Coronary angiography and percutaneous coronary intervention

Question 1

Define coronary angiography:

Answer 1

• A coronary angiography = minimally invasive procedure to access the coronary circulation and blood filled chambers of the heart using a catheter.

The catheter is inserted into the heart via the femoral or radial artery or venous system.

Question 2

define PCI:

Answer 2

A non-surgical procedure used to treat narrowing (stenosis) of the coronary arteries.

A coronary angiogram is used to visualise the vessels, and then an angioplasty is performed using a balloon catheter. Stents can be used to keep the vessel open.

Question 3

What is done?

Answer 3

o Sample blood to assess oxygen saturation and measure pressures
o Inject radiopaque contrast medium to image cardiac anatomy and blood flow
o Perform angioplasty (+/- stenting), valvuloplasty, and cardiac biopsies, or to do procedures
o Perform intravascular ultrasound or echocardiography

Question 4

Indications:

Answer 4

o Coronary artery disease: diagnostic and therapeutic (angioplasty, stent insertion)
o Valvular disease: diagnostic to assess severity, therapeutic (valvuloplasty if patient too ill for valve surgery)
o Congenital heart disease: diagnostic and therapeutic (balloon dilatation)
o Cardiomyopathy
o Pericardial disease
o Endomyocardial biopsy

Question 5

Complications:

Answer 5

• Contrast reaction
• Loss of peripheral pulse due to dissection/thrombosis/arterial spasm
• Angina
• Arrhythmias
• Pericardial tamponade
• Infection