We carry out a range of cardiac procedures to investigate and treat cardiac disease:
Diagnostic coronary angiography is carried out to investigate chest pains. Via the small artery in your wrist, under local anaesthetic we pass a catheter through the arm to the heart and inject some dye down the coronary artery's. Using a X-ray machine we take some X-ray pictures of the arteries to look for any narrowing's.
The procedure is well tolerated and carried out under local anaesthetic as a day case procedure.
Cardiac Resynchronisation Therapy & Defibrilators
Cardiac resynchronisation therapy involves implanting a special type of pacemaker with two or three leads in the heart. This is carried out for patients with heart failure with electrical dysnchrony between the left and right side of the heart to improve symptoms of breathlessness and fatigue.
Defibrilator devices are implanted for patients with cardiac disease which has a high risk of life threatening arrhythmias. The device can treat such arrhythmias with pacing or a electrical shock.
Both procedures are carried out under local or general anesthetic and also tolerated very well.
Once a diagnostic coronary angiogram has identified a narrowing in the coronary artery, this can be treated with a balloon to dilate the lesion (angioplasty) followed by a stent to keep the artery open (stenting).
Sometimes the physiological significance of the narrowing needs to be assessed further. Intravascular imaging and pressure wire studies can be used for this and a stent deployed at the same time if needed.
These procedures are also well tolerated and carried out under local anaesthetic as day case procedures. They can be performed under conscious sedation.
For patients with borderline coronary disease, we can stress the heart pharmacologically or with exercise to to see if the narrowing's and hemodynamically significant, and look for wall motion abnormality's using echocardopgraphy.
Stress echocardiogrpahy can also be used to investigate borderline valve disease.
Pacemakers are implanted for people experiencing dizziness, collapse episodes or loss of conscious episodes as a result of slow heart rates. A small box is implanted under the skin with pacing leads attached into the heart. The procedure is well tolerated and performed under local anesthetic as a day case.
Loop Recorder Implantation
Implantable loop recorders (ILR) monitor the heart rhythm closely. For patients with infrequent symptoms of palpitations, dizziness or loss of consciousness we can implant a ILR device (4mm x 7mm x 44mm) under the skin though a small 10 mm incision. This monitors the heart 24hr a day for up to 3 years. It can be monitored and interrogated remotely via our home monitoring service. Once you've experienced your typical symptoms can can look at the underlying heart rhythm for any abnormality's.
For patients with complicated valve disease Transoesphageal echocardiography can be carried out to image the heart valves more closely from the inside. This involves passing a probe down the oesophagus and using ultra sound to image the heart. The procedure is carried out under conscious sedation and is usually tolerated very well.