Cardiac catheterization laboratory

Unit

In the Cardiac Catheterization Laboratory Unit, part of Cardiology Unit, are performed invasive diagnostic procedures in Coronary artery disease, valvulopathies and congenital cardiopathies.

The Coronary interventional cardiology include percutaneous angioplasty of coronary arteries with endoluminal narrowing and/or occlusion in clinical pictures of acute and chronic coronary syndrome (myocardial infarction or unstable angina) .

Valvular interventional cardiology treats some valvular heart disease in patients who present a high risk for cardiac surgery repair and/or valve replacement. The valvulopathies that can be treated with percutaneous transcatheter technique are degenerative and rheumatic aortic valve stenosis, aortic valve insufficiency, mitral valve insufficiency, rheumatic mitral valve stenosis, tricuspid valvular insufficiency, pulmonary valve stenosis. Candidate patients are carefully evaluated for clinical indication and anatomical suitability and subsequently discussed in a multidisciplinary context to ensure the best therapeutic option.

Dedicated biological valve prostheses are used, based on the characteristics of the valvular disease, or transcatheter repair systems such as Mitraclip, or dedicated balloon catheters in the treatment of mitral and aortic valve stenosis. The same techniques can be used in rigorously selected patients for the treatment of degenerated and malfunctioning biological cardiac surgery valves.

Structural interventional cardiology treats peculiar pathologies: partial detachment of biological and mechanical cardiac surgery prostheses with a clinical picture of heart failure or persistent hemolysis; occlusion of Patent foramen ovale in patients with outcomes of cryptogenic brain ischemia; percutaneous occlusion of the left atrial appendage  in patients with non-valvular atrial fibrillation and contraindications to anticoagulant therapy; post-infarct interventricular defect closure in patients at high cardiac surgery risk; embolisation of symptomatic pulmonary arteriovenous fistulas and alcoholisation of septal coronary arteries in obstructive hypertrophic cardiomyopathy.

Interventional cardiology of adult congenital heart disease deals with the treatment of congenital heart disease such as the ostium secundum atrial septal  defect type, occlusion of the patent ductus arteriosus, angioplasty of the isthmic coarctation of the aorta, embolisation of coronary fistulas.

The following procedures are performed in the Cardiac Catheterization Laboratory Unit:

Invasive diagnostic procedures

  • Selective coronary angiography and check-up of aortic-coronary by-pass
  • Right and left cardiac catheterisation with pharmacological tests of pulmonary vessel reactivity

Coronary interventional cardiology procedures

  • Primary percutaneous coronary angioplasty in myocardial infarction
  • Percutaneous coronary angioplasty in unstable acute coronary syndrome
  • Complex percutaneous coronary angioplasty

Valvular interventional cardiology procedures

  • Transcatheter Aortic Valve Implantation of biological percutaneous  valve (TAVI) for aortic valve stenosis
  • Transcatheter Aortic Valve Implantation of biological percutaneous  valve in degenerated aortic and mitral surgical bioprostheses (valve in valve technique)
  • Percutaneous transcatheter repair of mitral valve insufficiency with Mitraclip
  • Percutaneous transcatheter repair of mitral valve insufficiency by anuloplasty
  • Percutaneous valvuloplasty of aortic and mitral valvular stenosis

Structural interventional cardiology procedures

  • Percutaneous transcatheter closure of partial detachments (leaks) of surgical  prostheses in aortic and/or mitral seats
  • Percutaneous transcatheter closure of patent oval foramen for cryptogenic stroke prevention
  • Percutaneous transcatheter closure of the left atrial appendage  for non-pharmacological prevention of systemic thrombus-embolism in non-valvular atrial fibrillation
  • Percutaneous transcatheter closure of post-infarct interventricular defects
  • Embolisation of congenital pulmonary arteriovenous fistulas
  • Septic alcoholisation of hypertrophic obstructive cardiomyopathy
  • Percutaneous pericardiocentesis

Interventional cardiology procedures of adult congenital heart disease

  • Percutaneous transcatheter closure of the interatrial defect ostium secundum
  • Percutaneous transcatheter closure of patent ductus arteriosus
  • Angioplasty with aortic coarctation stents
  • Embolisation of coronary fistulas

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