Interventional cardiology is the treatment and diagnosis of specific heart disease done by using catheters. Doctors who perform this surgery are known as interventional cardiologist with additional knowledge, training and expertise in treating heart problems with thin, flexible catheters. A catheter is inserted into a blood vessel in the arm; groin or neck to the heart is called cardiac catheterization. This procedure can be used to detect any blockages, blood or muscle sample, measuring blood pressure and oxygen, for detecting congenital heart disease and repairing it, repairing or replacing heart valves, angioplasty, balloon valvuplasty, correcting arrhythmia.
During the treatment of angioplasty interventional cardiologist will give anesthesia to the area where catheter will be inserted. Then a thin plastic tube (sheath) is placed into an artery (groin, arm). A catheter (thin, long hallow tube) is passed through the sheath guiding up a blood vessel to arteries alongside the heart. A contrast liquid is put into the blood vessel through catheter and can seen through the x-ray as it moves through the patient’s heart chambers, valves and other major vessels. This can show whether the coronary arteries are narrowed/ blocked or if the valves are functioning properly. In angioplasty surgeon may move catheter into the blocked artery and following are some procedures that surgeon may use while performing the angioplasty depending on the disease/problem:
1. Balloon procedure- a catheter with a small balloon at its tip is guided through narrowing in patient’s artery. Balloon is inflated to push the plaque once it is at its place and stretch open the artery to boost the blood flow to the heart. A balloon catheter placed over the guided wire puts the stent (small tube that supports the inside of coronary artery) into the narrowing of the coronary artery.
2. Stenting – is a small tube that acts as support of coronary artery walls. The stent is expands to the size of artery and holds it open once the balloon in place is inflated. Arteries heal around the stent over weeks. The stent is usually made of material that body can absorb over time.
3. Rotablation: a catheter with acorn shaped, diamond coated tip is guided to the narrowing of the coronary artery. The tip of this special catheter spins at a high speed and grinds away the plaque on the artery walls. Small microscopic particles are washed away in the bloodstream of the patient. This process can be repeated to improve the blood flow.
4. Atherectomy: in this process, the catheter has a hollow cylinder on the tip with balloon at one side and open window on the other side. When this catheter is placed into the narrowed artery the balloon is inflated and pushes the window against the plaque that protrudes into the window. The shavings are caught in the catheter chamber and removed then. This can be repeated to improve the blood flow.
5. Cutting Balloon: catheter used in this procedure has a special balloon tip with small blades. The blades get activated when the balloon is inflated. Small blades remove the plaque and then balloon presses the plaque against the artery wall.
After the procedure patient will be kept under observation overnight. If stent is placed doctor will give medicines to reduce the risk of forming blood clot. Patient can gradually get back to normal routine after a week and should maintain a healthy lifestyle and suitable exercise with healthy diet.