Description
Recent advancements in interventional cardiology have witnessed the evolution of cutting-edge techniques and technologies aimed at improving patient outcomes. From innovative stent designs to refined imaging modalities and minimally invasive procedures, interventional cardiologists now have a broader arsenal to address complex coronary artery disease. Drug-eluting stents with novel coatings aim to reduce restenosis rates, while bioresorbable scaffolds offer the promise of temporary vessel support without long-term metal implantation. Moreover, advances in imaging, such as intravascular ultrasound (IVUS) and optical coherence tomography (OCT), enable more precise lesion assessment and optimized stent placement. Additionally, the advent of transcatheter aortic valve replacement (TAVR) has revolutionized the treatment of aortic stenosis, offering a less invasive option for high-risk patients. These developments underscore the continuous pursuit of innovation in interventional cardiology, striving for enhanced patient care, and improved long-term outcomes.
Summary Listen
- Interventional Cardiology utilizes catheter-based techniques for diagnosing and treating heart diseases, offering minimally invasive, painless procedures with quicker recovery times. Coronary artery disease, characterized by blocks in the arteries supplying the heart, is a key focus, often addressed through coronary angioplasty involving wire insertion, balloon expansion, and stent implantation.
- New techniques, such as 3D Optical Coherence Tomography (OCT), provide detailed visualization of artery lumen and stent deployment compared to traditional 2D fluoroscopy. Calcium modification tools, including intravascular lithotripsy and rotational atherectomy, are employed to tackle calcified plaques previously requiring bypass surgery. Laser atherectomy heats and softens severe blocks, enabling balloon passage when standard methods fail.
- Cutting balloons, equipped with blades, address fibroelastic plaques that resist conventional balloon expansion. These balloons cut through fibrous tissue, preventing plaque recoil but requiring careful pressure control to avoid artery dissection or perforation. Structural heart diseases involving valve defects, particularly the aortic valve stenosis, are also treated interventionally.
- Transcatheter aortic valve implantation (TAVI) replaces damaged aortic valves without open-heart surgery, using a catheter inserted through the femoral artery. Similarly, mitral valve leaks are addressed using the MitraClip, which clips valve leaflets together to reduce leakage, again avoiding open surgery.
- Drug-eluting stents, containing medications like sirolimus or tacrolimus, prevent tissue in-growth and re-stenosis compared to bare-metal stents. Complex coronary lesions, such as chronic total occlusions (CTOs), are managed with advanced techniques like antegrade/retrograde approaches, stiffer wires, and cart/reverse cart techniques, leading to increased success rates.
Sample Certificate
About the Speakers
Dr. Nischal Hegde
Consultant Interventional Cardiologist, The Bangalore Hospital, Bangalore
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