The coronary arteries supply the heart with blood; Constrictions or closures can have life-threatening consequences. One method to dilate narrow spaces relatively gently is PTCA or balloon dilatation. In many cases, balloon dilation can bypass open heart surgery. Like any other muscle, the heart muscle needs oxygen-rich blood to do its pumping work. This is brought from the coronary vessels. If these are constricted or even closed, the blood supply is reduced - a limited heart work with pain under pressure (angina pectoris) up to the heart attack as well as heart muscle weakness threaten. First of all, an attempt can be made to get it under control with medicines. If these no longer help, a bypass surgery can be performed, a surgical procedure with risks. For many years, another option has been proven: the PTCA, short for "percutaneous transluminal coronary angioplasty".
The principle of PTCA
The name already roughly describes the procedure: Through the skin (percutaneously), the so-called cardiac catheter, a thin flexible plastic tube, is inserted into the vessel lumen (transluminal), advanced into the arteries of the heart (coronary), and its clearing restored (angioplasty: angio = Vessel, plastie = restoration).
The other common term, "balloon dilatation", describes how to do this: with the help of a balloon on the tip of the tube, which is placed and inflated at the narrowed site, expanding the dilatation of the vessel from the inside, causing the deposits to become like fat and lime - And pressed into the elastic vessel wall and remain there.
In order for the doctor to find the right position, the examination is carried out under X-ray control. In order to be able to see the vessels better, contrast agent is injected into the catheter. Also, the result of the expansion is controlled by X-ray. In most cases, the process of expanding must be repeated several times in succession.
When will the PTCA be carried out?
As balloon dilatation - like any procedure - involves risks, it is not performed until the constrictions of the coronary arteries have exceeded a certain limit. The guideline is a narrowing of the vessel cross-section of more than 75%. Most patients have discomfort only from a narrowing of 80%. In many cases, PTCA is possible even if a vessel has multiple constrictions or multiple coronary arteries are affected. Less suitable situations are when all three major branches or the main trunk of the left coronary artery are narrowed. Then a bypass operation is usually inevitable.