Percutaneous Transluminal Coronary Angioplasty

Question: Can any tell me what Percutaneous Transluminal Coronary Angioplasty (PTCA) is? I need to know what it is in plain English, I keep getting these super scientific answers. I know its a medical term, but can anyone break it down for me simply?

Answer: This procedure is done in a cardiac catheterization lab, not a regular operating room. Usually it is done by a cardiologist especially trained in interventional cardiology, but occasionally another specialist might do it also. Percutaneous means "through the skin".In this case the cardiologist will make a puncture, usually in the groin, occasionally in the arm, into an artery through which a guidewire and catheter is placed. It is run through the arteries and up to the entrance to the heart. The coronary arteries are the first arteries that come off the aorta (the main artery taking blood to the whole body) after it leaves the heart. They can use fluoroscopy -a sort of X-ray - to see where they are going with the guidewires. After the arteries involved in blockages have been identified by a cardiac catherization (shoot dye thru the catheter into the coronary arteries to see and measure the extent of any blockages) then a intervention (PTCA) can be done if needed. Sometimes it is done immediately after the cardiac catheterization, but sometimes it can be done later. Occasionally if a person needs several arteries unblocked, it will be done in so-called staged procedures. They do the most dangerous one first and then the others at a later date. What the procedure consists of: The tranluminal coronary angioplasty basically consists of taking a special catheter with a tiny balloon on its tip up to the point of a blockage in the artery. The balloon is then inflated to break up the plaque that is causing the blockage (the catheter also vacuums up any fragments that might result) so that the inside dimensions of the artery (its lumen) are increased. The flow through the artery is measured before and after the procedure to make sure that the artery has been adequately opened. That's basically what an intervention is. Often, but not inevitably, the cardiologist will place a stent in the area to hold it open, so that is usually part of the procedure and might be referred to as "PTCA with stent placement." Sometimes, instead of the balloon to open an artery, the cardiologist feels that the blockage will not be amenable to that procedure. In that case they may do something called a "rotational atherotomy" which is using a tiny rotating blade to peel away the atherosclerosis from the inside of the artery. I think that this is much less common than PTCA. The "transluminal" portion of the name PTCA refers to the fact that this procedure is accomplished by going through the artery, not operating on it from outside. The "coronary" refers to the heart's blood vessels. The term "angioplasty" comes from the root "angio" which refers to blood vessels and "plasty" which is from a root word relating to a procedure to form or shape an organ. Medications are used during and after the procedure to try to minimize the chances of the artery closing up again. The duration of medication depends in part on the location in the arteries, the type of stent if any is used, and the cardiologist's preference. The medications (chiefly Plavix or clopidgrel) that are taken by outpatients are quite expensive, but extremely important to keep the arteries from reblocking. Hope this is helpful.

Question: Are there PTCA videos on the internet. (Percutaneous Transluminal Coronary Angioplasty)? My father's attorney wants to see a video of how Angioplasty is done. Also, are there any videos with a Cutting Balloon being used? My dad's cardiologist dissected his left main coranary while pulling the device out and my dad's heart stopped immediately. It took them 2 hours to revive my dad and he ended up having a double bypass. The Cardiologist dissected 2 additional arteries B4 this one during the procedure and should have stopped aftert the first dissection and called the OR for an emergent Bypass. Appearantly, my dad's cardiologist didn't have a Cardiothoracic Surgeon on immediate standby as was agreed upon between my dad and his Cardiologist.. My dad is still alive but he is dying from heart failure and we need to depose his Cardiologist next week.

Answer: Video: http://www.mayoclinic.com/health/coronar… Another good description: http://www.nlm.nih.gov/medlineplus/ency/…

Question: I was got done the PTCA(percutaneous transluminal coronary angioplasty)during year 2004 as well as 2005 fo? after gotting the ptca i once again got some breathing proble. got angiogram and found that the right coroanry artery where two cyper stents implanted were once again occuleded.what is the reason for this blockage and how to get that cleared.now only LCAis working .Is it safe for carrying the life with one artery.What are tmedicaion you suggest for me to run the life. dr advised me to use cytoguard,imdure,dilzem,atrovastatin-40m… deplatt.inspite of using all the medicines I am getting some times breathing problem and anxiety.what will you suggest for recovery.

Answer: Complication:-Thickness of the right lateral coronary wall will be reduced due to myocardial infarction. This will lead to Cardiomegaly i.e., enlargement of right auricle and right ventricle. There may be slight enlargement of left ventricle also. When the heart is enlarged, the pumping is proportionately reduced and the tricuspid valve may become defective (The leaflets may touch the wall) and regurgitate the blood from right ventricle to right auricle. Symptoms such as pedal edema and cardiac asthma will be present. If conditions become worse, right sided heart failure will occur. You may undergo echocardiogram. Please note that I am not a medical professional. Please see Google search on Off-pump CABG.

Question: Anesthesia in Angioplasty.? I'm planning on studying medicine and have eben studying it on my own for a few years now. I'm currently researching Percutaneous Transluminal Coronary Angioplasty, and I think have pretty much everything I need except one thing - I can't seem to figure out which analgesic and which sedative/s are used for the procedure. If anyone can help me out with this, I'd really appreciate it. Thanks, it'd be really useful. =)

Answer: Most likely a patient would be given a supportive IV (e.g. 5% dextrose in water or NSS or sometimes 0.5 NSS). The sedative (calming kind of sedative e.g. valium or midazolam) is given into the IV line but not infused. Patient is awake. A local anesthetic such as novacaine, mepivacaine or bupivicaine is administered s.c. to the groin area in the vicinity of the femoral artery (or other area at which the catheter will be inserted.

Question: can someone help me answer my case study project? GENITO URINARY CASE STUDY You are working in the ICU of an acute care hospital and assume the care of E.B., a 78-year old woman who is 3 days post inferior wall MI. E.B. had been healthy before admission ecept for a longstanding history of ostheoarthritis treated with rofecoxib(VIOXX) 50 mg daily and longstanding hypertension treayed with atenolol( Tenormin) 50 mg daily. On presentation to the ED. E.B. had severe hypertension (210/122mmhg); therefore, thrombolytics were contraindicted. An IV was PTCA(percutaneous transluminal coronary angioplasty). Her angioplasty was succesful, and values: Na142 mmol/L, CI 100mmol/L, BUN 60 mg/dl, creatinine 3.8 mg/dl, glucose 158mg/dl. 1. What abnormalities are there E.B.'s lab work? 2. What are the possible causes for these abnormalities? 3. Describe prerenal, intrarenal, postrenal causes of acute renal failure(ARF). Given the potential causes of E.B.'s elevated BUN and creatinine, how would you th causes of E.B.'s elevated BUN and creatinine, how would you they be categorized? 4. You are given the results of E.B.'s lab work from today . The results are NA 140mmol/L, K5.0mmol/L, CI 104 mmol/L, CO2 24mmol, BUN68 mg/dl, creatinine 4.0 mg/dl, glucose 104 mg/dl. Based on these values, what is your next going to be? 5. Define oliguria and anuria. Which term best describe E.B.'s reanl function? 6. In reviewing E.B.'s VS, you cannot identify nay episodes of hypotension since her admission. What might be a possible explanation for her increase BUN and creatinine? 7. What are your interventions and priorities for a patient in ARF? 8. E.B. has been very quiet. Suddenly she asks you, "Am I going to die?" how will you respond? 9. You talk to her about the possibilty of dialysis, which may be a treatment option for her.She responds, "You know, Im 78 years old. I've had a pretty good life and I dont want to be hooked to a machine." What will you say?

Answer: bun, creatinine and glucose bun and creatinine indicate renal damage what is the potassium? in mi, there may be a shift for potassium from intracellur to interstitial prerenal is a dehydration, sepsis and severe blood loss anything that obstructs blood flow because the kidneys need blood for the GFR and their own bp intrarenal is inside-so glomerular nephritis, acute interstitial nephritis post is anything that obstructs outflow so like BPH or tumors causes of E.B.'s elevated BUN and creatinine, how would you they be categorized? creatinine and bun are from actual parenchymal loss so i would say intrarenal 4. You are given the results of E.B.'s lab work from today . The results are NA 140mmol/L, K5.0mmol/L, CI 104 mmol/L, CO2 24mmol, BUN68 mg/dl, creatinine 4.0 mg/dl, glucose 104 mg/dl. Based on these values, what is your next going to be? is co2 correct? is it mEq/L? if so, it's normal. monitor urine output. check for edema 5. Define oliguria and anuria. Which term best describe E.B.'s reanl function? oliguria is scant urine and anuria is none. 6. In reviewing E.B.'s VS, you cannot identify nay episodes of hypotension since her admission. What might be a possible explanation for her increase BUN and creatinine? intrarenal parenchymal damage 7. What are your interventions and priorities for a patient in ARF?depends, nursing or medicine? urine output, less parenchymal destruction 8. E.B. has been very quiet. Suddenly she asks you, "Am I going to die?" how will you respond? 9. You talk to her about the possibilty of dialysis, which may be a treatment option for her.She responds, "You know, Im 78 years old. I've had a pretty good life and I dont want 2 days ago to be hooked to a machine." What will you say? explain more to her and listen