Interventional/invasive cardiology

What is interventional cardiology?

Interventional cardiology is the medical speciality dedicated to operative procedures on the cardiac cavities and vessels (coronary arteries), without resorting to surgery.

Interventional cardiology is used to treat diseased coronary arteries and to intervene in the treatment of some cardiac arrythmias. Tests are carried out in the cardiac catheterisation room.

Care

The most common test is coronary angiography, which is used in the treatment of diseased arteries. Then, for the treatment of arrythmias, there are electrophysiological tests that allow for the diagnosis and/or treatment of the causes of cardiac dysrhythmia. Some dysrhythmias may result in the fitting of a pacemaker or an implantable defibrillator. These devices are implanted in the patient at Clinique de Genolier’s operating theatre.

The coronary angiography is a test that allows for all the coronary arteries to be seen, under radiological control, thanks to the insertion of a catheter and the injection of contrast agent. The catheter (a narrow, flexible, plastic tube) is inserted into the vascular network (artery or vein), as far as the cavity or artery to be treated.

It is mainly used to dilate a narrowed coronary artery (to treat a myocardial infarction or angina pectoris) by means of a balloon. This procedure is called angioplasty. Once the angioplasty has been carried out, a stent may be inserted into the blocked area. The positioned stent helps to maintain the blood flow of the coronary artery and irrigate the cardiac muscle.

A medicinal treatment may be prescribed by the cardiologist following the coronary angiography. This treatment is aimed at favouring the optimal implantation of the stent. It is intended to prevent the stent from becoming blocked after it has been inserted and/or to support cardiac muscle activity in the event of heart failure after a heart attack.

In some very complex cases, cardiac surgery may be envisaged at a specialised centre.

Types of pathologies

Other pathologies may be treated during a procedure in the cardiac catheterisation room:

  • congenital diseases, for example, PFO (patent foramen ovale);
  • treatment with peripheral angioplasty of circulatory disorders of the arteries in the leg: peripheral arterial occlusive disease (PAOD).

PFO and its treatment:

Some people are born with an abnormality known as patent foramen ovale or PFO. This is a small opening between the right atrium and the left atrium (atrial septal defect). It closes naturally a few weeks after birth.

Sometimes, this closure does not occur and may result in the migration of blood clots with significant consequences. Its closure is envisaged in complications such as a stroke or myocardial infarction. A small device (an umbrella) is inserted into the heart cavities and opened on either side in order to restore the seal between the two sides.

Narrowing of the arteries in lower limbs and their treatment:

PAOD (peripheral arterial occlusive disease):

The treatment of peripheral arterial occlusive disease (PAOD) consists of dilating the arteries in the legs so as to restore proper blood circulation. A stent may also be positioned.

In the cardiac catheterisation room, electrophysiological tests may also be carried out.

  • AV (atrioventricular) node ablation;
  • Flutter ablation;
  • AF (atrial fibrillation) ablation;
  • Wolff-Parkinson-White (WPW) syndrome.