Diagnosing and Treating Heart Disease Using a Catheter
Interventional cardiologists use a thin catheter that they thread through blood vessels and into the coronary arteries. They then use X-rays to look for signs of heart disease. They can also determine the size and location of fat and calcium deposits that may narrow the openings in the arteries.
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Cardiac Catheterization Treatments
- Transradial Cardiac Catheterization (through the wrist): Summerlin Hospital is one of a few hospitals in the area to offer this alternate approach that has a lower risk of bleed complications and is generally more comfortable for the patient. During this procedure, the interventional cardiologist accesses the patient's heart through the inside of the patient's wrist. This typically enables the patient to sit up immediately after the procedure and leave the same day, and it is more comfortable for patients who have difficulty lying down for several hours. It reduces the risk for bleeding complications.
- Angioplasty: Angioplasty is an alternative to open-heart surgery. During this procedure, a balloon tipped catheter is used to unblock a coronary artery. Stents –small, flexible tubes made of plastic or wire mesh – are sometimes used to support the damaged artery walls.
- Atherectomy: During this surgical procedure a laser beam or a whirling blade is used to cut the plaque build-up on an artery wall. This increases blood flow in narrowed arteries. Stents may also be implanted during this procedure.
- Coronary Thrombectomy/Thrombolysis: This procedure is very effective for treating deep vein thrombosis (DVT). A catheter-directed thrombolysis is performed under imaging guidance by interventional radiologists. DVT is a blood clot commonly found in the lower leg, thigh or deep veins of the pelvis. The clot may travel through the bloodstream and potentially lodge in the brain, lungs, heart or other area causing severe damage.
Intracoronary Ultrasound
During this procedure, high-frequency sound waves are used to evaluate the heart and determine different treatment needs. A catheter with a miniature sound probe (transducer) on the tip is threaded through the coronary arteries to the heart. It then emits sound waves to create the images.
Evaluation of Pulmonary Hypertension
To best evaluate treatment options for pulmonary hypertension, physicians test a patient's response to medication during a right heart catheterization, which is performed in the cardiac cath laboratory. These tests help pulmonologists optimize patient treatment.
Advanced Devices
Sometimes patients need devices implanted in the heart to help it function properly. The following devices are implanted in the cardiac cath laboratory:
Cardiac-Assist Device
The Abiomed Impella® cardiac assist device – the world's smallest ventricle heart pump – provides partial circulatory support for up to six hours in critically ill patients. The device is inserted through the femoral artery in the groin area. It is then placed in the left ventricle with the help of a guide wire.
Atrial Septal Defect (ASD) Closure
An atrial septal defect is an abnormal opening in the wall (septum) that divides the two upper chambers of the heart (atria). People with ASD have an increased risk for developing a number of complications, including:
- Atrial fibrillation (in adults)
- Heart failure
- Pulmonary overcirculation
- Pulmonary hypertension
- Stroke
If the defect is small and symptomatic, patients may not need treatment. However, when the heart is enlarged or patients are experiencing symptoms, treatment may be recommended. At Summerlin Hospital, physicians implant an atrial septal device to correct this abnormal opening. The procedure involves placing an ASD closure device into the heart through catheters to seal off the opening. Patients will typically go home the same day as the procedure.