Invasive Cardiology Services
- Diagnostic Catheterization
- Endomyocardial Biopsy
- Balloon Angioplasty
- Coronary Artherectomy
- Coronary Stents
- Peripheral Angioplasty
- PFO/ASD/ASD Closures
- Mitral and Aortic Valvuloplasty
With diagnostic catheterization, catheters (small, hollow plastic tubes) are inserted into veins and/or arteries through the neck, leg or arm. Once placed, the catheters are then advanced to the heart. After they are positioned correctly, the catheters can be used to measure the pressure of blood in the heart’s chambers, take blood samples, or insert dye to allow for x-ray visualization of the heart.
Catheterization is used to either confirm or exclude the presence of a condition that may be suspected due to a patient’s history, physical exam, or from other noninvasive procedures such as ECG, x-ray or stress test. Catheterization can also be used to clarify findings from tests that are unclear, and can confirm a condition in a patient that is scheduled for heart surgery, while excluding other conditions that might require a surgeon’s attention.
Endomyocardial biopsy is the removal of a sample of heart tissue to check for signs of damage that can be caused by organ rejection and is done primarily as a follow-up to a heart transplant. It can also be used to diagnose other heart conditions, such as cardiomyopathies, myocarditis, infiltrative lesions, arrhythmias, and drug toxicities.
During the procedure, a catheter is placed in a vein in either the neck or groin. A biopsy catheter is placed in a plastic tube and positioned inside the heart, through the aid of x-ray. Samples of heart tissue are removed and examined for rejection or abnormalities that could cause weakening of the muscle.
Balloon Angioplasty is a procedure through which a deflated balloon is threaded up the coronary arteries. The balloon is inflated to widen blocked areas where blood flow to the heart has been decreased or completely cut off.
Patients may choose balloon angioplasty because it can greatly increase blood flow through a previously blocked artery, decrease chest pain, increase one’s ability for physical activity, reduce the risk of a heart attack and in some cases, can open neck and brain arteries to reduce the risk of stroke.
During a coronary artherectomy, a catheter with a rotating shaver on its tip is inserted to cut away plaque from an affected artery. This procedure increases blood flow by removing built-up plaque and may also be used in carotid arteries to remove plaque and reduce the risk of stroke.
Coronary stents are wire mesh tubes that are used during an angioplasty to prop open an artery. The stent will stay in the artery permanently. Stents hold the artery open, thus improving the blood flow to the heart and relieving chest pain.
The rotoblator is a device that is inserted into an artery through a catheter. Once it is placed properly, it begins to spin between 140,000 and 200,000 revolutions per minute. Through the use of a diamond-tipped burr on the end of the rotoblator, plaque is broken up inside the artery. It may be used along with a balloon angioplasty in patients with coronary artery disease.
Peripheral angioplasty captures images of arteries in the lower abdomen, kidneys, arms, legs and feet. These peripheral arteries often do not show up on x-ray alone. During a peripheral angioplasty, contrast dye is used to capture the images via x-ray. A catheter is inserted into a blood vessel in the groin area or arm. Once placed, the dye is released and angiograms are taken. The angiogram can indicate the build up of plaque on artery walls and detect peripheral vascular disease.
Patent Forament Ovale (PFO) or Atrial Septal Defect (ASD) closures are innovative, non-surgical procedures used to close these defects. The patent foramen ovale is a small, flap-like opening between the right and left upper chambers of the heart that typically closes at birth. In an atrial septal defect, the wall between the two atrial chambers remains open. For patients who require repair, a small catheter is inserted through the leg and then positiond into the heart. A small mesh device is advanced through the catheter to close the hole. While some patients with PFO or ASD may not have symptoms, others experience fatigue, shortness of breath or cardiac rhythm abnormailities.
Mitral and Aortic Valvuloplasty:
Valvuloplasty is used in patients whose heart valves do not open fully. During the procedure, a tube with a balloon on its tip is threaded through the blood vessels and into the proper valve. Once placed, the balloon is inflated to widen the opening of the valve. Once the valve is open, the balloon is removed. Valvuloplasty can relieve symptoms of heart valve disease and for some patients with mitral valve stenosis; it can work as well as surgical repair, but is much less invasive.