Heart Procedures

Cardiac Catheterization

A cardiac catheterization or angiogram is a procedure that identifies possible problems with the heart or its arteries. During a catheterization, a thin plastic tube, called a catheter, is inserted into a blood vessel in the groin or arm. The catheter is guided up toward the heart. A special dye is injected into the catheter so x-rays can identify any artery blockage or other heart problems. This comprehensive test shows narrowing in the arteries, overall heart size and pumping ability of the heart. If a narrowing of a heart artery is found, this can usually be treated with balloon angioplasty and stenting, including the drug coated stents. This is usually performed on an outpatient basis with the majority of our patient going home the same day.

Minimally invasive treatments include;

Balloon Angioplasty- PTCA

Angioplasty is a technique used to mechanically widen a narrow or obstructed vessel by using a balloon. The balloon crushes the fatty deposit found in the artery and improves blood flow by opening up the blood vessel. A stent may or may not be inserted at the time of ballooning to ensure the vessel remains open.

Coronary Stents Bare Metal Stents

Coronary stents are wire mesh tube that is use in conjunction with rotational atherectomy and/or balloon angioplasty. It is use to keep a vessel open and allow blood to flow freely. There are two type of coronary stents used drug eluting or bare metal.

Electrophysiology (testing and treating of heart rhythm disorders)

Electrophysiology testing involves placing a special catheter in the low pressure side of the heart that relate to the electrical pathway or the conduit of the heart.Mapping is done and patients receive ablation or burning of the specific areas causing irregular heart rhythms to bring them back to a regular heart rhythm.

Permanent Pacemaker

Your doctor has recommended a pacemaker because there are signs that your heart is not beating fast enough or there is a problem with the normal electrical signal which causes your heart to beat. A permanent pacemaker consists of a generator and leads which are usually implanted into the upper chest through a small incision. The generator is a metal case containing the power source and a timer that regulates how often the pacemaker sends out electrical signals. The generator life is usually 7 to 10 years. The leads allow the pacemaker to monitor your heart rhythm and to send out electrical signals to make your heart beat when needed.

Intra-aortic balloon pump

The Intra-aortic balloon pump (IABP) is a mechanical device that increases myocardial oxygen perfusion while at the same time increasing cardiac output. Increasing cardiac output increases coronary blood flow and therefore myocardial oxygen delivery

Internal Cardiac Defibrillators

An AICD is a device that monitors a person’s heart rate. They are generally implanted into heart failure patients. The device is programmed to perform the following tasks; speed up or slow down your heart, depending upon the heart rate. The AICD gives your heart a shock if you start having life threatening arrhythmias or an abnormally high heart rate. Arrhythmias occur when your heart does not beat normally. Some arrhythmias can cause the heart to completely stop beating. The shock given by the AICD can make the heart start beating normally again. An AICD can also make your heart beat faster if your heart is not beating fast enough. There are different kinds of AICDs, but they all have 2 parts: electrodes (thin flexible wires) and a generator. The electrodes or “leads” sense or watch the heart’s electrical activity. The generator is the battery power source and the “brains” of the AICD. It is a small metal can about the size of a deck of cards. The generator stores information about any arrhythmias you have. The generator also keeps track of how often it needs to give your heart a shock. Some AICDs also function as pacemakers for heart rates that are too slow or too fast.

Intravascular Ultrasound

An invasive procedure, performed along with cardiac catheterization; a miniature sound probe (transducer) on the tip of a coronary catheter is threaded through the coronary arteries and, using high-frequency sound waves, produces detailed images of the interior walls of the arteries. Where angiography shows a two-dimensional silhouette of the interior of the coronary arteries, IVUS shows a cross-section of both the interior, and the layers of the artery wall itself.

Open heart surgery

Open Heart Surgery also known as traditional cardiac surgery, is performed by making a large incision, roughly 6-8”, in the chest to gain access to the heart. Once the heart is exposed, the heart is actually stopped and the patient is connected to a heart-lung bypass machine that does the work of the heart and lungs to allow the surgeon to perform the surgery.
Open heart surgery is often performed to treat:

  • Aortic Disease
  • Atrial Fibrillation
  • Coronary Artery Disease
  • Congenital Heart Disease
  • Heart Failure
  • Heart Transplants
  • Place ventricular assistive devices (VADs)
  • Valvular Heart Disease

Though similar heart conditions can be treated with minimally invasive methods, traditional surgery may be recommended for some patients based on factors such as age, previous heart treatments and overall health. Each patient will be evaluated to determine which surgical care option is best suited for their specific heart condition.

Left-Ventricular assist device (Impella)

The Impella catheter procedure is an assist device that is placed in the main pumping chamber of the heart to use as an extra help in difficult procedures.It allows patients to have their cardiac output increased to withstand an exam that would otherwise go to the operating room.

Rotational atherectomy

A rotational atherectomy is a type of interventional coronary procedure to help open coronary arteries blocked with more calcified material and restore blood flow to the heart. This procedure utilizes a high speed rotational “burr” that is coated with microscopic diamond particles. It rotates at high speed (approximately 200,000 rpm), breaking up blockages into very small fragments (smaller than red blood cells) which can pass, harmlessly, into the circulation. Often angioplasty/stent is performed after rotational atherectomy to improve the results.