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What Is an Interventional Cardiologist?

An interventional cardiologist specializes in non-surgical techniques to treat blocked arteries and chest pain and prevent heart attacks caused by reduced blood flow to the heart. The interventionist's tools of choice are balloons, used to inflate the artery to open blood flow, and stents, which are tiny spring-like wires used to hold blocked arteries open.

  1. PCI Versus CABG

    • Percutaneous coronary intervention, or PCI, is the procedure used by interventional cardiologists and includes stenting and balloon angioplasty. These procedures are less invasive than CABG (coronary artery bypass surgery, or "open heart" surgery), which are performed by cardiothoracic surgeons. This invasive procedure involves opening the chest wall to access the heart while a bypass machine takes over the function of the heart and lungs.

    The PCI Procedure

    • PCI, commonly known as "heart cath," involves having the patient lie on a table in the cath lab. The right groin is sterilized, usually with Betadine, and a thin, flexible catheter is inserted in the femoral artery and threaded to the heart by the cardiologist.

    Treatments

    • A number of interventions can be done once the catheter reaches the heart, which provides a live view of the organ and its arteries on a special monitor. Narrowed or blocked vessels are visible, allowing the interventionist to perform stenting or ballooning to open them. The procedure also allows internal pressures to be measured to further evaluate heart function.

    History

    • The concept of cardiac catheterization began in Egypt around 3,000 B.C., where bladder catheterizations were performed using metal pipes. By 400 B.C., catheters were made from hollow reeds and used in cadavers to study the function of heart valves. In 1977, Andreas Gruentzig performed the first angioplasty on an awake patient in Zurich. In 1980, he moved to Atlanta and became director of interventional cardiology at Emory University.

    The Future

    • Techniques used by interventional cardiologists are being used to treat other conditions, such as arterial kidney disease. Angioplasty and stents may soon be used to minimize or stop damage from stroke by treating the carotid arteries that supply blood to the brain. Breakthroughs in stent technology include a bio-absorbable stent that dissolves once the artery heals.

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