Interventional Cardiology refers to various non-surgical procedures that involve the use of catheters - long, thin, flexible tubes - to diagnose and treat cardiovascular disease. During the procedures, catheters are inserted into blood vessels for diagnostic testing, repairing damaged vessels, or treating other heart structures. Interventional cardiology often reduces the need for traditional surgery. Chester County Hospital features state-of-the-art cardiac catheterization laboratory facilities for both diagnostic and therapeutic procedures.
Diagnostic Cardiac Catheterization (Angiography)
Diagnostic cardiac catheterization or coronary angiogram is the most common type of heart catheter procedure. It uses a catheter and X-ray imaging to see inside your heart's blood vessels. During the test, a catheter is inserted into a blood vessel, usually in the groin, and then advanced to your heart under X-ray guidance.
Catheterization is used to measure blood flows and pressures in your heart. Contrast dye is injected through the catheter, which enables moving X-ray images to be taken of your heart valves, coronary arteries, and the chambers of your heart. The images will help your doctor determine the source of the problem and any treatments that may be needed, such as an interventional catheter procedure (angioplasty) or heart surgery.
Before your diagnostic coronary angiogram, you will have an opportunity to speak with a member of the team who will tell you what to expect before, during and after your procedure. If you are having the procedure as an outpatient, plan to be at the hospital for five to nine hours on the day of your catheterization. If it is determined that additional treatment is needed, you may need to be admitted to the hospital for further care.
- Intravascular Ultrasound (IVUS)
Intravascular Ultrasound (IVUS) is most often used as an accessory to angiography to evaluate complex blockages in the coronary arteries (especially in the left main coronary artery) and to detect disease that is not clearly visible during routine angiography.
- Intracoronary Pressure Measurement
Intracoronary Pressure Measurement is another test that is used along with diagnostic catheterization. If you have several narrowings or more than one coronary artery is blocked, your doctor may need more information to determine the best treatment for you. In this case, he or she will perform intracoronary pressure measurement or fractional flow reserve during your cardiac catheterization. The test will provide a more precise measure of the extent to which the blockage prevents the free flow of blood to your heart muscle.
Interventional Catheter Procedures (Angioplasty)
Cardiac catheterization is used to treat coronary heart disease by therapeutic interventional procedures involving special catheters that enable doctors to "open" blocked arteries. An interventional procedure starts out in the same way as a diagnostic cardiac catheterization, but the doctor passes the catheter into the blocked artery and uses devices attached to the catheter to open the blocked artery.
There are several interventional procedures that may be used to open an artery. The process often involves the use of a balloon to open the blockage and wire mesh tubes called stents to keep the artery open and improve blood flow through the area.
Therapeutic catheterization procedures usually require an overnight hospital stay to accommodate the necessary preparation and recovery time. Before, during and after the procedure, you will be cared for and monitored by a team of specially trained registered nurses, nurse practitioners, cardiovascular technologists, and doctors. Following the procedure, you will move to our Post Interventional Unit (PINU).
Our nurses and doctors will answer any questions you or your family may have, and they will make sure you have the information you need to care for yourself at home. Almost every patient who has a stent placed will need to take medication, which thins the blood and helps keep the stent open.
- Balloon Angioplasty (Percutaneous Transluminal Coronary Angioplasty or PTCA)
A balloon-tipped catheter is inserted to the location of the blockage. Once in position the balloon on the catheter is inflated several times. The material responsible for the blockage (plaque) is compressed against the walls of your artery, opening the blockage and improving blood flow through your artery.
- Balloon Angioplasty with Stent
Usually during a balloon angioplasty, your doctor will place a stent in your coronary artery. There is substantial evidence that stents help to keep the artery open long-term. After the balloon has been inflated, your doctor will insert the stent (a small, metal mesh cylinder) inside your artery. The stent remains in your artery permanently and is designed to prevent the artery from narrowing again.
- Primary Angioplasty
Primary angioplasty is a rapid, life-saving process that can stop a heart attack in its tracks and save the heart muscle from permanent damage. The CardioVascular Center, in conjunction with Emergency Medical Services (EMS) and our Emergency Department, is prepared to activate a rapid response team approach for patients arriving at the hospital with signs and symptoms of an on-going acute myocardial infarction (AMI), commonly known as a heart attack.
If you are scheduled for a cardiac catheterization and/or an intervention, please bring a list of all the medications you take (including over-the counter medications and herbal supplements).