Angioplasty and Stents
Angioplasty is a minimally invasive surgical procedure used to open narrowed areas in the arteries of the heart by inflating a tiny balloon in the artery. Angioplasty, also known as percutaneous coronary intervention, relieves the recurrence of chest pain, reduces complications of heart disease and can improve quality of life.
Plaque or fat can cause the inside of the arteries to narrow or completely close, causing insufficient blood flow to the heart muscles. With angioplasty, a small balloon at the end of a catheter is inflated in the artery, which compresses the plaque or fatty deposit that has caused the artery to narrow. This restores adequate blood flow through the artery to the heart muscle.
In most cases, a stent – a small metal coil or mesh tube – is inserted within the coronary artery to prevent it from narrowing after the balloon is deflated and removed.
Cardiac Ablation
After your electrophysiology study, a cardiologist might recommend that you receive cardiac ablation therapy. Ablation is a medical procedure performed to prevent abnormal electrical impulses from occurring.
Many people have abnormal heart rhythms, or arrhythmias, that cannot be controlled with lifestyle changes or medications. In some cases, the most effective treatment is to destroy the tissue that is the cause of the problem.
Ablation is performed exactly like an electrophysiology study; however, an additional catheter is placed in the heart at the site of the arrhythmia so radiofrequency can slowly destroy the cells causing the problem. This procedure is performed through the Electrophysiology Program.
Pacemakers and Implantable Cardiac Defibrillators (ICDs)
Pacemaker and ICD implant devices correct an abnormally slow heartbeat by sending electrical impulses to one or more chambers of the heart, helping it to beat in a more regular rhythm.
What is the difference between a pacemaker and an ICD?
A pacemaker is a small, battery-powered device designed to control the rhythm of the heart. An ICD is similar to a pacemaker, but is also designed to deliver a low-level shock to the heart when a life-threatening arrhythmia, or heartbeat abnormality, has occurred.
How is the implantation procedure performed?
After numbing the area with a local anesthetic, the physician makes a small incision in your upper chest and places the pacemaker or ICD just under the skin. Pacing and ICD leads are the wires that connect your heart to the device. The physician threads the leads under the skin.
How long does the procedure take?
Pacemaker or ICD implantation takes 2 to 3 hours. After the procedure, patients typically stay in the hospital for 24 hours or less. If you already have a pacemaker but need the battery replaced, you will be seen as an outpatient in the Pacemaker and Defibrillator Clinic and go home the same day.
Is the procedure painful?
Because the area of the incision will be numbed with a local anesthetic, you should not experience pain during the procedure. Following the procedure, patients report mild to moderate discomfort in the area of the incision that should last 24 to 48 hours.
Coronary Artery Bypass Surgery
Coronary artery bypass surgery is where a new pathway is created around a blocked artery or arteries, bypassing them so that blood flow can continue to the heart.
Coronary artery bypass surgery is recommended if angioplasty is unsuccessful, if the location of blockage is difficult to access by angioplasty or if there is blockage to two or more major vessels.
An open-heart surgery, coronary artery bypass surgery involves the use of a heart-lung pump that is used to reroute blood away from the heart. The pump works as the body's heart and lungs, allowing the surgeon to operate on a "still heart" while maintaining oxygenated blood flow to the body.
Are there alternative options to bypass surgery?
Under certain circumstances, patients may be candidates for newer bypass procedures, such as:
- Minimally invasive bypass surgery, which involves making a smaller incision in the chest.
- "Off-pump" bypass surgery, which is performed on the beating heart without the aid of the heart-lung machine.
Both types of surgery have restrictions and may not be ideal for many patients. Your cardiologist should discuss the various treatment options available to you.
Heart Valve Surgery
Heart valve surgery is performed to replace or repair a malfunctioning heart valve or valves and restore proper blood flow through the heart.
Heart valve surgery is recommended if one or more of the four valves that control blood flow into and out of the heart is not functioning correctly. Certain diseases, birth defects and aging can affect the functioning of heart valves; they may narrow and not allow enough blood to pass through or leak, causing the blood to go the wrong direction or allowing too much blood to pass through.
An open-heart surgery, heart valve surgery involves the use of a heart-lung pump that is used to reroute blood away from the heart. The pump works as the body's heart and lungs, allowing the surgeon to operate on a "still heart" while maintaining oxygenated blood flow to the body.
