Cardiac Procedures

The following procedures are often used in the evaluation and treatment of cardiovascular disease. Consult your physician or heart care professional for more specific information.

Cardiac procedures for abnormal heart rhythms:

• Catheter ablation. This procedure uses radio waves or freezing to silence an abnormal area in the heart's electrical system, which is usually found during an electrophysiology study.

• Permanent pacemaker. A permanent pacemaker is inserted into the patient's heart and upper chest to provide a reliable heartbeat when the heart's own rhythm is too slow or irregular. A permanent pacemaker is usually inserted while the patient is in the electrophysiology lab.

• Internal cardioverter defibrillator (ICD). A defibrillator wire is inserted into the patient's heart and connected to an implanted device in the chest to send out a small amount of electricity when needed to jolt the heart rhythm back to normal.

Cardiac procedures for heart disease:

• Cardiac catheterization. With this procedure, a catheter or tube is placed into the heart through the leg or arm. Then, X-rays are taken after a contrast agent is injected into an artery to locate the narrowing, occlusions, and other abnormalities of specific arteries. 

• Coronary angioplasty. With this procedure, a balloon is used to expand a narrowing in the blood vessel to increase blood flow. Although angioplasty is performed in other blood vessels elsewhere in the body, percutaneous coronary intervention (PCI) refers to angioplasty in the coronary arteries to permit more blood flow into the heart. PCI is also called percutaneous transluminal coronary angioplasty (PTCA). There are several types of PCI procedures, including:

  • Balloon angioplasty. A small balloon is inflated inside the blocked artery to re-establish blood flow.  

  • Atherectomy. The blocked area inside the artery is "shaved" away by a tiny device on the end of a catheter.

  • Laser angioplasty. A laser is used to help "vaporize" the blockage in the artery.

  • Coronary artery stent. A tiny coil is expanded inside the blocked artery to open the blocked area and is left in place to keep the artery open.

• Coronary artery bypass. Most commonly referred to as simply "bypass surgery," this surgery is often performed in people who have angina (chest pain) and coronary artery disease (plaque buildup in the arteries). During the surgery, a bypass is created by grafting a piece of another vessel above and below the blocked area of a coronary artery, enabling blood to flow around the obstruction. Veins are usually taken from the leg, and arteries from the chest or arm may also be used to create a bypass graft.

• Heart transplant. A surgical procedure for selected patients whose hearts are so severely damaged that medications, procedures, and surgical repair cannot help. A donated heart is transplanted into the patient to replace the damaged heart.

Cardiac procedures for valve disease:

• Valvuloplasty. A procedure in which a catheter with a large balloon is used to open a heart valve that has become narrowed. The catheter is guided through the aorta to the aortic  valve, and once in place within the leaflets, the balloon is inflated until the leaflets are loosened. The balloon is then deflated and withdrawn from the body. This procedure may also be done on the mitral valve.

• Valve repair. A surgical procedure in which a damaged valve is repaired by loosening stiff valve leaflets or tightening loose valve leaflets.

• Valve replacement. In this surgical procedure, a mechanical or tissue valve is transplanted into the heart to replace the damaged valve.