Cardiac Imaging & Intervention in Fort Worth
Heart disease is the leading cause of death in the United States. Brought on by aging, heart disease is also strongly linked to a sedentary lifestyle and a diet of high-fat, processed food. Most forms of heart disease can be prevented, minimized or treated if you're willing to make the necessary lifestyle adjustments.
Just as crucial, you need access to the kind of advanced cardiac care provided at Medical City Fort Worth of Fort Worth. We offer a full menu of advanced diagnostic tests, technologies and interventional procedures, all meant to keep your heart going strong for years - and potentially decades - to come.
Cardiac catheterization (or coronary angiogram) is a specialized study of the heart to find narrowing or blockages in the coronary arteries. It is used to check blood flow and blood pressure in the chambers of the heart, find out how well the heart valves work, and check for defects in the way the wall of the heart moves.
The purpose of cardiac catheterization is to find out if you have disease in your coronary arteries (atherosclerosis). If you have atherosclerosis, this test can pinpoint the size and location of fat and calcium deposits (plaque) that are narrowing your coronary arteries. Results from cardiac catheterization help determine whether treatment with bypass surgery or percutaneous coronary intervention (PCI), such as angioplasty, may be effective.
During the cardiac catheterization procedure, a catheter (a thin, hollow, flexible tube) is inserted into the artery of the groin or arm. Under x-ray visualization, the tip of the catheter is guided to the heart. An iodine dye is injected into the artery so that a visual representation of the coronary arteries can be made.
In most hospitals, the catheter is introduced through the groin artery. However, at Medical City Fort Worth of Fort Worth, we have perfected the radial approach of inserting the catheter through an artery in the arm. This sophisticated technique offers the following benefits:
- Less invasive
- No need for a bandage in the groin area
- Any bleeding is more readily apparent
- You can sit up immediately after the procedure
- You can usually go home sooner
- Especially convenient for large patients, in whom the arm may be more accessible than the groin
- We also use this innovative radial approach during angioplasty.
Heart Bypass Surgery
Coronary artery bypass grafting (CABG), or bypass surgery, restores blood flow to the heart muscle. This is done by using blood vessels from other parts of your body to make a new route for blood to flow around blocked coronary arteries.
Bypass typically requires open-chest surgery. However, not everyone with coronary artery disease needs bypass surgery. Many people can be helped by angioplasty with stents. Your doctor may advise bypass surgery if:
- Your left main heart artery is very narrow.
- All three arteries of the heart are blocked or the amount of blood flowing through them is very low.
- Your doctor thinks that bypass surgery will be more successful than angioplasty with stents.
- You also need surgery to repair or replace a heart valve damaged by heart valve disease.
- You have diabetes and two or more blocked arteries.
- Your heart is having trouble pumping.
- Your choice may depend on the number of arteries that are blocked or which arteries are blocked.
Medical City Fort Worth performs most bypasses as beating heart surgery. Unlike standard bypass surgery, beating-heart, "off-pump" surgery does not require that your heart be stopped, and you don't need to be connected to a heart-lung machine. Instead, your heart is kept beating throughout the procedure.
Carotid Diagnostic Testing
This refers to testing, such as ultrasound exams, used to locate plaque build-up in the carotid arteries of the neck.
Angioplasty and Stenting
Angioplasty, also called percutaneous coronary intervention (PCI), is a procedure to open a coronary artery that was narrowed or blocked during a heart attack. The coronary artery might be blocked by a blood clot and fat and calcium from a ruptured plaque that caused the heart attack.
At Medical City Fort Worth, we provide the fastest heart attack treatment in Tarrant County. In fact, we can remove your blockage twice as fast as the average U.S. hospital. That's 45 minutes from the time you arrive at our door to the time you are diagnosed, treated with angioplasty or another procedure, and stabilized. The national average is 90 minutes.
Angioplasty can open blocked arteries in about 9 out of 10 people. As an alternative to bypass surgery, angioplasty only requires that a catheter be inserted in your artery. A tiny balloon is moved through the catheter and is used to open the artery. The balloon is inflated for a short time, and then it is deflated and removed. The pressure from the inflated balloon makes more room for the blood to flow, because the balloon presses the plaque against the wall of the artery.
Most of the time, stents (small, expandable tubes) are permanently placed during angioplasty to keep the artery open. When stents are used, there is only a small chance that the artery will become narrow again. Essentially, the stent acts as a brace, or scaffolding, to hold the artery open and allow for unobstructed blood flow.
Stents are commonly placed in the carotid artery, coronary artery or peripheral arteries (in the lower extremities like the legs). Types of stents include:
Bare Metal Stent - The standard stent, it is designed to conform to the shape of the wall of the artery in order to hold the wall to its fully opened position. For maximum durability and flexibility, bare metal stents are commonly constructed of materials such as stainless steel and cobalt chromium, and come in various sizes. Learn about the bare metal stents used at our hospital.
- VeriFLEX™ Bare-Metal Coronary Stent System, by Boston Scientific
- MULTI-LINK VISION Coronary Stent System, by Abbott Vascular
- Integrity® Coronary Stent System, by Medtronic
Drug Eluting Stent - Also known as a coated or medicated stent, a drug eluting stent is a normal metal stent that has been coated with a drug to prevent re-blockage of the artery (called restenosis). Sometimes the drug is imbedded in a thin polymer to allow for a time-release effect. Learn about the drug eluting stents used at our hospital.
- PROMUS® Everolimus-Eluting Coronary Stent System, by Boston Scientific
- ION™ Paclitaxel-Eluting Platinum Chromium Coronary Stent System, by Boston Scientific
Your Medical City Fort Worth cardiologist can determine if this innovative approach to cardiac catheterization is right for you.
Impella® 2.5, by Abiomed - Impella is the world's smallest heart pump and about the size of a coffee stirrer. As an alternative to the standard balloon pump, it enables life-saving coronary interventions for high-risk patients. These include patients with severe coronary artery disease and the 10 percent of cardiac patients who cannot withstand the stress of surgery. Before the Impella became available, these patients' only options were medication to treat their pain - and eventual heart failure.
The Impella mimics the natural function of your heart by assisting its main pumping chamber to drive up to 2.5 liters of blood per minute through the body. The device may be in place for an hour or two (during the interventional procedure) and up to two weeks afterward, allowing the heart muscle to rest and heal.
Medical City Fort Worth was the first hospital in Tarrant County to use this breakthrough technology.
This procedure may be done during cardiac catheterization to open a blocked coronary artery. Once the catheter reaches the narrowed portion of the artery, a cutting device, a whirling blade (rotational atherectomy), or a laser beam is used to remove the plaque.
Heart Valve Surgery
This is surgery to replace a damaged heart valve. The heart's four valves, which open and tightly close, allow blood to flow from one chamber to another. The valves also allow blood to leave the heart through the large blood vessels and help blood to only flow forward when the heart squeezes. Usually, only one valve is replaced at a time. But, in some cases, one or more valves may need to be replaced.
Abdominal Aortic Aneurysm Repairs (Triple A Repairs)
An abdominal aortic aneurysm is a potentially fatal condition that occurs when the walls of the arteries become weak and bulge out in the part of the aorta that passes through the abdomen. At Medical City Fort Worth in Fort Worth, we use a minimally invasive approach that repairs the aneurysm from within the artery itself, avoiding a major abdominal incision.
A patent foramen ovale (PFO) is a hole in the wall (septum) that separates the two upper chambers (atria) of the heart and also the two lower chambers (ventricles). Usually after birth, the atrial and ventricular septa gradually grow and seal these openings.
However, in infants with atrial septal defects (ASDs), the atrial septum does not close properly or is malformed during fetal development. When the hole in the ventricular septa does not close, it causes a ventricular septal defect (VSD).
The opening (PFO) in the septum persists long after it should be closed, resulting in an increased workload on the heart and excessive blood flow to the lungs.
ASDs and VSDs are estimated to be present in 10-20 percent of American adults, and they are the most prevalent cause of strokes in those under the age of 35. Left untreated, ASDs and VSDs can also cause heart failure and various respiratory problems. The defect frequently goes undiagnosed until school age or even adulthood.
In the past, correcting this hole required open-heart surgery. However, Medical City Fort Worth offers a leading-edge, minimally invasive approach to PFO closure. Through a small cut in the groin, tiny instruments are threaded through a narrow catheter (a thin, hollow, flexible tube) to the heart.
A small device called a septal occluder, similar to an umbrella, is then deployed to seal the hole. (Learn about the septal occluders used at our hospital.) The entire procedure usually takes less than an hour, and patients go home the next day.
This procedure is as effective as open-heart surgery but offers far less risk for complications and a much quicker recovery.
- AMPLATZER® Septal Occluder
- GORE® HELEX® Septal Occluder
- AMPLATZER Special Occluder
According to the American Heart Association, out-of-hospital cardiac arrest - in which the heart stops effectively pumping blood through the body - annually occurs in about 300,000 adults in the United States.
This period of insufficient blood flow can permanently damage the brain, which competes with other organs for much-needed oxygen. However, inducing hypothermia in unconscious patients who have been revived from sudden clinical death can actually improve chances of survival - and without brain damage.
For many years, doctors have used hypothermia therapy in the operating room to gradually decrease a patient's need for oxygenated blood during surgery. Research shows that cooling the body allows the patient to survive with less oxygen by reducing the body's need for it.
Since 2005, the American Heart Association has recommended applying the same technique with cardiac arrest patients. By cooling externally with special pads or by inserting a catheter with chilled saline solution, a patient's body temperature is lowered. The patient is monitored so they stay between 89.6 and 93.2 degrees Fahrenheit for 24 hours after resuscitation.
Study after study proves that hypothermia therapy dramatically increases survival rates - without brain damage - in cardiac arrest patients.