Heart and Vascular Treatments

Heart and vascular tests are performed to determine whether or not your symptoms are arising from underlying cardiovascular disease. Explore here to view some of the most commonly ordered testing in cardiovascular disease. Click on a topic to learn more.

Alcohol septal ablation
With this technique a small portion of the thickened heart muscle is destroyed by injecting alcohol through a catheter into the artery supplying blood to that area. Alternatives include spetal myomectomy which is surgical removal of a portion of heart muscle.
Aneurysm clipping and coiling
Clipping of an aneurysm is usually accomplished surgically by placing a clip at the base of the aneurysm to prevent blood flow from leaking into it. Coiling usually is an endovascular procedure where thrombogenic coils are packed into the aneurysm sac to shut the aneurysm down.
This is a minimally invasive procedure where an endovascular operator uses a tool that has a cutting mechanism to cut and remove the plaque from inside the artery and in most cases remove the plaque from the body.
Balloon valvuloplasty
This is a non-surgical procedure that restores blood flow through a narrowed heart valve. A catheter with a small balloon on the end is advanced across the affected valve. After positioning, the balloon is inflated to expand the valve, which will alleviate the obstruction.
Cardiac catheterization
One of the most commonly performed cardiovascular procedures is cardiac catheterization. The operator doing the procedure will gain access into a major artery of your body, usually the radial or femoral artery. The operator will then advance small tube-like catheter designed to enter the arteries of your heart. A combination of a contrast “dye” and advanced x-ray imaging creates pictures to evaluate the flow through the arteries of your heart.
Cardiac defibrillation
Cardiac defibrillation uses a device that delivers an electric shock to the heart in order to reestablish a normal heartbeat. It’s most commonly used in patients experiencing a life threatening arrhythmia or cardiac arrest.
Carotid stenting and endarterectomy
These two procedures are performed to treat patients with carotid occlusive disease. Stenting is a less invasive option that requires the use of balloon angioplasty and stenting to alleviate the obstruction. The procedure is performed using some form of embolic protection device in order to minimize the liberation and embolization of plaque into the brain. Surgery usually requires general anesthesia and a surgical cut down onto the carotid artery in order to cut the plaque out of the artery. The surgeon then repairs the artery by using stiches and often a patch to seal the vessel.
Catheter ablation
Catheter ablation is a minimally invasive procedure that treats certain forms of arrhythmia, or abnormal heartbeats. An electrophysiology specialist will insert one or more catheters into a vein in your groin, arm, or neck and guide them into your heart. A special machine sends energy, usually radiofrequency energy, into the tissue to destroy the tissue causing the abnormality.
Coil embolization
Coil embolization is a minimally-invasive procedure that halts blood flow into an aneurysm by placing a small metallic coil inside of the aneurysm. Your doctor will insert a catheter into a blood vessel in your groin and guide it to the aneurysm. Then the coil is inserted into the aneurysm, where it blocks blood flow with the goal of preventing it from rupturing. The tissue then heals around the coil.
Coronary angioplasty (percutaneous coronary intervention)
Percutaneous coronary intervention is performed by using a balloon usually combined with a stent to clear an obstruction of an artery. The balloon enlarges the artery and the stent prevents the artery from recoiling and narrowing the artery down again.
Coronary artery bypass surgery (CABG)
Coronary artery bypass grafting surgery is a surgical procedure used to bypass blockage(s) and allow blood to flow to the coronary arteries. A heart surgeon will use a healthy blood vessel from another part of your body to detour around the blocked part of the coronary artery. Some CABG surgeries require several of these bypasses to restore proper heart function.
Electrical cardioversion
Electrical cardioversion is a procedure that employs electrical shocks to treat a fast or irregular heart rhythm. It is usually done under sedation for comfort.
Endovenous thermal ablation
Endovenous thermal ablation also known as EVLT is a treatment for venous insufficiency and varicose veins that uses a laser or high-frequency radio waves to close a malfunctioning vein. The vein is located and isolated using ultrasound and a catheter is inserted into the vein, usually just below the knee. Then a salt water solution and an anesthetic will be injected into the vein, followed by laser or radiofrequency waves. Local anesthesia is usually given for this same day procedure.
Heart transplant surgery
Heart transplant surgery is performed to replace a severely impaired heart and replace it with a healthy donor heart. A specialized surgeon will make a cut in your ribcage to expose the inside of your chest. The old heart is explanted and the new heart implanted.
Heart valve repair/ replacement surgery
Heart valve surgery is performed to repair or replace a severely obstructed or leaky valve. Various procedures are used to repair a valve, depending on the cause of malfunction. A valve may need to be opened if it’s narrowed; sealed if it leaks; reshaped if it’s malformed; decalcified if it’s covered in calcium buildup; or patched if it’s been damaged by a hole.
Implantable cardioverter defibrillator (ICD)
An implantable cardioverter defibrillator (ICD) is a small device implanted in the chest that delivers high-energy electrical signal (shock) to the heart to arrest potentially lethal arrhythmias that it identifies. All ICD’s have the ability to perform basic pacemaker functions. They can also be programmed to attempt to “pace” or override a lethal rhythm before a shock is delivered.
Mechanical assist devices
Mechanical assistance devices provide circulatory support to the heart in times of heart pump failure or if the heart is at risk during a surgical or coronary stent procedure. A mechanical assistance device can help support the heart during or after surgery, while you’re waiting for a heart transplant, or if you learn that you’re ineligible for a heart transplant. These devices can be located outside the body (transcutaneous ventricular assist device) or inside the body (implantable ventricular assist device). An implantable device requires open chest surgery, a procedure in which your surgeon will make a cut in the center of your chest and open your rib cage to attach the device to your heart. An Impella device is a device that can be implanted through a large sheath in the groin percutaneously without a surgical procedure. This device is commonly implanted during a high risk percutaneous coronary angioplasty procedure or during a heart attack when the heart has failed due to injury.
A pacemaker is a small device that is implanted just under your skin in the chest wall. It can control your heartbeat by providing low-energy electrical pulses that keep the heart beating normally. The device consists of two parts: it has a pulse generator that contains a battery and a small computer that regulates the rate of electrical pulses sent to your heart and leads (electrodes) with insulated wires which are placed in a chamber, or chambers of your heart and deliver the electrical impulses to adjust your heart rate. There are different types of pacemakers and the doctor will determine the one that is right to treat your specific condition.
Pericardiocentesis is a minimally invasive procedure. A large bore needle is introduced under either x-ray or ultrasound guidance into the sac around the heart. A catheter is then inserted to obtain/remove fluid from your pericardium. The fluid can then be sent to a laboratory for microscopic examination for abnormal cells. The test is often used to help diagnose an infection, cancer, or the cause of extra fluid surrounding your heart.
Radiofrequency ablation
RFA is a minimally-invasive procedure used to treat dangerous arrhythmias (abnormal or irregular heartbeats). An electro-physiologist inserts wires and catheters to your heart. The catheter has an electrode at the tip that localizes the area(s) causing the arrhythmia. The catheter tip transmits energy to burn or destroy that area and terminate the arrhythmia.
Sclerotherapy is a procedure where a chemical agent is injected into damaged veins. This will cause varicose veins to scar and collapse the forcing blood to reroute through a functioning vein. The collapsed vein is eventually absorbed by the leg, and varicose veins tend to fade after a few weeks.
Thrombectomy is a procedure designed to remove clot from a vein or artery in the body. The procedure is done using a small catheter that either macerates, sucks, drags the clot out of the body.
Thrombolysis is the use of a clot busting medication to remove clot from an artery or vein inside the body. The drug can either be given locally at the site or given through a vein in the body.
Transcatheter aortic valve implantation
Transcatheter aortic valve implantation (TAVI) is a minimally-invasive procedure that replaces the heart’s aortic valve in people with aortic stenosis. Access is obtained depending on the best route needed to get to the positioning inside of your aorta. A catheter is then positioned and the replacement valve is passed through the catheter. A balloon is expanded to deploy the replacement valve into place or the valve self-expands depending on the technology being used.
Vein ligation and stripping
Vein ligation and vein stripping are minimally-invasive procedures that stop blood from pooling in the leg. In this procedure, a small cut is made in your skin to isolate the affected vein. The vein is then tied off or removed.