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Cardiac Catheterization: Changing the landscape of heart treatment

Bookmark and Share To the untrained eye, the digital image on the computer monitor reveals a blur of motion — a beating heart, rushing blood and not much else. But for Frank Fish, MD, medical administrative director of Virtua Memorial's low-risk cardiac catheterization lab, one glance is enough to confirm that there's something unusual about this patient's heart.

Dr. Fish jots down a quick note, barely taking his eyes off the screen; he waits to see the extent of the disease. In a few seconds, another view reveals two blockages. After a brief discussion with his team, Dr. Fish explains the findings to the patient, who is fully conscious, comfortable and waiting patiently to move to the recovery area where his family will join him. The entire procedure took only 25 minutes, but it set the patient on a new course to health.

Lifesaving diagnoses in a heartbeat
What happens during cardiac catheterization
High-level intervention
A new landscape

Lifesaving diagnoses in a heartbeat
"Cardiac catheterization is the most definitive way to diagnose the extent of disease in coronary arteries," says Dr. Fish. Memorial's cath lab serves patients with stabilized coronary artery disease who are in need of further evaluation. "But we provide more than precision diagnostics and instant results," says Dr. Fish. "We offer a truly exceptional patient experience."

The anchor of this experience is the peri-catheterization physician (peri-cath doc), a cardiologist like Dr. Fish who is present during each step of the catheterization process, offering a familiar and comforting presence for patients and families. "In my role as peri-cath doc, I meet patients and their families the morning of the procedure to answer questions and explain what's going to happen," notes Dr. Fish.

What happens during cardiac catheterization
During the test, the patient is mildly sedated while an interventional cardiologist guides a narrow tube, called a catheter, to the heart through an artery in the arm or leg. Charles Dennis, MD, interventional cardiologist and medical director of the Memorial cath lab explains his role in the process: "Once the catheter is in place, I inject contrast dye into the coronary arteries and left ventricle, allowing the team to view the heart's function and coronary anatomy from different angles." With the aid of advanced imaging technology, both physicians can observe the findings simultaneously.

"I monitor the entire procedure, discuss the results with the interventional cardiologist and explain them to the patient and family in easy-to-understand terms," says Dr. Fish. "Patients leave with a complete understanding of their heart condition and a comprehensive care plan."

This plan may include non-invasive treatment options like medications and cardiac rehabilitation, enhanced external counterpulsation (EECP) or additional catheterization procedures including angioplasty and stenting.

High-level intervention
"Angioplasty or stents can be used during a cardiac catheterization to open up narrowed or blocked arteries," explains Randy Mintz, MD, medical director of the cardiac catheterization lab at Virtua Marlton Hospital, which treats patients with heart failure, heart valve problems, advanced coronary disease or a recent heart attack.

This lab is designated by the New Jersey State Department of Health to provide emergency intervention including emergency angioplasty and stenting for high-risk patients experiencing a heart attack. "During angioplasty, a small balloon on the end of a catheter is inflated in the blocked section of the artery to increase blood flow," explains Dr. Mintz. When necessary, a stainless-steel mesh tube, called a stent, is placed in the newly cleared artery to prevent the blockage from reforming.

A new landscape
"Cardiac catheterization has changed the landscape of heart treatment," says Dr. Mintz. "Advances like medicated stents that prevent the formation of scar tissue and refined catheters that help treat complex blockages, are drastically reducing the need for bypass surgery."

Cardiac catheterization is just one of the many services offered at Virtua Health. Other services include electrocardiography, comprehensive stress testing and echocardiography and pacemaker evaluations. Virtua is also a member of Women's HeartAdvantage, a program designed to raise awareness of heart disease in women.