CHENNAI HEART CARE SERVICES- Invasive & Non-Invasive Cardiology
Radial Artery Access
About95 percent of our catheterizations are done using radial artery access. An interventional cardiologist places a catheter in the radial artery in your wrist instead of in the femoral artery in your groin. Radial artery access offers you many advantages which include less bleeding, fewer complications and a shorter hospital stay. You will be able to get out of bed and walk around soon after the procedure
Coronary Angiography: ( Radial Route)
Coronary Angiography is a diagnostic procedure which is done to detect blockage in the vessels supplying the heart. It is a procedure done under light sedation. Angiography can be done through the arm vessel (Radial) or leg (Femoral). The procedure is indicated in patients who have Angina (chest pain) to direct further therapy which may be medical treatment, angioplasty or bypass surgery.
Percutaneous Transluminal Coronary Angioplasty (PTCA) –Radial route
PTCA is a Cardiovascular interventional procedure where blocked vessels of the heart are opened by minimal access invasive technique. The blood vessels of the heart is a usually accessed through an arm vessel (Radial route) or leg vessel (femoral route) and a guide wire is passed through the blockage and the portion is dilated with a balloon which is passed over the wire. This can be done in an emergency when a patient is in heart attack (Primary Angioplasty) or as an elective case in a stable patient. Following angioplasty usually a medicated (drug eluting) stent is implanted in the vessel. Thereafter, patient is observed in the hospital for a day or two and discharged.
Balloon Mitral Valvuloplasty (BMV)
This is a Cardiac Interventional procedure in which the left sided valve (mitral valve) is dilated by means of a balloon which releases the obstruction of the valve (mitral valve). Rheumatic heart disease is very common in India and mitral stenosis is its common sequelae. This procedure is carried under light sedation and a balloon to passed over the wire through the groin to the left side and the mitral valve is dilated. Similarly, other valves of the heart such an aortic and pulmonary valve can also be opened by means of a minimal access procedure which are known as Aortic Valvuloplasty and Pulmonary Valvuloplasty respectively. The procedure is done under light sedation.
Peripheral Angioplasty :
Obstruction of the blood vessel of the thighs and legs cause pain while walking (claudication) and can also cause gangrene of the limbs and intervention can open leg or arm vessels with stents. The procedure is simple and easily amenable to intervention.
Carotid Angioplasty :
Obstruction of the blood vessels of the neck can give rise to strokes which is known as Carotid Stenosis. Carotid obstruction is opened by wire, balloon and stent. However such opening can lead to stroke due to embolisation of plaque in the brain during procedure. Therefore, a filter device ( umbrella device) is used to trap the plaque and is necessary during carotid stenting.
Transcatheter Aortic Valve Replacement (TAVR)
Our Transcatheter Aortic Valve Replacement (TAVR) program is extensive. This is for patients who have severe symptomatic aortic stenosis (narrowing of the aortic valve opening) and cannot have traditional open chest surgery.
Endovascular Stent Grafting for Abdominal Aortic Aneurysms
An endovascular stent graft is a fabric tube (graft) supported by a metal structure (stent). It is used to reinforce a weak spot (aneurysm) in an artery. The stent graft seals your artery above and below the aneurysm. This allows your blood to pass through the stent without pushing on the bulge. This is a newer form of treatment for aneurysms. It is done with the use of a catheter and does not require surgery Electro Physiology - Pacemaker Implantation- Single & Double Chamber Biventricular Pacemaker for heart Failure- CRT AICD Implantation Radiofrequency ablation Pediatric Cardiology ASD/VSD/PDA Device Closure Other Vascular Interventions Carotid Angiography and Angioplasty Intracranial Aneurysm Coiling
STEMI Program (Fast Track STEMI Care (Door-to-Balloon Care)
STEMI (ST-segment elevation myocardial infarction) is a medical emergency and one of the deadliest forms of heart attack. The relationship between reperfusion and survival in STEMI patients can be measured in minutes. Primary percutaneous coronary intervention (PCI) is now the dominant reperfusion strategy for these patients.
STEMI patients are referred via the paramedic-referred pathway (field) or the inter-hospital transfer pathway. Current guidelines recommend achieving a door-to-balloon time (i.e., revascularization) of less than 90 minutes for patients presenting to a PCI capable hospital and of less than 120 minutes for patients referred by inter-hospital transfer to a PCI hospital.The program operates 24/7 and has expanded to include many hospitals outside the boundaries of the city. Cardiac catheterization is performed within 24 hours of arrival or immediately if clinically indicated. Since the launch of the STEMI program, heart attack deaths have been reduced by morethan 70 % .
Echocardiograpy is the most frequently used and usually an initial cardiac imaging test to evaluate all cardiovascular diseases related to a structural, functional or haemodynamic abnormality of heart or great vessels. It is used for diagnosis of valve related congenital and acquired disease of heart. In special cases, trans-esophageal Echo is also done. An endoscope like instrument is passed in the food pipe (through the mouth) to evaluate structure of heart.
The Treadmill Test (TMT) is an exercise test which is designed to put gradually increasing stress on the heart and circulatory system to evaluate the response of heart to stress and in diagnosis of CAD, determine the functional capacity and estimate prognosis. A number of times rhythm disorder of heart can also be evaluated by treadmill test.
Two types of Stress Testing :1)Exercise using Treadmill 2)Pharmacological (by giving I/V medication) Exercise Stress Testing
Exercise Electrocardiography is one of the most frequent non-invasive modalities used to assess patients with suspected or proven coronary artery disease. Echocardiogram is done before exercise (at rest) and after exercise to see the effects of stress on heart.
Pharmacological Stress TestM
In this dobutamine is given in the form of infusion increasing the dose at regular intervals as mentioned in the protocol till the THR calculated according to the age of patient is reached. Echocardiogram is done at basal level and after peak dose of dobutamine infusion to see the effect of stress on heart.
HEAD-UP TILT TEST
The tilt table test is a standard and widely accepted test for evaluating patients with syncope. It provides diagnostic evidence indicating susceptibility to neurally mediated syncope. This test is performed by tilting the table at 70 º angles and observing the patient for 20 min of 70º angle tilt with and without provocation with medicine.
24 HOURS ABPM AND HOLTER MONITORING
24 hours Ambulatory BP monitoring checks the blood pressure of patient multiple times in a day (typically more than 30 readings are taken). The instrument is like a normal BP Apparatus and is worn by patient for 24 hours at home. It gives much better idea about blood pressure of patient and effectiveness of medicines especially white coat hypertension.
Arterial Ultrasound or Ankle-Brachial Index (ABI):
This test measures blood pressure at the ankle and in the arm. A large difference between the two can signal the presence of peripheral artery disease (PAD). Peripheral artery disease is a condition in which the arteries in your legs or arms are narrowed or blocked. People with peripheral artery disease are at a higher risk for heart attack, stroke, poor circulation, and leg pain.
Upper & Lower Limb Arterial and Venous Doppler:
Doppler ultrasound is a painless way to detect blood flowing through a small artery. It can detect abnormalities such as, blockages in the arteries, blood clot in the arteries or veins, narrowing or widening of an artery, or venous occlusion (closing of the vein).