flow
more easily through it. The balloon catheter is
then removed. The procedure usually lasts about
three hours.
Coronary
Bypass surgery
Two
types of blood vessels are commonly used for the
coronary artery bypass graft: the saphenous veins
in the legs, or the left or right internal mammary
artery (also called thoracic arteries), which
lies in the chest wall. Both types of blood vessels
can be used for bypasses because there are other
pathways that circulate blood to and from the
tissues of the chest wall and legs. The surgeon
determines which graft(s) to use depending on
the location and amount of blockage in the coronary
arteries.
If the saphenous vein is used, it is surgically
removed from the leg. The vein graft is then sewn
from the aorta (the large artery leaving the heart)
to the coronary artery below the site of blockage.
Oxygen-rich blood flows from the aorta, through
the saphenous vein graft, past the site of blockage
to the coronary artery to nourish the heart muscle.
If a mammary artery is used, it is kept intact
at its origin because it carries oxygen-rich blood
originally coursing through the aorta, and it
is sewn to the coronary artery beyond the blockage
site. Prior to admission to the hospital, your
doctor will discuss the specific bypass procedure
with you.
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