Interventional cardiology specifically uses catheter based diagnosis and
treatment procedures. A large number of procedures can be completed on
the heart using a catheter, typically with less pain, time in the hospital,
and improved recovery than other methods of treating heart disease.
Stenting
A small mesh tube called a stent is usually placed in the newly widened
part of the artery during an angioplasty. The stent holds up the artery
and lowers the risk of the artery narrowing again. Stents are made of
metal mesh and look like small springs.
Angioplasty
Percutaneous transluminal coronary angioplasty (PTCA) is performed to open
blocked coronary arteries caused by coronary artery disease (CAD) and
to restore arterial blood flow to the heart tissue without open-heart
surgery. A special catheter (long hollow tube) is inserted into the coronary
artery to be treated. This catheter has a tiny balloon at its tip. The
balloon is inflated once the catheter has been placed into the narrowed
area of the coronary artery. The inflation of the balloon compresses the
fatty tissue in the artery and makes a larger opening inside the artery
for improved blood flow.
Catheterization
Cardiac catheterization is a medical procedure used to diagnose and treat
certain heart conditions. A long, thin, flexible tube called a catheter
is put into a blood vessel in your arm, groin (upper thigh), or neck and
threaded to your heart. Through the catheter, doctors can perform diagnostic
tests and treatments on your heart.
Cardiac Catheterization Lab
Cardiac catheterization (cardiac cath or heart cath) is a procedure to
examine how well your heart is working. A thin, hollow tube called a catheter
is inserted into a large blood vessel in the arm, groin or neck that leads
to your heart. Dye is injected from the catheter into blood vessels to
make them visible using special x-rays called angiograms. The procedure
takes 2-3 hours.
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Right Heart Catheterization
Left Heart Catheterization
Radial angiography with quicker recovery
Percutaneous Coronary Intervention (PCI)
Angioplasty
Cardiac stenting
Peripheral Angiograms
Angioplasty
Peripheral stenting
WATCHMAN: A One-Time Implant that Helps Reduce AFib Stroke Risk
Mary Washington Hospital adds Watchman treatment for Atrial Fibrillation
to its heart patient services.
How Does AFib Increase Stroke Risk?
The average person with atrial fibrillation (also called AFib or AF) is
five times more likely to have a stroke than someone with a regular heartbeat.1 That’s because AFib can decrease the heart’s pumping capacity
by as much as 30%.2 Because blood isn’t pumped out of the heart normally, it’s
easier for blood cells to stick together and form clots in an area of
the heart called the left atrial appendage (LAA).2, 3 When a blood clot escapes from the LAA and travels to another part of the
body, it can cut off the blood supply to the brain, causing a stroke.1, 4
An Alternative to Blood Thinners
WATCHMAN is a permanent implant that offers an alternative to the lifelong
use of blood thinners. It’s about the size of a quarter and made
from very light and compact materials commonly used in many other medical implants.
How WATCHMAN Works
WATCHMAN effectively reduces the risk of stroke by permanently closing
off the LAA to keep blood clots from escaping. WATCHMAN can eliminate
the bleeding risks and regular blood tests and food-and-drink restrictions
that come with warfarin. In a clinical trial, 9 out of 10 people were
able to stop taking warfarin just 45 days after the WATCHMAN procedure.6
How is WATCHMAN Implanted?
WATCHMAN is implanted into your heart in a one-time procedure. To implant
WATCHMAN, your doctor makes a small cut in your upper leg and inserts
a narrow tube, as done in a standard stent procedure. Your doctor then
guides WATCHMAN into your heart’s LAA. The procedure is done under
general anesthesia and takes about an hour. Patients commonly stay in
the hospital overnight and leave the next day.
After the Procedure
Following the WATCHMAN procedure, you’ll take warfarin for 45 days
or until your LAA is permanently closed off. During this time, heart tissue
will grow over the implant to form a barrier against blood clots. Your
doctor will monitor this process by taking pictures of your heart to see
when you can stop taking warfarin.
Your doctor will then prescribe a medicine called clopidogrel (also known as Plavix®) and aspirin for you to take for six months. After that, you’ll
continue to take aspirin on an ongoing basis. A very small number of patients
may need to keep taking blood thinners long term.
In a clinical trial:
92% of patients were able to stop taking warfarin just 45 days after the procedure6
99% of patients were able to stop taking warfarin within 1 year after the procedure6
Is WATCHMAN Right for You?
If you have a history of bleeding or a lifestyle, occupation or condition
that puts you at risk for bleeding, WATCHMAN may be right for you. But
like any medical procedure, WATCHMAN comes with risks, so it isn’t
right for everyone.
Your cardiologist will weigh your risk of a stroke against your risk of
a serious bleeding problem to determine the right treatment for you.
Sources
1. National Stroke Association.
Making the Afib-Stroke Connection. https://www.stroke.org/sites/default/files/resources/Afib-Connection%20for%20hcp.pdf.
Published 2012. Accessed September 1, 2016.
2. Harvard Health Publications. Atrial fibrillation. http://www.health.harvard.edu/heart-health/atrial-fibrillation-common-serious-treatable. Harvard University Medical School. Published November 2011. Accessed August 25, 2016.
3. Blackshear JL, Odell JA. Appendage obliteration to reduce stroke in
cardiac surgical patients with atrial fibrillation.
Ann Thorac Surg. 1996;61:755-759.
4. Cleveland Clinic. Atrial fibrillation (Afib). http://my.clevelandclinic.org/services/heart/disorders/arrhythmia/atrial-fibrillation-afib. Published May 2015. Accessed August 25, 2016.
5. National Stroke Association. Making the Afib-Stroke Connection. https://www.stroke.org/sites/default/files/resources/Afib-Connection%20for%20hcp.pdf. Published 2012. Accessed September 1, 2016.
6. Holmes DR Jr, Kar S, Price MJ, et al. Prospective randomized evaluation
of the Watchman Left Atrial Appendage Closure device in patients with
atrial fibrillation versus long-term warfarin therapy: the PREVAIL trial.
J Am Coll Cardiol. 2014;64(1):1-12.
