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Therapeutic Services

 Atherectomy

Atherectomy is a procedure that your doctor may recommend to remove certain types of plaque that block your coronary arteries. The goal of this procedure is to improve the flow of blood to your heart. An atherectomy catheter has a special rotating burr on its tip that is used to shave away the plaque inside your artery. Following catheterization and angiography, this plaque-shaving device is inserted through the catheter, then carefully steered through the vessel to your blocked coronary artery. Your cardiologist will then use the specialized burr-tipped catheter to remove the plaque in your blood vessel. Angioplasty or stent implantation may immediately follow the atherectomy to further reduce the possibility of re-narrowing in your opened coronary artery. The Cardiovascular Laboratory staff at Abbott-Northwestern Hospital will answer any further questions you or your family may have about this procedure.


Aortic Aneurysm Surgery

Arteries carry oxygen-rich blood away from the heart to the rest of the body. The largest artery is the aorta. An aortic aneurysm forms when the walls of the artery weaken and/or expand. One danger with an aortic aneurysm is that the weakened walls could burst, creating a need for urgent medical attention. During aortic aneurysm surgery your surgeon replaces the weakened aortic wall with a manmade graft (a tube) of a strong fabric. Your surgeon secures the graft to the aorta during open surgery.

Valve Repair/Replacement
Valve disease can prevent a heart valve from opening fully or closing tightly. And that means less blood gets through the open valve, while some blood escapes between chambers from the closed valve. Valve disease strains the heart, making it work harder to meet the body’s needs. Valve disease can also lead to further heart complications. Valve surgery may be needed to repair or replace a valve.

Valve repair involves making your original valve better able to open and close properly. Valve replacement involves replacing your valve with a mechanical valve or a tissue valve. Your physician will talk with you about the benefits of each kind of replacement valve.

Cardioversion
Your doctor wants you to have a cardioversion. This process uses a small amount of electrical energy to make your irregular or rapid heartbeat regular and slower. The energy is delivered to your heart through special patches placed on your chest.

The cardioversion is done in the cardiovascular lab. You may be there for 30 to 60 minutes.

Coronary Angiograph (and Heart Catheterizations)
Your physician has determined the need to directly evaluate the blood flow within the arteries to your heart and the function of your heart muscle. This can be accomplished by performing a test known as a coronary angiogram. Angiography differs from other diagnostic cardiac tests (i.e. echocardiograms and stress tests) because it is an invasive procedure, which means that the body is entered through a small puncture in the skin. In order to obtain special x-ray pictures known as angiograms, your cardiologist must first perform a cardiac catheterization. The catheterization procedure is done in a specialized area of the hospital called the CV Lab or “Cath” Lab. A catheter (a long, thin, flexible tube) is inserted into the major blood vessel in your groin (less commonly the arm is used for catheterization) and carefully steered through the vessel to your heart. A contrast solution (or dye) is then injected through the catheter into your heart’s arteries. This liquid dye allows your physician to examine the arteries of your heart on a x-ray picture known as an angiogram. Your cardiologist can study this angiogram to analyze blood vessels that may be blocked or narrowed, and assess your need for further cardiovascular treatment. In other words, a coronary angiogram will provide information for your physician to make a diagnosis and, if needed, an interventional cardiac procedure may be performed to treat the problem.

Coronary Bypass Surgery
Coronary arteries supply oxygen-rich blood to the heart. These arteries can become narrowed and blocked with fatty deposits (“plaque”), which can reduce the flow of blood to the heart. In a Coronary Artery Bypass Surgery procedure, your surgeon uses a blood vessel from another part of the body to bypass the narrowed or blocked part of the coronary artery.

Coronary artery bypass surgery sometimes takes place using the heart-lung machine. Sometimes the surgery takes place with the heart beating by itself. Your surgeon will determine which type of surgery best suits your needs.

Coronary Stent Implantation
A stent is a small, mesh-like, stainless steel tube that can be used to open blockages in your coronary arteries. Quite similar to the angioplasty procedure, the stent is pre-mounted on a balloon-tipped catheter and inserted through the major blood vessel in your groin (less commonly the arm is used for catheterization). It is then carefully steered through the vessel to your blocked coronary artery. Inflating the balloon opens the stenosis (blockage), and presses the stent into the artery wall. The stent then remains in place permanently and holds the artery open. Once the stent is successfully placed in the coronary artery, the catheter is removed.

Electrophysiology Study and Catheter Ablation
Electrophysiology (EP) Study and Catheter Ablation are very similar procedures. While an EP study is a diagnostic test to identify the presence and mechanism of arrhythmia, catheter ablation is a non-surgical technique that ablates (destroys) parts of the abnormal electrical pathway or circuit that is causing the arrhythmia. During the study, electrode catheters (long, flexible wires) are inserted into blood vessels and positioned inside the heart. Your doctor may decide to perform both the EP study and the ablation procedures, one after the other, while you are in the EP lab. This possibility will be discussed between you and your doctor prior to your procedure. When the exact area to be ablated is found, the ablation can be done. A special electrode catheter is placed near the problem pathway or circuit. Energy waves sent through the catheter destroy (ablate) the problem cells. The rest of your heart muscle is unharmed. Depending on the particular arrhythmia, a comprehensive EP study and ablation procedure can last from two to six hours.

Enhanced External Counterpulsation Treatment (EECP)
Enhanced External Counterpulsation, or EECP, is a non-invasive outpatient treatment that has been proven (no longer a research trial) to decrease or even eliminate chest pain (angina) in patients who are not ideal candidates for coronary artery bypass or coronary angioplasty. The theory behind the EECP system is that the counterpulsation pumps oxygenated blood to the heart when the heart is at rest, and helps open new pathways for blood to travel around the narrowed or blocked arteries that are causing your angina. The ultimate goal of the EECP treatment is to decrease or eliminate your angina, by increasing the amount of blood being supplied to your heart.

ICD Devices
Your doctor may have told you that you need an implantable cardioverter defibrillator (ICD.) An ICD is a small, lightweight electronic device that is placed inside your body that keeps track of your heart rhythm. When you have an arrhythmia, the ICD helps your heart return to normal rhythm. The ICD is not a cure for your heart rhythm problem. However, it can save your life by quickly bringing a dangerously fast heart rhythm (which could lead to cardiac arrest) under control. If the determination is made that you will have an ICD implanted, you will need the device for the rest of your life, so having one implanted means a lifelong commitment.

Intra-Aortic Balloon Insertions
Balloon angioplasty is a treatment for coronary artery disease that can improve blood flow to your heart. A balloon-tipped catheter (a long, thin, flexible tube) is inserted into your blocked artery. Inflating the balloon within the narrowed segment opens the stenosis (blockage), thus widening that artery and improving blood flow to your heart. Once the narrowed artery is successfully opened, the catheter is removed.

Pacemaker Implantation
A pacemaker is a small electronic device prescribed for people whose heart is beating too slowly, and/or whose two lower chambers beat out of rhythm with one another. The pacemaker stimulates the heart muscle with precisely timed electrical pulses, which keep the heart beating at the right pace. A pacemaker has two main parts: a pulse generator and one, two or three leads.

The pulse generator is a smooth, lightweight metal case containing a battery and circuitry. The battery supplies the electrical energy. The circuitry produces tiny electrical pulses and controls the timing of the electrical pulses delivered to the heart.

A lead is an insulated, flexible wire that is placed in the heart. The lead carries electrical energy from the pacemaker to the heart. It also relays information about the heart’s activity back to the pacemaker. Most leads are threaded through a vein from the pacemaker to the inside of the heart. Depending on the type of pacemaker that’s implanted, one to three leads may be used.

Implanting a pacemaker is a common procedure typically with no major associated risk. However, as with any surgery, problems or complications can occur.

Percutaneous Atria Septal Defect (ASD) and Patent Foremen Ovale (PFO)
Your doctor has found a small hole in your heart. This hole is called a patent foramen ovale (called a PFO) or an atrial septal defect (called an ASD). This hole is between the right and left atria (upper chambers) of your heart.

Your doctor wants to close the small hole using an implant. The implant looks like two small fabric umbrellas, one on each side. Over time, the tissue around the hole grows into the fabric and the implant becomes a permanent part of your heart.

Peripheral Interventions
Peripheral vascular disease causes blocked or narrowed arteries in the neck, arms, legs and abdomen. These blocked or narrowed blood vessels can cause strokes, leg pain, kidney problems and high blood pressure. Your doctor will want to take your medical history, give you a physical exam and give you other tests before deciding which treatment is best for you.

He or she will often recommend an angiogram (special X-ray images). This is a procedure that lets your doctor see how well blood flows in your arteries. Your doctor will make a small puncture site in your groin or arm. He or she will insert a sheath (thin, flexible tube) into a major blood vessel through the puncture site. From this site, special catheters can be advanced to the area of interest and dye can be injected. This process is known as angiography. From these special X-rays, your doctor can plan your treatment.

Thoracic Surgery: Carotid Endarterectomy
The carotid arteries are the main arteries of the neck. These arteries can become narrowed with fatty deposits (“plaque”), which can reduce blood flow to the brain. In addition, tiny bits of plaque can break free and travel as “emboli” through the carotid artery. If emboli enter the smaller vessels in the brain, they can block the flow of blood and cause a stroke.

Carotid endarterectomy is surgery to reopen a narrowed carotid artery. The surgeon removes plaque, reopens and smoothes the carotid artery – which reduces the chance of emboli forming.

Thoracic Surgery: Minimally Invasive Esophageal
Esophageal cancer has traditionally been treated by resection which involves large incisions on the abdomen, neck, and chest. Recent advances allow a much less traumatic approach, using the tube-like thoracatomy video scope to enter the area and perform procedures. Minimal incisions and use of video scopes has resulted in improved recovery after the surgery.

Thoracic Surgery: Minimally Invasive Lung
When a diagnosis is unknown but a nodule must be removed to be examined, a minimally-invasive lung operation like a thoracoscopy may be suggested. With just a few small incisions, a tube-like instrument containing a video camera can be maneuvered to view the lung. The surgeon can also perform procedures with the instrument.

Thoracic Surgery: Operations for Lung Cancer
Lung cancer is one of the most common types of cancer. The most effective treatment for lung cancer involves the surgical “resection” or removal of the cancer, along with the part of the lung where that cancer resides. Patient's of St. Luke's Cancer Care Center receive a comprehensive evaluation that includes all subspecialties required in the treatment of lung cancer, like oncologists, radiation oncologists, pulmonary doctors, radiology, surgeons and others. Together the team develops a comprehensive treatment plan.

Transplant Surgery: Heart Transplant
Heart failure occurs when the heart is unable to pump enough blood to meet the needs of the body. If your heart failure symptoms and heart function cannot be improved by medications or surgery, you may benefit from a heart transplant.

When a donor heart becomes available, your surgeon and transplant team prepare you for surgery and then remove the old heart and attach the new heart to the incoming and outgoing blood vessels.

 

 

 

 

 

 

 

 


 


 


 

 

 

 

 

 

 

 

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