Cardiac Procedures at Fort Sanders Regional

Intracardiac echocardiography (ICE) is an imaging technique that uses a catheter with an ultrasound probe to create clear images of the inside of the heart. ICE may be used as a diagnostic tool, or to guide the physician during minimally invasive procedures inside the heart such as stent placement, or repair of a hole in the heart such as atrial septal defect.

Intravascular ultrasound (IVUS) allows physicians to see images inside the heart and coronary arteries using a catheter with a tiny ultrasound probe. It is a diagnostic tool that offers a 360-degree view of the arterial wall from the inside, with a more complete assessment than is possible with angiography. IVUS technology helps physicians more accurately select and place stents and other devices to restore blood flow at the site of a blockage.

Rotational atherectomy is an interventional coronary procedure that uses a high speed, diamond-coated rotational “burr” to grind away plaque from a blocked calcified coronary artery and restore blood flow to the heart. An angioplasty/stent is often performed after rotational atherectomy to improve the results.

Fractional Flow Reserve (FFR) is a guide wire-based procedure that can accurately measure blood pressure and flow through a specific part of the coronary artery. The measurement of Fractional Flow Reserve helps a physician decide whether or not to perform angioplasty or stenting on “intermediate” blockages.

The Impella device is a catheter-based miniaturized ventricular assist device that pumps blood from the left ventricle into the ascending aorta and is responsible for systemic circulation.

The Ekosonic Endovascular System (EKOS) is an ultrasound machine that is used to break up blood clot(s) in a desired area of your body. It uses ultrasound waves and special clot dissolving medication that helps remove the clot(s).

Percutaneous Coronary Intervention (PCI), (also known as Coronary Angioplasty) is a group of procedures used to treat accumulated plaque in the heart arteries. PCI often involves the precise placement of coronary stents to open blocked arteries.

Peripheral Vascular Intervention (PVI) uses a catheter inserted in the groin or leg to open blocked coronary arteries and to restore arterial blood flow without the need for open-vascular surgery. PVI usually involves angioplasty and stent placement. A tiny wire is inserted through the catheter into the artery and threaded across the blockage. A tiny balloon is advanced to the blockage and inflated inside the artery to improve blood flow. It is performed in either an emergency setting (for treatment of critical limb ischemia) or in an outpatient setting (to treat a severe blockage causing leg pain).

Pericardiocentesis is a procedure that uses a needle to remove fluid from the pericardial sac, the tissue that surrounds the heart.

Right Heart Catheterization (RHC) is a procedure performed to evaluate the blood pressure in the right side of your heart and lungs. The test involves inserting a catheter (thin rubber tube) through a vein in your leg or neck, and passing it up into your heart to measure the blood pressure. It is known as a “right heart cath” or sometimes a “heart cath.” This test should not be confused with a “left heart cath”, which evaluates pressures on the left side of the heart and looks for blockages in the coronary arteries (which can cause heart attacks).

An atrial septal defect (ASD) is a hole in the muscular wall that separates the heart’s two upper chambers. An ASD occurs when part of the atrial wall does not form properly. Until recently, open-heart surgery was required to close large ASDs, but now many such defects may be repaired with minimally invasive techniques.

Patent Foramen Ovale (PFO) is a small hole between the upper chambers of the heart. The hole exists naturally during fetal development to allow for blood flow from the right to the left side of the heart. It normally closes within the first two years after birth, but does not close in approximately 20% of the population. There is evidence that PFO may be associated with an increased risk of stroke, and possibly contribute to the development of migraines.

In valvuloplasty, a balloon-tipped catheter is threaded from the groin to the site of the narrowed cardiac valve. The balloon is inflated to enlarge the valve opening and improve blood flow. Symptoms of narrowed or blocked cardiac valves may include blood pressure abnormalities, shortness of breath, chest pain, irregular heartbeat, or fainting.