Interventional cardiology is a branch of the medical specialty of cardiology that deals specifically with the catheter based treatment of structural heart diseases. Andreas Gruentzig is considered the father of interventional cardiology.
A large number of procedures can be performed on the heart by catheterization. This most commonly involves the insertion of a sheath into the femoral artery (but, in practice, any large peripheral artery or vein) and cannulating the heart under X-ray visualization (most commonly fluoroscopy, a real-time x-ray. The radial artery may also be used for cannulation; this approach offers several advantages, including the accessibility of the artery in most patients, the easy control of bleeding even in anticoagulated patients, the enhancement of comfort because patients are capable of sitting up and walking immediately following the procedure, and the near absence of clinically significant sequelae in patients with a normal Allen test.
The main advantages of using the interventional cardiologic approach is the avoidance of the scars, pain, and long postoperative recovery associated with surgery. Additionally, the interventional cardiology procedure of primary angioplasty is now the gold standard of care for an acute myocardial infarction. It involves the extraction of clots from occluded coronary arteries, deployment of stents and balloons through a small hole made into a major artery, leaving no scars, which has given it the name "pin-hole surgery" (as opposed to "key-hole surgery").
Procedures performed by specialists in interventional cardiology:
- Also called percutaneous transluminal coronary angioplasty (PTCA), angioplasty is an intervention for the treatment of coronary artery disease.
- Valvuloplasty is the dilation of narrowed cardiac valves (usually mitral, aortic, or pulmonary).
- Congenital heart defect correction
- Percutaneous approaches can be employed to correct atrial septal and ventricular septal defects, closure of a patent ductus arteriosus, and angioplasty of the great vessels.
- Percutaneous valve replacement: An alternative to open heart surgery, percutaneous valve replacement is the replacement of a heart valve using percutaneous methods.
- Coronary thrombectomy
- Coronary thrombectomy involves the removal of a thrombus (blood clot) from the coronary arteries.
- Cardiac ablation
- A technique performed by clinical electrophysiologists, cardiac ablation is used in the treatment of arrhythmias.
Surgery of the heart is done by the specialty of cardiothoracic surgery. Some interventional cardiology procedures are only performed when there is cardiothoracic surgery expertise in the hospital, in case of complications.
Cardiac catheterization (KATH-e-ter-i-ZA-shun) is a medical procedure used to diagnose and treat certain heart conditions.
A long, thin, flexible tube called a catheter is put into a blood vessel in your arm, groin (upper thigh), or neck and threaded to your heart. Through the catheter, doctors can do diagnostic tests and treatments on your heart.
For example, your doctor may put a special dye in the catheter. This dye will flow through your bloodstream to your heart. Once the dye reaches your heart, it will make the inside of your coronary (heart) arteries show up on an x ray. This test is called coronary angiography (an-jee-OG-ra-fee).
The dye can show whether a substance called plaque (plak) has narrowed or blocked any of your coronary arteries. Plaque is made up of fat, cholesterol, calcium, and other substances found in your blood.
Plaque narrows the inside of the arteries and, in time, may restrict blood flow to your heart. When plaque builds up in the coronary arteries, the condition is called coronary heart disease (CHD) or coronary artery disease.
Blockages in the coronary arteries also can be seen using ultrasound during cardiac catheterization. Ultrasound uses sound waves to create detailed pictures of the heart's blood vessels.
Doctors may take samples of blood and heart muscle during cardiac catheterization and do minor heart surgery.
Cardiologists (heart specialists) usually do cardiac catheterization in a hospital. You're awake during the procedure, and it causes little to no pain. However, you may feel some soreness in the blood vessel where the catheter was inserted. Cardiac catheterization rarely causes serious complications.