Interventional Cardiology

Interventional cardiology deals specifically with the catheter-based treatment of heart diseases. Interventional cardiologists are board-certified cardiologists who perform interventional cardiology procedures, most often in a cardiac catheterization lab at a hospital.

The majority of interventional cardiology procedures are performed in the cardiovascular (heart, veins and arteries) system. Most interventional cardiology procedures are considered to be minimally invasive because they do not require an instrument to enter the body or large incisions; most incisions are approximately 1 inch. These procedures usually involve the insertion of a catheter (hollow tube) into the femoral artery in the upper leg. The catheter is guided toward the heart or vascular area through the use of real-time X-ray.

Some of the advantages of minimally invasive interventional cardiology are decreased pain, less risk of infection, avoidance of large scars and shorter postoperative recovery times. In many instances, patients are awake during the procedure, requiring only a local anaesthetic. Additionally, many procedures are performed on an outpatient basis, allowing patients to go home within hours of the procedure.

Peripheral Angiography

Peripheral angiography is an outpatient diagnostic study for patients who may have blocked blood vessels in their legs and lower body.Utilizing an iodine-based dye that is injected to make arteries (which aren't detectable by X-rays) visible when mixed with blood, doctors can have a "map" of a patient's blood vessels to determine if there's disease or blockage and where the problem is located.

In the short term, blocked arteries can lead to leg cramps and can deter wounds in the lower extremities from healing properly. In the long term, the condition can set the stage for high blood pressure or stroke. A peripheral angiogram may also be used to detect potential blood-flow problems in the upper body and in the abdominal area.

Peripheral Angioplasty

Peripheral angioplasty is a minimally invasive procedure where a catheter with a balloon tip is inserted into a peripheral artery (arteries in the lower abdomen, kidneys, arms, legs or feet) and inflated to compress plaque buildup.

This procedure is performed in a state-of-the-art cardiovascular catheterization laboratory. A catheter is inserted into a blood vessel in the upper thigh (groin) or arm. Using high-resolution fluoroscopic (X-ray) video and film equipment, the catheter is guided through to the peripheral artery that is being treated.

Cardiac Catheterization

Cardiac catheterization (KATH-eh-ter-ih-ZA-shun) is a medical procedure used to diagnose and treat some heart conditions.

A long, thin, flexible tube called a catheter is put into a blood vessel in your arm, groin (upper thigh), or neck and threaded to your heart. Through the catheter, your doctor can do diagnostic tests and treatments on your heart.

For example, your doctor may put a special type of dye in the catheter. The dye will flow through your bloodstream to your heart. Then, your doctor will take x-ray pictures of your heart. The dye will make your coronary (heart) arteries visible on the pictures. This test is called coronary angiography (an-jee-OG-rah-fee).

Balloon Valvuloplasty

Balloon valvuloplasty (also called valvulotomy or valvotomy) is a procedure that widens a heart valve that is narrowed. The cause of this narrowing in the aortic valve is aortic valve stenosis.

During this procedure, a thin flexible tube called a catheter is inserted through an artery in the groin or arm and threaded into the heart. When the tube reaches the narrowed heart valve, a balloon at the end of the tube is inflated. The balloon presses against the hardened (calcified) tissue and enlarges the valve opening.

During the procedure, you will be awake. But you will receive local anesthesia where the catheter is inserted as well as intravenous (IV) pain medicine along with a sedative to help you relax.

Coronary Angiography

Coronary angiography (an-jee-OG-rah-fee) is a test that uses dye and special x rays to show the insides of your coronary arteries. The coronary arteries supply oxygen-rich blood to your heart.

A waxy substance called plaque (plak) can build up inside the coronary arteries. The buildup of plaque in the coronary arteries is called coronary heart disease (CHD).

During coronary angiography, special dye is released into the bloodstream. The dye makes the coronary arteries visible on x-ray pictures. This helps doctors see blockages in the arteries.

Coronary Angioplasty & Stenting

Coronary angioplasty (AN-jee-o-plas-tee), also called percutaneous coronary intervention, is a procedure used to open clogged heart arteries. Angioplasty involves temporarily inserting and inflating a tiny balloon where your artery is clogged to help widen the artery.

Angioplasty is often combined with the permanent placement of a small wire mesh tube called a stent to help prop the artery open and decrease its chance of narrowing again. Some stents are coated with medication to help keep your artery open (drug-eluting stents), while others are not (bare-metal stents).

Carotid Angioplasty & Stenting

Carotid angioplasty (kuh-ROT-id AN-je-oh-plas-te) is a procedure that opens clogged arteries to prevent or treat stroke. The carotid arteries are located on each side of your neck and are the main arteries supplying blood to your brain. The procedure involves temporarily inserting and inflating a tiny balloon where your carotid artery is clogged to widen the artery.

Carotid angioplasty is often combined with the placement of a small metal coil called a stent in the clogged artery. The stent helps prop the artery open and decreases the chance of it narrowing again. Carotid angioplasty and stenting may be used when traditional carotid surgery isn't feasible or is too risky.

Device Closure of PDA / ASD / VSD

Patent ductus arteriosus (PDA) is a congenital disorder in the heart wherein a neonate's ductus arteriosus fails to close after birth. Early symptoms are uncommon, but in the first year of life include increased work of breathing and poor weight gain.

Atrial septal defect (ASD) is a defect between the two upper heart chambers (the atria). This defect allows mixing of oxygenated and deoxygenated blood, eventually causing right heart enlargement and high pressure in the lungs (pulmonary hypertension).

A ventricular septal defect (VSD) is a defect in the ventricular septum, the wall dividing the left and right ventricles of the heart. The ventricular septum consists of an inferior muscular and superior membranous portion and is extensively innervated with conducting cardiomyocytes.

Electrophysiology & R F Ablation

Electrophysiology is the cardiology specialty that diagnoses and treats heart arrhythmias, or problems related to the heart’s electrical system.

Radio frequency ablation (RFA) is a medical procedure in which part of the electrical conduction system of the heart, tumor or other dysfunctional tissue is ablated using the heat generated from high frequency alternating current (in the range of 350–500 kHz).[1] RFA is generally conducted in the outpatient setting, using either local anesthetics or conscious sedation anesthesia.

Pacemaker Implantation

Pacemaker implantation is a procedure to put a small device called a pacemaker into your chest. The pacemaker sends regular electrical pulses that help keep your heart beating regularly.

Having a pacemaker fitted can greatly improve your quality of life if you have problems with your heart rhythm, and the device can be lifesaving for some people.

Pacemaker implantation is one of the most common types of heart surgery carried out in the UK. During 2012-13 in England, more than 40,000 people had a pacemaker fitted.

Renal and Angioplasty

A small flexible tube called a catheter can be positioned inside the renal artery. An angioplasty is performed by using a catheter that has a tiny balloon attached to the end. The angioplasty balloon is inflated inside the vessel and presses any plaque (blockage) into the walls of the vessel.

In addition to percutaneous angioplasty, a vessel may require stent placement. A stent is a mesh metal tube that is pressed into the sides of the vessel in order to hold the vessel open. An un-deployed stent is wrapped around an angioplasty balloon.

The balloon is at the end of the catheter. The balloon and stent combination are positioned at the stenosis inside the vessel.

Transesophageal ECHO

Transesophageal (tranz-ih-sof-uh-JEE-ul) echocardiography (EK-o-kar-de-OG-rah-fee), or TEE, is a test that uses sound waves to create high-quality moving pictures of the heart and its blood vessels.

TEE is a type of echocardiography (echo). Echo shows the size and shape of the heart and how well the heart chambers and valves are working.

Echo can pinpoint areas of heart muscle that aren't contracting well because of poor blood flow or injury from a previous heart attack.

EP Study & RF Ahalatirn

An electrophysiology study (EP test or EP study) is a minimally invasive procedure that tests the electrical conduction system of the heart to assess the electrical activity and conduction pathways of the heart. During EPS, sinus rhythm as well as supraventricular and ventricular arrhythmias of baseline cardiac intervals is recorded.

Radiofrequency catheter ablation is a procedure that is performed to correct a disturbance in heart rhythm. A brief review of how a normal heart rhythm occurs and a description of some of the rhythm problems that are treated with this procedure will help in the understanding of radiofrequency catheter ablation.