TESTS AND PROCEDURES

Cardiac Procedures

March 21, 2017

Cardiac Procedures

These procedures are used to evaluate and treat heart and blood vessel disease (cardiovascular disease or coronary artery disease). Talk to your doctor or heart care professional for more specific information.

Procedures for abnormal heart rhythms

  • Catheter ablation. This procedure uses radio waves or freezing to silence an abnormal area in the heart's electrical system, which is usually found during an electrophysiology study. This procedure can break a problematic electrical circuit that is causing an irregular heartbeat (arrhythmia).

  • Permanent pacemaker. A permanent pacemaker is inserted into the upper chest and connected to the heart to provide a reliable heartbeat when the heart's own rhythm is too slow or irregular.

  • Internal cardioverter defibrillator (ICD). A defibrillator wire is inserted into the heart and connected to an implanted device in the chest to send out a small amount of electricity when needed to jolt the heart rhythm back to normal. This can be life saving when life threatening rhythms are detected.

Procedures for heart disease

  • Cardiac catheterization. With this procedure, your doctor will place a thin tube called a catheter into the heart through a blood vessel in the leg or arm. Then, a contrast agent is injected and X-rays are taken. This is done to find the narrowing, blockages, and other abnormalities of specific arteries. 

  • Coronary angioplasty. With this procedure, a balloon-tipped catheter is used to expand a narrowing in the blood vessel to increase blood flow. Although angioplasty is done in other blood vessels elsewhere in the body, percutaneous coronary intervention (PCI) refers to angioplasty in the coronary arteries to let more blood flow into the heart. PCI is also called percutaneous transluminal coronary angioplasty (PTCA). There are several types of PCI procedures, including:

    • Balloon angioplasty. A small balloon is inflated inside the blocked artery to re-establish blood flow.  This is often accompanied by stent placement.

    • Coronary artery stent. A tiny mesh coil is expanded inside the blocked artery to open the blocked area and is left in place to keep the artery open.

    • Atherectomy. The blocked area inside the artery is "shaved" away by a tiny device on the end of a catheter.

    • Laser angioplasty. A laser is used to help "vaporize" the blockage in the artery.

  • Coronary artery bypass. Often called  "bypass surgery," or CABG (pronounced cabbage), this surgery is often done in people who have chest pain (angina) and plaque buildup in the arteries (coronary artery disease). During the surgery, the blocked artery is bypassed by using a piece of another healthy blood vessel from elsewhere in the body. The healthy blood vessel is attached above and below the blocked area of a coronary artery. This lets blood flow around the blockage. Veins are usually taken from the leg. Arteries from the chest or arm may also be used to create a bypass graft. Sometimes, multiple bypasses may be needed to restore blood flow to all areas of the heart.

  • Intra-aortic balloon pump (IABP).  An IABP is a device to help your heart pump more blood. The device consists of a thin, flexible tube (a catheter) with a long balloon at its tip (intra-aortic balloon, or IAB). At the other end, the catheter attaches to a computer. The balloon is inflated and deflated. An IABP lets blood flow more easily into your coronary arteries to help give oxygen to the heart muscle. It also lets your heart pump more blood with each contraction.

  • Ventricular assist device (VAD). A VAD is a mechanical device used to take over the pumping function for one or both of the heart's ventricles, or pumping chambers. A VAD may be needed when heart failure progresses to the point that medicines and other treatments are no longer effective. A VAD can be used as a bridge to transplant for a person who is waiting for a heart transplant.

  • Heart transplant. A surgical procedure for selected people whose hearts are so severely damaged that medicines, procedures, and surgical repair cannot help. A donated heart is transplanted into the patient to replace the damaged heart.

Procedures for valve disease

  • Valvuloplasty. In this procedure, a balloon-tipped catheter is used to open a narrowed heart valve. The catheter is guided through the aorta to the aortic valve, and once in place within the leaflets, the balloon is inflated until the leaflets are loosened. The balloon is then deflated and withdrawn from the body. This procedure may also be done on the mitral valve.

  • Valve repair. A surgical procedure in which a damaged valve is repaired by loosening stiff valve leaflets or tightening loose valve leaflets.

  • Valve replacement. In this procedure, a mechanical or tissue valve is transplanted into the heart to replace the damaged valve.

Updated:  

March 21, 2017

Sources:  

Bain, DS. Grossman's Cardiac Catheterization, Angiography, & Intervention (2006); 7th ed. pp s5-s8, Circulatory Assist Devices, Cardiopulmonary Assist Device and Short-Term Left Ventricular Assist Devices, Up To Date, Rosengart, TK. Percutaneous and Minimally Invasive Valve Procedures. Circulation (2008); 117(13); pp. s1750-s1767

Reviewed By:  

Fraser, Marianne, MSN, RN,Gandelman, Glenn, MD, MPH