Interventional cardiology refers to specialized procedures in which thin tubes called catheters are guided by X-ray to:
- Your coronary arteries to help open blockages
- Your heart to make repairs
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.
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.
Our hospitals have some of the highest success rates and outcomes for patients undergoing interventional procedures, including emergency and non-emergency angioplasty, a stent procedure used to clear blocked arteries.
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.
In our state-of-the-art catheterization labs, highly specialized teams of diagnostic and interventional cardiologists treat conditions including congenital heart disease, peripheral artery disease, heart valve disease, pulmonary hypertension, atrial septal defect and atherosclerosis:
In these diseases, heart valves do not correctly regulate blood flow through the heart chambers, due to birth defects, or damage by rheumatic fever, bacterial infection, heart attacks, or the aging process. The heart pumps harder, and may still be unable to supply adequate blood circulation.
- Pulmonary hypertension
- Atrial septal defect
In this disease, plaque builds up inside the arteries. Plaque consists of fat, cholesterol, calcium and other substances found in the blood. Eventually, plaque hardens and narrows the arteries, decreasing the flow of oxygen-rich blood to organs and other parts of the body. Atherosclerosis can lead to serious problems including heart attack, stroke or even death.
We treat those and other conditions with nonsurgical diagnostic and interventional catheterization procedures.
Cardiac catheterization is used to diagnose and even treat some conditions, usually chest pain. 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. The procedure does not require anesthesia, and causes little or no pain, though there may be soreness in the blood vessel where the catheter was inserted. Doctors may take samples of blood and heart muscle during catheterization or do minor surgery. Catheterization rarely causes serious complications.
Catheterization treatments may include:
- Radial artery catheterization — 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.
- Ultrasound — This shows blockages in the coronary arteries by using sound waves to create detailed pictures.
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.
Atherectomy — A device is inserted through a catheter into your arteries or veins. The device has a laser or cutting tip that cuts through the accumulated plaque and scrapes it from the artery or vein.
Bypass surgery — This creates a new pathway for blood to flow by bypassing a blocked area in your vein or artery.
Hybrid open/endovascular procedures — This combines traditional (open) surgery with minimally invasive surgery, using advanced imaging technology.
Balloon angioplasty (percutaneous coronary intervention, or PCI) — 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.
Coronary artery stent, stent insertion procedure/stent placement — May be done at the same time as angioplasty. A stent is a small, metal mesh tube that a surgeon inserts through a catheter to prop open an artery.
Valvuloplasty — May be done to open a stenotic (stiff) heart valve. 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 (ASF) closure — Larger atrial septal defects (a hole in the wall that separates the two chambers of the heart) may require closure, either by catheterization or traditional heart surgery. 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.
Percutaneous coronary intervention (PCI) — 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 — Also known as “coronary angioplasty" or "balloon angioplasty," this 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.
The primary goal of treatment is to reopen the artery to allow blood to flow. Minimally invasive surgery is our first approach; however, our vascular specialists will work with you to design an individualized treatment.