Category: Minimally Invasive Cardiac Surgery

What is Interventional Cardiology?

Interventional cardiology is the branch of cardiology that involves catheter-based treatments.  Some treatment Balloon Angioplasty and Stantingtechniques employed by interventional cardiology include:

  • Carotid Stents. Carotid stents are tiny tubes placed in the carotid arteries of the neck if they become blocked by plaque (a condition called carotid artery stenosis).  These arteries supply blood to the brain, so carotid artery stenosis treatment is essential to preventing stroke.
  • Balloon Angioplasty. A tiny balloon is inserted into the blocked artery, inflated, and then removed to expand the space.  This allows for increased blood flow.
  • Intracoronary Stenting. After a balloon angioplasty, a tiny stent (tube) is placed permanently into the artery to keep the new space open.  Some stents release medication directly into the bloodstream.
  • Implantable Cardioverter Defibrillators, or ICDs. These devices use electrical pulses to control an irregular heartbeat, which can save a patient’s life.  They are implanted through a small incision near the shoulder.
  • Pacemakers. Pacemakers use electrical pulses to regulate the heart’s pumping, which allows for patients with an abnormally slow heartbeat (or patients at risk of a major cardiac event) to lead normal lives.
  • Congenital Heart Defect Correction. This treatment can be used to correct congenital defects (defects a person was born with) in the walls between the atria and ventricles or if the patient has a defect called patent ductus arteriosis wherein the aorta and pulmonary artery are joined.

Interventional cardiology procedures are often used to treat conditions like atherosclerosis or to reduce the risk of heart attack or stroke in high-risk patients.  Exercise and following a healthy diet rich in whole fruits and vegetables an dlow in saturated fat can help reduce one’s risk, but risk of heart disease is not always eliminated.  Regular checkups with a cardiologist are important for good heart health in patients with heart disease or a family history of heart problems.

Interventional cardiology procedures are often minimally invasive, meaning that they are performed through very small incisions and patient recovery time is often quite brief.  For treatments involving the insertion of a catheter or stent, the incision is usually made in the femoral artery of the leg and guided up toward the heart using a real-time x-ray.  Additionally, many interventional cardiology Panama City FL procedures require only a local anesthetic rather than general anesthesia.  Patients also tend to experience less pain during recovery and have a decreased risk of infection, an invaluable benefit in older patients with weaker immune systems.

Heart Valve Replacement Surgery: Open Heart vs Minimally Invasive

When it comes to heart valve replacement surgery, many patients now have two different options. The first option is for a standard open heart valve replacement which involves an incision through the breast bone. The second and newest option is called a minimally invasive heart valve surgery can be performed thought a small incision just under the heart.

In order to help understand the differences between the different heart valve replacement surgery procedures I have chosen these two YouTube videos:

Open Heart Valve Replacement Surgery

Minimally Invasive Valve Surgery

Heart Valve Replacement Surgery In the News

What is a Carotid Stent and Why is it Used?

If you are someone with plaque buildup in the blood vessels in your neck leading to your brain, known as the carotid arteries, you may find yourself a candidate for a cardiac procedure known as a carotid stent. This surgical technique is performed by cardiologists Northwest Florida, among other areas of the US, and is indicated to help reduce stroke risks in individuals.

Carotid Artery Disease

The carotid arteries are the two main blood vessels than are on either side of the neck which supply blood to the brain. Like the other blood vessels in the body, the carotid arteries can develop buildup of a fatty substance known as plaque. This buildup of plaque is similar to that of a clogged drain. As the build up narrows the inside of the vessel there is decreased blood flow to the brain as well as a risk that this plaque will cause a blood clot to form. This blood clot can dislodge into the vessels of the brain, causing a stroke.

What is the Treatment for Carotid Artery Disease?

The treatment for carotid artery disease depends on the degree of which the vessels are blocked. First line of treatment typically includes exercise and diet management and sometimes cholesterol-lowering medications. However, once the carotid arteries are blocked by 50 percent or more then the patient is at a high risk for stroke and a candidate for either a cardiac endarterectomy or a carotid stent to unblock the arteries.

A cardiac endartectomy is a surgical procedure in which a surgeon would go directly into the carotid arteries and scrape out the plaque while the patient is under a general anesthesia. However, due to risks related with this type of surgery, another option for this same condition, known as a carotid stent, was developed. This option is less invasive, can be performed with local anesthesia only, and has been shown in studies to be equally as effective as a endartectomy.

How is a Carotid Stent Procedure Preformed?

The placement of a carotid stent is done during a procedure known as a carotid angioplasty:

  • First a doctor will administer a local anesthesia at the incision site to numb the area.
  • A small incision will be made into the femoral artery, which is located on the inside part of the upper thigh, or groin area.
  • With the guided assistance of a special x-ray machine a catheter will be passed from the femoral artery to the blocked carotid artery. The patient will receive contrast material through the catheter in order to help the doctor visualize the blood vessel and blockage. In some cases an ultrasound device will be used as well for enhanced visualization.
  • Once the site of blockage is identified, the doctor places a small filter just above the site in order to prevent blood clots from being passed on to the brain during the procedure.
  • When the filter is in place, a small balloon located on the catheter is inflated, compressing the buildup up against the walls of the artery, widening the vessel.
  • The balloon is then removed and a stent is placed to support the carotid vessel walls and maintain a wide passageway. The stent is a permanent device that is left inside the arteries and within several weeks the carotid artery will heal around the stent.

Who is Eligible for a Carotid Stent?

In 2004, the surgical stent was approved for the use in all “high risk” patients who were not candidates for surgery. However, on Friday May 6, 2011 the FDA approved the use of this procedure in all patients who are at a high risk for stroke – regardless of whether not they are eligible for surgery. This approval was based upon a 10 year study called the CREAT study which found that carotid stets are both a safe and effective treatment for carotid artery disease. Other studies, including the CHOICE study which involve cardiologists Panama City FL, are continuing to evaluate the ongoing effect of carotid stenting on high risk surgical patients.

Resource: Carotid Artery Disease: Northwest Forida Cardiologists Offer an Excellent Prognosis

Minimally Invasive Cardiac Surgery for Heart Valve is Effective, Study Says

Those needed a heart valve replacement surgery may benefit from a new minimally invasive cardiac surgery technique that researchers are saying is just as effective as regular open heart surgery. Although still experimental, experts believe that this new procedure will likely become standard treatment for future heart valve replacement patients.

This new procedure, called Transcatheter aortic valve implantation (TAVI) involves inserting a new valve into the heart through a leg artery or a very small incision in the chest. This minimally invasive cardiac surgery procedure avoids the need to open the breastbone, stop the heart and be put on a heart-lung bypass machine which are all a part of traditional open heart surgery for valve replacement.

Researchers from Edwards Lifesciences Corp. conducted a study involving 699 high-risk patients diagnosed with aortic stenosis and eligible for surgery. The purpose of this stage of the study was to determine whether or not the TAVI procedure would be just as effective as the standard open heart treatment for this disease. By the end of the first year of the trial, researchers were able confidently make this conclusion.

Speaking at the 2011 American College of Cardiology Scientific Sessions, Howard C. Herrmann, MD, director of the Interventional Cardiology and Cardiac Catheterization Laboratories at Penn, said, “The results are a win-win for patients. Surgery was better than expected and TAVI was even better at 30 days and as good as surgery at one year. High risk patients with this common life threatening disease will likely soon have a less invasive alternative to open heart surgery. I anticipate that the results of TAVI will only get better with experience and further improvements in the technology.”

However, the downside of this trial was it appeared that TAVI recipients had a higher risk for stroke and other vascular complications than their counterparts at 30 days and 1 year. Nonetheless, experts remain optimistic that this minimally invasive cardiac surgery will one day become a viable alternative to traditional open heart surgery for valve replacement.