- Cardiac Conditions We Treat
- Cardiac Electrophysiology
- Cardiac Rehabilitation Program
- Cardiothoracic Surgery
- Familial Heart Disease Clinic
- Cardiovascular Program for Women
- Diagnostic Procedures & Treatments
- Heart Failure Program
- Interventional Cardiology Program
- Onco-Cardiology Program
- Preventative Cardiology Program
Interventional Cardiology Program
Not all heart conditions can be managed by managing risk factors through medication, diet, and exercise. Interventional cardiology uses a variety of minimally invasive procedures to test for and treat cardiac conditions like coronary artery disease, congenital heart disease, heart valve disease, and peripheral artery disease.
Under the direction of Dr. Adhir Shroff, The Interventional Cardiology Program at UI Health is team of experts in electrophysiology, heart failure, cardiovascular anesthesiology, radiology, endovascular surgery, cardiac surgery, and vascular surgery that works together to provide the best care and most successful outcomes to patients from around Chicagoland.
INTERVENTIONAL CARDIOLOGY PROCEDURES
Our interventional cardiologists possess extensive expertise in a comprehensive range of both standard-of-care and leading-edge procedures, including:
Angioplasty and Stenting
Angioplasty — also known as percutaneous coronary intervention (PCI) — is performed to restore blood flow for patients who have had or are at risk of having a heart attack due to a blockage in an artery of the heart or those with chest pain, shortness of breath, or other symptoms that indicate reduced blood flow in a coronary artery.
During angioplasty, an interventional cardiologist:
- Sends a catheter through the arteries to the site of a blockage
- Passes a balloon over a wire inside the catheter and inflates it to push plaque against the vessel wall
- Deflates and removes the balloon
Angioplasty alone is rarely enough to prevent re-narrowing of the vessel, so interventional cardiologists typically use a catheter to place a mesh tube called a stent in the vessel to hold it open and allow blood to flow.
At UI Health, interventional cardiologists perform more than 90 percent of angioplasty and stenting procedures by placing a catheter through the radial artery in the wrist via a small hole in the skin. Compared with using the femoral artery in the groin, another common entry point, the radial approach allows patients to sit up immediately after the procedure rather than have to lie still for hours, and it significantly decreases the risk of bleeding.
Our interventional cardiologists use angioplasty and/or stenting to treat less common conditions of the coronary arteries, including:
- Blockages in the left main coronary artery (LMCA): A critical pathway for blood in the heart, the LMCA can narrow as plaque accumulates over time. Coronary artery bypass grafting (CABG), a type of open-heart surgery, is one way to restore blood flow. Certain patients, however, are candidates for a nonsurgical alternative to CABG, in which an interventional cardiologist performs PCI, typically through the wrist, to place one or more stents in the left main coronary artery.
- Chronic total occlusion: Certain patients may develop complete rather than partial blockages in the coronary arteries that force the body to develop new vessels to reroute the flow of blood. Those vessels are poor substitutes for an artery, so UI Health has developed a program to treat complete arterial blockages, also known as chronic total occlusions. Interventional cardiologists use several sophisticated methods to reopen totally blocked arteries, including antegrade dissection re-entry. With this specialized angioplasty technique, an interventional cardiologist guides a wire past the blockage, inflates a balloon to open the artery from the rear, and sends a stent into the vessel to keep it open.
Our interventional cardiologists also use angioplasty and stenting to treat blockages in the peripheral arteries, especially those in the legs, where reduced blood flow can cause pain when walking.
A through-the-skin procedure, atherectomy may precede angioplasty and stenting when patients have a lot of calcium in the arteries. The goal of atherectomy is to soften or dislodge the calcium to make it easier to insert a balloon in the artery and allow stents to fully expand. UI Health offers three kinds of coronary atherectomy:
- Rotational atherectomy: This procedure uses a diamond-tipped, drill-like instrument to bore into the calcium and soften it.
- Orbital atherectomy This also uses a diamond-tipped, drill-like device to cut into calcium in a circular pattern.
- Laser atherectomy: This type of atherectomy uses a laser to soften and clear out calcium, and it is especially effective for treating calcium buildup in patients who already have stents and have experienced re-narrowing of the arteries.
Left Atrial Appendage Occlusion/The Watchman™ Procedure
Certain individuals with atrial fibrillation, the most common type of abnormal heart rhythm, have an above-average risk for stroke because the irregular pumping of the heart can cause a blood clot to form in the left atrial appendage (LAA), a small structure in the top-left chamber of the heart. If the clot dislodges and travels to an artery that sends blood to the brain, it can cause a stroke.
Cardiologists often prescribe a blood-thinning medication to prevent the formation of blood clots in patients with atrial fibrillation who have an increased risk for stroke, but UI Health offers an alternative: Watchman, a small device that closes the LAA. Using a percutaneous approach, an interventional cardiologist uses a catheter inserted through a vein in the groin to send Watchman to the LAA and seal it. The device is permanent, and most patients taking a blood thinner are able to stop the medication after Watchman is placed.
Coronary Artery Bypass Grafting (CABG)
This form of open-heart surgery is appropriate for people who have severe coronary artery disease or who are not candidates for angioplasty and stenting. While a heart-lung machine keeps blood moving through the patient’s body, a surgeon reroutes blood flow around the blocked arteries by creating new pathways using blood vessels taken from the patient’s chest or legs. UI Health surgeons perform many CABG operations each year and have an excellent safety record.
STRUCTURAL HEART PROGRAM
The heart contains four valves that keep blood flowing forward as it makes its way through the organ, and ultimately, to the rest of the body. Two common problems that can affect the valves, especially the mitral and aortic valves, are stenosis — stiffening of a valve that prevents it from opening all the way — and regurgitation, which is leakiness that occurs when blood flows backward through a valve. The Structural Heart Program at UI Health provides treatments to problems affecting the valvular makeup of the heart, including:
A treatment for stenosis, balloon valvuloplasty involves sending a catheter through the groin to a stiff heart valve and inflating a balloon to push open the leaflets (flaps) of the valve. Interventional cardiologists typically perform this procedure to open the aortic and mitral valves.
A less invasive alternative to open-heart surgery, the MitraClip procedure is a catheter-based treatment that involves placing the MitraClip device — a metal clip with a covering of polyester fabric — on a regurgitating mitral valve, the gateway between the heart’s left atrium and left ventricle. MitraClip pins part of the valve together, which allows the rest of the structure to open and close around it and prevents blood from leaking backward.
Transcatheter Aortic Valve Replacement (TAVR)
For certain patients with a damaged aortic valve as a result of aortic stenosis, open-heart valve replacement surgery can be risky, especially if they are older and have other health conditions. Such patients once had few other options, but now an alternative exists: transcatheter aortic valve replacement (TAVR). This procedure involves introducing a new valve without having to remove the old one.
To perform TAVR, an interventional cardiologist introduces a catheter through a vessel in the groin or shoulder. The doctor sends a collapsible valve through the tube to the aortic valve, where the replacement valve expands. It pushes the old valve’s leaflets out of the way and begins opening and closing normally to allow blood to pass.
UI Health interventional cardiologists are experts not only in first-time valve replacement using TAVR but also in valve-in-valve TAVR, which is for patients with previous surgical aortic valve replacements. If a surgical replacement valve becomes damaged or is poorly sized for a patient, an interventional cardiologist can use TAVR to implant a replacement.
Outpatient Care Center, Suite 3C
1801 W. Taylor St.
Chicago, IL 60612
To make an appointment with the Interventional Cardiology team, please fill out the online form or call 312.996.6480.