Cardiology Procedures

A cardiac catheterization involves threading a thin tube (catheter) through an artery that leads to the heart. It is used to identify how well your heart is working and whether there is a narrowing or blockage in the arteries.

If a blockage is identified, your doctor may use an angioplasty and stent to open the blocked blood vessel.

During the angioplasty, a small balloon at the tip of the catheter is guided into the blocked blood vessel, where the balloon is inflated. Once the inflated balloon has opened the blood vessel, the balloon is deflated and removed.

A stent – a tiny, expandable coil – may also be inserted through the catheter to hold open the blood vessel to improve circulation and prevent the vessel from becoming blocked again.

Angioplasty and stenting used in this way, to explore heart function and open blocked blood vessels in the area, are also referred to as percutaneous coronary intervention.

When these procedures are used to open arteries in the arms or legs, it is called a peripheral angioplasty. Even the large arteries that supply blood to the kidneys may be unblocked by angioplasty and stenting – in which case the procedure is known as rental artery stenting.

A procedure in which a problematic heart valve is replaced with an artificial one.

For the majority our patients at Cardiology Consultants of North Morris, we perform a catheter-based version of this procedure, called transcatheter aortic valve replacement (TAVR). See more about the TAVR approach below.

An atherectomy is a minimally invasive technique in which a catheter enters the bloodstream and is guided to a blocked or narrowed artery. A blade is then used to remove plaque buildup from a blood vessel, gaining access to the target artery through a small puncture in the artery wall.

A coronary atherectomy removes plaque from the coronary arteries.

Different types of surgical equipment may be used during an atherectomy. For example, in a rotational atherectomy and orbital atherectomy, a rotating instrument moves in a manner so there is less need to manipulate the blade. These tools may be preferred in cases where there is extensive plaque calcification in the arteries.

Cardiac catheterization provides information about heart function. During the procedure, the cardiologist advances a thin flexible tube through an artery and into the heart. An imaging technique records pictures of the heart while it beats.

Cardiac catheterization can help cardiologists diagnose heart defects, heart disease, heart enlargement, blood clots, coronary artery blockage, valve problems, or aneurysm.

If a blockage is identified by cardiac catheterization, a stent may be inserted through the catheter. The stent holds open the coronary artery to allow greater blood flow.

Learn more about cardiac catheterization and  coronary artery disease.

For patients experiencing persistent atrial fibrillation, electrical cardioversion may help shock their hearts back to a more normal rhythm. This may be tried before a more permanent solution, like a pacemaker or defibrillator, is implanted under a patient’s skin.

When performed in a cardiologist’s office, a patient is typically intravenously sedated before the electrical cardioversion. The electrical jolt will be delivered to the chest area with paddles or patches applied to the skin with a gel.

The mitral valve, located on the left side of the heart, regulates blood flow into the heart’s left ventricle. In mitral valve prolapse and stenosis (narrowing of the mitral valve), the valve doesn’t properly open or close, causing the backflow of blood. This can weaken the heart muscle over time, a condition known as congestive heart failure. Mitral valve repair is the treatment of choice for mitral leaking or regurgitation.

Pacemakers are commonly used to treat patients with a slow heart rate (bradyarrhythmia). The pacemaker, a device implanted under the skin, delivers electrical impulses whenever it detects a slow heartbeat, triggering a more regular rhythm. Pacemakers can also help regulate a fast heart rate (tachycardia). This is considered a long-term solution for patients with cardiac arrhythmia.

Sometimes, only temporary heartbeat regulation is needed – such as during recovery from a heart attack, surgery, or infection. In these cases, a temporary transvenous pacemaker may be utilized.

It involves using a catheter, inserted into a vein in the neck or groin, to place a wire in the heart. The other end of the wire (outside the body) is connected to an external pacemaker that can deliver electrical impulses to the heart. This procedure is also called transvenous cardiac pacing or endocardial pacing.

Pacemakers can connect to a single chamber of the heart or both chambers (atrium and ventricle) on the right side of the heart, or they may be biventricular (connecting to three locations: right atrium, plus right and left ventricles). Biventricular pacemakers are also known as a cardiac resynchronization therapy (CRT) device.

Like a pacemaker, an implantable cardioverter defibrillator (ICD) is a device implanted under the skin of the chest or abdomen that monitors heartbeat rhythm and delivers low-level electrical impulses to regulate abnormal heart rates. An ICD can also deliver high-level electrical stimulation when needed to shock the heart back into a regular rhythm in the event of a heart attack.

Peripheral artery angioplasty and stenting for peripheral artery disease is a procedure performed to open the artery and increase blood flow, thereby improving circulation and reducing symptoms.

Same-day, minimally invasive transradial surgical approaches forego the awkward point of entry in the groin. Instead, these innovative techniques involve using the radial artery in your arm or wrist for catheter access during a cardiovascular procedure – for a faster, safer, and more comfortable diagnostic and treatment experience.

Transradial cardiac catheterization, like an angioplasty, offers cardiac access using a catheter that is guided to the heart via a patient’s blood vessels. However, by utilizing the radial artery in the arm, the transradial approach offers these additional benefits to patients:

• Safer (reduces bleeding complications)
• More comfortable
• Less post-procedure discomfort as is typical with access through the groin

Due to its transradial approach, this type of cardiac catheterization procedure is sometimes referred to as a wrist cardiac cath.

When treatment such as the placement of a stent is performed during a cardiac catheterization, it is then considered a transradial percutaneous coronary intervention (PCI).

Due to the less invasive nature of these procedures, patients can often go home the day of the procedure. Same-day transradial PCIs are a preferred option for many of our patients at Cardiology Consultants of North Morris.

Transcatheter aortic valve replacement (TAVR), also known as transcatheter aortic valve implantation (TAVI), is a minimally invasive approach to treating aortic stenosis (the narrowing of the aorta, which supplies oxygenated blood from the heart to the rest of the body). It is especially beneficial for those patients who are unable to safely undergo open-heart surgery.

In this procedure, the damaged heart valve is not removed; rather, a replacement valve is inserted via a catheter that travels through the bloodstream to the heart. Once in place, it pushes the old valve out of the way and takes over blood flow regulation.

At Cardiology Consultants of North Morris, we are committed to treating patients with valvular heart disease in the least invasive way possible. Read about the amazing results with TAVR for one of our patients.

Click here to see our Valve Center info.

Walter's Story

After having the TAVR procedure, Walter was back to being active and working with his hands. Today, at age 96, Walter continues to be active in his grandchildren’s lives, attending their baseball games and music concerts and anxiously awaiting postcards from their travels abroad.

Click here to see Walter's Story.