Certain procedures must be performed in the hospital to correct problems with your heart or arteries. Some of these procedures are surgical and include some recovery time. Others are non-surgical and are done on an outpatient basis.
Cardiac catheterization is a procedure where a long, thin tube called a catheter is inserted in an artery or vein in your upper thigh, neck or arm and threaded through the blood vessel to your heart. The catheter helps determine any heart disease or blockages in your arteries.
During the procedure, the cardiologist will have visual help of a special monitor to place the catheter precisely in the spot that needs further treatment. If a blockage is discovered, the doctor may fix it with a balloon or stent. A stent is a small mesh or fabric tube used to support weak or narrow arteries and to improve blood flow.
Some patients may feel some chest pressure or even some pain when the doctor inflates the stent. Once the procedure is complete, the catheter is removed and a bandage is placed on the incision site.
Cardiac catheterization requires you to stay in the hospital for a couple of hours and likely overnight if a stent is performed. Your blood pressure and incision site are regularly monitored. Some patients are sore for several days after the procedure, and your cardiologists will tell you when you can resume normal activity.
Cardioversion is a minimally-invasive procedure by which an abnormally fast or irregular heart beat is converted to a normal heart rate using electricity or medications. The cardiologists may give you one or more medicines to regulate your heart beat or recommend electrical cardioversion.
During electrical cardioversion, the physician will deliver an electrical shock through two paddles, which may be placed both on your chest or one of your chest and one of your back. The shock lasts less than a second. You may receive one shock or more, depending on when your heart beat becomes regular.
Patients are advised to not eat or drink for at least eight hours before cardioversion and not use any lotions, powders or perfumes on the chest or back for 24 hours before the procedure. Patients are administered medicine before cardioversion that will make them sleep and therefore should not feel any pain. Most don’t remember the shock(s). The procedure takes about 30 minutes.
A pacemaker is a small device that is placed in the chest to help treat arrhythmias, which occur when your heart beats too fast, too slow or erratically. The device uses low-energy electrical pulses to prompt the heart to beat at a normal rate.
Patients are awake during the procedure but the cardiologist will inject a numbing medicine to the chest so that you will not feel pain. Some patients feel a pulling sensation as the pacemaker is attached and adjusted. You will be connected to monitors that will record your blood pressure and other vital signs, as well as a monitor for the doctor to use as a visual guide as the pacemaker is put in place.
You should not eat or drink anything after midnight the day of your procedure. Following the procedure, you may be allowed to leave or the cardiologist may request you stay overnight. Your doctor will let you know when to return to normal activity as well as electrical devices to avoid, ensuring the pacemaker stays in working order.
An ICD is a surgical solution for patients whose heart beats abnormally in such a way that is life threatening. The surgery typically takes a few hours and patients should expect to stay in the hospital a day or two to recover and make sure the ICD is working properly.
During the procedure, you will be given medication to help you relax. The cardiologist numbs the area where an incision will be made to place the ICD. A special monitor is used as a visual guide to place the ICD and attach it properly. The device uses low-level electrical shocks to help control the beating of your heart at a normal rate.
After the procedure, you may be prescribed antibiotics to help prevent infection. Some patients feel some discomfort where the ICD was implanted. Your cardiologist will tell you when you can return to normal activity.
Aortic heart valves can calcify, losing the ability to open properly and decreasing blood flow from your heart through your body. This condition is called aortic stenosis. If you have been diagnosed with aortic stenosis but your doctor has advised that open heart surgery is too risky for you, TAVR can be a viable option.
Unlike open heart surgery, the TAVR procedure is minimally-invasive. A catheter is passed through the artery of the leg or groin up to the heart. A collapsible valve is then positioned in place to take over the job of the damaged one. The new valve begins
regulating blood flow immediately, allowing the patient the possibility of a healthier, prolonged life.
Unlike the months-long recovery time of open heart surgery, patients who have the TAVR procedure typically recover within a few days.
Patients diagnosed with Atrial Septal Defect or Patent Foramen Ovale have a 10 to 30 millimeter hole between the top chambers of the heart. This can cause too much blood flow in the wrong direction and overtime cause heart failure. Now, there is a minimally-invasive procedure to reduce the risk of heart failure and stroke that gives patients their lives back without open surgery or a long hospital stay.
The St. Jude Amplatzer Septal Occluder is a two-disk, button shaped implant to close the hole in the heart. During the procedure, the implant sits inside a catheter that is guided to the heart. Using a flourascope and intracardiac ultrasound, the cardiologist carefully positions the implant through the hole in the heart and then expands the two sides of the disc until the middle part of the implant rests snuggly against the heart wall.
Patients typically go home within a day or two. In about 95 percent of patients, the hole is closed immediately. Over a period of five to six months, the lining of the heart grows completely over the implant.
For patients with Atrial Fibrillation – an irregular, often rapid heartbeat – who cannot safely take blood thinners long term, there is a minimally-invasive procedure that prevents the formation of blood clots and drastically reduces the risk of stroke.
The Watchman is about the size of a quarter and shaped like an umbrella. The cardiologist snakes The Watchman on a catheter through a small hole in the patient’s leg and up through a vein into the heart. The Watchman is then expanded, sealing off the left atrial appendage. This prevents clots from forming and breaking loose to the brain, lungs or other parts of the body. The tissue in the heart eventually seals over the device allowing for the safe discontinuation of blood thinners.
The entire procedure only takes an hour. Most patients are discharged the next day. While there’s no extended recovery time, patients are typically discharged on a short course of warfarin following implant for 45 days. More than 90 percent of those who received The Watchman stopped taking the warfarin after 45 days.
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