Cardiac Procedures

Carolina Cardiology Consultants performed the listed procedures at Greenville Memorial Hospital and Baptist Easley. We work closely with the cardiac cath lab staff at each facility to provide input regarding the up to date equipment and cardiac procedures. Our cardiologists specialize in cardiac catherization, angioplasty, stenting and pacemaker placement.

Angioplasty/Stenting

Percutaneous Transluminal Coronary Angioplasty (PCI), or Angioplasty, is an invasive procedure performed to reduce or eliminate blockages in coronary arteries. The goal of PCI is to restore blood flow to blood-deprived heart tissue, reduce the need for medication, and eliminate or reduce the number of episodes of angina (chest pain).

Opening a blockage, or a plaque, in a coronary artery typically involves the use of an angioplasty balloon. When the blockage is calcified or so dense that a balloon cannot be placed, other devices are used. Plaque can be cut out, ablated with a laser, or bored out using a surgical drill bit. Often, a stent is implanted after angioplasty to keep the artery open and prevent restenosis (regrowth of plaque).

Peripheral Vascular Intervention

Peripheral Vascular Intervention procedures help to open blockages in peripheral arteries and restore blood flow to the lower body, legs or kidneys. If it is determined that a blockage is causing an obstruction, Angioplasty is performed. Angioplasty involves inflating a tiny balloon within the obstructed artery in order to open the narrowed area. After Angioplasty, one or more stents may be placed to keep the artery open.

Cardiac Catheterization

This is a procedure done on the heart. The cardiologist inserts a thin plastic tube (catheter) into an artery or vein in the arm or leg. From there it can be advanced into the chambers of the heart or into the coronary arteries. This test can measure blood pressure within the heart and how much oxygen is in the blood. It’s also used to get information about the pumping ability of the heart muscle and check for blockage in the coronary arteries.

To help you through the process, we’ve developed these patient education sheets to make your experience as seamless as possible:

ASF/PFO Closure

There are two kinds of holes in the heart. One is called an atrial septal defect (ASD), and the other is a patent foramen ovale (PFO). Although both are holes in the wall of tissue (septum) between the left and right upper chambers of the heart (atria), their causes are quite different.

An ASD is a failure of the septal tissue to form between the atria, and as such it is considered a congenital heart defect, something that you are born with. Generally an ASD hole is larger than that of a PFO. The larger the hole, the more likely there are to be symptoms.

PFOs, on the other hand, can only occur after birth when the foramen ovale fails to close. The foramen ovale is a hole in the wall between the left and right atria of every human fetus. This hole allows blood to bypass the fetal lungs, which cannot work until they are exposed to air. For the vast majority of the millions of people with a PFO, it is not a problem, even though blood is leaking from the right atrium to the left. Problems can arise when that blood contains a blood clot.

Depending on whether the clot takes a right or left turn as it exits the heart, it can travel to the brain and cause stroke. Statistically speaking, the odds of this happening are low, but it can happen.

How would you know?

Finding out whether you have a PFO is not easy, and it’s something that isn’t usually investigated unless a patient is having symptoms like severe migraines or stroke.

PFO is diagnosed with an echocardiogram. An echocardiogram, also called a cardiac echo, creates an image of the heart using ultrasound.

TAVR (Transcatheter Aortic Valve Replacement)

What is TAVR?

This minimally invasive procedure allows cardiologists and cardiac surgeons to implant a prosthetic aortic valve through a catheter placed in the femoral artery, much in the same way a cardiac catheterization is performed. The TAVR procedure can be performed through three different approaches – transfemoral (through an incision in the leg) or transapical (through an incision in the chest between the ribs) and transaortic. TAVR provides a treatment option for patients with severe, symptomatic aortic stenosis who have been determined by a heart team to be at intermediate risk for open-heart surgery.

How do I know if TAVR is right for me?

TAVR is not right for everyone; in certain cases, the risk of the procedure outweighs the benefits. However, any patient diagnosed with aortic stenosis is encouraged to be referred to this program for assessment as a TAVR candidate.

What are the benefits of TAVR?

Because TAVR does not require open-heart surgery and, in most cases, patients do not need their heart stopped for the procedure, those who qualify may reap significant benefits. Typical benefits include the following:

  • Fewer days in the ICU and shorter hospital stays
  • Earlier return to normal activities
  • Less blood loss than with traditional surgical valve replacement
What is the TAVR program?

The TAVR program is a true multidisciplinary effort, with patients seen and evaluated by cardiac surgeons, interventional cardiologists, and imaging cardiologists in the Prisma Health Valve Center. Carefully selected patients then undergo the TAVR procedure with cardiac surgeons and cardiologists working side by side in a state of the art, Hybrid Operating Room/Cardiac Catheterization Laboratory at Prisma Health. The TAVR program had a coordinator who guides the patient through the evaluation process from beginning to post operative visit assuring communication among the TAVR multidisciplinary team.

Why should you have your TAVR at Prisma Health?

The cornerstone of this effort is our state-of-the-art hybrid catheterization laboratory/operating room, in which the full complement of catheter-based and surgical procedures may be performed. We believe our close working relationship between cardiologists and cardiothoracic surgeons is unique among tertiary heart centers. Patients with complex valvular heart disease are discussed at a weekly conference where optimal, individualized treatments plans are developed. At least one cardiologist and one cardiothoracic surgeon are scrubbed for the entirety of each TAVR case.

The benefits of TAVR include a highly significant improvement in quality of life and reduced mortality in patients who are “inoperable.” Additionally, TAVR performs at least as well as surgical atrial valve replacement (AVR) in “high risk” patients, offering a less invasive option with similar mortality and symptom improvement. Importantly, the hemodynamic performance of the prosthetic aortic valve following TAVR is excellent out to 3 years.

WATCHMAN Implant

WATCHMAN is for people with atrial fibrillation (AFib) not caused by a heart valve problem who need an alternative to warfarin (blood thinners). The device is a permanent implant designed to close the left atrial appendage in the heart in an effort to reduce the risk of stroke.

AFib is the most common cause of stroke within the United States. As a result, stroke prevention is the most important element of atrial fibrillation therapy.

In the event that bleeding is seen when you are on a blood thinner, a stroke prevention device such as a WATCHMAN may be appropriate. Currently, the WATCHMAN (from Boston Scientific) is the only device FDA approved to prevent strokes without blood thinners.

Prisma Health is the only facility in the Upstate currently using this technology.

Learn how a permanent heart implant may replace the need for long-term blood thinners.

Transesophageal Echocardiogram

A Transesophageal Echocardiogram, or TEE Echo, allows your doctor to record images of your heart from inside your esophagus (the tube that leads from your throat to your stomach.)