Invasive Cardiology (Cath Lab)

Invasive Cardiovascular Procedures are tests or treatments that require something (catheter, needle, etc) to be inserted into the body to perform a diagnostic test or to treat a disease or condition found from a diagnostic test.

Because the procedures are invasive and a cardiologist performs the procedure, a referral to a cardiologist is necessary. The cardiologists at Trinity are Cardiovascular Associates, P.C. They can be reached at 205-599-3500 or www.cvapc.com. The cardiologist office will set up your appointments for referral and for any test or treatments you may need.

Some of the procedures we perform include:

Cardiac Catheterization (Coronary Angiography, Coronary Arteriography, Coronary Angiogram): 

This is a diagnostic procedure done to detect problems with the heart and its blood supply. This procedure is generally done as a diagnostic test after a person experiences chest pains or other symptoms that could point to a problem with the heart. 

Coronary Angioplasty (Balloon Angioplasty, Percutaneous Transluminal Coronary Angioplasty [PTCA], Percutaneous Coronary Revascularization, Percutaneous Coronary Intervention [PCI], with or without Stent Placement): 

This is a treatment done by the insertion of a catheter carrying a balloon, through an artery in the groin or arm, into a blocked artery in the heart. The balloon is quickly inflated and deflated to open the artery to allow blood flow. To open a blocked artery in the heart to allow more normal blood flow through that artery. Sometimes a stent is implanted with in the artery. The placement of a stent, which is a mesh, metal tube placed in an artery in the heart (a coronary artery) to help keep the artery open after an angioplasty procedure.

Angiography (Catheter Angiography, Arteriography, Angiogram): 

An x-ray exam of the blood vessels when they are filled with a contrast material (a substance that makes the blood vessels visible on an x-ray). Can be used in blood vessels throughout the body. This procedure is performed to help doctors identify diseased, narrowed, enlarged, and blocked blood vessels, and to determine where internal bleeding may be occurring.

Electrophysiology study with or without Ablation (EP Study, EPS): 

An electrophysiology study is a procedure that examines the heart’s electrical activity and pathways.  Radiofrequency ablation is a procedure that uses heat to destroy abnormal electrical pathways in the heart.

Automatic Cardioverter Defibrillator Implantation:  (Implantable Cardioverter Defibrillators [ICD], Automatic Implantable Cardioverter Defibrillator [AICD]):

Automatic cardioverter Defibrillator implantation is the surgical insertion of an implantable cardioverter defibrillator (ICD). An ICD is a small battery-operated device that is implanted in the chest and continuously monitors the heart’s rhythm. These days, implantable defibrillators combine the function of a pacemaker with the function of an external defibrillator. The mechanism monitors the heart’s rate and rhythm. If the heart slows or speeds up too much, the pacemaker element provides pacing to restore a normal heart rate. If the heart begins to beat in a disorganized fashion, the device provides a shock to restore normal rhythm.

Pacemaker Insertion: 

The surgical insertion of an artificial pacemaker, which is a small, battery-operated device that helps maintain a normal heartbeat by sending electrical impulses to the heart.

Atherectomy/Angioplasty of Noncoronary Vessel including Carotid Stenting:

Atherectomy and angioplasty are methods that can be used to open the arteries without surgery. There are several different devices that can be threaded through blood vessels to the site of a narrowing or occlusion. Once there, these devices remove the obstruction so that blood flow is restored. The placement of a stent, which is a mesh, metal tube placed in an artery to help keep the artery open after an angioplasty procedure.

Cardioversion: 

The delivery of an electric shock to the chest via electrodes or paddles in order to correct a dangerous heart dysrhythmia. A dysrhythmia is an abnormality of the heartbeat which may be either a faster or slower than normal rate.Cardioversion can be done as an elective (scheduled) procedure, or may be done urgently if a dysrhythmia is immediately life threatening.

Transesophageal Echocardiography:

An imaging procedure in which sound waves are passed from an ultrasound probe in the esophagus to provide clearer images of the heart

Intravascular Ultrasound (IVUS):

An imaging procedure in which sound waves are passed from an ultrasound probe mounted on a catheter that is passed into the blood vessel to help determine the severity and type of blockage in the blood vessel. This procedure is usually done in conjunction with a cardiac catheterization and angioplasty.

Intracardiac Echocardiography (ICE): 

An imaging procedure in which sound waves are passed from an ultrasound probe mounted on a catheter that is passed directly into the heart through the veins to provide clearer images of the heart. This procedure is usually done in conjunction with a PFO Closure.

Patent Foramen Ovale Closure (PFO) and Atrial Septal Defect Closure (ASD):

Patent Foramen Ovale and Atrial Septal Defects are small holes in an area between the chambers of the heart. A device mounted on a catheter is placed across the hole to close the hole.

Abdominal Aortic Aneurysm Stent Graft: 

An aortic aneurysm is a weak, bulging area in the wall of the aorta. Depending on where the aneurysm is located and how complex it is, stenting may be done. A stent-graft is a polyester tube covered by a tubular metal web. The stent-graft is inserted through a small incision in the upper thigh into the aorta. Using x-ray, it is guided through the aorta to the site of the aneurysm. With the stent-graft in place, blood flows through the stent-graft instead of into the aneurysm, eliminating the chance of rupture.

What to expect:
Most patients are brought into the hospital on the day of their procedure. After checking into admitting, the patient will be sent to the Early Morning Admission Unit (EMA) to be prepped for their procedure. Here the patient will change into a hospital gown, have an IV started, blood drawn for lab work, EKG and chest X-ray if needed. Then they will be sent to the cath lab for their procedure. The patient's family will be asked to wait in the waiting area. The cardiologist will speak to the patient's family as soon as the procedure is complete. Prior to the procedure the patient is held in the holding/recovery area where a pre-assessment will be done and there is an opportunity to speak to the cardiologist for any unanswered questions. The patient is then taken into the cath lab suite for the procedure. After the procedure they will remain in recovery for 30 minutes to one hour.  The patient will then be taken to a room until the physician discharges them from the hospital which may be the same day or the following day. If the patient has questions at any time, they should ask the physician, nurses or technologists.