Interventional Cardiology

Interventional cardiology focuses on the diagnosis and treatment of certain heart problems through the use of catheters. Cardiac catheterization is a procedure used to place the catheter, which is a long, thin tube, in the heart or a nearby artery. During this procedure, a catheter is inserted into a blood vessel in the arm, groin or neck area and guided to the heart. When the catheter reaches the heart, it can be used to:

• Detect any blockages or abnormalities
• Measure blood pressure and oxygen levels
• Detect and repair heart defects
• Perform an angioplasty
• Perform a balloon valvuloplasty

Cardiac catheterization is usually performed in a hospital but does not require the use of anesthesia. It is a safe procedure with little to no pain and a low risk of complications.

The Catheter Angiography Procedure

During the catheter angiogram procedure, an IV line is inserted into the arm, into which a small dose of sedative may be administered to relieve anxiety and any pain associated with this procedure. The catheter is then inserted under local anesthesia into the groin or arm, depending on the location of the area to be examined. The doctor guides the catheter to the targeted area under imaging guidance and then injects a contrast dye into the area before a set of X-rays is taken. The procedure takes between one and three hours. The catheter is then gently removed. No stitches are needed to close the incision.

Stenting

A stent is a small, expandable mesh cylinder that is used to keep narrowed arteries and blood vessels open. In terms of the heart, a stent is surgically placed in a coronary artery during a coronary (balloon) angioplasty, which is a procedure performed to improve blood flow in the arteries of the heart by reopening or enlarging blocked blood vessels. The stent also helps the artery from re-narrowing. Over time, the inside lining of the artery grows over the metal surface of the stent.

Candidates For Stenting

There are a number of candidates for coronary stenting; included are those who have had heart attacks, or who have damaged blood vessels and/or blocked arteries that are causing chest pain or discomfort. Those for whom lifestyle changes and taking medication have been ineffective in treating coronary-related conditions are also stent candidates.

Stent Placement

A patient is usually sedated but awake during the procedure to place a stent. An incision is made in the arm or groin, and a catheter is inserted. A contrast dye is injected through the catheter to highlight the clogged areas. A tube with a deflated balloon is inserted through the catheter to the area of blockage. The balloon is inflated to widen the artery, pushing the blockage aside to allow the blood to flow through smoothly. A stent is then inserted to hold the artery open, and prevent it from narrowing again. Once the stent is in place, the catheter is removed, and the procedure completed. Some stents are coated with medication that is slowly released into the arteries to help prevent scar tissue that can block the artery from forming. The procedure takes approximately 1 to 2 hours to perform.

Recovery From Stent Placement

After stent placement, an overnight stay in the hospital is required so that the heart can be monitored. A patient may experience bruising, swelling or tenderness at the site of the catheterization for a few days after the procedure. Medication may be prescribed to help prevent blood clots.

Steve Romeo

Dr. Nelson saved my life!

He did a cath to see what was the possible blockage that didn’t show up with treadmill test. He stopped process and said I had a choice, bypass or stent. He performed the stent on the “Widowmaker” and ll went great! Spent 1 night in hospital so insertion point could heal! I was out of hospital at 7 AM and immediately went to walk dog!

His practice is very efficient for follow ups!