Cardiac Procedures
Coronary Angiogram
Our cardiologists may recommend a formal angiogram in hospital. This is performed as an x-ray test and dye is used to enable visualisation of the coronary arteries. A small tube is placed either in the patient’s arm or groin, and passed up towards the heart. Dye is then pumped through the tube to try and detect any blockages or narrowing of the coronary arteries. If any blockages are revealed, the cardiologist will recommend the appropriate treatment. Treatment options may include either medication or a stent to open up the blockage. This procedure may be able to be performed on the same day as the angiogram, but often requires another hospital visit.
An angiogram is generally done as a day patient. If the patient requires a stent, the patient will need to stay overnight stay in hospital. The cardiologist will discuss the outcome of the test with the patient following the procedure and the appropriate treatment will be arranged.
Coronary Artery Stenting
A stent is a small metal tube made of a mesh-like metal material that we use to open up a blocked artery. This procedure is usually done at the time of a coronary angiogram. When an angiogram shows a blockage in the coronary artery, we first balloon the artery and then a stent is inserted to keep the artery open. After the procedure, patients are given additional blood-thinning medication taken in conjunction with Aspirin usually for a twelve month period.
Transesophageal Echocardiogram
DC cardioversion is a procedure where an electrical current is delivered to the heart to restore normal rhythm. This procedure is done under a short acting general anaesthetic. It can be done on its own or it can be done after the patient has had a transoesophageal echocardiogram. A transoesophageal echocardiogram is a probe, not too dissimilar to an endoscopy camera, placed down the oesophagus in order to look at the heart and exclude any clots prior to the DC cardioversion. This is usually a day only procedure and the patient stays in hospital for a few hours after the procedure. As they are given a general anaesthetic, they are not able to drive for a 24 hour period.
EPS Studies and Ablation
Electrophysiological studies are conducted in the cardiac cath lab, to determine the location of an electrical or rhythm problem in the heart. Often the group of cells responsible for this abnormal rhythm can be zapped, offering relief for this problem.
TAVI and Mitra Clip
Some patients have valve problems requiring intervention. Some patients may be suitable for a procedure to open up a valve via a catheter, without the need for open heart surgery. Sometimes a leaky valve can have a clip inserted via a catheter. These interventions are carefully assessed on a case by case basis.
LAA Closure
Patients with atrial fibrillation are at high risk of developing blood clots in their heart which could lead to stroke. Most of these clots develop in a particular part of the heart called the left atrial appendage, a small pocket on the side of one of the top chambers of the heart. In the majority of cases, patients are put on a blood thinning medication to prevent these clots from forming. In certain circumstances where patients cannot take these medications however, the left atrial appendage can be closed using a device inserted through a catheter (a thin tube, inserted via the groin).
Loop Recorder Insertion
An implantable loop recorder is a small electrical device that is able to continuously record the heart activity. It is often used to help find a cause for recurrent unexplained syncope when there is a strong suspicion of a heart rhythm cause but all other simple tests have been normal. It can also be used to monitor patient’s heart rhythm after atrial fibrillation ablation procedures.
The implantable loop recorder comes in many different sizes is generally about the size of a computer USB and sits underneath the skin. There are no wires to the heart. It allows continuous recording of the heart’s activity so that we can diagnose arrhythmias.