Cardiac and Vascular Interventions
Coronary Angioplasty and Stent Placement
Angioplasty and stent placement are techniques for re-opening blocked or narrowed coronary arteries. The procedures can be performed to relieve angina, abort a heart attack, or to improve the function of the heart in patients with heart failure. Most procedures only require one overnight stay in the hospital. Angioplasty is the use of a tiny balloon to compress plaque to the sides of an artery and to widen the inside of the artery (the lumen), increasing blood flow. Once the artery is opened by angioplasty, a small, metal mesh tube called a stent is used to prop the artery open.
Transcatheter Aortic Valve Replacement (TAVR)
TAVR brings together cutting edge technology and sophisticated medical techniques to offer the benefits of an aortic valve replacement to patients who may not be surgical candidates. In this minimally invasive procedure, a team of physicians uses a catheter to deliver the prosthetic valve to the heart though a balloon small enough to go through an artery. Once the valve is in place, it is carefully deployed to improve cardiac function. Most procedures require a short hospital stay and offer a relatively rapid recovery.
Peripheral Vascular Angiography and Stent Placement
Angioplasty and stent placement are techniques used for treating blocked or narrowed arteries. These techniques can be performed on the arteries of the legs or arms to relieve burning or pain in muscles, when the symptoms are caused by insufficient blood flow. Angioplasty can also be performed on the arteries supplying the kidneys, in certain patients who have renal insufficiency and/or hypertension which cannot be controlled easily by medications. Finally, angioplasty and stenting is being performed on patients with narrowing of the carotid arteries (arteries supplying the brain). Angioplasty is the use of a tiny balloon to compress plaque to the sides of an artery and to widen the inside of the artery (the lumen), increasing blood flow. Once the artery is opened by angioplasty, a small, metal mesh tube called a stent is used to prop the artery open.
Pacemakers are used for chronic conditions that cause persistent or intermittent slowing of the heart rate. If heart muscle cells are damaged such that electrical signals to the heart are interrupted, delayed, or sent down the wrong path, the heartbeat may become irregular, too fast, or too slow. Others are born with conditions that may also cause similar irregularities. Pacemaker insertion is often a straightforward procedure, is done under local anesthesia and light sedation, and requires only one overnight stay in the hospital.
Internal Cardiac Defibrillator Implantation
Internal Cardiac Defibrillators (ICDs) are devices that monitor the heart’s rhythm, and have the ability to correct a life-threatening arrhythmia and restore a normal heart beat by delivering a shock to the heart. They can also act like pacemakers, to take control of the hearts rhythm, without having to generate a shock. Indications for an ICD can include: history of cardiac arrest, heart failure, and other conditions which have a high risk for the development of arrhythmias. Implantation of an ICD is usually straightforward; only one hospital night stay is required. The small device is implanted under the skin and connected to the heart with specialized wires, called leads.
Cardioversion is a procedure that uses electrical energy to correct abnormal rhythms of the heart, such as atrial fibrillation or atrial flutter. It is an outpatient procedure, and is performed at the hospital under sedation.
Patent Foramen Ovale (PFO) Closure
After birth, our heart continues to develop. Patients with Patent Foramen Ovale (PFO) have a hole between the right and left upper chambers of their heart, or atria, that did not close as expected in infancy. While up to 1 in every 4 persons may have a PFO, most do not know they have it and do not require treatment. PFO may be diagnosed following diagnostic imaging, such as an echocardiogram. Your cardiologist may request a Bubble Study or use Color Flow Doppler to better visualize your heart. In some circumstances, your physician may recommend PFO closure. This may be done using a cardiac catheter to bring a medical device to the opening and effectively plug the hole, or as a surgical repair.
Atrial Septal Defect (ASD) Repair
An Atrial Septal Defect (ASD) is also a hole in the heart between the right and left chambers of the heart, or atria. Unlike PFO, ASD is considered congenital as it began before birth. The cause is not known, but genetics may be a factor. While a large ASD will likely be identified and treated early in life, small ASD may not be diagnosed or require treatment. Diagnosis typically involves testing, including electrocardiograms and echocardiograms. Where there is significant blood flow through the defect, referred to as shunting, or the right side of your heart is bigger than normal, treatment is recommended. Many ASD may be closed with a medical device brought to the opening on a cardiac catheter to plug the hole. In other situations, surgery may be needed. Both surgery and catheterization require careful follow up with your cardiologist.