Interventional Cardiology

In Liv Hospital Coronary Angiography and Cardiac Catheterization Laboratory, interventional procedures such as angiography, balloon and stent are applied with modern treatment methods.


 

Procedures at the Interventional Cardiology Clinic of Liv Hospital

• Coronary angiography
• Peripheral angiography
• Right and left heart catheterization
• Vascular resistance measurement for pulmonary hypertension
• Diagnostic procedures such as renal angiography
• Complex percutaneous coronary interventions
• Carotid Attempts
• Renal stent
• Alcohol septal ablation in hypertrophic obstructive cardiomyopathy
• Percutaneous closure of atrial and ventricular septal defects
• Renal denervation in resistant hypertension
• TAVI (Transcatheter aortic valve implantation) in patients at risk of operation

Wrist Angio

Angiography performed by entering the leg vein may make the patient dependent on the bed for 6 hours and may cause the bleeding risk. Balloon and stent procedures are performed by the pulse artery in the wrist at the Liv Hospital Interventional Cardiology Clinic. In this way, patients can be discharged after a very short period of time after angioma.

The risk of hemorrhage is significantly reduced after angiogenetic wrist operations. This rate is observed around 5% in the world, and the rate of radial artery intervention is 0.2%.

In the procedures performed in the Liv Hospital Interventional Cardiology Clinic and in the percutaneous interventions, radial artery (Wrist) is preferred as 95% of the patients. This rate is above world standards. There was no bleeding complication due to angiography entry in clinical applications. After diagnostic procedures, discharge can be provided in patients with radial artery access after 2-3 hours. On the other hand, in patients with preferred femoral access, the resting time of 6-12 hours with groin closure devices is reduced to 2 hours and there is no need for the use of applications such as sandbags.
 

Vessel Stiffness with Featured Stents Does Not Re-occur

The rate of drug-eluting stent and fusible stent use in our laboratory is 90%. This rate is well above the general standards of 60 percent. The drug-eluting stents used are FDA-approved and provide significant advantages in reducing the occurrence of stenosis in the vessel.
 

Accurate Diagnosis with Advanced Technology

In addition to advanced intracoronary imaging techniques such as intravascular ultrasound (IVUS) and OCT (Opticalcoherencetomography), the first and only wireless-flow-wire application in our country can be routinely integrated into existing angiography system and always ready to use FFR measurements. In this way, accurate coronary lesions, stent application can be more sensitive decision. The laboratory is organized in accordance with the safety and quality standards set by the SCAI. For patients admitted to the laboratory with cardiogenic shock, intra-aortic balloon pump support is present in the catheter laboratory at all times. The set-up is suitable for complex initiatives such as TAVI and has been approved by teams from abroad.
 

Major Processes

Coronary Angiography

Coronary angiography is the visualization of the vessels (coronary arteries) that provide and supply the heart with a painted liquid. Angiographic procedures can be performed for all vessels of the body. Eye, brain, heart and leg veins are usually the most frequently investigated vascular systems. The procedure to examine the heart vessels is called coronary angiography.

Coronary angiography, also referred to as cardiac catheterization or angiography, is an invasive imaging modality for evaluating cardiovascular function and function.
 

Diagnosis and treatment of cardiac catheterization

• Coronary artery, heart valve or aortic vein diseases
• Evaluation of heart muscle function
• Determining advanced treatment methods such as coronary balloon angioplasty and stent, coronary bypass surgery, cardiac valve interventional or surgical intervention

 

Preparation of Coronary Anion

During coronary angiography, a thin, soft, plastic sheat is placed in the groin or arm at the arm. Through this sheath, the soft and thin plastic is advanced through the hollow catheters into the outlet of the heart vessels. The catheter is directed to the coronary arteries with the help of a special x-ray machine.

The contrast material (angiographic dye) is injected via the catheter and the moving x-ray films are recorded in digital media. This part of the procedure is called coronary angiography. In addition to these images, it may be necessary to perform advanced imaging and evaluation methods such as intravascular ultrasound (IVUS), optical coherence tomography (OCT) or fractional current reserve (FFR). IVUS provides more detailed images with ultrasound in the coronary arteries. OCT provides detailed information about the inner wall of the vessel with a special light source. The FFR provides information on the severity of the constriction by determining the nature of the blood flow. These advanced assessment methods should be carried out in centers with experienced operators.
 

Balloon Angioplasty and Stent (Coronary Intervention) Installation

Coronary interventional procedure is a non-surgical treatment of narrowed coronary arteries to increase blood flow to the heart. When coronary angiography is detected during coronary angiography, it can be treated with angioplasty and stent method in the same session or planned in a separate session with the joint decision of the physician and patient. This decision may vary depending on the patient's clinical condition. Coronary interventional procedure begins in the same way as a coronary angiography. Balloon angioplasty and stent are performed to open the coronary arteries after the catheter is placed in the coronary arteries.
 

Balloon Angioplasty

Fluid located at the end of a thin catheter can be opened in the narrowed coronary artery by inflating an expanding balloon. Balloon angioplasty is technically referred to as percutaneous coronary angioplasty (PTCA) or percutaneous coronary intervention (PCI). When the balloon is inflated, the oily plaque is compressed against the occluded artery walls, and blood flow is increased.
 

Balloon Angioplasty with Stent

In most cases, stent placement is performed in combination with the balloon angioplasty procedure. Stent coronary is a small metal cage tube that acts as a skeleton to provide support within the artery. To insert a stent in the narrowed artery, a balloon catheter is used which is guided through the guide wire. When the stent arrives in the narrowed area, the balloon is inflated and the stent expands appropriately to the diameter of the artery and attaches to the vessel wall. After the balloon is quenched, the stent remains permanently at the point of placement. Within a few weeks, the stent is covered with normal vascular cells (endothelium). Angioplasty with stent is usually applied to patients with congestion or obstruction in 1-2 coronary arteries. If more than two coronary arteries are obstructed, coronary artery bypass surgery may be involved.
 

Drug Release Stents (ISP)

Drug-eluting stents are released at the site where the stent is placed for a certain period of time and include medications to reduce re-narrowing in the vessel. Drug-eluting stents are also made of metal stent structure. However, there is a medicated layer with thin and controlled release on the surface.

Many studies have shown that in drug-eluting stents, the likelihood of contraction is lower than that of non-drug-eluting stents. Drug-elongated stents have significant advantages, especially in thin veins, in cases where the diseased area is long, in fully occluded vessels, where the veins are divided into two (bifurcation). It is recommended that you discuss this with your interventional cardiologist because the applicability of the drug-eluting stent may vary according to the patient's clinical condition and vascular structure. It is very important that patients using drug-eluting stents should use a double-coagulant medication as long as the cardiologist recommends, and does not interrupt without the permission of their doctor.

Cardiac catheterization and interventional procedures are not considered as surgical procedures since the chest is not surgically opened and there is no wound. The procedure time is shorter than surgery. In some cases, coronary interventional procedures may be recommended to the patient depending on the results of the surgical procedure.