Cardiac Catheterization is a procedure performed to examine arteries that supply the heart with blood. A small catheter is placed inside the heart and coronary arteries. Contrast dye is injected and x-rays are taken to visualize the blood vessels. The information obtained helps doctors choose the most effective treatment for the condition. Treatments include Percutaneous Coronary Intervention (PCI), Surgery, or medical management. If percutaneous coronary intervention is indicated then angioplasty or stenting is usually performed during the same setting. In some instances you may be brought back at a later date to have the intervention performed. If surgery is required then all of the information gathered will be sent to an institute with cardiac surgery. In many instances you are able to decide on the timeframe in which surgery will take place and you will be able to travel to the institute on your own. If surgery is required on a more immediate timeframe you may be transferred via ground or air ambulance. In many instances neither percutaneous intervention nor surgery are required.
Percutaneous Coronary Intervention
St. James Healthcare has an interventional cardiology program. Coronary Interventions include angioplasty or percutaneous transluminal coronary angioplasty (PTCA), and coronary stenting. These are techniques used to widen the narrowing in arteries without surgery.
Angioplasty
The basic idea of angioplasty is to position a catheter with a small inflatable balloon on the end within the narrowed section of the artery. Inflation of the balloon catheter causes the balloon to push outward against the narrowing and surrounding wall of the artery. This process reduces the narrowing until it no longer interferes with blood flow. The balloon is then deflated and removed from the artery.
Stenting
Your doctor may recommend placing a coronary stent in the diseased area. A stent is a wire mesh tube that acts as a scaffold inside the artery. The stent is placed on a specially designed balloon catheter which takes it to the diseased area. The balloon is inflated to spread the stent and flatten plaque against the artery wall. This increases blood flow by holding the wall open. Once the stent is fully opened, the balloon is deflated and removed leaving the stent in place in your artery permanently. It may be necessary to place more than one stent, depending on how much of your artery is blocked. Medicated or drug eluting stents may also be placed in your artery instead of or in addition to a standard metal alloy stent depending on the circumstances and criteria of the blocked artery.
St. James Medical Staff members Dr. Sharon Hecker, Cardiologist, of Rocky Mountain Clinic, and Dr. Vincent Siragusa, Cardiologist, of Montana Cardiac Institute, round out the hospital's complement of cardiac physicians.
Cardiac Pacemaker, Rhythm Management
A variety of pacemakers and defibrillators are available for implantation, depending on need. Pacemakers and defibrillators can be implanted as an inpatient or outpatient procedure in the St. James' Cath Lab and followed locally in Butte. A pacemaker is a small electronic device that helps your heart's electrical system beat at the right pace. Inserting the pacemaker into your body is called implantation. You stay awake during the procedure. You may be asked some questions or be asked to take some deep breaths. An ICD is a device that is placed inside your body to help control your heart rhythm. Putting the ICD in your body is a surgical procedure.
Reveal Insertable Loop Recorder System
Similar to the external event monitor, the reveal system is implanted under the skin with local anesthesia as well as moderate sedation. The device is used to look for cardiac events that may be accompanied with dizziness, palpitations, shortness of breath etc.). This device can be left in for an extended period of time (months if indicated) and is followed by your physician at the office.