Interventional Cardiology - A Broadview

Introduction:

Interventional cardiology procedures differ from normal cardiology procedures. The interventional cardiologist undergoes specialized training to perform catheter-based cardiac management procedures, which the normal cardiologist cannot perform. Interventional cardiology procedures are minimally invasive and are essential to avoid critical open heart surgeries.

What Is Meant by Interventional Cardiology?

Interventional cardiology is a division of specialty cardiology that deals with diagnosing and treating heart conditions using minimally invasive procedures, such as angioplasty and stenting. These procedures are typically performed using catheters (long, thin tubes) inserted into the blood vessels through small incisions in the skin. The goal of interventional cardiology is to improve blood flow to the heart, decrease symptoms, and prevent complications associated with heart disease.

How Do Interventional Cardiology Procedures Differ From Cardiothoracic Surgery?

Interventional cardiology and cardiothoracic surgery are medical specialties that treat heart and blood vessel conditions, but they use different techniques and approaches. Interventional cardiology typically uses catheter-based procedures, such as angioplasty and stenting, to treat blocked or narrowed blood vessels. On the other hand, cardiothoracic surgery involves open surgical procedures, such as bypass surgery, to treat heart and blood vessel conditions. While both specialties work towards the same goal of improving cardiovascular health, they have different methods of treatment and recovery time.

What Are the Procedures That Interventional Cardiologists Perform?

Interventional cardiologists use medical procedures to diagnose and treat heart and vascular conditions. They use various techniques, including catheter-based procedures, to access the heart and blood vessels. Some common procedures by interventional cardiologists include

• Angioplasty: Through angioplasty, clogged or narrowed blood arteries are opened using a catheter and tiny balloon. For better blood flow, the balloon is expanded to enlarge the vessel. A stent, a tiny mesh tube, may be inserted to keep the vessel open.

• Atherectomy: Plaque is removed from the blood artery walls using an atherectomy operation, which employs a catheter with a tiny blade or laser. By doing so, obstructions are less likely, and blood flow is improved.

• Coronary Artery Bypass Surgery: Coronary artery bypass surgery (CABG) aims to enhance blood flow to the heart by avoiding blocked or congested coronary arteries. A healthy blood artery from another body region is used in CABG to generate a new blood flow conduit to the heart.

• Percutaneous Valve Replacement: This procedure can replace a damaged heart valve without needing open-heart surgery. A catheter is used to guide a replacement valve to the heart and positioned in the damaged valve. Percutaneous transluminal coronary angioplasty (PTCA) treats narrow or obstructed coronary arteries. The treatment entails inserting a catheter with a tiny balloon on its end into the artery's constricted section; the balloon is then inflated to enlarge the constricted section and enhance blood flow.

• Placement of Stent:The stents are placed in blood vessels or hollow organs to provide structural support.

• Left Atrial Appendage Closure (LAAC): It is a medical procedure to close off the heart's left atrial appendage (LAA). The LAA is a small pouch on the left side of the heart's atrium (upper chamber). It is believed that blood clots that form in the LAA are a major source of emboli (clots that travel to other parts of the body) and can lead to stroke.

• Atrial Septal Defect (ASD): This closure is a surgical procedure performed to repair a hole in the wall (septum) that separates the upper chambers of the heart (atria). The septum's hole leads to blood mixing from the left to the right atrium, reducing oxygen levels in the body and an elevated risk of heart problems. The procedure can be performed either by open-heart surgery or a less invasive procedure called a transcatheter closure, which uses a small device guided through a vein in the leg to the heart.

• Alcohol Septal Ablation: Alcohol septal ablation is a medical procedure used to treat a condition called hypertrophic cardiomyopathy, a thickening of the heart muscle in the septum, which refers to the wall which divides the right and left sides of the heart. The procedure involves injecting alcohol into a small artery that supplies blood to the affected area of the septum, which causes the muscle to shrink and improves blood flow through the heart. It is considered a minimally invasive procedure and can be done on an outpatient basis. The procedure is not widely accepted and recommended for all patients; it is still experimental.

• Thrombolysis: Thrombolysis refers to a medical procedure involving dissolving the blood clots that are developed in the blood vessels.

• Renal Artery Denervation: Damaging the renal artery nerves to reduce blood pressure. This is done in elevated blood pressure cases that do not subside with medications.

• Closure of Patent Foramen Ovale: The foramen ovale closes after birth in most cases, but if it persists, it is referred to as a patent foramen ovale. The patent foramen ovale closure is a procedure that closes the hole in the heart.

What Are the Conditions in Which the Interventional Cardiology Procedure Is Utilized for Treatment?

Some common conditions treated with interventional cardiology include:

• A medical condition known as coronary artery disease (CAD) occurs when the arteries that are supposed to carry blood to the heart constrict or are clogged.

• Decreased blood supply to the heart muscle causes angina (chest pain) and discomfort.

• An obstruction of the coronary artery leads to a heart attack, a significant medical emergency.

• With peripheral artery disease (PAD), blood arteries in the legs and feet have constricted or become clogged.

• Aortic stenosis is a disorder where the aortic valve in the heart narrows, making it challenging for the heart to pump blood.

• The mitral valve located in the heart is narrowing due to a condition known as mitral stenosis; blood flow from the left to the right atrium is impeded.

• An aneurysm refers to the bulge or the balloon formation of a blood vessel's wall brought on by the vessel's structural deterioration. Although it can happen in any blood channel, the aorta experiences it most frequently (the main vessel that carries blood from the heart to the remaining body parts and the brain). Aneurysms can be harmful if they burst since this can result in significant bleeding and, occasionally, fatalities.

• Atrial and ventricular defects in the septum.

Conclusion:

Interventional cardiology is a division of specialty called cardiology that utilizes minimally invasive procedures to diagnose and treat heart conditions. However, it is essential to analyze that the best treatment option for a particular patient will depend on the specific condition and overall health. In conclusion, interventional cardiology is an important and effective branch of cardiology that uses minimally invasive procedures to diagnose and treat heart conditions.