An angioplasty is a procedure that uses a balloon to widen narrowed arteries.
MacNeal Hospital cardiovascular experts offer multiple procedures to repair congential and other defects to the aorta. We offer open thoracic and abdominal aneurysm repair, aortic surgery for occlusive disease and minimally invasive aortic surgery. Specific surgical procedures include aortofemoral bypass, mesenteric bypass, renal bypass, thoracic endovascular aneurysm repair (TEVAR), abdominal endovascular aneurysm repair (EVAR), iliac artery stenting, mesenteric artery stenting and renal artery stenting. Complex aortic reconstructions are also offered by our specialists, including aortic dissection and debranching procedures in preparation for minimally invasive aneurysm repair with a stent.
Artificial heart valve surgery
Artificial heart valve surgery involves replacing an abnormal or diseased heart valve with an artificial one.
A treatment used to remove the plaque that is blocking the artery. Commonly performed with the use of the Diamondback 360® Coronary System.
An atherectomy is a procedure in which a catheter with a sharp blade on the end removes plaque from a blood vessel. The catheter is inserted into the artery through a small puncture in the artery, and it is performed under local anesthesia. The catheter is designed to collect the removed plaque in a chamber in the tip, which allows removal of the plaque as the device is removed from the artery. The process can be repeated at the time the treatment is performed to remove a significant amount of disease from the artery and eliminating a blockage.
There are three main types of atherectomy, each using a specific type of catheter tip. Rotational Atherectomy
Sometimes called “rotoblator”, rotational atherectomy is a common procedure. It uses a catheter tipped with a diamond burr that is guided to the blockage. While the burr spins at a very high speed, it grinds the hardened plaque into minute particles that can be safely eliminated by the body.Directional Atherectomy
Directional Atherectomy is designed to remove buildup of softer plaque. After catheter insertion, a balloon is inflated along the catheter that pushes the blade toward the plaque. The blade cuts away at the plaque and stores it in a special chamber. The balloon is then deflated and the plaque is removed with the chamber as the catheter is withdrawn.Transluminal Extraction
Transluminal Extraction is a device that uses spinning blades to cut away plaque and a vacuum device to suction the plaque out of the blood vessel through the catheter.
Angioplasty is the technique of mechanically widening a narrowed or obstructed blood vessel, usually due to narrowing of the vessel due to atherosclerosis. Sometimes called percutaneous transluminal coronary angioplasty (PTCA), balloon angioplasty is a minimally invasive procedure that opens blocked or narrowed blood vessels.
Using a guide wire called a balloon catheter, physicians insert a very small, empty and collapsed balloon into the narrow portion of the target blood vessel and momentarily inflate it to a fixed size. The balloon crushes the fatty deposits, opening up the blood vessel to improved flow before the balloon is collapsed and removed. Balloon angioplasty can be used to unblock clogged arteries in the legs, arms, kidneys, brain and other parts of the body. Angioplasty has come to include all manner of vascular interventions typically performed in a minimally invasive (percutaneous) method.
A balloon valvuloplasty is a minimally invasive procedure in which a patient’s narrowed heart valve is stretched open to allow improved function and blood flow without open heart surgery. Using a catheter, physicians insert a small deflated balloon into the blood vessel that is threaded up to the opening of the narrowed heart valve. The balloon is inflated, which stretches the valve open.
Bi-Ventricular Pacing Devices
Our experts are internationally known for their extensive work with bi-ventricular pacing devices. By stimulating the left and right ventricles simultaneously, the bi-ventricular pacing system resynchronizes the heart and dramatically improves the heart’s ability to pump blood.
Bypass surgery creates a detour around the narrowed or blocked sections of the artery. To create this bypass, a cardiovascular surgeon connects a vein or a tube made from man-made materials above and below the area that is blocked. This creates a new path for blood to flow.
In a cardiac ablation procedure, a catheter is used to guide tiny electrodes into the heart. When the damaged tissue is identified, a burst of radiofrequency energy destroys the tissue that is causing the abnormal electrical signals. With the damaged tissue destroyed, the heart usually returns to a normal rhythm.
The CardioMEMS HF System measures and monitors the pulmonary artery (PA) pressure and heart rate in certain heart failure patients. The System consists of an implantable PA sensor, delivery system, and Patient Electronics System. The implantable sensor is permanently placed in the pulmonary artery, the blood vessel that moves blood from the heart to the lungs. The sensor is implanted during a right heart catheterization procedure. The PA sensor is about the size of small paper clip and has a thin, curved wire at each end.
The sensor monitors the pressure in the pulmonary artery. Patients take a daily reading from home or other non-clinical locations using the Patient Electronics System which sends the information to the doctor. After analyzing the information, the doctor may make medication changes to help treat heart failure.
During cardiomyoplasty, skeletal muscles are taken from the back or abdomen and wrapped around the heart. The added muscle can help boost pumping, aided by an implanted stimulator.
Our expert physicians often perform cardioversion, either with drugs or an electrical impulse, to “reset” the heart to its normal rhythm (sinus rhythm).
Cardioversion may successfully restore regular heart rhythm in more than 95 percent of patients, but it’s not always effective as a long-term solution. More than half of patients eventually go back into atrial fibrillation. In these instances, anti-arrhythmic medications may be needed indefinitely.
Carotid Artery Stenting
This minimally invasive treatment can prevent stroke in patients with carotid artery disease. Carotid artery stenting with embolic protection system gives new hope to high-risk patients who might not otherwise be candidates for traditional surgery.
The key to this procedure is a tiny blood filter (embolic protection system) that collects plaque that might dislodge from the artery wall and cause a stroke. As a result, this minimally invasive procedure is safer for high-risk patients than the traditional surgery. In time, minimally invasive procedures like this may prevent up to half the strokes that occur today.
Diamondback 360® Coronary System
Specially designed to remove calciﬁc and ﬁbro-calciﬁc plaque in blocked coronary arteries, thereby facilitating effective stent placement and restoring blood ﬂow to the heart. The device has an eccentrically mounted, diamond-coated crown that comes in four sizes: 1.25, 1.50, 1.75 and 2.00 mm. It is mounted on a 145 cm long catheter (Figures 1, 2) that is thread over and spins on the proprietary ViperWire™ Guide Wire.
The system operates on the principles of centrifugal force. As the crown rotates and orbit increases, centrifugal force presses the crown against the lesion or plaque, removing a small amount of plaque with each orbit.
The Diamondback 360° Coronary System has a unique mechanism of action called differential sanding which discriminates between compliant arterial tissue and hardened plaque (including diseased ﬁbro-calciﬁc or calciﬁc plaque). Compliant tissue ﬂexes away from the crown as it passes (Figure 4). Diseased calciﬁc and ﬁbrotic plaque is not compliant and provides resistance, allowing the orbiting crown to sand the plaque (Figure 5). That plaque becomes minute particles that are absorbed by the body.
Endovascular Stent Grafting
Endovascular stent graft repair is designed to help prevent an aneurysm from bursting. The term endovascular means inside blood vessels, and surgeons use specialized instruments that require only small incisions or punctures in an artery or vein. Through these punctures, a cardiovascular surgeon inserts long thin tubes, called catheters, which carry the devices through the blood vessels to the location of the aneurysm. They can then be placed to re-align and strengthen arteries.
An endovascular stent graft is a tube composed of fabric supported by a metal mesh called a stent. It can be used for a variety of conditions involving the blood vessels, but most commonly is used to reinforce a weak spot (an aneurysm) in an artery.
An Implanted Cardioverter Defibrillator (ICD) is a device that is implanted in a patient’s body to help control the heart’s rhythm. ICDs are extremely effective in stopping dangerous arrhythmias and are the most effective therapy for treating ventricular fibrillation, the major cause of sudden cardiac death. The ICD continuously monitors the heart rhythm and delivers a “pacemaker” shock when the heart rhythm gets too slow. If the heart rhythm gets dangerously fast, the ICD can deliver a life-saving shock that returns the heart to a normal rhythm.
The heart has a natural “pacemaker” that regulates electrical impulses in the heart. This natural “pacemaker” is called the sinoatrial node. But sometimes the sinoatrial node does not work properly and an artificial pacemaker is needed to regulate the heart’s rhythm. An implantable pacemaker device continuously monitors the rhythm of the heart and transmits electrical impulses to stimulate the heart if it is beating too slowly or unevenly.
Percutaneous Coronary Interventions
Percutaneous coronary interventions are minimally invasive therapeutic procedures for rebuilding and unblocking occluded (clogged) blood vessels. A catheter is inserted through a small puncture in the skin and into a blood vessel. Your physician then uses tiny, camera-guided wires and tools to locate and repair clogged blood vessels through the use of balloon angioplasty, stent insertion, the use of other mechanical devices or specialized lasers.
Vena Cava Filter
This is a small metal device that is temporarily inserted to capture blood clots and prevent them from moving to other areas of the body. The filter allows blood to pass through the vein as it normally would.
An interventional radiologist or vascular surgeon inserts the filter into the vena cava, which is the main vein going back to the heart from your lower body. To reach this vein, which is in the abdomen, the doctor inserts the filter into a leg, neck, or arm vein.
Atrial fibrillations can be caused by a small section of abnormal tissue in the heart, which can be destroyed with catheter radiofrequency ablation. In this procedure, a catheter (a thin, flexible tube) is used to guide tiny electrodes into the heart. When the damaged tissue is located inside the heart, a burst of radiofrequency energy destroys the tissue that is causing the abnormal electrical signals. With the damaged tissue destroyed, the heart usually returns to a normal rhythm.
MacNeal cardiovascular physicians use AV node ablation with pacemaker
In this procedure, radiofrequency energy is applied through a catheter to destroy a small area of tissue near the atrioventricular (AV) node. For most patients, this procedure completely blocks the heart's electrical impulses and eliminates atrial fibrillation. As a result, doctors must implant a pacemaker to establish a normal rhythm. Anticoagulation medication may also be required to reduce the chance of developing blood clots.
A stent procedure involves installing a wire mesh tube into a narrowed coronary artery to keep it open. It is often used in conjunction with an angioplasty procedure.