Therapeutic Cardiac Interventions
Sometimes symptoms are not relieved by medications. Sometimes test results tell us that something more than medicine is required. Thankfully science has given us a number of safe procedures that can improve symptoms and life expectancy.
Even if one of these procedures is indicated, we will continue to urge you to stop smoking, control your blood pressure, diabetes, cholesterol, exercise, and idealize your weight.
Most of these procedures are generally done with conscious sedation. A small amount of sedation is used so that you are comfortable but not deeply sedated. Oxygen levels, heartbeat, and blood pressure are continuously monitored.
Also called coronary arteriography. This test uses dye and x rays to show your coronary arteries which supply blood and oxygen to the heart. To deliver the dye a long, thin, flexible tube called a catheter is put into a blood vessel in your arm, upper thigh, or neck. The tube is then threaded into your coronary arteries, and the dye is injected into your bloodstream. Special x rays are taken while the dye is flowing through the coronary arteries.
We are able to measure size and function of the heart chambers, measure the pressures inside the heart and take pictures of the coronary arteries. This test is usually done in hospitals.
Coronary angioplasty is a procedure like heart catheterization in which a balloon is used to open a blockage in a coronary (heart) artery narrowed by atherosclerosis. By blowing up the balloon, we relieve the blockage.
A stent is a small mesh tube that's used to treat narrowed or weakened arteries. A small mesh tube is placed in the artery at the site of the blockage and stretched to hold the artery open while it heals. You may have a stent placed in an artery as part of a procedure called angioplasty. Some stents are coated with medicines that are slowly and continuously released into the artery. These medicines help prevent the artery from becoming blocked again.
A pacemaker is a small device that's placed under the skin of your chest or abdomen to help control abnormal heart rhythms. This device uses electrical pulses to prompt the heart to beat at a normal rate.
Pacemakers are used to treat heart rhythms that are too slow, fast, or irregular which cause a patient to feel fatigue (tiredness) and fainting. A pacemaker can help a person who has an abnormal heart rhythm resume a more active lifestyle.
An implantable defibrillator is a small device that's placed in your chest or abdomen. A defibrillator uses electrical pulses or shocks to help control life-threatening, irregular heartbeats, especially those that could lead the heart to suddenly stop beating.
Regular follow-ups for both defibrillators and pacemakers are required.Top
Catheter ablations can be used to treat cardiac arrhythmias – a problem with the speed or rhythm of the heartbeat. During catheter ablation, a long, thin, flexible tube is put into a blood vessel in your arm, groin (upper thigh), or neck. This tube is called an ablation catheter. It's then guided to your heart through the blood vessel. A special machine sends energy through the catheter to your heart. This energy finds and destroys small areas of heart tissue where abnormal heartbeats may cause an arrhythmia to start.
Peripheral Arterial Stent and Angioplasty
Angioplasty may be performed to restore blood flow through a narrowed or blocked artery in your arm or leg. A thin catheter tube is inserted into a blocked artery and a small balloon on the tip of the catheter is inflated. When the balloon is inflated, plaque is pushed against the artery walls. This causes the artery to widen, restoring blood flow. A stent, a tiny mesh tube that looks like a small spring, is now used in most angioplasties. Some stents are coated with medicine to help prevent the artery from closing again.
Occasionally, stents can be placed in the abdominal aorta to treat an abdominal aortic aneurysm.
Tremendous advances in open-heart surgery have been made and results of heart surgery in adults are often excellent. "Off pump" and minimally invasive techniques decrease recovery time. Open-heart surgery is done under complete general anesthesia and sometimes a heart/lung machine is used.
The most common type of open-heart surgery is coronary artery bypass grafting (CABG). During CABG, a healthy artery or vein from another part of the body is connected, or grafted, to a blocked coronary artery. The grafted artery or vein bypasses (that is, it goes around) the blocked portion of the coronary artery. This improves the flow of blood and oxygen to your heart muscle. CABG relieves chest pain and reduces the risk of heart attack.
Heart surgery is also used to repair leaky heart valves, correct congenital defects or implant medical devices.Top
"This page has been adapted from the national heart lung and blood institute."