Coronary Revascularisation

Question 1

Angiography

Answer 1

Visualise arterial and venous vessels in the body.
Catheter advanced from wrist/groin to coronary arteries
Contrast (iodine) injected through catheter
X-rays taken as dye flows through vessels
Always done before angioplasty/PCI

Question 2

PCI/Angioplasty

Answer 2

Procedure to widen blocked/narrowed arteries
Balloon stretches the occluded vessel.
Insert a stent into the artery to prevent narrowing.

Catheter advanced from wrist/groin to coronary arteries.
Thin, flexible wire passed through catheter to beyond the narrowed area.
Balloon passed over the wire to narrowed area and is inflated.
Fatty material in walls of artery are squashed to widen artery.
Stent can then be fitted (optional)
Balloon, guide wire and catheter are removed.
Stent remains inside the artery.

Question 3

CABG

Answer 3

Diverts blood around narrowed/occluded arteries to improve blood flow and O2 supply to heart.

Median sternotomy
Blood vessels taken from long saphenous vein (leg) or internal mammary artery (chest) or radial artery (arm).
During op - blood is re-routed to a heart-lung bypass machine while the heart is temporarily stopped.
Grafts attached above and below affected artery to divert blood supply.