Interventional cardiology at Leeds Hospital

What is interventional cardiology?

Interventional cardiology is a specialty that diagnoses and treats conditions affecting the heart and its surrounding vessels using thin tubes called catheters, guided in via an artery, rather than through open-heart surgery.

What conditions does interventional cardiology treat?

Interventional cardiology can be used for:

• coronary artery disease, where the arteries supplying the heart become narrowed or blocked
• heart valve disease, including narrowed or leaky valves
• peripheral artery disease
• congenital heart conditions and structural problems, such as holes in the heart
• aneurysms and blood clots
• cardiomyopathy and carotid artery disease.

What are the benefits of interventional cardiology?

Compared with open-heart surgery, catheter-based procedures generally mean smaller cuts, less blood loss during the procedure, a faster recovery, and a shorter hospital stay.

Some interventional cardiology procedures can be lifesaving, such as opening a blocked artery during a heart attack.

Are there different types of interventional cardiology procedures?

A number of different procedures fall under interventional cardiology, including:

• coronary angiography, examining the arteries around the heart for any narrowing or blockage
• percutaneous coronary intervention (PCI), commonly known as angioplasty, which stretches open a narrowed artery, often followed by placing a stent to keep it open
• transcatheter aortic valve implantation, known as TAVI, to replace a narrowed aortic valve
• mitral transcatheter edge-to-edge repair (also called TEER or MTEER), to repair a leaky mitral valve
• sealing off the left atrial appendage, and clearing arteries that have been completely blocked for a long time
• other procedures, including atherectomy, closing a hole between two heart chambers, and thrombolysis (dissolving blood clots).

These procedures are usually carried out in a specialist procedure room known as a Cath lab, using real-time X-ray imaging to guide the catheter.

What happens before an interventional cardiology procedure?

At an initial appointment, your cardiologist will ask about your symptoms, how long you've had them, and any personal or family history of heart or blood vessel problems. It helps to bring a list of everything you take, including anything without a prescription.

You'll usually be examined too, which might include listening to your heart and checking your blood pressure. If a procedure is recommended, this is normally booked as a separate appointment, giving you time to consider the risks and benefits and ask any questions beforehand.

What happens during an interventional cardiology procedure?

What happens depends on the specific procedure, but most share a similar approach: a catheter is guided through a blood vessel, usually accessed at your wrist or groin, up towards your heart, with imaging used throughout so your interventional cardiologist can see exactly what they're doing.

For a narrowed artery, this often means inflating a small balloon to widen it, sometimes followed by placing a stent to hold it open. For valve problems, specialist devices can be guided through the same catheter to repair or replace the valve, without needing to open your chest.

What does recovery look like?

Since these procedures avoid a cut to the chest, recovery tends to be quicker than after open-heart surgery. Depending on which procedure you've had, you might go home the same day or the day after.

Your team will explain what to expect for your particular procedure, including any advice about looking after the site on your wrist or groin where the catheter was inserted while it heals.