• Procedures


  • Cardiac Catheterization Laboratory (Cath Lab)

    The Cardiac Catheterization Laboratory (Cath Lab) provides 24-hour coverage by an expert team of board-certified interventional cardiologists, nurses, and radiology technicians who have special training in invasive diagnostic and interventional cardiac procedures.

    Cardiac catheterization is a method doctors use to perform tests and procedures that are available to diagnose and treat coronary artery disease. The cardiac catheterization procedure involves threading a long, thin tube, called a catheter, through an artery or vein in the leg or arm and into the heart.

    Our Heart Center is known for outstanding performance in treating a specific heart attack known as ST-elevation myocardial infarction (STEMI).

    STEMIs are caused by a sudden blockage in a coronary artery and recent studies have indicated that rapid cardiac intervention is the most effective treatment for saving the heart muscle. In the Cath Lab these blockages may be opened by using a balloon catheter and/or implanted stent.

    "Door-to-balloon" time is the measurement of time starting when a patient is diagnosed with a STEMI in the ambulance or the ER, to the time when the blockage in the coronary artery causing the STEMI is opened with a balloon angioplasty, or a stent in the Cath Lab. Every minute counts when heart muscle is involved.

    Routine procedures in our Cath Lab are scheduled weekdays, from 7:30 a.m. to 4:30 p.m., by your physician's office staff. Emergency cardiac diagnostic, interventional, and therapeutic procedures are available at all times.

    Interventional Procedures

    Interventional procedures are non-surgical coronary interventions that are performed in the cardiac catheterization laboratory by a specialized cardiologist and a cardiovascular team of nurses and technicians. The procedures utilize special catheters that are used to "open" blocked arteries that supply blood to the heart.

    There are several types of catheters that are used in these procedures:

    • Balloon Angioplasty
    • Stent
    • Rotoblation
    • Cutting Balloon
    • Pacemaker
    • Implantable Cardioverter Defibrillator (ICD)

    An interventional procedure starts out in the same way as a diagnostic cardiac catheterization. The catheter will be selectively passed into the artery with the blockage, and the doctor will perform the interventional procedure to open the blocked artery. The procedure usually lasts about 1-1/2 to 2-1/2 hours, but the preparation and recovery time add several hours. An overnight stay is sometimes required.

    Balloon Angioplasty

    A specially designed balloon catheter with a small balloon tip is guided to the point of narrowing in the artery. Once in place, the balloon is inflated to compress the fatty matter into the artery wall and stretch the artery open to increase blood flow to the heart.

    A pacemaker can pace the heart's upper chambers (the atria), the lower chambers (the ventricles), or both chambers at times. Pacemakers may also be used to prevent the heart from going into fast, irregular rhythms.

       

      Balloon Angioplasty
      Balloon is inflated to compress fatty plaque

    Stent

    A stent procedure is used along with balloon angioplasty. It involves placing a small stainless steel mesh-like tube that acts as a scaffold to provide support inside your coronary artery at a site narrowed by plaque. The stent is mounted on a balloon-tipped catheter, threaded through an artery, and positioned at the blockage. The balloon is then inflated, opening the stent. Then, the catheter and deflated balloon are removed, leaving the stent in place permanently.

        Stent
      A stent is a small stainless steel mesh tube that acts as a scaffold to provide support inside your coronary artery.

    Rotoblation

    A special catheter, with an acorn-shaped diamond-coated tip, is guided to the point of narrowing in your coronary artery. The tip spins around at a high speed and grinds away the plaque on your artery walls. The microscopic particles are washed safely away in your blood stream and filtered out by your liver and spleen.

        Rotoblation
      Tip spins at high speeds to grind away blockage.

    Cutting Balloon

    The cutting balloon catheter has a special balloon tip with small blades. When the balloon is inflated, the blades are activated. The small blades score the plaque, then the balloon compresses the fatty matter into the artery wall.

    Pacemaker

    A pacemaker is a small device that is powered by a battery. It helps the heart beat in a regular rhythm. Pacemakers are needed for those who have a slow and irregular heart rhythm.

    A pacemaker is about the size of a small matchbox. The pacemaker "can" or container has two parts inside:

    • A pulse generator, which includes the battery and several electronic circuits.
    • Wires, called leads, which are attached to the heart wall. Depending on the type of pacemaker you need, there may be one or two leads.

    The pacemaker is implanted under the skin and fatty tissue near the collarbone. If only one lead is needed, it is placed in the lower-right chamber (the right ventricle). If two leads are needed, the other lead is placed in the upper-right chamber (the right atrium). The leads are then attached to the pacemaker (pulse generator).

    Once the pacemaker is implanted, the leads carry signals back from the heart. The pulse generator "reads" these signals. When the heart rate is too slow, it sends an impulse to the heart to help beat in a regular rhythm.

    Implantable Cardioverter Defibrillator (ICD)

    An Implantable Cardioverter Defibrillator is a small, battery powered, pager size device.

    It is used in patients at risk for:

    • Ventricular tachycardia (when the lower chambers of the heart independently beat faster than 100 beats per minute)
    • Ventricular fibrillation (when the muscle fibers of the lower chambers of the heart contract in a fast, uncoordinated manner)
    • Sudden cardiac death caused by arrhythmias

    Once the ICD is implanted, the leads monitor the heart rate. If the ICD detects ventricular tachycardia or fibrillation, it sends out a controlled burst of impulses (called "overdrive" pacing). If this does not work, the ICD "shocks" the heart to restore a normal rhythm. ICDs are very effective in preventing sudden deaths and can be implanted with a low rate of complications.

    A defibrillator is made up of two parts:
    • A pulse generator, which includes the battery and several electronic circuits
    • Wires, called leads that are attached to the heart wall. Depending on the type of ICD, you may have one to three leads.

    The defibrillator is implanted beneath the skin, near the collarbone. The leads are placed inside the heart or on its surface and are attached to the defibrillator.