Type of Surgery
Last updated: 11/24/2009
The procedure generally takes from 90 minutes to two hours to perform, but the preparation and recovery time add several hours to the overall procedure time. Although patients often go home the same day or the evening of the procedure, they should...
plan to stay at the hospital most of the day.
Recovery in the hospital
The patient is instructed to stay flat in bed without bending the legs so that the artery can heal from the insertion of the catheter. A stitch or collagen plug may be placed at the site of the catheter insertion to seal the wound and firm pressure may be applied to the area. A flat position is required for two to six hours after the procedure. A health care provider will help the patient get out of bed for the first time when the doctor approves it. The patient will be allowed to eat after he or she is able to get out of bed.
The patient is closely monitored during the recovery period. Vital signs and other parameters such as the heart's rhythm and electrical activity as well as oxygen and carbon dioxide levels in arterial blood are checked frequently. A catheter may be placed to drain urine during the recovery period.
A blood thinner may be given to the patient intravenously for the first few hours after the procedure to prevent clotting.
Recovery at home
Medications are prescribed to control pain. Minor chest discomfort is common after the procedure. However, the patient should notify the health care provider if severe chest, arm, or back discomfort is experienced. Some bleeding and bruising near the catheter insertion site are also common after the procedure. However, severe bleeding should be reported to a health care provider immediately. If bleeding occurs, the patient should contact 9-1-1 and lay down immediately. The dressing covering the area should be removed and firm pressure should be applied to the area until help arrives.
Ointments, lotions, and dressings should not be applied to the catheter insertion site unless specific instructions have been given.
Medications are prescribed to prevent unwanted blood clotting. Daily doses of aspirin or other anticoagulant medications are started after the procedure and are continued after the patient goes home.
The patient should not have any magnetic resonance imaging (MRI) tests for six months after the procedure, because the magnetic field may move the stent.
LIFESTYLE CHANGES. The patient needs to make several lifestyle changes after surgery, including:
- Quitting smoking. Smoking causes damage to blood vessels, increases the patient's blood pressure and heart rate, and decreases the amount of oxygen available in the blood.
- Managing weight. Maintaining a healthy weight by watching portion sizes and exercising is important. Being overweight increases the work of the heart.
- Participating in an exercise program. The exercise program is usually tailored for the patient, who will be encouraged to participate in a cardiac rehabilitation program supervised by exercise professionals.
- Making dietary changes. Patients should eat a lot of fruits, vegetables, grains, and non-fat or low-fat dairy products, and reduce fats to less than 30% of all calories. A diet low in cholesterol and vitamin K (to prevent interference with the anticoagulant medication) may be recommended.
- Taking medications as prescribed. Aspirin and other heart medications may be prescribed, and the patient may need to take these medications for life.
- Managing other health conditions such as diabetes or high blood pressure. Taking medications as prescribed and following the doctor's guidelines are very important ways for the patient to manage his or her health.
- Following up with health care providers. The patient needs to regularly see the physician to monitor his or her recovery and control risk factors. Routine stress testing is a part of the follow-up treatment to detect restenosis that may occur without symptoms.
A physician describes how the heart works and two specific diseases of the heart, namely congestive heart failure and aortic aneurysms.
A coronary stent is an artificial support device used in the coronary artery to keep the vessel open.
Coronary stenting usually follows balloon angioplasty, which requires inserting a balloon catheter into the femoral artery in the upper thigh. When this catheter is positioned at the location of the blockage in the coronary artery, it is slowly inflated to widen that artery, and is then removed. The stent catheter is then threaded into the artery and the stent is placed around a deflated balloon. When this is correctly positioned in the coronary artery, the balloon is inflated, expanding the stent against the walls of the coronary artery. The balloon catheter is removed, leaving the stent in place to hold the coronary artery open. A cardiac angiography will follow to insure that the stent is keeping the artery open.
We are trying to balance those kinds of losses with the profitable side of business, which includes doing more cardiac surgeries. An emphasis has been placed on cardiac care because the medium age of residents is increasing, and more people are showing up with symptoms of heart disease.
-Kevin M. Spiegel
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