Atherectomy is a procedure to remove plaque from arteries. Plaque is the buildup of fat, cholesterol and other substances in an artery’s inner lining. Coronary atherectomy removes plaque from the arteries supplying blood to the heart muscle, using a laser catheter or a rotating shaver. The catheter is inserted into the body and advanced through an artery to the area of narrowing. Balloon angioplasty or stenting may be used after an atherectomy.
Patients with plaque buildup in the carotid arteries or major arteries of the neck are at a higher risk for stroke. Carotid endarterectomy is an effective surgical procedure that can remove plaque to reduce that risk.
Automatic Implantable Cardioverter Defibrillators (AICD/ICD) have been useful in preventing sudden death in patients with known sustained ventricular tachycardia or fibrillation. Studies have shown they may have a role in preventing cardiac arrest in high risk patients who have not had, but are at risk for life-threatening ventricular arrhythmias.
A battery-powered pulse generator is implanted in a pouch under the skin of the chest or abdomen, often just below the collarbone. Wires or leads run from the pulse generator to positions on the surface of or inside the heart. When the ICD detects ventricular tachycardia or fibrillation, it shocks the heart to restore the normal rhythm.
Percutaneous Corornary Interventions (PCI/PTCA/Angioplasty/Balloon Angioplasty) are used to open blocked arteries and restore normal blood flow to heart muscles that have become clogged from a build up of cholesterol, cells or other substances.
A catheter tube is threaded through the arterial system via a small insertion in the groin or arm until it reaches the coronary (heart) artery. A very thin wire is threaded across the blockage. Over this wire, a catheter with a thin, expandable balloon on the end is passed to the blockage. The balloon is inflated, which compresses the plaque and dilates the artery. A stent (wire mesh tube) may be locked into position to keep the artery open so that the heart receives the blood it needs.
click for larger image
Beta-Radiation is a cardiac treatment used to prevent re-closure of an artery using a small amount of radiation therapy.
Cardiac catheterization is a procedure to examine blood flow and blood pressure within the heart, and test how well the heart is pumping. A cardiologist inserts a catheter (thin plastic tube) into an artery or vein in the arm or leg, and from there it can be advanced into the chambers of the heart or into the coronary arteries.
Coronary angiography is when a catheter is used to inject dye into the coronary arteries.
Stents (a wire metal mesh tube) are used depending on certain features of an artery blockage. This includes the size of the artery and where the blockage is located. A stent is collapsed to a small diameter and put over a balloon catheter, then moved into the area of the blockage. When the balloon is inflated, the stent expands, locks in place and forms a scaffold which holds the artery open, improving blood flow to the heart muscle and relieving symptoms.
In certain patients, stents reduce the re-narrowing that occurs after balloon angioplasty or other procedures that use catheters. Stents also help restore normal blood flow and keep an artery open if it’s been torn or injured by the balloon catheter.
Re-closure (restenosis) is an issue with the stent procedure. It is very important that patients take their anti-clotting medicines as directed by their cardiologist.
click for larger images
Electrophysiologic tests examine why a heart is beating irregularly.
A radiofrequency ablation is a non-surgical procedure used to treat some types of rapid heartbeating, such as atrial fibrillation, atrial flutter and atrial tachycardia. It is most often used to treat supraventricular tachyarrhythmias.
Transcatheter ablative therapy utilizes a technique of an electrode catheter being inserted through a blood vessel to perform targeted electrocautery in the heart. This therapy is rapidly becoming the treatment of choice for many supraventricular tachycardias.
Laser Angioplasty opens coronary arteries blocked by plaque. In this technique, a catheter with a laser at the tip is inserted into an artery. The catheter is then advanced through the artery to the blockage in the coronary artery. When the laser is in position, it emits pulsating beams of light that vaporize the plaque.
A pacemaker uses batteries to send electrical impulses to the heart to help it pump properly. An electrode is placed next to the heart wall and small electrical charges travel through the wire to the heart. Most devices are demand pacemakers, which have a sensor that turns the signal off when the heartbeat is above a certain level and turns it back on when the heartbeat is too slow.
PVD refers to diseases of blood vessels outside the heart and brain. It is often a narrowing of vessels that carry blood to the legs, arms, stomach or kidneys. There are two types of these circulation disorders, functional and organic. Functional peripheral vascular diseases do not involve defects in the blood vessels’ structure. They are usually short term effects related to spasms that come and go.
Organic peripheral vascular diseases are caused by structural changes in the blood vessels, such as inflammation and tissue damage. Peripheral artery disease (PAD) is caused by fatty buildups in arteries that block normal blood flow. These blockages restrict blood circulation mainly in arteries leading to the kidneys, stomach, arms, legs and feet. People with PAD often have fatty buildup in the arteries of the heart and brain.
Tilt Table Studies/Tilt Table Testing (TTT’s): A tilt table test may be advised for some people who have had recurrent fainting episodes (syncope). This test shows how your heart rate and blood pressure respond to a change in position from lying down to standing up. In this test, an intravenous line is usually started in case medications need to be administered during the test. A catheter may also be placed in the artery to monitor blood pressure from inside the artery.
Transesophageal Echocardiography (TEE): A TEE is a special type of echocardiogram. A tube with an echocardiogram transducer on the end is passed down a person’s throat and into the esophagus. The esophagus is right behind the heart, therefore images from the TEE can provide very clear pictures of the heart and its structures.