• Cardiac_Catheterization
  • Coronary_Angioplasty_with_Stent
  • Intravascular_Ultrasound_LG.jpg
  • Intraaortic_Balloon_Pump_LG.jpg
  • Carotid_Arteriography_LG
  • Peripheral_Arteriography_LG.jpg
  • Peripheral_Transluminal_Angioplasty_with_stenting_LG.jpg
  • Transesophageal_Echocardiography_TEE_LG
  • Electrical_Cardioversion
  • Tilt_Testing
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Hospital Procedures

Cardiac Catheterization

Cardiac Catheterization ("heart cath") is a test that evaluates the anatomical and functional status of your heart. The primary component of this procedure is coronary angiography which assesses for the presence and severity of coronary artery disease, and the pumping function of the heart. It is performed by inserting a small plastic tube called catheter in the coronary arteries and heart. X-ray video pictures are then taken by injecting opaque contrast dye. This is one of the most accurate tests in diagnosing coronary artery disease. Your cardiologist may recommend this test if the benefit of knowing this information outweighs the small risk of the procedure. The procedure typically takes about 30 minutes.

For further information, please go to Patient Education Page

Coronary Angioplasty with Stent

Coronary Angioplasty, also known as percutaneous coronary intervention (PCI) or precutaneous transluminal coronary angioplasty (PTCA), is a catheter-based treatment of severe coronary artery blockage. The procedure involves a long thin plastic tube with a balloon at the tip, which is aligned and inflated at the site of blockage. This pushes the plaque against the vessel wall. Once deflated, it is removed out of the body. Angioplasty is a generic term describing a mechanical reconstruction of the blood vessel and it can mean a simple balloon inflation (balloon angioplasty) alone or in conjunction with other devices.

This is commonly performed at the time of the diagnostic cardiac catheterization and frequently involves implanting a stent when technically feasible. Stent is a thin metal tube mounted on the balloon and is inserted at the site of blockage when the balloon is inflated. The fully expanded stent enhances the blood flow and is left as a part of the artery after the delivery balloon catheter is removed out of the body. The stent is eventually covered by the inner lining of the blood vessel called intima.

There are various sizes and types of stents, but the major distinction involves bare metal stent (BMS) and drug-eluting stent (DES). DES or commonly known as "medicated stent" has shown superb long term results by keeping the stent patent but requires much longer, uninterrupted period of blood thinning by taking double platelet inhibiting medications. This interventional procedure usually takes about 45 minutes to one hour, but sometimes longer if technically difficult. Your cardiologist will discuss this with you prior to the initial diagnostic cardiac catheterization or the scheduled angioplasty.

For further information, please go to Patient Education Page

Intravascular Ultrasound

Intravascular ultrasound is sometimes used during cardiac catheterization and coronary or peripheral angioplasty to obtain detailed information regarding the inner lining of the involved artery segment. The procedure utilizes a thin plastic tube with high frequency ultrasound probe attached at the tip. Among the visual data gathered to guide further treatment are intrinsic size of the vessel channel, the actual plaque burden, characteristics of the plaque, and the appearance of the implanted stent.

Intraaortic Balloon Pump

Intraaortic balloon pump (IABP) is a device that helps increase blood flow to the heart and its contractile function. It is used primarily as an assisting apparatus when the heart is not able to maintain its proper function such as during extensive heart attack with severe cardiac injury or during the unstable period waiting for coronary bypass surgery due to multiple critical blockages. It is a catheter with long balloon which is placed in the aorta, the great artery arising from the heart, and pulsates during heart cycles. Properly used, this can be a life-saving device.

Carotid Arteriography

Carotid arteriography assesses for the severe blockage of carotid arteries, the main arteries in the neck that supply blood to the brain. It is performed by inserting a small plastic tube called catheter in the carotid arteries. X-ray video pictures are then taken by injecting opaque contrast dye. If a critically narrowed blockage is found, mechanical treatment such as endarterectomy (surgical removal of the fatty plaque) or stenting is considered in order to prevent stroke.

For further information, please go to Patient Education Page

Peripheral Arteriography

Peripheral arteriography is a catheter-based procedure that assesses for critical blockages in the arteries of legs, hips, arms, kidneys or guts. If you show symptoms and signs of peripheral artery disease (PAD), and the initial non-invasive tests such as ultrasound study also support this suspicion, your cardiologist may recommend this procedure to help guide your treatment. It is performed by inserting a small plastic tube called catheter in the artery in question. X-ray video pictures are then taken by injecting opaque contrast dye. Once critical blockage(s) is defined, further treatment options such as angioplasty, bypass surgery and/or medical treatment will be discussed with you and your family.

For further information, please go to Patient Education Page

PTA with Stenting

Peripheral transluminal angioplasty or PTA is a catheter-based treatment of peripheral artery disease (PAD). Once the critical blockage in the artery in question is confirmed by the initial diagnostic arteriography, PTA may be considered to either relieve symptoms or to prevent limb loss in the case of lower or upper extremity PAD.

The procedure involves a long thin plastic tube called a catheter with a balloon at the tip, which is aligned and inflated at the site of blockage. This pushes the plaque against the vessel wall. Once deflated, it is removed out of the body. Angioplasty is a generic term describing a mechanical reconstruction of the blood vessel and it can mean a simple balloon inflation (balloon angioplasty) alone or in conjunction with other devices.

The angioplasty frequently involves implanting a stent when technically feasible. Stent is a thin metal tube mounted on the balloon and is inserted at the site of blockage when the balloon is inflated. The fully expanded stent enhances the blood flow and is left as a part of the artery after the delivery balloon catheter is removed out of the body. The stent is eventually covered by the inner lining of the blood vessel called intima.

TEE (Transesophageal Echocardiography)

Transesophageal Echocardiography, or commonly known as TEE is a high resolution ultrasound test which enables visualization of the cardiac structure and function from the esophagus, located behind the heart.

This is frequently performed to assess for a blood clot in an upper chamber called left atrium prior to electrical cardioversion of atrial fibrillation (a common form of arrhythmia). TEE is also a useful test to evaluate for any heart source of embolus (traveling clot) in patients who suffered a stroke of unclear cause, and to better assess heart valve dysfunction prior to open heart surgery. This is usually an outpatient procedure.

For further information, please go to Patient Education Page

Electrical Cardioversion

When medications fail to convert atrial fibrillation, your cardiologist may recommend applying an electrical current to restore normal rhythm. This is called electrical cardioversion.

It is generally an elective procedure performed under light anesthesia and controlled setting. The electrical jolt is applied to the heart via electrodes placed on the back and chest while briefly under anesthesia. This is usually an outpatient procedure.

For further information, please go to Patient Education Page

Tilt Testing

As a part of diagnostic tests to evaluate recurrent syncope or fainting, tilt test is occasionally performed to confirm its suspected vasovagal mechanism. Although syncope can be brought on by several causes, including heart arrhythmia (rhythm disturbance), coronary artery disease (CAD), stroke, dehydration, low blood sugar, or heart valve disease, the most common type is vasovagal syncope.

This is due to a malfunction between nervous and cardiovascular systems. Prolonged or sudden standing tends to keep the blood volume away from the brain; normally, this is countered by constriction of blood vessels, maintaining normal blood pressure. When this natural bodily response is lost, a drop in blood pressure and/or heart rate occurs, and syncope may follow. Tilt test is designed to reproduce this vasovagal syncope by gradually raising the patient strapped onto a table to a nearly vertical position. Blood pressure, heart rate and oxygen level are frequently monitored during the procedure. If syncope is induced, once the table is horizontal, the patient regains consciousness as the blood flow to the brain is restored.

For further information, please go to Patient Education Page