Interventional cardiology
Overview
Interventional cardiology is a branch of cardiology that deals specifically with the catheter-based treatment of heart diseases. The field includes the diagnosis and treatment of conditions such as coronary artery disease, heart valve disease, and congenital heart defects, among others. Interventional cardiologists use non-surgical techniques, primarily involving the use of catheters, to repair damaged or weakened vessels, narrowed arteries, or other affected parts of the heart structure.
History
The field of interventional cardiology has its roots in the early 20th century, with the development of cardiac catheterization by Werner Forssmann in 1929. Forssmann's work laid the foundation for Andreas Grüntzig's development of coronary angioplasty in the late 1970s, which marked the beginning of modern interventional cardiology.
Procedures
Interventional cardiology includes a range of procedures, such as coronary angioplasty, stent placement, balloon valvuloplasty, atherectomy, and thrombectomy. These procedures are minimally invasive and can offer patients a quicker recovery time and less discomfort compared to traditional open-heart surgery.
Coronary Angioplasty
Coronary angioplasty, also known as percutaneous coronary intervention (PCI), is a procedure used to open blocked or narrowed coronary arteries. The procedure involves the insertion of a thin flexible tube, or catheter, into the artery. A small balloon on the end of the catheter is then inflated to widen the artery and improve blood flow.
Stent Placement
Stent placement is often performed in conjunction with coronary angioplasty. A stent is a small, mesh-like device that is placed in the artery to keep it open after angioplasty. Stents can be bare-metal or drug-eluting, with the latter releasing medication to help prevent the artery from becoming blocked again.
Balloon Valvuloplasty
Balloon valvuloplasty is a procedure used to treat heart valve diseases, such as mitral stenosis or aortic stenosis. The procedure involves the insertion of a catheter with a balloon on the end into the heart valve. The balloon is then inflated to widen the valve and improve blood flow.
Atherectomy
Atherectomy is a procedure used to remove plaque from a blood vessel. The procedure involves the use of a catheter with a small cutting device on the end. The cutting device is used to cut away the plaque from the blood vessel wall.
Thrombectomy
Thrombectomy is a procedure used to remove a blood clot from a blood vessel. The procedure involves the use of a catheter with a suction device on the end. The suction device is used to remove the blood clot from the blood vessel.
Training and Certification
Training in interventional cardiology involves a one to two-year fellowship following a three-year general cardiology fellowship. The training includes both theoretical and practical aspects, covering a wide range of procedures and techniques. After completing the fellowship, physicians can take the certification examination offered by the American Board of Internal Medicine (ABIM).
Future of Interventional Cardiology
The future of interventional cardiology looks promising, with ongoing advancements in technology and techniques. These advancements are expected to improve patient outcomes and expand the range of conditions that can be treated using interventional procedures. Some areas of focus include the development of bioresorbable stents, advancements in imaging technology, and the use of robotics in interventional procedures.