Category: Biology Second Paper Lecture Sheet

Implantable Cardioverter Defibrillator

Intensive Care Unit

Percutaneous Coronary Intervention

Coronary Artery Bypass Grafting

Coronary Artery Bypass Surgery

(i) 2% of patients may have a heart attack during ring teaching.
(ii) Excessive bleeding may occur during operation.
(iii) The balloon may burst.
(iv) Circumcision of the ring may cause complete cessation of blood flow.
(v) Blood clots may occur at the site of stent placement.
(vi) Patient may be re-booked.
(vii) Sometimes blood clots form in the area where the ring is applied and the clot enters the blood vessels of the brain causing a stroke.
(viii) Many may be allergic.
(ix) It is an expensive medical procedure.

(i) Removal of the arterial occlusion by angioplasty relieves the patient’s chest pain.
(ii) Chances of heart attack are eliminated.
(iii) The patient can do light activities within a few days.
(iv) Prolonged precautions are not required.
(v) Patient recovers within one month.

1. Before starting laser angioplasty, the patient’s heart rate, blood pressure and diabetes are controlled.
2. The patient is sedated by applying local anesthesia to the skin of the groin or arm to prevent pain.
3. A puncture is made in a major blood vessel in the groin or arm with a thick needle.
4. A guide catheter (narrow, flexible and long tube) is inserted through the hole.
5. The tip of the guide catheter is inserted into the atheroma segment of the coronary artery.
6. A laser catheter is passed through the guide catheter.
7. Dye is injected into the catheter to mark areas of arterial plaque. This method is called fluoroscopy. The dye helps monitor whether the catheter has reached the precise location. It is monitored by X-ray monitor.
8. After reaching the plaque-laden part of the artery, the laser beam destroys the plaque layer by layer. Destroyed plaque evaporates.
9. As a result, blood circulation becomes normal.

1. Surgery is done after confirmation by angiogram.
2. Before starting angioplasty, the patient’s heart rate, blood pressure and diabetes are controlled.
3. The patient is sedated by applying local anesthesia to the skin of the groin or arm to prevent pain.
4. A puncture is made in a major blood vessel in the groin or arm with a thick needle.
5. A guide catheter (narrow, flexible and long tube) is inserted through the hole.
6. The tip of the guide catheter is inserted into the atheroma segment of the coronary artery.
7. A balloon catheter covered by a stent is passed through the guide catheter.
8. Dye is injected into the catheter to mark areas of arterial plaque. This method is called fluoroscopy. The dye helps monitor whether the catheter has reached a specific location. It is observed with the help of monitor.
9. Within 30-60 seconds of delivering the balloon and stent to the atheroma, the balloon is inflated. This compresses the fat in the atheroma and dilates the narrowing of the artery.
10. A metal stent or ring is placed over the part of the artery dilated by the balloon. After placing the ring, the catheter with the balloon is taken out.
11. The ring contains a drug coating that is always released into the artery. The free drug dissolves arterial fat and inhibits re-bulking.
12. A single angioplasty takes 30-40 minutes and the patient has to stay under a doctor’s observation for a day.
Sometimes balloon pressure does not dilate narrowed arteries. As a result angioplasty was not possible and the patient underwent CABG surgery.

1. Balloon angioplasty
2. Stenting angioplasty
3 . Laser angioplasty
4 . Coronary atherectomy