Cardiac/Coronary Intervention

Cardiac catheterization also known as heart or coronary cath, is used to detect or confirm the presence of coronary artery disease, heart valve disease or disease of the aorta. In this procedure, a guide wire is inserted into the blood vessel via the groin area (femoral access) or the wrist area (radial access). A thin tube called catheter is then guided to the heart under x-ray to view the arteries, valves, muscles and aorta. Once the catheter is in place, one or more of the following can be performed:  coronary angiography, angioplasty, stent placement, rotablation, LASER atherectomy. Depending on the procedure to be performed, the catheter will have an appropriate attachment.

For more information on Coronary artery disease and coronary interventions, please click here.

Fractional flow reserve (FFR) is defined as the pressure beyond the coronary stenosis relative to the pressure before the stenosis. After cardiac catheterization FFR is measured to determine need for a coronary intervention when blockages may appear to be borderline severe on angiogram.

Intravascular Ultrasound (IVUS), also known as endovascular ultrasound or intravascular echocardiography is an invasive test that uses high frequency sound waves to see the inside of blood vessels.

 

It is performed after cardiac catheterization and sometimes after angioplasty. During this intervention, the catheter with an ultrasound transducer attached to the tip emits sound waves that are converted into images.

 

IVUS is used to visualize the progression of atherosclerosis within the blood vessels, and to estimate the amount, type and configuration of plaque when traditional angioplasty may not give accurate results. It is also used to determine the type and size of the stent or balloon required, and to evaluate correct placement of the stent. In the aorta, IVUS is used to evaluate plaque buildup and to determine the blood vessels involved in aortic dissection.

 

Pericardiocentesis or pericardial tap is an invasive procedure used to remove excess fluid from the sac around the heart (pericardium).

Pericardium is a double layered sac which helps keep the heart in its place and stops heart from expanding in case of fluid overload. There is a little amount of fluid between the two layers which helps lubricate to decrease the friction and also helps with smooth movement when the heart beats.

Sometimes the amount of pericardial fluid may increase and is called pericardial effusion.  When the amount of fluid becomes too much, it may exert pressure on heart muscle and impair pumping of heart muscle. This life threatening condition is known as Cardiac Tamponade.

Pericadiocentesis is performed to remove excess pericardial fluid using a needle and a catheter. Sometimes the catheter may have to be left overnight. The pericardial fluid is then sent for laboratory analysis to determine the cause of the effusion. Once the fluid has drained, the catheter is removed.

 

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