Temple cardiologists use minimally invasive approaches whenever possible to diagnose and treat heart problems. Many of these procedures involve the use of a catheter—a long, thin, flexible tube that is inserted through a blood vessel (usually in the arm, wrist, leg/groin or neck) and guided into the heart or surrounding vessels. The doctor can see and guide the catheter by watching images from an X-ray machine placed above the patient. Through the catheter, physicians can perform numerous tests or conduct treatments using specialized equipment attached to the catheter’s tip. Catheterization or "intervention," administered by a heart specialist known as an interventional cardiologist, avoids the need for more open surgery, which usually means reduced pain, risk and recovery time.
Traditionally, this procedure has been done by placing a catheter in the leg or groin area. More recently, Temple cardiologists often can utilize a different approach called transradial artery access, where the procedure is done via the wrist (radial artery).
This can be a gentler access route that is more comfortable for patients, causing less pain and potentially allowing for faster recovery. This patient-preferred access route can also be safer, with fewer complications such as bleeding.
Temple interventional cardiologists are highly experienced in performing diagnostic and therapeutic catheter procedures for patients with coronary blockages, myocardial infarction, valve disease, heart failure, congenital/structural heart disease, and other cardiac or vascular conditions. We are a regional leader in patient-preferred “transradial” catheterization. Our catheterization laboratory is one of the largest in the region, with five state-of-the-art catheterization suites and nine full-time technicians. We see over 3,000 patients every year, many of whom are considered "high-risk" and could not be helped at other institutions.
The most common types of interventional cardiac procedures performed at Temple are:
- Intravascular ultrasound
- Right/left heart catheterization
Measuring the pressure or movement of blood within a heart chamber can frequently help to diagnose problems or determine the right treatment. Catheters enable several measurement techniques - for example, injecting a dye inside the largest heart chamber that enables X-ray imaging of blood flow. The catheter can also measure the blood pressure in various locations to diagnose tight valves, high blood pressure in the pulmonary artery, or other problems.
- Angioplasty and stenting
- Cardiac (endomyocardial) biopsy
- Septal (ASD/PFO) closure
- Transcatheter valve therapies
Some types of heart valve disease can now be treated with a catheter. In valvuloplasty, for example, a catheter with a balloon tip is moved inside a stenotic (stiff and narrowed) valve, then inflated to widen the valve opening. Valvuloplasty can be used for mitral, pulmonary, or aortic valve stenosis. Newer methods of catheter valve repair also being explored at Temple include mitral clips to reduce leakiness in the mitral valve (regurgitation) and replacement valves for severe aortic stenosis.
- Hybrid procedures
Patients with certain heart conditions may be eligible for hybrid vascular and valve-repair procedures that perform more than one treatment at the same time—for example, angioplasty plus coronary artery bypass graft surgery. Combining the procedures avoids multiple hospital trips and recovery periods, and often causes less trauma to the body; it may even avoid the need for open surgery. Special operating rooms with catheter equipment are required for these hybrid techniques—as is a skilled, cohesive treatment team. Both are available at Temple.
- Alcohol septal ablation
After cardiac arrest (a sudden drop in blood circulation, often due to a heart attack), some patients can avoid brain damage due to lack of oxygen if their body temperature is lowered. Inserting a cooling catheter inside a major vessel is a fast way to bring about therapeutic hypothermia. Temple's emergency physicians and interventionalists work together to provide this special treatment.
- Supportive procedures for high-risk and critically ill patients
Temple faculty have vast experience caring for patients with complex, severe, or rare heart conditions. For many who are considered "high-risk," Temple can employ a temporary assist device that helps keep the blood flowing during a complex intervention. Assistive devices available at Temple include the TandemHeart®, developed in part by a Temple physician, which has paved the way for many successful coronary interventions and has been used to stabilize critically ill patients before surgery; the Impella 2.5; and the intraaortic balloon pump.