Interventional cardiac procedures are minimally invasive techniques carried out in a cardiac catheterisation laboratory (cath lab) to diagnose or treat heart and vascular problems without the need for open surgery. They use catheters (thin flexible tubes) guided through blood vessels under X-ray imaging (fluoroscopy).
The range of interventional procedures in adult cardiac care includes: coronary angiography (passing a catheter to the coronary arteries to inject contrast dye and visualise blockages or narrowings); percutaneous coronary intervention (PCI) (balloon angioplasty and stent insertion to open blocked coronary arteries, the primary treatment for heart attack); balloon valvuloplasty (inflating a balloon across a narrowed valve to stretch it open, for mitral or aortic stenosis in selected patients); catheter ablation (using radiofrequency energy or cryotherapy to destroy abnormal electrical pathways causing arrhythmias including atrial fibrillation and ventricular tachycardia); structural heart interventions (device-based procedures to close holes in the heart or repair leaking valves); and ICD and pacemaker implantation (inserting cardiac device leads via a vein into the heart).
For cardiac arrest survivors, emergency PCI is often performed immediately after resuscitation to open a blocked coronary artery. Later in the admission, electrophysiology studies and catheter ablation may be used to assess and treat the arrhythmia responsible for the arrest.
Interventional procedures carry risks including bleeding, vascular injury, and arrhythmia; these are discussed during the consent process. Most procedures are performed under local anaesthetic, and many patients return home the same day or the following day.
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