• Title/Summary/Keyword: Percutaneous Coronary Intervention

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Development of Algorithm for Nursing Interventions after Percutaneous Coronary Intervention (경피적 관상동맥중재술 후 간호중재 알고리즘 개발)

  • Ji, Hye-rim;Kim, Dong-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.24 no.1
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    • pp.18-29
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    • 2017
  • Purpose: The purpose of this study was to develop an algorithm for nursing care after percutaneous coronary intervention in order to improve patients' safety and prevent complications, because percutaneous coronary intervention is becoming a common treatment for coronary artery diseases. Methods: By reviewing related literatures and interviewing nurses, items and paths that were to be used in the algorithm for nursing care after percutaneous coronary intervention were drawn up and a draft algorithm was developed. The final algorithm was determined based on the results of the evaluation performed after clinical application. Results: According to the outcome after allowing nurses to apply the revised algorithm with 11 patients, suitability on items composing the algorithm were highly rated whereas promptness was lowly rated. Although the patients (n=11) to whom the algorithm was applied complained of less back pain (p=.001) and discomfort (p=.026) compared to the patients (n=17) to whom the algorithm was not applied, no significant difference in bleeding complication was found. Conclusion: The findings in the study support the clinical utilization of the algorithm for nursing care after percutaneous coronary intervention as the use of this algorithm reduced back pain and discomfort without increasing bleeding complications at the femoral puncture site.

The Effects of Heat Therapy on Low Back Pain, Blood Pressure and Pulse Rate after Percutaneous Coronary Intervention (경피적 관상동맥 중재술 후 온요법이 요통, 혈압 및 맥박에 미치는 효과)

  • Yun, So-Young;Cho, Bok-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.18 no.3
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    • pp.348-355
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    • 2011
  • Purpose: This study was done to examine the effects of heat therapy on low back pain, blood pressure and pulse rate after percutaneous coronary intervention. Method: The participants in this study were 40 patients who were admitted after having percutaneous coronary intervention. The experimental group, 20 patients, had heat therapy and the control group, 20 patients, maintained a supine position for 12 hours after the intervention. Back pain (VAS), blood pressure and pulse rate were measured just after removal of the sheath, and at 2-hour intervals up to 6 hours. Data were analyzed using SPSS 15.0. Results: The experimental group had significantly lower VAS for low back pain (F=23.44, p=.001). However no significant differences were found between two groups for blood pressure and pulse rate. Conclusion: The findings indicate that heat therapy is effective in reducing low back pain in patients who have had percutaneous coronary intervention. Therefore, heat therapy could be used as nursing intervention percutaneous coronary intervention.

Combined Percutaneous Transluminal Coronary Angioplasty and Minimally Invasive Coronary Arterial Bypass Grafting(Hybrid CABG) (경피적 경혈관 관상동맥 중재술과 최소침습성 관상동맥 우회술의 병용요법)

  • 장지민;유원희;김기봉
    • Journal of Chest Surgery
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    • v.32 no.12
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    • pp.1127-1130
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    • 1999
  • Percutaneous coronary intervention including intracoronary stenting is currently an accepted treatment modality in the treatment of coronary artery disease and is widely performed to treat the patient with multivessel disease with decreased morbidities and less cost compared with conventional coronary rtery bypass grafting(CABG), Repeated interventions due to restenosis even after successful angioplasty are the major disadvantage of the angioplsty especially when the lesion is located inthe left anterior descending artery(LAD) Recently CABG through left anterior small thoracotomy using the left internal thoracic artery to revascularize the LAD territory without cardiopulmonary bypass so called Minimally Invasive Direct Coronary Artery Bypass(MIDCAB) was intrduced and performed with comparable early outcomes. In this regard the integrated approach with percutaneous coronary intervention and minimally invasive direct coronary artery bypass surgery so called 'Hybrid CABG' was suggested to be an effective treatment in suitable patients with multivessel coronary artery disease. We report three cases of Hybrid CABG.

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Brachytherapy in Coronary Artery Disease (관상동맥질환의 방사성동위원소 치료)

  • Song, Ho-Chun
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.2
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    • pp.113-119
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    • 2006
  • Coronary artery disease is a loading cause of morbidity and mortality across the world. Percutaneous coronary intervention has become the major technique of revascularization. However, restenosis remains a major limitation of this procedure. Recently the need for repeat intervention due to restenosis, the most vexing long-term failure of percutaneous coronary intervention, has been significantly reduced owing to the introduction of two major advances, intracoronary brachytherapy and the drug-eluting stents. Intracoronary brachytherapy has been employed in recent years to prevent restenosis lesions with effective results, principally in in-stent restenosis. Restenosis is generally considered as au excessive form of normal wound healing divided up in precesses: elastic recoil, neointimal hyperplasia, and negative vascular remodeling. Restenosis has previously been regarded as a proliferative process in which neointimal thickening, mediated by a cascade of inflammatory mediators and other factors, is the key factor. Ionizing radiation has been shown to decrease the proliferative response to injury in animal models of restenosis. Subsequently, several randomized, double blind trials have demonstrated that intracoronary brachytherapy can reduce the rates of both angiographic restenosis and clinical event rates in patients undergoing percutaneous coronary intervention for in stent restenosis. Some problems, such as late thrombosis and edge restenosis, have been identified as limiting factors of this technique. Brachytherapy is a promising method of preventing and treating coronary artery restenosis.

Development and Evaluation of a Self Care Education Program for Elderly Patients with Percutaneous Coronary Intervention (경피적 관상동맥 중재술을 받은 노인환자의 자가간호 교육프로그램 개발 및 평가)

  • Jo, Gyeong-Jin;Yang, Jin-Hyang
    • The Journal of Korean Academic Society of Nursing Education
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    • v.20 no.2
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    • pp.266-275
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    • 2014
  • Purpose: The purpose of this study was to identify the effects of the education program to promote self care for elderly patients with percutaneous coronary intervention. Method: The research was a quasi-experimental study using a nonequivalent control group non-synchronized design. The participants was 56 patients, 28 in the experimental group and 28 in the control group. A pretest and a posttest were conducted to measure main variables. The self care education program, consisting of flash animation, leaflet and telephone counseling, was given for the experimental group. Data were analyzed using ${\chi}^2$, Fisher's exact test, and independent t-test with SAS statistics program. Results: There were statistically significant increase in knowledge and self care behavior, and decrease in anxiety by difference between a pretest and a posttest in the experimental group compared to that in the control group. Conclusion: The result of this study indicate that the self care education program is effective in increasing knowledge and self care behavior, and in decreasing anxiety for elderly patients with percutaneous coronary intervention. Therefore, it can be usefully utilized in the field of nursing for elderly patients with percutaneous coronary intervention.

A Structural Model of Health Behavior Compliance in Patients with Percutaneous Coronary Intervention based on Self-Determination Theory (자기결정성이론 기반 관상동맥중재술 환자의 건강행위 이행 구조모형)

  • Park, Ae Ran
    • Journal of East-West Nursing Research
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    • v.24 no.2
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    • pp.101-109
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    • 2018
  • Purpose: The purpose of this study was to construct and test a structural equation model of health behavior compliance among patients with percutaneous coronary intervention based on self-determination theory. Methods: A total of 227 participants who received follow-up care after percutaneous coronary intervention were recruited. A structured questionnaire was used to assess health providers' autonomous support, basic psychological needs, autonomous motivation, controlled motivation, type D personality, and health behavior compliance. Collected data were analyzed using SPSS 21.0 and AMOS 21.0 program. Results: The final hypothetical model showed a good fitness with data: GFI=.94, RMSEA=.07, CFI=.96, NFI=.92, TLI=.94. The results revealed that autonomous support of health care providers, basic psychological needs, and autonomous motivation, and D-type personality accounted for 51.8% of health behavior compliance. Conclusion: The findings of this study indicate that enhanced autonomous support of health care providers is essential to promote patients' basic psychological needs and autonomous motivation. This leads to maximized compliance to the health behaviors among patients who underwent percutaneous coronary intervention. We recommend that health care institutions establish various measures to foster the special environments in which health care providers can actively provide and utilize autonomous support for their patients.

Recommendation of Optimal Treatment Method for Heart Disease using EM Clustering Technique

  • Jung, Yong Gyu;Kim, Hee Wan
    • International Journal of Advanced Culture Technology
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    • v.5 no.3
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    • pp.40-45
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    • 2017
  • This data mining technique was used to extract useful information from percutaneous coronary intervention data obtained from the US public data homepage. The experiment was performed by extracting data on the area, frequency of operation, and the number of deaths. It led us to finding of meaningful correlations, patterns, and trends using various algorithms, pattern techniques, and statistical techniques. In this paper, information is obtained through efficient decision tree and cluster analysis in predicting the incidence of percutaneous coronary intervention and mortality. In the cluster analysis, EM algorithm was used to evaluate the suitability of the algorithm for each situation based on performance tests and verification of results. In the cluster analysis, the experimental data were classified using the EM algorithm, and we evaluated which models are more effective in comparing functions. Using data mining technique, it was identified which areas had effective treatment techniques and which areas were vulnerable, and we can predict the frequency and mortality of percutaneous coronary intervention for heart disease.

Influencing Effects of Type D Personality on Symptom Experiences and Quality of Life in Patients with Percutaneous Coronary Intervention (Type D 성격 유형이 관상동맥중재술 환자의 증상 경험과 삶의 질에 미치는 영향)

  • Jo, Eun Hee;Han, Sun Hee;Lee, Myung Ha;Kim, Sung Reul
    • Korean Journal of Adult Nursing
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    • v.28 no.5
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    • pp.536-545
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    • 2016
  • Purpose: The aim of this study was to investigate the influencing effects of type D personality on symptom experiences and quality of life in percutaneous coronary intervention patients. Methods: A descriptive, cross-sectional study design was used. A total of 158 patients with percutaneous coronary intervention participated in this study, between July 1 and November 1, 2015. Data were analyzed by means, standard deviations, t-test, $x^2$ test, ANCOVA, and stepwise multiple regression analysis using SPSS 22.0 program. Results: About 53.8% of participants were classified as type D personality. The type D personality group reported statistically significantly higher symptom experience, lower cardiac function, and lower cardiovascular-specific quality of life compared to non-type D personality group. On stepwise multiple regression, the most significant factor of quality of life was symptom experiences (adjusted $R^2=.25$, p<.001), followed by type D personality (adjusted $R^2=.31$, p<.001). Conclusion: Personality trait assessment is recommended for patients with percutaneous coronary intervention to assess symptom experiences and quality of life. In addition, development of nursing intervention might be beneficial to manage symptom experience and quality of life in percutaneous coronary intervention patients with type D personality.

Usefulness of Myocardial Perfusion SPECT after Percutaneous Coronary Intervention (PCI) (경피적 관상동맥 중재술(Percutanerous Coronary Intervention; PCI) 후 심근 관류 SPECT의 유용성)

  • Lee, Jong-Jin;Lee, Dong-Soo
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.2
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    • pp.114-117
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    • 2005
  • As the indication of percutaneous coronary intervention (PCI) has expanded to the more difficult and complicated cases, frequent restenosis is still expected after PCI. According to AHA/ACC guideline of the present time, routine use of myocardial perfusion single photon emission tomography (SPECT) is not recommended after coronary intervention, but symptom itself or exercise EKG is not enough for the detection of restensis or for the prediction of event-free survival. In high risk and/or symptomatic subjects, direct coronary angiography is required myocardial perfusion SPECT could detect restenosis in 79% of the patients if performed 2 to 9 months after PCI. Reversible perfusion decrease in the myocardial perfusion SPECT is known to be the major prognostic indicator of major adrerse cardiac event in PCI patients and also the prognosis is benign in the patients without reversible perfusion decrease. Though the cumulated specificity is 79% in the literature and optimal timing of myocardial perfusion SPECT is in controversy, SPECT is recommended even in asymptomatic patients at 3 to 9 months after PCI. Considering the evidences recently reported in the literature, myocardial perfusion SPECT is useful for risk stratification and detection of coronary artery restenosis requiring re-intervention in the asymptomatic patients after PCI.

The Effects of Hand Massage in Patients Who Underwent Transradial Percutaneous Coronary Intervention (요골동맥을 통한 경피적 관상동맥 중재술 환자의 손마사지 효과)

  • Shin, Eun Sil;Kim, Myung-Hee
    • Journal of Korean Academy of Nursing
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    • v.48 no.4
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    • pp.465-474
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    • 2018
  • Purpose: This study aimed to determine the effect of hand massage in patients who underwent transradial percutaneous coronary intervention. Methods: This was a quasi-experimental study with a nonequivalent control group and non-synchronized design. The study included 30 patients in the experimental group and 30 in the control group. Hand massage was performed 2 times for 5 minutes each in the experimental group and the control group only received usual nursing interventions. Pain, level of discomfort, and vital signs were defined as key outcome measures, and the data were analyzed using the chi-square test, an independent t-test, Mann-Whitney U test, repeated-measures analysis of variance, and Friedman test. Results: Significant differences were observed between the 2 groups in the pain score (F=7.91, p=.003), discomfort score (F=18.15, p<.001), pulse (F=12.92, p<.001), and respiration rate (${\times}^2=19.35$, p<.001). Conclusion: Hand massage can be a helpful nursing intervention for transradial percutaneous coronary intervention by reducing pain and discomfort to a considerable degree.