Interventional procedures using cardiac catherization

The procedures below use cardiac catheterization. Cardiac catherization involves inserting a catheter (a thin, flexible tube) into an arm or leg artery and guiding it into coronary arteries.

Angioplasty

Angioplasty -- also called percutaneous transluminal coronary angioplasty (PTCA ) or percutaneous coronary intervention (PCI) -- is the method used to repair a narrowed or blocked artery.

Percutaneous means that the procedure is done through the skin.
Transluminal means that it is done inside the artery.
Coronary means that it is an artery of the heart.

Angioplasty helps more blood flow through your coronary arteries. If you have this procedure, here is what to expect...

Atherectomy with rotablator

In an atherectomy, a special catheter is used to cut plaque out of the artery of the heart. The plaque is pushed into the small cone (tip) of the catheter and removed.

A rotablator is a high-speed diamond drill that can cut through blockage in the artery. The particles are broken up so they are very small (smaller than a red blood cell) and can be filtered out of the body by the liver. The rotater blade is sometimes used for arteries that have a build-up of calcium.

For more information, see Atherectomy for coronary artery disease.

Clot removal

A special catheter (tube) can be used to break up blood clots and vacuum (suction) to remove the clots from the artery of the heart or other blood vessels in the body.

Coronary stent

A stent (small stainless steel mesh tube put on a balloon catheter) helps more blood flow through your arteries. The catheter is guided into place and the balloon is inflated. The stent expands and stays inside the artery to support the walls and keep the artery open. After about 4 weeks, your artery builds a coating of cells around the stent and it will feel like a normal artery wall to your body.

Drug-eluting stent

This stent has a medicine that is slowly released to help prevent scar tissue from building up and narrowing the artery.

Interventional procedures on the heart's electrical system

Cardioversion

This procedure involves a controlled electrical shock to return your heart to a normal rhythm. Patches are placed on your chest and back. Through the patches, energy is delivered to your heart in an attempt to break your abnormal heart rhythm and restore a regular rhythm.

You will be connected to several machines to check your blood pressure, cardiac rhythm, and oxygen supply. An intravenous (IV) line will be started so you can be given a short-acting anesthetic or sedative. Your doctor and nurse will perform the cardioversion after the anesthesia has taken effect. The cardioversion only takes a few minutes. After you wake up, you will feel groggy for about one hour.

Electrophysiology study/ablation

During an electrophysiology study (EP), your doctor may find an extra electrical path that developed. That extra path is causing your rapid heart rhythm. If this happens, your doctor may choose to do an ablation (to destroy abnormal tissue).

The catheter used for the EP study will be placed close to the abnormal electrical pathway. Heat (radiofrequency) energy passes through the catheter. The tip of the catheter heats up and destroys the small area of the heart tissue that contains the abnormal pathway. This stops the short circuit.

Interventional procedures on the heart's anatomy

Patent foramen ovale (PFO) or atrial septal defect (ASD) closure

A patent foramen ovale (PFO) or atrial septal defect (ASD) closure is done to close a defect or hole between the upper chamber (atria) of the heart with an implant. After a local anesthesia, a catheter is threaded through a leg vein to the atria. An implant (about the size of a dime) is used to close the hole.

Valvuloplasty

This procedure uses a catheter to open a valve that is narrowed. A balloon-tipped catheter is threaded through an artery in the leg and passed to the heart valve. Then the balloon is inflated to separate the valve flaps and reopen it.

Enhanced external counterpulsation (EECP)

This series of treatments may stimulate the opening of or create small branches of blood vessels or create a natural bypass around narrowed or blocked arteries. Air pressure cuffs are placed on your calves, thighs and buttocks. The pumping is timed with your heartbeat to increase blood flow to your heart and ease your heart's workload.