Interventional Cardiology is a sub-specialty of the broader cardiology stream and focuses specifically on the treatment of heart diseases through catheters. A catheter is a long, thin, fine tube mounted with a tiny balloon that is inserted into an artery or vein in the groin, neck or arm and moved to the heart through the blood vessels.
Interventional cardiology uses specialized imaging and diagnostic procedures to assess the flow of blood and pressure in the heart’s arteries and chambers. Moreover, it also involves using technical procedures and medications to cure abnormalities impairing the cardiovascular system.
Interventional cardiology diagnoses and treats clinical issues such as:
- Ischemic/coronary heart diseases
- Heart valve diseases
- Congenital heart abnormalities
- Peripheral vascular diseases
- Resistant hypertension
- Patent foramen ovale
- Hypertrophic cardiomyopathy (HCM)
These clinical issues are treated through interventional methods such as:
Angioplasty: This interventional cardiology procedure is undertaken to restore the blood flow to the heart after a heart attack. In this, a catheter mounted with a tiny balloon is inserted into the blocked artery by making an incision in the arm or groin. The catheter is then specifically directed to the area of blockage via special dyes, X-rays, etc. and then the mounted balloon is inflated to remove the blockage from the artery and allow free flow of blood. Post the supply is regulated; the balloon is deflated and removed from the body.
Stenting: Post angioplasty, sometimes the doctors place a stainless-steel mesh known as a stent in the heart to ensure the arteries do not clog again. Some stents are also medically coated to avoid narrowing of the arteries in the future. These stents are placed on top of the balloon on the catheter, such as that upon the opening of the balloon, the stent opens up and reinforces the walls of the artery.
Rotational Atherectomy: In this procedure, a high-speed instrument – rotary shaver- called burr, is placed at the tip of the catheter and is used to cut through a heavily calcified plaque to reopen a blocked coronary artery.
Embolic Protection: This interventional cardiology procedure involves eliminating the loose particles of accumulated plaque – that are flowing in the blood – via filters.These loose plaque particles increase the chances of stroke and heart injuries.
Percutaneous Valve Repair: Interventional cardiology can repair damaged valves by using catheters to guide clips and other surgical devices via the blood vessels to repair the valve and restore the flow of blood in the heart.
Balloon Valvuloplasty: In this procedure, a balloon is placed at the top of the catheter which is guided to the narrow or constricted heart valves to stretch it open. When the catheter is at the right place in the heart, the balloon is inflated pushing the walls of the artery to open properly.
Valve Replacement: This procedure is similar to a balloon valvuloplasty, though the only difference is that there will be implantation of an artificial valve in the replacement of a damaged or a narrowed valve.
Radiofrequency Catheter Ablation: This method uses radio waves to send signals to the heart muscles via a catheter to permanently restrict the abnormal way used by electric signals in the heart. This might involve placing of more than one or more catheter so that energy is directly focussed on the part of the heart causing abnormalities. This cures rapid heartbeats known as tachycardia.
Moreover, in some cases, interventional cardiology might only suggest using medications and adopting certain lifestyle changes to cure the heart problem. Today, interventional cardiology is increasingly being preferred by patients and also being deeply researched by doctors to better the ways of treatment of heart diseases, as well as to widen its horizon to cover more heart problems.
The main advantages of interventional cardiology are – minimum scars, less pain, lower chances of infections and post-operative complications, and shorter recovery period.
While some of the risks involved in interventional cardiology are:
- Swelling at incision
- Heart attack
- Damage to the artery, veins or area of catheter insertion
- Irregular rhythm and heartbeat
- Damage to the kidneys
- Allergies to dye
- Allergies to medication
- Blood clots
The risks are those that apply to all other heart surgeries but its advantages outweigh these risks, though the choice of interventional cardiology treatment will depend on the case of the patient.
Interventional cardiology vs. Surgery
As compared to surgery, interventional cardiology is often the preferred method of treatment. Such as cases of heart attacks that are caused because of artery blockages can be treated via balloon angioplasty to restore normal blood flow. Moreover, in cases where the patient is allergic to general anesthesia, interventional cardiology comes in play because it does not require general anaesthesia during treatment. Risks in interventional cardiology are considerably lower than surgeries and the recovery time is shorter – in many cases the patients can go home the next day.
Further, for patients those are considered riskier for surgeries can be advised for interventional cardiology treatment. Broadly, interventional cardiology is a lower-risk alternative as compared to surgical procedures for some heart problems.