Interventional
cardiology is thea branch of cardiology
that deals specifically with the catheter based treatment of
structural heart diseases. The procedures performed are done by
initially placing a catheter into the heart, or into the arteries
that feed the heart itself. This is a Cardiac Catheterization.
Cardiac Catheterization
A Cardiac Catheterization is performed
by placing a long, thin, hollow tube (known as a catheter) into the
right or left femoral artery or femoral vein. These vessels are
accessed through a small puncture site in either the left or right
groin. Local anesthesia is used in the groin to permit relatively
painless introduction of a small plastic tube (Sheath) into the
blood vessel. A Catheter is then advanced through the sheath, up to
the heart. This catheter can be used to take pressure readings
and/or inject contrast (dye) to take pictures. This gives your
doctor valuable information about your heart. Your doctor may elect
to perform one or both of the following type of cardiac
catheterizations.
During a Right Heart Catheterization, your doctor
will place a catheter into the femoral vein and advance the catheter
into the right chambers of the heart. Pressure measurements from the
right side of the heart give your doctor information about how well
your heart and lungs are working. During a Left Heart
Catheterization, your doctor will place a catheter into the femoral
Artery and advance the catheter up the Aorta to the base of the
heart. With this procedure your doctor can take pictures of the
coronary arteries (Coronary Angiogram-see below), take pressure
readings and even take a picture of the Left Ventricle (the main
pumping chamber of the heart). This will tell your doctor if there
are any narrowing or blockages in these arteries, which feed the
heart, how well the heart is pumping and if there are any problems
with the aortic valve at the top of the heart. These diagnostic procedures
give your doctor valuable information.
Coronary Angiogram
A Coronary Angiogram is a series of x-ray pictures showing the
internal contours of blood vessels which feed the heart (Coronary
Arteries) and is taken during a Left Heart Catheterization. This
diagnostic test is usually performed when a patient is suspected of
having narrowing or blockages of the Coronary Arteries. Narrowing or
blockages of the Coronary Arteries is called Coronary Artery
Disease. Your physician may suspect that you have Coronary Artery
Disease based on your history, symptoms or recent stress test.
Aa Cardiac Catheterization and
Coronary Angiogram canhelp your doctor determine how best to
treat you. Based on the findings of your Cardiac Catheterization and
Coronary Angiogram you may need:
? No additional treatment
? To be treated with medication
? A coronary intervention
? Coronary by-pass surgery.
Coronary Intervention
A cardiac catheterization is a
diagnostic study of the heart. Coronary Intervention, which is often
done during a cardiac catheterization, is a type of treatment for
blocked or severely narrowed coronary arteries, a known as
"hardening of the arteries," Arthrosclerosis is a disease in which
the arteries are hardened and narrowed because of plaque, which has
built up along the insides of the artery walls. While some forms of
arteriosclerosis occur naturally over time, arthrosclerosis
involves an unnatural build up of plaque, which is made up of fats
(lipids), cholesterol (lipoproteins), calcium and other materials.
These masses of plaque may eventually lead to a partial or complete
blockage of the blood flow through the artery. Coronary Intervention is the treatment of a patient with
hardening of the arteries. Coronary Intervention refers to
several possible methods of treatment that your doctor can use to attempt to
open your blocked or severely narrowed coronary arteries.
Coronary Angioplasty (Stent Placement)
Angioplasty/Stent
means that a small balloon is inserted into an
artery that is blocked or severely narrowed in your heart. This
balloon may or may not have a metal mesh sleeve around it (Stent).
The balloon is inflated in an attempt to push the cholesterol build
up (plaque) to the side, opening the passageway of the artery, after whiche, the balloon is then deflated and removed, allowing blood to
flow more freely. If the balloon is one with a metal mesh sleeve
around it, when the balloon is inflated, the metal mesh sleeve
expands and is imbedded to the artery?s wall. Once the balloon is
deflated and removed, the sleeve (Stent) remains in the artery,
helping to keep the artery open.
PFO Closures -Special Interventional Cardiac Procedures
Patent Foramen Ovale (PFO)
The foramen ovale is a small opening located between the atria
that is used during fetal circulation to speed up the flow of
blood through the heart. A fetus does not use its own lungs
for oxygen, it relies on its mother to provide oxygen rich blood
from the placenta through the umbilical cord to the fetus.
Therefore, blood can travel from the veins to the right side of the
baby's heart and cross to the left side of the heart through the
foramen ovale and skip the trip to the baby's lungs.
Normally the foramen ovale closes at birth when increased blood
pressure on the left side of the heart forces the opening to close.
If the atrial
septum does not close properly, it is called a patent foramen ovale or
PFO. This type of defect can be problematic in adults, and can cause strokes
or heart attacks.
Interventional
Cardiologists can now seal this opening by performing a cardiac
catheterization and placing a closure device (septal occluder) in the
PFO.
|
AMPLATZER® ASD septal occluder |
Two illustrations of one of the
types of devices used to close a PFO. The picture on the left
shows how the device is deployed. The brief video on the
right shows the device in place in a human heart. |
 |
Winthrop
Interventional Cardiologists
Kevin P. Marzo, MD - Chief Division Of
Cardiology
Srihari S. Naidu, MD,- Director Cardiac
Catheterization Laboratory
Voluntary Attending Staff
Anthony Gambino, MD
Richard Schwartz, DO
Jin Park, MD
Dave Witkes, DO
Michael Sassower, MD
Stephen Blumenthal, MD
Ralph Caselnova, MD
Joshua DeLeon, MD
Peter Angelopoulos, MD
Emilio DelPriore, MD
Rakesh Gupta, MD
Shahram Hormozi, MD
Steven Lederman, MD
Sriram Naidu, MD
Paul Lee, MD
