Coronary Angiography is an imaging technique or a radiological test that helps visualize the insides of the coronary arteries. It shows the exact location and severity of any plaque formation and the consequent narrowing of the coronary arteries. This helps the doctor to decide what treatment is needed.

The test is commonly carried out within the Cath lab in a hospital set up. The procedure normally takes around 15 to 20 minutes.

The site of the procedure or insertion of the catheter at the upper part of the thigh near the groin or an artery in the arm. is anaesthetized using a local anaesthetic injection. This will numb the site of the test.

A thin, plastic tube called a sheath is inserted into an artery. Catheters are passed through this sheath to the coronary arteries of the heart Via this catheter, under x-ray guidance contrast medium or dye is injected through the catheter into the coronary arteries. As the blood along with the dye flows through the arteries and the chambers of the heart, x-rays show the path of the blood and outline the branches of the arteries. A series of x-ray pictures from different angles to check for blockages is recorded.

FAQs

What are the preparations for Coronary Angiography?

Patients who are prescribed this test need to be admitted to the hospital on the day of the test. Sometimes admission on the previous evening and a stay overnight may also be advised. A few hours of fasting with nothing taken via the mouth (including water) is recommended.

What are the implications of angiography results?

A normal result of coronary angiography means that there is an adequate blood supply to the heart. An abnormal result on the other hand means that one or more coronary arteries may be blocked or narrowed in one or more places. The degree or percentage of each block is also reported. If the narrowing of the arteries is mild, it can be treated with medicines alone. If the arteries and their branches are more severely occluded and narrowed, coronary artery bypass graft or coronary angioplasty may be required.

Angioplasty is a specialised procedure performed in a Cath lab (cardiac catheterisation laboratory). Since the patients are awake and alert through the procedure, they are given medication before and during the angioplasty procedure to help relax.

The procedure begins by inserting a sheath into a blood vessel, usually in the upper leg, groin or arm. A hollow tube termed a catheter is pushed through this sheath into the mouth of the coronary artery. Through this catheter, another small balloon catheter is deployed into the coronary arteries.

Once the balloon is at the blocked or narrowed area in the artery, it is inflated to widen the pathway. In most cases the inflation lasts from 30 seconds up several minutes, depending upon the nature of the blockage. The inflation of the balloon may cause chest pain in some patients, similar to angina. This happens because the balloon temporarily blocks the flow of blood and oxygen that it carries to the heart. If such pain is experienced, the patient should report the same to the doctor.

Nowadays, a stent is crimped on the balloon and is positioned at the site of obstruction. A stent is an expandable mesh tube. It is implanted to support and widen the artery and keep the vessel open for continuous blood flow. After the block has been opened the balloon is deflated and retracted back through the blood vessel. A stent implant is a permanent one.

FAQs

What are the advantages of placing a stent?

Stent prevents acute vessel closure, means the sudden collapse of the narrowed artery after the balloon has opened it. It also reduces restenosis, recurrence of blocks after balloon angioplasty

Can I be back to my routine after the procedure?

You would be kept under observation for 2-3 days. Once home, you can resume full activity within couple of days. Angioplasty is not a cure, but a treatment to reduce the effects of Coronary Artery Disease. Following angioplasty, diet and medications have to be strictly followed to reduce the risk of recurrence. Your health relies on the lifestyle you choose

An endovascular aneurysm repair is a form of endovascular surgery which is commonly used to treat an abdominal aortic aneurysm. It is the condition in which there is an enlargement in the lower part of the aorta which causes life- threatening bleeding. Aorta is a major blood vessel that supplies blood to the body. This condition is common in older men and smokers. When this condition is in a growing stage, there might not be any symptoms. As it grows, there is a pulsating feeling near the navel. If the rupture is to happen, then there will be a pain in the back or stomach.

It is a minimally invasive procedure that is done with the help of a stent- graft which is inserted through small incisions. There is no requirement for a surgical procedure. This is the main reason why it is preferred these days. It is safer than traditional surgery along with a shorter stay in hospital and faster recovery.

But not everyone is a candidate for this surgery. It is difficult to treat aneurysms arising close to or above the kidneys using this procedure. An abdominal ultrasound will be given to you to check the candidacy.

The preparation of this surgery is similar to open surgery. You are administered anaesthesia before beginning this procedure. In this procedure, a synthetic graft is inserted through the groin which is attached to the end of a thin tube and threaded up to the aorta. This graft is covered by a metal mesh support and placed at the site of the aneurysm. The metal mesh fastens the graft in place with the help of small hooks and pins. The use of this graft is to reinforce the weakened section of the aorta to prevent rupture of the aneurysm.

FAQs

What are the risks involved?

Deep vein thrombosis is the most common risk for which you may require extra treatment prolonging your stay in the hospital. General complication which occurs includes infection in the wound, chest infections and diarrhea. Up to 1 in 10 men may have difficulty in sustaining an erection.

What is the recovery process?

You are able to eat and drink properly after you are awake from the procedure. Normal recovery takes around two weeks however some people may require several months. You can return to work after a month.

TAVR is a non-surgical procedure to replace Heart Valve (Aortic) by going from a Groin vessel (like Angioplasty) in the majority (95% to 97%) of the cases.

This is US-FDA approved for intermediate and high risk and is better than Open Heart Surgery in certain parameters.

Who needs TAVR?

TAVR is a non-surgical procedure to replace Heart Valve (Aortic) by going from a Groin vessel (like Angioplasty) in majority (95% to 97%) of the cases.

This is US-FDA approved for intermediate and high risk and is better than Open Heart Surgery in certain parameters.

WHO NEEDS TAVR?

Aortic Valve Stenosis

Aortic valve stenosis is a condition marked by the narrowing of the Aortic valve, which decreases the supply of oxygenated blood to the body. It is a very common and equally serious valve disease that is most likely to affect elderlies. The patient has a long latent phase.

Symptoms

• Chest pain
• Fluttering heartbeat
• Breathlessness
• Dizziness and lightheadedness
• Syncope
• Swelling in the ankles
• Trouble sleeping

Causes

• Calcification
• Congenital disorders
• Rheumatic heart diseases
• Radiation therapy

Procedure

TAVR is a minimally invasive heart procedure that aims at replacing a stenotic aortic valve with a new biological valve. The procedure is also referred to as TAVI (Transcatheter Aortic Valve Implantation). It is a catheter-based procedure carried out under the influence of general anaesthesia. You may spend the night in the intensive care unit for monitoring after the procedure. In most cases, you will spend two to five days recovering in the hospital. Blood-thinning medications are prescribed to you to prevent blood clots.

Interventional Cardiology pertains to a patient's evaluation which involves exposure to the patient's blood. These are generally considered advanced forms of diagnostic or therapeutic techniques. The procedures under this section are carried out in our well-equipped and high-tech Cardiac Catheterization laboratories.

Coronary

• Coronary Angiography (CAG)
• Coronary Angioplasty
• IVUS, FFR
• ROTA Ablations
• Intra-Aortic Balloon Pump

Structural & Valvular Heart Disease

• TAVI / TAVR
• Device Closures ASD, VSD, PDA
• Paediatric Catheterization / Angiography (Right & Left)
• BMV, BPV, BAV
• Right Heart Catheterization
• HOCM
• Cardiac Shock Wave- Therapy

EP & Heart Failure

• EP Study
• 3D Mapping
• ICD, CRT, CRT-D Implantation
• Radio Frequency Ablation
• Pacemaker Implantation - Leadless / Single / Double

Endovascular Diseases

• Renal Angiography & Angioplasty
• Peripheral Angiography & Angioplasty
• IVC Filter Implantation
• Thoracic & Abdominal Aortic Aneurysms