Hospital Procedures

Transesophageal echocardiography (TEE) is an ultrasound test to evaluate you heart. By having you swallow a mobile, flexible probe, the cardiologist can see the structure of your heart without having the skin, ribcage or muscles of the chest interfere with the pictures.

Cardiac Catheterization or Coronary Angiogram is a minimally invasive procedure that allows the physician to see the blood flow through your coronary arteries and the inside of your heart as it pumps. It also can help to determine if any of the blood vessels are blocked, if the heart valves are working properly, if the heart has been damaged by disease or if you were born with a heart defect.

Information will be given to you by the physician's office regarding the instructions to follow prior to the procedure. If you have any questions, please give our office a call.

The procedure is done in a special area of the hospital. A small intravenous (IV) catheter is inserted into your arm or hand so fluid and/or medication can be given as needed. Medication can be given to help you relax; however, you will need to be awake during the procedure. Electrodes will be placed on your arms and legs so the staff can monitor your heart rhythm. Numbing medication will be injected into the skin at the site where the catheter will be inserted. This will either be in your arm or groin (most common site). A small opening is made in the artery in this area and a small hollow tube (sheath) is placed into the blood vessel. A thin flexible tube (catheter) is then inserted and guided through until it reaches the heart. Once there, dye, which is visible to X-ray, is injected into the heart. Pictures are then taken and reviewed by the physician.

The catheterization can take about 20 minutes to an hour. There are several methods to close the puncture site in the artery; pressure and bed rest, stitches or a collagen plug. The physician will determine the method which is best for you.

Incision care and discharge instructions should be given to you prior to leaving the hospital. Please ask the hospital staff and/or physician if you have any questions.

A Coronary Balloon Angioplasty (PTCA) is a minimally invasive procedure that is done to open a heart artery that has been narrowed by plaque. It also can be done to reduce the risk of a heart attack or to prevent further heart damage. This increases the amount of blood flow through your coronary arteries. The physician will determine if you need this procedure after reviewing the X-ray pictures from your cardiac catheterization.

A flexible tube (guiding catheter) is inserted into the artery through the sheath and guided towards the blocked area within the artery. The physician is able to view the procedure using the X-ray images on a monitor. There is a deflated balloon at the tip which is inflated to open up the blockage by compressing the plaque and stretching the artery open. It is then deflated and removed. Some patients will require stent placement to help keep the artery open. (See stent implantation)

This procedure can take 30 minutes to an hour. An overnight stay in the hospital is required.

Sometimes prior to a balloon angioplasty, an Atherectomy is done. The catheter for this procedure has a coarse burr near its tip. The physician uses this device to shave the plaque inside the artery into small bits. These bits are carried away in the bloodstream. A stent may also be placed after this procedure. An Atherectomy along with balloon angioplasty and stenting can take one to two hours to complete.

Incision care and discharge instructions should be given to you prior to leaving the hospital. Please ask the hospital staff and or physician if you have questions.

The need for a coronary stent is determined by the physician after reviewing cardiac catheterization images. They are inserted after most balloon angioplasties. Stents are small, metal, spring-like devices about the size of a spring in an ink pen. Some patients think they look like a small chain link fence rolled into a tube. They are used to help prevent the coronary artery from narrowing again (restenosis). There are different sizes and types of stents. Drug eluting stents are coated in a medication to help reduce the amount of scar tissue that forms in the artery. The type of stent that is used will be determined by the physician.

During the procedure, the stent is mounted on a balloon-tipped catheter. The physician moves the catheter into the area of the blockage and inflates the balloon. This causes the stent to expand and press against the artery wall. The balloon is then deflated and withdrawn, leaving the stent in place to hold the artery open and allow blood flow through the artery. X-ray pictures are taken again to evaluate the improvement of blood flow.

The procedure can take approximately 60 to 90 minutes to complete if done with a balloon angioplasty. An overnight stay in the hospital will be required.

To reduce the risk of a blood clot from forming inside your stent, the physician may prescribe an anti-platelet medication for you take to make the platelets in the blood less sticky. Other medication changes may also be suggested by the physician. These medications are extremely important and should not be stopped or adjusted without consulting your cardiologist.

Incision care and discharge instructions will be given to you prior to leaving the hospital. Please ask the hospital staff or physician if you have any questions.

A Peripheral Angiogram is a minimally invasive procedure that allows the physician to see the blood flow through different blood vessels in your lower body and legs. It can determine if there is any narrowing of these arteries or if any of these arteries are blocked.

Information will be given to you by the physician's office regarding the instructions to follow prior to the procedure. If you have any questions, please give our office a call.

The procedure is done in a special area of the hospital. Numbing medication will be injected into the skin at the site where the catheter will be inserted. This will either be your arm or groin. The most common site is the groin. A small opening is made to expose the artery and a small hollow tube (sheath) is placed into the blood vessel. A thin flexible tube (catheter) is then inserted into the sheath and guided into the artery that needs examined. Contrast dye is then injected and X-ray pictures are taken. The physician will decide on treatment options after reviewing these images on the monitor.

The procedure will take about 30 minutes to an hour to complete. There are several methods to close the puncture site in the artery: pressure and bed rest, stitches or a collagen plug. The physician will determine which is best for you.

Incision care and discharge instructions should be given to you prior to leaving the hospital. Please ask the hospital staff and/or physician if you have any questions.

Peripheral Balloon Angioplasty (PTA) is a procedure that helps open narrowed arteries or blockages in the arteries in the lower part of your body and legs. The physician will determine if you need this procedure after reviewing the X-ray pictures from your peripheral angiogram.

A flexible tube (catheter) with a deflated balloon will be inserted through the sheath and guided to the area of blockage in your blood vessel. The physician inflates the balloon to compress the plaque against the artery walls to open the narrowed vessel. The balloon is then deflated and removed.

With this procedure, the physician may recommend a placement of a stent. This is a small, metal, spring-like device about the size of a spring in an ink pen. The stent is placed over the balloon and once inflated, is pressed against the artery wall. This will help to hold the artery open and should improve blood flow.

The procedure can take approximately one to two hours to complete. The physician will determine if an overnight stay is needed.

To reduce the risk of a blood clot from forming inside your stent, the physician may prescribe an anti-platelet medication for you to take to make the platelets in the blood less sticky. Other medication changes may also be suggested by the physician.

Incision care and discharge instructions will be given to you prior to leaving the hospital. Please ask the hospital staff or physician if you have any questions.