Interventional cardiology is a fairly young branch of cardiology that has developed with the improvement of medical imaging. Through interventional cardiology procedures, doctors specialising in the field can diagnose and treat cardiovascular conditions through minimally invasive procedures. Thus, given that at the level of the European Union cardiovascular diseases are the main medical factor of mortality (according to the National Institute of Public Health), free access of the population to interventional cardiology procedures is welcome news.

Types of interventional cardiology procedures

Interventional cardiology involves a variety of minimally invasive procedures to diagnose and treat cardiovascular disease. Here are some of the most common interventional cardiology procedures:

Cardiac catheterization

Cardiac catheterization is an interventional cardiology test or procedure used for certain heart or blood vessel problems, such as clogged arteries or an irregular heartbeat. The cardiac catheterization procedure uses a catheter that is guided through a blood vessel to the heart. Cardiac catheterization provides important details about the heart muscle, heart valves, and blood vessels in the heart and can be used to evaluate heart function, diagnose heart disease, or perform certain therapeutic procedures. The cardiac catheterization procedure can be used for both diagnostic and therapeutic purposes.

Cardiac catheterization as a diagnostic method

 •   Coronary angiography: to view the coronary arteries and identify blockages or narrowings.

•   Measurement of intracardiac pressure: to assess the function of the different chambers of the heart and the valve.

•   Assessment of ventricular function: to measure the pumping capacity of the left and right ventricle.

•   Endomyocardial biopsy: taking samples of heart tissue to diagnose certain diseases of the heart muscle.

Cardiac catheterization as a therapeutic procedure

•   Balloon and stent angioplasty: to open narrowed or blocked coronary arteries.

•   Valvuloplasty: to treat narrowing of the heart valves.

•   Transcatheter aortic valve replacement (TAVI/TAVR): to replace a damaged aortic valve.

•   Catheter ablation: to treat cardiac arrhythmias.

•   Septal defect closure: to correct defects in the dividing walls of the heart.

•   Patent foramen ovale (PFO) closure: to seal the abnormal opening between the atria.

Angiography

The coronary angiography procedure allows visualization of the blood vessels around the heart. Specialists in interventional cardiology who recommend a coronary angiography procedure use both cardiac catheters to perform the procedure, but also a special imaging device, called an angiograph. The coronary angiography procedure involves the same method of inserting a tube in order to highlight the heart arteries. An injection of a contrast agent is also required.

 The coronary angiography procedure is recommended in situations such as: 

•   assessment of patients who complain of chest pain, especially after exertion

•   diagnosis of angina pectoris

•   post myocardial infarction evaluation

•   following an abnormal result or changes in the EKG

•   when the existence of coronary lesions was found

•   before and after cardiac surgery.

 Heart stent

 A heart stent is a small metal or plastic tube that is inserted into an artery to keep it open. Insertion of a heart stent is an interventional cardiology procedure that is required in cases where the coronary arteries have become narrowed or blocked due to the accumulation of fatty plaques or other deposits.

The heart stent is inserted into the artery through a catheter that is guided by the specialist doctor to the exact place where there is a blockage in the artery. Once the site is identified, the stent placed in the heart opens and holds the artery open, which allows blood to flow properly in the artery. It is good to know that when the specialist in interventional cardiology recommends the insertion of a stent in the heart, the procedure can prevent the occurrence of a myocardial infarction.

 When are interventional cardiology procedures needed?

 Interventional cardiology procedures are performed using thin catheters (very fine tubes) that are inserted into the blood vessels towards the heart. Thus, the main advantage of interventional cardiology procedures is that they eliminate surgical intervention on the patient for diagnosis. If a few decades ago, for a correct diagnosis of coronary artery disease it was necessary to sedate the patient and make an incision, through interventional cardiology procedures the diagnosis is made by inserting these small tubes into the path of the blood vessels, especially through the femoral artery and the radial artery. The main heart conditions that require interventional cardiology procedures are:

•   cardiac valvulopathies

•   atherosclerosis

•   carotid disease

•   heart attack

•   coronary artery fistula

•   chronic venous disease

•   aneurysm

•   blood clots in the arteries.

 If you have symptoms of cardiovascular diseases, if you need a second opinion following a cardiology diagnosis or if you need to know better what an interventional cardiology procedure entails, we invite you to an online discussion with the primary cardiologist with interventional cardiology skills Maria Cristina Popică.