Interventional cardiology engages in the diagnosis and treatment of various cardiovascular diseases, the use of catheters and other specialized materials in the heart.
For many years now, in Greece and abroad, interventional cardiology offers valuable information for the treatment of cardiovascular diseases and holds a central position in leading Cardiology Clinics. The procedures are made either selectively (scheduled) or on an emergency basis, depending on the patient’s situation, with the ultimate aim being the treatment of the condition, with maximum safety.
Through which body part are the interventional procedures carried out?
Interventional cardiology procedures are carried out through small arteries of the body, usually through the artery of the foot or hand. All the procedures are performed under local anesthesia and with minimal discomfort to the patient. If there are pre-existing vascular problems, this should be discussed with the attending cardiologist, in order to select, ahead of time, the right artery through which the heart will be accessed.
Which procedures need to be done urgently?
There are some cardiac procedures which must be carried out urgently. The cardiologist is responsible for informing the patient if such a procedure is needed, as well as explaining the reasons for emergency surgery. In general, this is only necessary in sudden and serious heart problems, for which the procedure could save the patient’s life. These are:
Coronary angiography and angioplasty in acute myocardial infarction or to the unstable angina (it is demonstrably the most correct treatment during the first hours after the heart attack)
The use of devices that assist the performance of the heart, in cases of severe heart failure
The placement of a temporary pacemaker, when a very slow pulse is observed
Stretching the stenosed valve (balloon valvuloplast), in cases of severe heart failure
Heart biopsy in cases of severe and potentially catastrophic infection in the myocardium
Which other hospital departments does the Interventional Cardiology unit cooperate with?
The interventional cardiology unit works closely with other hospital departments and laboratories for the patient’s comprehensive care and treatment. Departments such as, the Cardiac Surgery Department, Cardiology laboratories (ultrasound, Holter, stress test), the Departments of Imaging (CT, MRI), the Invasive Radiology Department, the Intensive Care Unit, Department of Physical Therapy and Rehabilitation and the Dialysis Unit.
How do you prepare for cardiac surgery?
Preparing for cardiac surgery starts with meticulous assessment of the clinical problem by the attending cardiologist. Sometimes special cardiology or other tests are needed, blood tests, etc., before an interventional procedure is performed. A review of the patient’s pharmaceutical treatment is done and after scheduling with the Secretariat of the cardiology department, the patient is admitted to the Hospital, unfed, for surgery. Many times it is necessary to adjust, stop or start a pharmaceutical treatment before surgery, so each patient should receive proper instructions from the cardiologist.
How is coronary angiography carried out?
Coronary angiography is a filming of the heart arteries (arteries are blood vessels that supply the heart with blood and oxygen).
After topical anesthesia at a peripheral artery of the body, the cardiologist inserts (this process is called puncture) a thin plastic and flexible tube (probe), about 2 mm thick, which is suitably advanced to the heart. The catheter is introduced in the various arteries of the heart and then successive filming of the artery takes place, during the injection of contrast material (liquid which appears prominently in the angiography). After completion of the coronary angiography, the catheter is removed from the body and the artery is compressed in order to close the puncture site.
Angioplasty is a procedure within the arteries of the heart, in cases of stenosis. It is performed in a manner similar to coronary angiography (with local anesthesia), with the difference that in this procedure a miniature balloon is introduced at the narrowed or blocked areas.
The cardiologist inflates the balloon with fluid, with the aim of stretching the artery and improving blood flow to the heart. During surgery, the doctor inflates the balloon several times, while each opening of the stenosis takes a few seconds.
A stent is a very thin metal tube, which is inserted at the site of stenosis, after it has been opened by a balloon. It is used to assist in making the artery patency permanent. Your cardiologist will make a recommendation, based on your medical exam, regarding the type of stent that is most suitable for you (bare metal or drug-eluting).
What are the warning signs of a heart attack?
The treatment of myocardial infarction, in the acute stage, should be quick and careful. The symptoms of acute myocardial infarction are not typical, that’s why many patients connect them with other diseases such as gastroenteritis, various types of arthritis, indigestion etc. In some patients there are no symptoms.
The main discomfort is described as some kind of pressure, the feeling of “being squeezed down”, tightness, burning or pain usually located in the chest or on the left arm, jaw or back. They may be accompanied by shortness of breath, sweating or vomiting.
The treatment of a heart attack should start as soon as possible, thus any serious discomfort similar to the aforementioned, should lead the patient to the cardiologist or the nearest hospital or to call “166”.
Various types of heart procedures
- Coronary angiography: the filming of the heart arteries to verify the possible existence of stenosis.
- Angioplasty (balloon): the opening of stenoses of the arteries by inflating a small balloon in the stenosis.
- Stenting (stent): the permanent implantation of a small metal mesh at the site of stenosis, after it has been opened by a balloon.
- Valvuloplasty: the opening of narrowed or blocked heart valves with an oversized balloon under local anesthesia.
- Percutaneous aortic valve replacement: Correction of aortic valve stenosis in patients who are unable to undergo open-heart surgery, through the artery of the foot or hand, without general anesthesia.
- Heart Catheterization: measurement of blood pressure within the heart and lungs and the calculation of heart performance and function, as well as heart valve diseases (stenosis or valve failure).
- MitraClip implantation
What should your cardiologist be made aware of before your procedure?
You must tell your cardiologist everything that has to do with your heart condition or other serious condition. The following are of major importance:
Your cardiac symptoms, and more specifically the presence of angina, difficulty in breathing or if you have an irregular heartbeat.
Any other medical or surgical conditions.
Your previous heart exams: heart ultrasound (triplex), stress tests, angiographies, balloon angioplasty and stents, heart surgery, etc.
Previous vascular diseases (vascular stenosis, possible strokes etc.).
All the medications you are currently taking.
Your recent blood results.
Allergies you may have to medicines, foods or chemicals.