Interventional

Coronary Angiography

Coronary angiography is a procedure that uses contrast dye, and x ray pictures to detect blockages in the coronary arteries that are caused by plaque buildup. The procedure is done through a artery of the wrist or the groin(upper thigh). It is done under local anaesthesia, the pain is that of a needle prick and is very very safe in skilled hands. It is usually recommended whenever there is a strong suspicion of blockage based on symptoms, abnormal stress test or after a heart attack.

Peripheral Angiography

Angiography done to detect blockages in the arteries other than that of heart, like that of legs, hands, arteries supplying other organs is usually called peripheral angiography.

Angioplasty

Angioplasty is the procedure to treat blockages in any artery. It could be just balloon angioplasty where balloon is used to clear blockages or more commonly a stent is put to keep the artery open and preventing it to recoil. It is done through the same routes as described in angiography & under local anaesthesia.

Valve treatment without open heart surgery

Valves are the gates in the heart. When they become diseased they either become do not open well, obstructing the forward flow of the blood or they do not close properly causing leakage of blood back. Many of the valve problems can be treated non surgically without open heart procedure.

Balloon valvuloplasty

Here the narrowed valve is opened up with the balloon under local anaesthesia and small prick in the groin.

TAVI/TAVR

This is a method of replacing diseased Aortic Valve (severe aortic stenosis) with a new valve most commonly through groin artery. Usually done under local anaesthesia.

TMVR

A damaged artificial tissue mitral valve previously implanted by open heart previously can be replaced with new valve through this procedure without open heart surgery.

Mitra Clip

This is treatment for severe leakage of mitral valve (mitral regurgitation) without open heart surgery. The clips are used to repair the valve.

Pacemaker Implantation

When somebody’s heart rate becomes too low either permanently or intermittently without any reversible cause, will need pacemaker implantation to increase the heart rate to normal which is a simple procedure done under local anaesthesia.

There are various kinds of pacemakers like single chamber and dual chamber, MRI compatible or non compatible. The smallest pacemaker is a leadless capsule sized pacemaker.

AICD

It is a kind of pacemaker which can give shock to revive the heart when the heart rate becomes dangerously high which can lead to cardiac arrest.

CRT device

It is a kind of pacemaker with 3 leads(biventricular pacemaker) which is implanted to improve the heart function in a persons with weak heart with heart failure symptoms. There is a specific criteria to select a patient who will benefit.

Electrophysiological studies and Radio Frequency ablation (EPRFA)

Patients suffering from very high heart rates (tachycardias) or frequent extra beats can benefit from this procedure by blocking the extra wires or extra beats by application of heat through radiofrequency. It is done under local anaesthesia without surgery through small pricks in the groin vessels. Used for treating conditions like SVT, Atrial flutter, Atrial fibrillation, VT, VPCs etc.

Device Closure of holes in the heart

Some babies are born with the hole in the heart from the birth. Some holes are detected in childhood and some are detected late in the adult age because of symptoms or on routine health check-up. Lot of these holes can be closed using small devices through a prick in the groin without surgery.

Latest Technologies to treat heart blockage with precision

FFR

Many a times there is a dilemma whether a blockage needs an angioplasty or a bypass surgery or just medicines are enough and different doctors can give different views. To eliminate this confusion FFR technique can be a used. A special pressure wire is passed across the block which measures the pressure difference before and after the block and only if it is significant it will need angioplasty or bypass, otherwise medicines alone will be better even if the block looks severe.

OCT/IVUS

These are miniature cameras which can be taken inside the arteries of the heart for visualisation with high clarity and very precise and accurate measurements can be done. These technologies are used in complex blockages to make the angioplasty procedure safe and precise.

Treatment of severely calcified blockages

Severely calcified blockages are a difficult subset to treat with angioplasty. However certain technologies makes the life easy. These are

Rotaablator : This procedure uses a diamond burr to shave off the calcium.

IVL : Intravascular lithotripsy is a procedure to crack calcium using shockwaves delivered through balloon. Shockwaves are sound waves at a particular frequency.

Cutting Balloon : It is a balloon with small blades and can crack the calcium

OPN High pressure balloons : These balloons can go upto very high pressure without bursting and high pressures can crack the calcium

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