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Advanced Cardiovascular Care

Procedures

Cardiac (Heart) Catheterization

What Is Cardiac Catheterization? 

Catheterization procedures involve threading a long tube (catheter) into the arteries to bring miniature cameras and instruments to a disease site in the heart or blood vessels.

A cardiac (heart) catheterization procedure allows doctors to:

  • Evaluate chest pain

  • Identify narrowed or blocked arteries

  • Restore blood flow to threatened heart tissues, without surgery, by:

  • Use the catheter to reopen the blocked artery

  • Hold the artery open with a small, meshwork collar called a stent

 

CHI St. Luke’s Health–The Woodlands Hospital Heart & Vascular Institute has one of the most experienced diagnostic and interventional cardiac catheterization programs in The Woodlands.

 

Conditions We Treat at CHI St. Luke’s Health–The Woodlands Cardiac Catheterization Labs

Our state-of-the-art heart catheterization labs provide our experts with the most modern imaging technology to diagnose and treat cardiovascular disease.

Staffed around the clock with specialists in emergency catheterization, we treat acutely ill patients — including many who arrive by helicopter from regional community hospitals.

We also evaluate and treat:

St. Luke’s cardiologists have experience in treating the most difficult cardiac cases using:

  • Stents

  • Intravascular ultrasound

  • Distal embolic protection devices

They also have an active program in treating peripheral arterial disease, including:

  • Carotid artery disease

  • Renal artery disease

  • Lower extremity vascular disease

Innovations in Cardiac Catheterization

  • Our cardiac catheterization program uses drug-coated stents, which release a drug into the blood vessel wall that significantly decreases the likelihood of re-narrowing.

  • Our cardiologists can also use a method to support heart function in critically ill patients without the use of surgery.

  • We have a dedicated transradial cardiac catheterization program. In select patients, this approach allows for diagnostic and therapeutic cardiac catheterization via the radial artery in the wrist, instead of the traditional leg approach.

Cardiac (Heart) Imaging

Cardiac imaging tests take pictures of the heart.

Benefits of Cardiac (Heart) Imaging

Cardiac imaging is a critical step in the accurate diagnosis of many heart conditions. Through these images, doctors can evaluate the size and structure of a patient’s heart and see how well it functions.

Patients who come to CHI St. Luke’s–The Woodlands Advanced Cardiac Imaging Program can benefit from the latest imaging technology and the combined expertise of cardiologists, cardiac surgeons, and cardiac imaging specialists. Our experts work as a team to develop individual treatment plans for each patient.

Types of Heart Imaging Tests

Echocardiography

 Precise measures of cardiac function including:

  • Stress echocardiography

  • Transesophageal echocardiography (TEE) 

  • TTE (transthoracic echocardiogram)

Coronary CT Angiography

  • Uses a special computer and x-ray technology with fast scanning time

  • Creates detailed 3D images of your coronary arteries

An electrophysiology (EP) study is a test performed to assess your heart's electrical system or activity and is used to diagnose abnormal heartbeats or arrhythmia. The test is performed by inserting catheters and then wire electrodes, which measure electrical activity, through blood vessels that enter the heart.

Conditions We Treat With Cardiac Electrophysiology

Heart conditions we treat at the Cardiac EP Program include:

  • Irregular heart rates

  • Cardiac syncope (fainting)

  • Cardiac arrest

  • Other heart rhythm disorders

Electrophysiology Treatments and Services

  • Medications

  • Pacemakers and defibrillators

  • Radiofrequency ablation

  • Risk identification and therapies to diagnose and treat cardiac arrhythmias

  • Noninvasive electrophysiology

  • Clinical electrophysiology

Noninvasive electrophysiology

Noninvasive electrophysiology techniques to detect and monitor arrhythmias include:

  • Signal-averaged electrocardiogram (EKG) testing

  • Endless loop EKG-event monitoring

  • 24-hour Holter monitoring

  • Novel technologies for analyzing heartbeat irregularities

Clinical electrophysiology

The Cardiac EP Program also offers the full range of clinical electrophysiologic procedures, including:

  • Implantation of pacemakers and implantable cardioverter defibrillators (ICD), including biventricular pacing devices for the treatment of advanced heart failure, as well as trans-telephonic monitoring for outpatient follow up.

  • Catheter-based ablation for complex supraventricular and ventricular tachyarrhythmias, using state-of-the-art mapping systems, intra-cardiac echocardiography, and pulsed fluoroscopy, all of which limit radiation exposure.

  • Comprehensive evaluation for people with syncope and palpitations, including:

    • Ambulatory and implantable cardiac monitoring.

    • Invasive electrophysiologic testing.

Cardiac Electrophysiology Labs

Invasive and noninvasive electrophysiology laboratories provide the latest equipment for diagnosing and treating abnormal heart rhythms.

Invasive cardiac electrophysiology laboratories

  • Specially equipped for enhanced sterility

  • Advanced imaging capabilities for complex catheter ablations

  • State-of-the-art intra-cardiac monitoring and recording

Transcatheter Aortic Valve Replacement (TAVR)

Aortic valve disease can decrease quality of life and lead to serious complications, including heart failure.

At CHI St. Luke’s Health–The Woodlands Hospital’s Heart & Vascular Institute, our experts specialize in the latest treatment options, including minimally invasive catheter-based techniques, and provide individualized treatment plans for each patient.

TAVR offers a minimally invasive valve replacement option for people with severe aortic stenosis and for patients with previous  failing surgical tissue aortic valve replacements.

Severe aortic stenosis is a condition in which the aortic valve does not fully open, decreasing blood flow from the heart to the body.

Many people with severe aortic stenosis develop debilitating symptoms that can restrict normal daily activities.

For many years, treatment options for severe heart valve conditions were limited to open heart surgery and medical therapy.

Now, TAVR offers a less invasive approach for people who are at increased surgical risk or have been turned down for traditional aortic valve replacement because of age or other medical conditions.

What to Expect With Transcatheter Aortic Valve Replacement (TAVR)

When referred to the TAVR program at The Heart and Vascular Institute, you will have a thorough evaluation by a multidisciplinary team of heart valve specialists. If you are a candidate for TAVR, you may expect:

  • No need to open the chest to perform open heart surgery

  • Smaller incision or no incision at all

  • Less anesthesia due to safer use of sedation and shorter time in operating room

  • Shorter length of stay in the hospital and faster recovery time

Your TAVR Journey

Exams and tests before TAVR

During your TAVR evaluation, you’ll meet with our multidisciplinary heart valve team that includes a cardiac surgeon, interventional cardiologist, and advanced practice providers.

Testing for TAVR evaluation before, during or after the visit may include:

  • Echocardiogram

  • Cardiac catheterization

  • CT angiography (CT scan)

  • 5-meter gait speed test 

  • Electrocardiogram (EKG)

  • Pulmonary function tests (PFTs)

  • Carotid ultrasound

  • Blood work and urine test to evaluate for infection prior to valve replacement

On the day of your TAVR

  • Arrive at the hospital about two hours before the procedure

  • Meet with the valve team and cardiac anesthesiologist

  • May repeat electrocardiogram and blood work

  • Plan on spending around one hour in the operating room before going to a progressive care unit for cardiac monitoring overnight

What happens during TAVR?

During a TAVR procedure, your doctor:

  • Accesses an artery in your groin.

  • Uses special moving x-ray imaging — called fluoroscopy — and guides a tissue valve with a metal frame on a catheter into the aortic valve.

  • Opens the new valve, using the catheter-based approach, within the old valve. The new valve expands within your existing valve, restoring proper blood flow.

Recovery and care after your TAVR

  • Repeat echocardiogram the day after TAVR.

  • Most patients spend one or two nights in the hospital.

  • Plan on needing help at home from a family member or caregiver for the first week after TAVR.

  • You may need additional outpatient blood work after TAVR.

  • The valve team will call you within a week of TAVR to check on you and make sure you are taking your medications as prescribed.

  • You will be seen in the valve clinic one month or sooner after TAVR with an echocardiogram the same day.

  • One year after TAVR you’ll schedule another visit with an echocardiogram.

What are the benefits of TAVR?

Since many people with severe aortic stenosis are at increased surgical risk and have considerable mortality in the short term, TAVR may provide a treatment pathway that would otherwise be unavailable. However, TAVR may not be appropriate for all risk categories.

TAVR:

  • Is a less invasive procedure that surgeons perform while the heart beats.

  • Does not involve open-heart surgery or require the need for a heart-lung bypass machine.

  • May result in a faster, milder recovery.

What are the risks of TAVR?

TAVR is a surgical procedure that involves anesthesia.

Placement of the valve may have serious adverse effects, including risks of:

  • Stroke

  • Damage to the artery used for insertion of the valve

  • Major bleeding

  • Other serious life-threatening events or even death