Coronary angiography

Overview

Your coronary arteries can become narrowed by the buildup of plaque, which is an accumulation of cholesterol and other substances. The buildup can decrease the amount of oxygen-rich blood flowing through your arteries into your heart. Using coronary angiography, your doctor can determine how much of your arteries are blocked and how to work with you to develop the most appropriate treatment plan.

Our cardiovascular specialists are known for their ability to perform complex procedures in difficult-to-treat patients. In fact, many patients come to us when other centers have been unsuccessful or unable to perform procedures on complicated coronary artery blockages.

Diagnosis

Coronary angiography
This is a diagnostic procedure that your doctor uses to see inside the arteries of your heart, called coronary arteries. If you're having coronary angiography, your doctor will insert a catheter into a blood vessel in your wrist or groin. This catheter will be guided through your blood vessels into your coronary arteries. A special X-ray device will show on a monitor a video of the catheter's progress. Your doctor will use this visual image to guide the threading of the catheter though your body to the affected location. A special dye is then injected through the catheter into your coronary arteries. This dye will allow your doctor to see on the video monitor any blockage in your coronary arteries. If blockage is detected, your doctor may perform coronary angioplasty (also known as balloon angioplasty). By directing a balloon through the catheter into your arteries at the location of the blockage, your doctor can inflate the balloon to push the accumulated plaque against the arterial walls. This creates a larger opening in the artery through which blood can flow. In most cases, when blockage is found, your doctor may insert a stent after the angiography procedure. A stent is a tiny mesh metal tube that is inserted into the artery to hold back the plaque.

Coronary angiography is a safe and painless procedure. You may experience some soreness or tenderness where the catheter was inserted. In most cases, coronary angiography is an outpatient procedure. In some cases, you may have to stay overnight. 

 

Catheterization
A cardiologist inserts a catheter into veins and/or arteries through the leg or arm. The catheters are advanced to the right and/or left sides of the heart. Once the catheters are positioned in the heart chamber(s) or blood vessel(s), the pressure of the blood in the chambers can be measured, blood samples taken and dye injected (angiography) to allow X-ray visualization. The goal of diagnostic catheterization is to identify and diagnose the specific heart problem. A diagnostic catheterization can become an interventional catheterization when the cardiologist determines that the problem can be effectively treated at the same time.
 

Nonsurgical treatment

Cardiac catheterization medications
Coumadin (also called Warfarin) is a pill prescribed for people who have blood clots or are at risk of forming blood clots. It can lower your risk of heart attack, stroke or even death by decreasing the ability of your body to form clots. Some patients take Coumadin for a short amount of time following a cardiac catheterization interventional procedure, and others need to take it forever.

Treatment

We offer a full range of cardiac catheterization and interventional procedures including:

  • Coronary angiography and left ventriculography
  • Percutaneous coronary intervention (PCI), including stenting and atherectomy
  • Right-heart catheterization
  • Assessment of congenital heart defects
  • Biopsy of heart tissue
  • Assessment of heart damage following a heart attack
  • Latest techniques for treatment of chronic total occlusions
  • Cardiovascular hemodynamic support in patients with heart failure and shocks

As innovators in interventional cardiac care, we frequently perform coronary interventions through transradial access. Transradial access means that the catheter is inserted through a small access point in the wrist instead of the groin area. This approach offers greater comfort, lower risk of complications, fewer bleeding problems and reduced recovery time. 

The following minimally invasive procedures are offered in our state-of-the-art cath labs:

Interventional catheterization procedures
Coronary interventions are specialized procedures in which thin tubes called catheters are guided by x-ray to your coronary arteries to help open blockages and to your heart to make repairs. Small tools are inserted through the catheters to perform a procedure. These minimally invasive procedures have the advantages of quicker recovery times, less bleeding, less trauma on the body, and small incisions. Essentially the same initial procedure as the diagnostic catheterization, an interventional catheterization is a type of cardiac catheterization during which interventional cardiologists perform actual treatments using specialized catheters. These specialized catheters include balloon catheters that can open up narrowed valves or arteries and catheters with devices that can close extra vessels or certain "holes" in the heart.

Interventional catheterizations can be performed using a traditional insertion by entering an artery in the groin. At our Center, most angioplasty procedures are performed entering an artery in the wrist. This technique, referred to as a radial artery catheterization, decreases related complications and allows for a quicker recovery. 

Balloon angioplasty procedure
This procedure uses a catheter with a small balloon on its tip that is designed to open narrowed arteries caused by plaque build-up. When the interventional cardiologist uses balloon angioplasty to inflate the balloon at the blockage site in the artery, the balloon flattens or compresses the plaque against the artery wall.

Percutaneous coronary intervention
You might know percutaneous coronary intervention (PCI) better as angioplasty, balloon angioplasty or angioplasty and stenting. PCI is also used to treat heart attack patients who come to the emergency room. In a heart attack, usually the blood is not getting to the heart because of a narrowed or blocked coronary artery. The longer your heart lacks the appropriate blood and oxygen, the more damage your heart may have. In PCI, the catheter is inserted, a balloon inflated and the artery opened. The faster this happens, the less damage to your heart. "Door-to-balloon" time means the amount of time it takes to get you through the doors of the emergency department and to a specialist who will perform PCI and open the artery causing the problem. 

Percutaneous transluminal coronary angioplasty (PTCA) / coronary artery stent
PTCA, also known as “coronary angioplasty" or "balloon angioplasty," is a procedure used to open up narrow areas in your coronary arteries. Coronary arteries are the blood vessels that supply blood directly to your heart muscle. Plaque build-up over time may cause blockages in your coronary arteries. Having major blockages may lead to symptoms such as chest pain (angina) or shortness of breath.

Stent insertion procedure
A stent is made of metal and shaped like a tube. During the stent insertion procedure, the stent is placed in the narrowed part of the artery and to hold it open. The stent remains in the body, but is not felt by the patient.

Valvuloplasty procedure
This procedure is used to open a blocked heart valve and can be an alternative to surgery. Heart valves direct the flow of blood through the chambers of the heart and then to the rest of the body. The valvuloplasty procedure uses a balloon to stretch the valve or to break up scars in the valve and restore blood flow.

Atrial septal defect (ASD) closure 
During this procedure, an atrial septal defect closure device is moved through the catheter to the location of the heart wall defect. Once in the correct location, the device expands its shape to straddle each side of the hole. The catheter is then removed. The atrial septal defect closure device will remain in the heart permanently to stop the abnormal flow of blood between the two atria chambers.

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Cardiology

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