Heart rings: procedures, risks, and follow-up care

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Definition of insertion of a heart ring

What is a heart ring?

Placement of a heart stent or in medical language known as a heart stent is a procedure performed to widen narrowed or blocked coronary arteries in the heart.

This blockage of blood vessels occurs due to the buildup of plaque from cholesterol or other substances that stick to the walls of the vessels.

Therefore, the placement of a heart ring aims to open the coronary blood vessels in the heart, so that it can again receive an adequate blood supply and reduce the possibility of a person having a heart attack.

What is the shape of a heart ring or stent?

Stents are made of metal or plastic in the form of small tubes composed of wires that look like nets. Generally, stents are about 15-20 mm long, but can vary, ie 8–48 mm and 2–5 mm in diameter.

The stent is permanent, so it will stick to the heart and cannot be removed again. Therefore, the surface of the stent is coated with a drug that helps keep the blocked artery from closing.

Installation of this small device is done in an angioplasty procedure. Angioplasty is a medical procedure used to open blocked and narrowed coronary (heart) arteries.

However, not all angioplasty procedures require insertion of a heart stent. Especially, if the blood vessels are too small or too large to place the stent, or when the patient has an allergy to the material in the stent (which is very rare).

When is it necessary to put on a heart ring?

The insertion of a heart stent is intended for people who experience symptoms of heart disease, such as chest pain and shortness of breath that do not improve with medication alone. And performed on people who have had a heart attack.

This medical procedure can also be used as an alternative treatment for heart disease in patients who cannot undergo heart bypass surgery.

Reporting from the British Heart Foundation website, in addition to treating heart disease, the installation of heart stents is also used to treat peripheral artery disease in the legs and neck.

Risks and side effects of inserting a heart stent

Just like other heart disease treatments, placing a heart stent or stent can also pose a risk of side effects, such as:

• There is a bruise on the skin when the tube to attach the ring is inserted. Usually, this condition will get better on its own in a few weeks.
• There is bleeding in the skin after the procedure. However, the risk of bleeding in the wrist is lower than in the groin. This is because the hand area is easier to apply pressure so it stops bleeding faster.
• An artery wall that divides as the balloon inflates. This condition is known as medical dissection and will be treated quickly with further stenting.
• There is a blood clot that causes a heart attack. However, the risk of this complication is very rare because doctors will prescribe clopidogrel (Plavix), prasugrel (Effient) or other types of blood-thinning drugs.

Preparation before undergoing a heart ring insertion

Before placing a heart stent, your doctor will review your medical history and perform a physical examination. You may also have a series of medical tests, such as a chest x-ray, electrocardiogram, blood tests, and coronary angiogram (heart catheterization) imaging tests.

Once the doctor finds a blockage, angioplasty and stenting will be scheduled while the heart is still catheter in place.

Preparations that you must do before this procedure is done is to stop taking certain medications before angioplasty, such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs) or blood thinners.

Be sure to tell your doctor about all medications you take, including herbal supplements. Usually, you should stop eating or drinking six to eight hours before angiography.

Take all the medications you took previously, including nitroglycerin and you will be asked to drink a little water the morning before the procedure.

The procedure for inserting a heart ring

The insertion of a heart stent is a non-surgical procedure under local anesthesia that is applied to the wrist or groin area. So, during the procedure, the patient will be conscious.

In addition, stenting generally does not take a long time. However, this depends on the difficulty and the number of rings to be installed.

Procedure steps

The procedure for placing a heart ring will begin with a catheterization process. Catheterization is carried out by the doctor by inserting a catheter tube which is equipped with a balloon and has been fitted with a heart ring through the blood vessels to the narrowed or blocked coronary arteries.

When the catheter is in the targeted area, the doctor will insert a contrast agent into the catheter to see the patient's heart condition as seen from the way the contrast agent travels in the blood vessels, making it easier for doctors to see the patient's heart condition that appears on the monitor screen.

When the catheter has been inserted into a blood vessel, the balloon at the end of the catheter is deflated along with the heart ring.

However, when the catheter has reached the narrowing and blockage area, the balloon at the end of the catheter will expand along with the heart ring. This balloon serves to stretch clogged arteries allowing increased blood flow.

After that the catheter balloon is inflated and then the catheter tube is pulled out. However, when the catheter is pulled out, the heart ring stays in that location to keep the blood vessels open.

Care after insertion of a heart ring

You may stay in the hospital overnight to adjust your medications as well as monitor your heart condition. You can usually go back to work or go back to your normal routine a week after the angioplasty is done.

When you return home, drink plenty of fluids to help rid your body of the contrast dye used during the procedure. Avoid strenuous exercise and heavy lifting, at least a day after you are allowed to go home.

Conditions that need to be watched out for

Ask your doctor or nurse about other restrictions on activity. Call your doctor right away if you have any of the following conditions:

• The area of ​​skin where the tube is inserted draws blood that is difficult to stop or causes swelling.
• You feel pain or discomfort in the area of ​​the skin where the tube was inserted.
• The skin that is inserted by the tube causes signs of infection, such as redness, swelling, discharge in the form of pus, and experiencing fever.
• You experience chest pain, shortness of breath, and a very tired body.
• There is a change in temperature and color in the legs and arms, which are the areas for the insertion of the heart ring.

Most people who have had an angioplasty with or without a stent will usually need to take aspirin indefinitely.

Patients who have had a stent inserted will need a blood thinner, such as clopidogrel, for six months to a year.