The Interventional Cardiology Clinic provides the services focusing on the invasive (usually catheter-based) diagnosis and treatment of heart diseases. Catheter-based treatments and continuous monitoring cover a variety of cardiovascular conditions, including myocardial infarction and vascular diseases, both acute and chronic conditions caused by coronary artery disease defined as the narrowing or blockage of the coronary arteries due to atherosclerotic plaques.
During cardiac catheterization, a long thin tube called a catheter is inserted in an artery or vein in the groin, neck or arm. The catheter is then threaded through the blood vessels to the heart. Combined with the use of X-ray, radiographic contrast dye is then injected in order to determine the abnormality of blood vessels in the heart. After reaching the narrowed artery, when the tip is in place, a balloon tip covered with a stent is inflated. The balloon tip compresses the plaques against the artery walls and expands the stent (known as balloon angioplasty). Once the plaque is compressed and the stent is in place, the balloon is deflated and withdrawn (known as coronary stent implantation). A stent is often left in the artery to help keeping the artery open. Other medical devices might be additionally used for improving treatment outcomes.
In case of emergency, treatment plans will be clearly explained to and discussed with the patients and families. Patient educations are conducted to impart information to the patients and families about alternative options with their pros and cons, treatment plan and preparation or instruction prior to and after treatments.
Since interventional cardiology principally involves less invasive procedures compared to cardiac surgery, superior advantages include less pain, shorter hospital stay and faster recovery time. Interventional procedures are:
- Percutaneous Coronary Intervention (PCI): by using balloon and/or stent (balloon angioplasty and stent implantation)
- Fractional Flow Reserve (FFR): a guide wire-based procedure that can accurately measure blood pressure and flow through a specific part of the coronary artery.
- Rotablation: Rotablation is the process of plaque and calcified deposits drilling. During rotablation, a special catheter is guided to the point of the narrowing in the coronary artery. The tip spins at a high speed and grinds away the plaque on the artery walls. The microscopic particles are washed away in the bloodstream.
- Intravascular ultrasound (IVUS) is a medical imaging test using a specially designed catheter with a miniaturized ultrasound probe attached to the distal end of the catheter. The proximal end of the catheter is attached to computerized ultrasound to display the structure and lining of the artery walls. Blockages or occlusions can be visually detected, allowing optimization of stent implantation at the time of PCI .
- Balloon Valvuloplasty: Balloon valvuloplasty aims to reopen a stiff (stenotic) heart valve without heart valve repair or replacement surgery. In valvuloplasty, a catheter is inserted into a blood vessel in the groin and advances it through the aorta into the heart. Once the catheter reaches the stiff valve, an interventional cardiologist inflates a large balloon at the tip of the catheter until the flaps (leaflets) of the valve are pushed opened. Once the valve has been opened, the balloon is deflated and the catheter is removed.
- Congenital Heart Diseases
- ASD closure: An atrial septal defect (ASD) is a hole between the two upper chambers of the heart. To close the hole, an interventional cardiologist places a special device in the child’s heart through catheterization.
- Patent Ductus Arteriosus (PDA): Patent ductus arteriosus (PDA) is a medical condition in which the ductus arteriosus fails to close after birth, allowing a portion of oxygenated blood from the left heart to flow back to the lungs by flowing from the aorta. Most children can have the PDA closed by inserting catheters.
- Peripheral Artery Disease (PAD)
- Catheterization and Percutaneous Coronary Intervention (PCI) using balloon and/or stent for non-coronary heart vessels