Interventional cardiology is a medical specialty that treats a range of heart diseases without surgically opening the chest. Instead, thecardiologist uses small tools and at least one catheter. A catheter is a small tube that is inserted into a blood vessel through a small cut, usually in the leg or arm, and threaded to the site of disease. Once in place, it acts as a tunnel, enabling the doctor to efficiently guide the tools to where they are needed. By using a catheter, doctors avoid making large surgical cuts. As a result, procedures that rely on a catheter generally decrease pain, pose less risk of infection, avoid large scars and shorten recovery times. In some cases, the patient may go home the same day.
Interventional cardiologists treat a wide range of heart diseases, and below are a few common examples.
Coronary angioplasty and stenting
The heart is mostly made up of muscle, and that muscle needs oxygen and nutrients if the heart is to beat. If the artery that feeds the heart muscle is blocked by plaque (a mixture of cholesterol, fat, calcium and other substances), the muscle will not work well, and the heart will not beat efficiently. In angioplasty, the doctor uses a catheter to guide a small, unfilled balloon to the site of the block. The balloon is inflated, pressing the plaque tight against the wall of the artery. After the balloon is removed, the opening in the artery is wider, and blood can flow more freely to the heart muscles.
After angioplasty, the catheter may be used to place a small mesh tube, called a stent, into the site of the blockage. The stent works to keep the plaque packed against the wall of the blood vessel and the site propped open.
The heart is a pump, and like a mechanical pump, has valves that regulate the flow of fluid (in this case, blood). These valves may fail to open fully because of disease or calcium build-up. A form of angioplasty, valvuloplasty uses a balloon to widen the opening of the valve and restore the valves’ function.
Congenital heart defect correction
The heart has four chambers separated from each other by muscular walls. Sometimes these walls have holes that allow blood to pass from one chamber to another. The holes are birth defects that may need to be closed. In these situations, a small device – in effect, a plug – is put in place using a catheter.
During an interventional cardiology procedure, you will have anesthesia, so the discomfort and pain will be minor. It may be a local anesthetic, just at the site where the doctor will insert the catheter into your groin or arm. You’ll remain awake and be able to follow the doctor’s instructions. In other cases, you may get a general anesthetic, so you will not be awake during the procedure. These procedures generally last between one and two hours. You’ll remain on your back throughout the procedure. After the procedure, you may stay in the hospital for one to two days to allow you to safely recover. If your procedure is performed early in the day and you are recovering well, you may be allowed to go home the same day.
Possible side effects include an allergic reaction to some of the medicines and dyes used during the procedure. You may experience irregular heartbeats. As with all operations, bleeding and infection are risks. Other risks include brain damage, heart attack, strokes, and more blockage of the artery over time.