Minimally-Invasive Hospital Procedures for Your Heart’s Health
Certain procedures must be performed in the hospital to correct problems with your heart or arteries. Some of these procedures are surgical and include some recovery time, while others are non-surgical and are done on an outpatient basis.
Cardiac Catheterization & Stenting
Your doctor may suggest a cardiac catheterization if you are experiencing chest pain. This test helps to determine any heart disease or blockages in your arteries. Before the procedure, it’s important that you communicate with your doctor about any medication you are taking and any other chronic illnesses (such as diabetes) that you may have.
During the procedure, you will be lying on your back and although you will be given medication to relax, you may remain awake. A small incision will be made in your upper thigh, neck, or arm where a catheter will be guided through your blood vessel to your heart. Because a numbing medicine will be used at the incision site, you will not feel the catheter being eased through your artery although you may feel some pressure.
Your doctor will have the visual help of a special machine so that he can place the catheter precisely in the spot that needs further tests or treatment. During your cardiac catheterization if a blockage is confirmed your doctor may fix the blockage with a balloon or stent. Stents are inserted to open a blocked vessel during cardiac catheterization. A stent is a small mesh or fabric tube used to support weak or narrow arteries and to improve blood flow. You may feel some chest pressure or even some pain when your doctor inflates the stent. Once your doctor completes the procedure, the catheter is removed and a bandage is placed on the incision site.
You will stay in the hospital for several hours or more likely overnight if a stent is performed. Nurses will check your blood pressure regularly and your incision site for bleeding. You may be sore for several days after the procedure and your doctor will advise you about when you can resume your normal activity (such as driving and lifting) and when you can return to work.
Pacemakers are devices that are used when your heart is beating abnormally or too slow, a condition called arrhythmia. Using low energy electrical pulses, the pacemaker controls your heart’s rhythm so that it beats correctly.
Before your pacemaker procedure, your doctor will instruct you about taking any of your prescription medication. You’ll also be instructed not to eat or drink anything after midnight the day of your procedure. Arrive at the hospital dressed comfortably and without any valuables since you will change into a hospital gown for the procedure.
At the start of your treatment, you will lie down on your back while a nurse administers an IV through your arm. You will also be connected to monitors that will record your blood pressure and other vital signs during the procedure. Another monitor will give your doctor a visual guide as he or she puts your pacemaker in place.
Although you will be awake during the procedure, you will be given medicine through the IV that will help you relax. Before your doctor inserts the pacemaker, he will inject numbing medicine to your chest so that you will not feel any pain when he makes the incision. You may feel a pulling sensation as he attaches the pacemaker and adjusts its setting, but if there is any significant discomfort or pain your doctor will want you to tell him immediately.
You may be allowed to leave the hospital after the procedure or your doctor may want you to stay overnight. You will receive instructions about lifting, exercise, and returning to work before you leave the hospital. You will also receive specific information about how and when to avoid electrical devices to ensure that your pacemaker stays in reliable working order.
Implantable cardioverter defibrillator (ICD)
An ICD is a solution for patients whose heart beats abnormally in such a way that it’s life-threatening. Not only for adults, an ICD can also be used to correct arrhythmia in children and teens.
The surgery typically takes a few hours but you should expect to stay in the hospital a day or two while you recover and your cardiologist makes sure your ICD is working appropriately. Similar to a pacemaker procedure, you will be given medicine through an IV in your arm to help you relax. Your doctor will numb the area where he will make an incision to place the ICD and use a special monitor to give him a visual guide as he places the ICD and attaches it properly. The device uses low-level electrical shocks to help control the beating of your heart at a normal rate.
After the procedure, your doctor may prescribe antibiotics to help prevent infection and you may feel some discomfort where the ICD was implanted. You will be given instructions as to when you can return to work or other activities, but most people resume their normal schedule a few days after receiving their ICD.
Transcatheter aortic valve replacement (TAVR)
Aortic heart valves can calcify, losing the ability to open properly and decreasing blood flow from your heart through your body. This condition is called aortic stenosis and may make you feel short of breath, experience chest pain or discomfort, dizziness, fatigue or even pass out. If you have been diagnosed with aortic stenosis but your doctor has advised that open heart surgery is too risky for you, TAVR can be a viable option. This fairly new procedure was approved by the FDA in 2011, but thousands of patients worldwide have since had this treatment with excellent results.
Unlike open heart surgery, the TAVR procedure is minimally invasive. A catheter is passed through the artery of the leg or groin up to the heart. A collapsible valve is then positioned in place to take over the job of the damaged one. The new valve begins regulating blood flow immediately, allowing the patient the possibility of a healthier, prolonged life. And unlike the months-long recovery time of open heart surgery, patients who have the TAVR procedure typically recover within a few days. Like any other surgical procedure, there are some risks, however, and your doctor will answer all of your questions and concerns so that you will be comfortable with your decision.