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Department of Cardiology

     

What is interventional cardiology?
Interventional cardiology is a globally recognised technique of cardiac care that uses a minimally invasive approach to diagnose and treat various diseases and ailments affecting the heart. It involves the use of cardiac catheterization technique with a tiny flexible tube, known as a catheter, for carrying out the procedure. This is introduced inside the body via a tiny keyhole skin puncture and guided with the help of imaging by a camera with an x-ray detector. The technique can help to perform the most complex cardiac procedures with minimal risks of complications and good outcomes. 

Conditions that can be treated using the interventional cardiology
There are a variety of different conditions that can be treated using interventional cardiology. The most common of these are:

  • Coronary artery disease: It is one of the most common cardiovascular diseases marked by restricted flow of blood in the arteries due to the build-up of plaque or narrowing of the arteries or clot formation in arteries, leading to an acute heart attack.
  • Valvular heart disease: This refers to any disease or ailment that affects the heart valves, which are 4 in number. The condition may affect only 1 valve or more at the same time. 
  • Peripheral vascular disease: It is a circulation disorder that progresses over time and is marked by restricted blood flow to the limbs, which is primarily due to plaque accumulation. 
  • Carotid Artery Disease: A condition with restricted blood flow into the brain through the carotid arteries.
  • Aortic Aneurysms: A condition due to ballooning of the aorta in its ascending or descending part in the thorax or abdomen.  
  • Rhythm Disorders: The condition is marked by an irregularity in the otherwise normal heart rhythm, that has been associated with an increased risk of clotting, stroke, and heart failure, it may be as ventricular or supraventricular tachycardia or atrial fibrillation, or heart conduction blocks.  
  • Congenital heart disease: It is an umbrella term used for a variety of structural and functional heart defects that are present since birth, which means that a baby is born with these. While some of these conditions can be treated while the baby is still inside the womb, others are to be addressed after it is born. 

Common procedures in interventional cardiology:

  • Balloon angioplasty and stent placement: PTCA with or without stent can be done by a procedure, recommended for patients with a blocked or narrowed artery, and aims at restoring the normal flow of blood. It involves the use of a catheter fitted with a balloon on one tip. The catheter is guided toward the affected area and the balloon is inflated to clear the blockage, following this, a stent is threaded over a wire into the artery and deployed at the sight using a balloon. A stent is a tiny, narrow tube made up of metal mesh that helps to prevent coronary blockage in the future. Some stents also contain medication that is absorbed slowly and gradually. 
  • Percutaneous valve implantation: The aortic valve is dilated using a balloon catheter and then an artificial valve is implanted via the same route (TAVI) or it can be done at the mitral valve (TMVI). Similarly, the Tricuspid valve can be treated by a balloon and a ring. Other, structural heart defects, like apertures (ASD, VSD, PDA) can be closed, using an umbrella device. 
  • Peripheral angioplasty: As in coronary angioplasty, balloon dilatation and stent placement can be done in peripheral arteries in upper and lower limbs with or without a stent.
  • Carotid Angioplasty: when angioplasty is done in the carotid arteries taking blood supply from the heart to the brain then it’s called carotid angioplasty. Similarly, angioplasty, coiling, and embolization can be done in the cerebral arteries of the brain for patients with stroke. 
  • Endo stent grafting:  For aortic aneurism in the thoracic or abdominal aorta, large endograft stents can be deployed in the aorta, removing the risk for rupture or bleeding from the aorta. 
  • EP study and RF Ablation: Electrophysiology studies are globally used modality for assessing the electrical impulses generated by the heart. These are conducted with the help of a catheter fitted with an electrode that helps to locate the extra or accessory pathway and deliver controlled electrical impulses to treat certain types of arrhythmia.
  • Electrical cardioversion: It involves the use of small paddles or patches to deliver controlled, low-voltage electrical current to certain areas of the heart with the aim of normalizing the heart rhythm. 
  • ICD implantation: ICDs or implantable cardioverter defibrillators are tiny implantable devices that help to monitor heart rhythm and deliver electrical signals to regulate the same in the case of any abnormality and treat heart failure. 
  • Pacemaker implantation: A pacemaker is a battery-powered device that is surgically implanted in the chest of a patient suffering from bradycardia, a condition marked by an abnormally slow heartbeat.
  • Congenital heart intervention: As an adult, treatment of structural heart disease or valves or apertures can be done to treat congenital heart disease in infants and children. 

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