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Interventional Cardiology

Interventional cardiology is the 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. A Cardiac Catheterization and Coronary Angiogram can help 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 which, 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.

Special Interventional Cardiac Procedures

Transcatheter Aortic Valve Replacement (TAVR)

TAVR is the name for a new, revolutionary procedure in cardiology and cardiac surgery that enables patients with a condition called severe aortic stenosis to receive a new heart valve without undergoing open-heart surgery. Traditionally, the primary treatment for aortic stenosis has been surgery. However, certain patients with severe stenosis were considered too sick for surgery. Therefore, their conditions were considered hopeless.

Not anymore! As a result of a pivotal new Partner Trial, the FDA has approved the use of the Edwards’ Transcatheter Heart Valve, which utilizes a minimally invasive procedure to implant a new valve using a method very similar to the implantation of a stent. Therefore, these patients can now receive a new valve without surgery and there is now hope for those whose conditions were previously thought to be untreatable. Read More

PFO Closures

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
Stephen Green, MD – Director, Interventional Cardiology

Voluntary Attending Staff

Anthony Gambino, MD
Richard Schwartz, DO
Dave Witkes, DO
Stephen Blumenthal, MD
Ralph Caselnova, MD
Joshua DeLeon, MD
Shahram Hormozi, MD
Steven Lederman, MD
Sriram Naidu, MD
Paul Lee, MD
Daniel Donohue, MD
Joseph Musso, MD
Jerome Zisfein, MD
Waqas Khan, MD
Brian Galler, DO
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