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Second Congress of Cardiology and Angiology of Bosnia & Herzegovina

 

PTCA - INTERVENTION PROCEDURE, SPECIFICITY AT OUR CLINIC
K. Kadrović, Dž. Hrustemović, J. Muminović and S. Spasojević
Clinic of Cardiology, Clinical Center University of Sarajevo, Bosnia and Herzegovina

PTCA - Percutaneous transluminal coronary angioplasty is an invasive technique aiming to reduce the stenoses caused by atherosclerosis of the coronary vessels.It is the alternative solution to coronary bypass operation.PTCA is advantageous procedure in cases of single lesions on one or more vessels.It is a complex method requiring radiological and physiological follow up of the patients, wide spectrum of material and very well educated medical personnel.It also requires parallel stand by of cardiac surgery and anesthesiology.In our conditions the compulsory preconditions for performing the interventional cardiology treatment have been theorecitally fulfilled.Practically the clinic of radiology, where the catheterisation laboratory is situated, is physically divided from the clinic of cardiology and cardiac surgery.Therefore it requires extremely well prepared stand by arrangements and staff in order to meet limited demands of cardiac emergency. The necessary guiding catheter is introduced into the femoral artery through the sheath.Then, a special wire, which has to pass the given stenoses, is introduced.During the procedure the catheters have to be flushed with heparin added saline.Also the solution of nitroglycerin have to be always prepared beforehand since there are no ready-made solutions at our market.After the balloon is placed over the wire into desired position, it is inflated with indeflator for certain period of time, depending on the type of the stenoses.Similarly the stent is placed over the wire and opened with indeflator. Afterwards all the patients are put on the treatment with Aspirin, in combination or not with Ticlopidine and they are referred to the intensive care unit. The sheats are withdrawn after 4-6 hours and the patients can be discharged after 24 hours.The situation would be different in case of emergency PTCA which has not been yet performed routinely due to the specific circumstances. Conclusion: The necessary preconditions for performing the PTCA procedure must be met although at our clinic there are certain specifiticies which must not be neglected .

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