Cardiac Catheterization Lab

The Union Hospital Cardiac Cath Lab started out in 1986 with only one lab, which had the capacity to perform seven scheduled procedures a day. The Cardiac Cath Lab first offered coronary angioplasty in 1988, the same year Union Hospital began performing open heart bypass surgery.

The Cath Lab today consists of three labs that perform approximately 4000 procedures a year. Besides heart catheterization, the lab performs carotid, abdominal, renal and messentric arteriograms, angioplasty of the coronary, renal and leg arteries and electrophysiology studies and ablations.

Treatment alternatives include:

• Angioplasty
• Atherectomy
• Stenting
• Electrophysiology Studies
• IVUS
• Pacemaker Insertion

Angioplasty is done to relieve an obstruction in the coronary artery. This procedure, done under a local anesthesia, inserts a catheter into an artery in the leg or arm and directs it into the coronary artery under constant x-ray guidance. A balloon at the tip is inflated at the site of the blockage. As the balloon expands the obstruction is relieved. The balloon is then deflated and removed.

Atherectomy is a newer procedure also used to clear obstructions. Atherectomy utilizes a very high-speed, rotating, abrasive, diamond-coated tip placed on a catheter. The tip literally carves through the obstruction.

Cardiologists may use stents, tiny spring-like devices that open when placed. They are useful when the vessel tends to collapse after angioplasty and atherectomy. Stents are placed by a catheter and do not require surgery.

IVUS, or Intravascular Ultrasound, is a specialized tool that cardiologists can use to assess the coronary or peripheral arteries from within the vessel. A catheter is inserted into a sheath, which is present in the femoral artery during a catheterization. This catheter has a small ultrasound device on the tip that rotates 360 degrees to ensure complete visualization. Measurements can be taken on specific areas of blockage to assess the exact nature of the blockage or lesion. This assists with sizing of the balloon or stents. After angioplasty or an interventional procedure is completed, IVUS can be used to confirm the results. A questionable lesion can be viewed with IVUS when deciding if angioplasty is needed.

Pacemakers are pulse generators that are inserted in patients who cannot generate an impulse in order for their heart to beat or a problem with conduction of the message that tells the heart to beat. The pacemaker sends a stimulus to the heart to tell it to beat at the appropriate rate per minute. This is an outpatient procedure completed under local anesthetic. The pacemaker is inserted through a small incision in the upper chest.