A. For Coronary Artery Disease (CAD)

Medications:

Ace Inhibitors- are used to treat high blood pressure and congestive heart failure. They work to lower the blood pressure by affecting an enzyme in the adrenal gland and are beneficial in the treatment of heart failure because they decrease the workload of the heart. This can help the heart to become a stronger and more efficient pump. Examples of ace inhibitors include Zestril, Vasotec and Monopril. <<back

Beta-blockers-affect the body's nervous system and work to decrease the heart rate, blood pressure and force of contractions of the heart. Examples of beta-blockers are Tenormin, Lopressor, Toprol and Sectral. <<back

Calcium-channel blockers- work to relieve spasm in the arteries and to lower the blood pressure. Some will also decrease the heart rate. This will increase the blood supply to the heart and decrease the workload of the heart. Examples of calcium-channel blockers are Calan, Cardizem, Norvasc and Procardia. <<back

Nitrates- are used to increase the blood supply through the arteries of the heart. They work by decreasing spasms in the arteries of the heart and by dilating the arteries themselves. Examples of nitrates are Nitroglycerin, IMDUR and ISMO. <<back

Interventional Procedures

Coronary Artery Bypass Grafting (CABG) Surgery-If your physician diagnoses significant coronary artery disease that cannot be treated with medication, angioplasty or a stent, CABG may be recommended. This operation is performed to literally "bypass", or go around, an artery that has become blocked from atherosclerosis. To perform the bypass, the surgeon will remove a section of the vein from the patient's leg. One end of this vein is attached to an opening made in the aorta, and the other end is attached to an opening made beyond the obstruction in the coronary artery. The narrowed area of the artery is not removed. Sometimes an artery (the internal mammary artery), which lies alongside the breastbone, is used instead of the vein as a bypass to supply blood. Bypassing the obstructed area in the coronary artery will improve the blood supply to the heart. Removal of the leg vein will not affect circulation since other leg veins are available to take over the work. <<back

Coronary Rotablator- is a rapidly rotating catheter tip which is passed through the artery over a thin guide wire. As the tip crosses the narrowed area, the blockage is reduced to particles of microscopic size. These particles are then removed through the body's waste system. <<back

Extraction Atherectomy-allows blockages within the coronary arteries to be shaved away and extracted from the body. This is done by using a microsurgical cutting component and vacuum device. <<back

Intravascular Ultrasound- is a procedure in which high-resolution images of the inner vessel wall are obtained by the use of a catheter placed within the artery. Accurate size and characteristics of the vessel are obtained. This allows the physician to assess the artery for interventional procedures such as angioplasty or atherectomy. <<back

Laser Angioplasty- is a procedure that uses a device to open blocked coronary arteries so that adequate blood supply is restored. Once a blockage in your coronary artery has been diagnosed by your physician from a heart catheterization or EBT Scan, your doctor can determine whether you are a candidate for a laser angioplasty. In laser angioplasty, a wire is inserted into the vessel opening and a catheter with a laser tip is slipped over the wire, literally blasting plaque into microscopic air bubbles that are carried away in the blood stream. Typically, the procedure is followed up with a balloon angioplasty to get a full opening into the artery. <<back

Percutaneous Transluminal Coronary Angioplasty (PTCA) is a procedure used to dilate blocked coronary arteries so that adequate blood supply is restored. Once a significant blockage has been discovered in your coronary artery with a heart catheterization or EBT Scan, your doctor can determine whether you are a candidate for PTCA. If so, a balloon tipped catheter is inserted into your groin, much like that for the heart catheterization (link to definition). The balloon is centered in the blocked area of the heart artery and the balloon is then inflated. Several inflations are made to push the blockage back and open the artery as much as possible. <<back

Stents- a stent is a small, latticed stainless steel tube that is introduced into your blood vessel on a balloon catheter. The doctor maneuvers the catheter into the blocked artery and inflates the balloon. This causes the stent to expand and press against the vessel wall. Once the balloon has been deflated and withdrawn, the stent stays in place permanently, holding the blood vessel open and thus improving blood flow. <<back

B. For Valvular Heart Disease: 

Valvuloplasty-This procedure requires the use of a balloon tipped catheter which is placed across a heart valve that has become thickened and narrowed to the point where not enough blood can pass across it. The balloon is inflated to dilate the valve opening, which increases the amount of blood that can pass through the valve. <<back

Valvular Repair-This surgical procedure is used to repair or remodel a leaky valve by adding a support ring around the valve for stabilization. This surgery will allow the valve to work better and decrease the patient's symptoms. <<back

Valve Replacement-This surgery is performed to replace valves that have become thickened or scarred, and are unable to open and close properly. There are several types of replacement valves available, and the surgeon will determine which would be best suited for the patient. Depending on the type of valve used, the patient may be required to take a blood thinner to prevent blood clots from forming on the new valve. <<back

C. Septal Heart Defects

The Septum-The septum is the wall separating the right and left sides of the heart. A septal defect is an opening or hole in this wall. If your physician determines that this defect is significant, surgery is usually recommended. The surgeon may close the hole by sewing together the edges of the opening or by sewing a patch over the opening. <<back

D.Peripheral Vascular Disease

Peripheral Angiography is much like a heart catheterization and the procedure utilizes x-ray equipment. A soft tipped catheter is placed in an artery and then contrast dye is injected into the artery. X-rays are taken and these pictures identify narrowing arteries or blockages in the arteries. Depending on the severity and nature of the blockages, medical treatment, surgery, angioplasty or stent placement may be the recommended treatment. <<back

Atherosclerosis occurs in the peripheral arteries as well as in the coronary arteries. Peripheral doppler ultrasound testing is performed to determine the amount and location of blockages in peripheral arteries and veins. Arm and leg arteries are tested by obtaining doppler ultrasound  tracings and blood pressures at various levels of the arms and legs. The carotid arteries of the neck are evaluated with color doppler imaging to determine the speed and direction of blood flow, and the presence of blockages in the arteries. Arm and leg veins are examined using color doppler ultrasound  combined with probe compression maneuvers to locate the presence and location of any blood clots. These tests are done without injections or dyes by utilizing doppler ultrasound  and blood pressure management.