Treatments & Procedures

Cardiac Catheterization

A process to gather information about the heart and the coronary arteries. Your doctor inserts a catheter into a blood vessel and guides it into the heart.

One of the most accurate tests in the diagnosis of coronary artery disease, cardiac catheterization is performed more than a million times each year. This minimally invasive procedure is used for diagnosing and/or treating cardiac problems.

During cardiac catheterization, the physician inserts a catheter, or long, thin tube, through a very small incision site in the groin, arm or wrist. The catheter is guided through a blood vessel into the heart. The physician tracks the course of the catheter by watching it on a fluoroscope, an x-ray machine that displays the catheter and blood vessels in real time on a screen.

Using a cardiac catheter, the physician has access to the beating heart, and a variety of measurements may be performed when the catheter is in place. Your doctor can check the heart’s internal blood pressure, assess blood supply, view coronary arteries on the surface of the heart and the aorta, and check the blood oxygen level. Then the catheter is removed.

Results should be available within a matter of hours, while the patient remains in recovery. Most cardiac catheterization patients go home after about six hours.

Cardioversion

A procedure to restore normal cardiac rhythm. Your doctor applies controlled electrical shock to the chest wall. Cardioversion can sometimes be accomplished with medication only.

Cardioversion converts certain types of abnormal heart rhythms to normal rhythms. Abnormal heart rhythms are called arrhythmias. Cardioversion can be accomplished as either an internal or external procedure. In an emergency situation, external cardioversion is performed with a defibrillator.

Non-emergency external cardioversion is usually scheduled on an outpatient basis. The most common type uses carefully timed mild electrical shocks to restore a normal heart beat by stopping an arrhythmia. During the procedure, the patient receives general anesthesia or a strong sedative, and does not feel any pain.

Cardioversion is successful in correcting specific arrhythmias, such as atrial fibrillation, that have not improved by medication alone. Some patients may be required to continue anti-arrhythmic drugs after the cardioversion procedure.

Balloon Angioplasty

A procedure to treat narrowed arteries. Your doctor inserts a balloon-tipped catheter into an artery to press plaque back against the vessel wall to widen or unblock the artery, therefore restoring blood flow.

Also called Percutaneous Transluminal Coronary Angioplasty (PTCA), balloon angioplasty is most commonly performed on the coronary arteries. In emergency situations, balloon angioplasty is sometimes used as treatment for a heart attack.

Along with medication and bypass surgery, balloon angioplasty is a standard treatment for coronary artery disease, or CAD. In CAD, hardened arteries (atherosclerosis) that are clogged with plaque deposits restrict blood flow to the heart. Balloon angioplasty attempts to push fatty plaque back against the artery wall, providing more room for blood flow through the artery. Improved blood flow reduces the risks for heart attack and sudden cardiac death.

During balloon angioplasty, the physician numbs a specific area of the patient’s body using a local anesthetic. Then, the physician inserts a long, thin tube (catheter) with a deflated balloon at the tip into the femoral artery, located in the upper thigh or groin area. The balloon-tipped catheter is guided to the heart and site of the blockage. The physician rapidly inflates the balloon, which pushes the plaque in the artery back against the wall of the artery. The catheter is then removed, but a wire mesh tube, or stent, is often permanently implanted to hold the artery open. After the balloon angioplasty, the patient is given time to recover and usually goes home after about 24 hours.

Coronary Stent

A procedure to hold an artery open, usually performed immediately following a balloon angioplasty. While the balloon-tipped catheter is still in place, your doctor inserts a wire mesh tube, or stent, through the catheter.

Stenting is a catheter-based procedure in which a small, expandable wire mesh tube is inserted into a diseased artery, providing a support to hold the artery open. First performed in the mid-1980s and approved by the U.S. Food and Drug Administration in 1994, stenting currently is performed most often in conjunction with other catheter-based procedures.

While catheter-based procedures such as balloon angioplasty or atherectomy partially reduce vessel narrowing, the stent functions to ensure little or no remaining narrowing within the coronary arteries. Stent insertion in conjunction with other procedures reduces the risk of the artery re-narrowing (restenosis) and almost eliminates the risk of abrupt vessel closures during and/or within 24 hours of the procedure. Drug-coated, or drug eluting, stents have been developed to help reduce the rates of long-term re-narrowing.

Within one month, a thin layer of the artery’s inner lining cells will cover the stent. Metal detectors and most mechanical equipment will not affect a stent. To ensure successful stenting, patients are strongly encouraged to learn and practice healthy lifestyle behaviors for good heart health. Risk factors such as smoking and high cholesterol levels can threaten the success of a stenting procedure. For instance, unchecked high cholesterol levels can lead to new blockages in the coronary arteries.