Cardiovascular Procedures and Definitions

•  Arrhythmias - a change in either the speed or the pattern of the heartbeat. The heart either beats too fast, too slow or irregular.
• Angioplasty - percutaneous coronary intervention (PCI), commonly known as coronary angioplasty or simply angioplasty, is a therapeutic procedure to treat the stenotic (narrowed) coronary arteries of the heart found in coronary heart disease. These stenotic segments are due to the build up of cholesterol-laden plaques that form due to atherosclerosis.
• Ablation - a technique to used to destroy (ablate) parts of the heart’s abnormal electrical pathway that cause heart rhythm disturbances.
• Atrial Fibrillation - an abnormal heart rhythm (arrhythmia) that starts in the upper chambers of the heart (atria). It causes irregular and unusually rapid heartbeats.
• Atrial Septal Defect (ASD) - a hole or defect in the wall that separates the upper chambers of the heart.
  
• Atrial Septal Defect Repair (percutaneous) - a catheter-based cardiac implant procedure that involves the implantation of a closure device that seals the defect.
  
• Brachytherapy - a form of radiotherapy where a source of radiation is applied to a coronary artery using radioactive seeds for treating an artery blockage in an area when a stent was previously placed.
  
• Cardiac Bypass Surgery (including minimally invasive technique & off-pump) - a surgical procedure where one or more blocked coronary arteries are bypassed with a blood vessel graft to restore normal blood flow to the heart. These grafts usually come from the patient's own arteries and veins located in the leg, arm, or chest. There are two new types of minimally invasive coronary artery bypass graft surgery: port-access coronary artery bypass (also called PACAB or PortCAB) and minimally invasive coronary artery bypass (also called MIDCAB). Both procedures enable surgeons to work on the coronary arteries through small chest holes called ports and other small incisions.
  
• Cardiac Catheterization - cardiac catheterization (also called heart catheterization) is a diagnostic procedure that does a comprehensive examination of how the heart and its blood vessels function. One or more catheters are inserted through a peripheral blood vessel in the arm (antecubital artery or vein) or leg (femoral artery or vein) with x-ray guidance. This procedure gathers information such as adequacy of blood supply through the coronary arteries, blood pressures, blood flow throughout chambers of the heart, collection of blood samples and x rays of the heart's ventricles or arteries.
  
• Cardiopulmonary Exercise Test or Metabolic Test - a stress test performed on a bicycle or treadmill while carefully and systematically increasing a patient's level of exertion. Both physiological parameters and symptoms are monitored. Physicians are able to detect loss of reserve energy or decreases in physiological capacity early on. Metabolic tests may also help to distinguish between shortness of breath that is caused by psychological factors, as opposed to problems caused by cardiac disease, pulmonary disease or muscle and vascular problems.
  
• Cardioversion - shocking the heart back into a normal rhythm.
• Coronary Stents - a small, self-expanding, stainless steel mesh tube that is placed within a coronary artery to keep the vessel open. Drug-eluting stents are coated with a medication that helps to prevent the blockage from returning.
• Directional Coronary Atherectomy - a catheter-based procedure where a tube is inserted through a peripheral blood vessel in the arm or leg with x-ray guidance where high speed drills are used to remove plaque (blockage) from the inside of the arteries of the heart.
• Dobutamine Stress Echo - a medication stress test (for patients unable to exercise) that includes echocardiography while the heart is being stressed. It helps doctors learn how well the heart works when it is made to beat harder and faster.
• Echocardiography - ultrasound that uses high-frequency sound waves to look at heart structures and function.
• Electrophysiology Study - intracardiac electrophysiology study (EPS) - Involves placing wire electrodes within the heart to determine the characteristics of heart arrhythmias.
  
• Endomyocardial Biopsy - removing a small piece of heart muscle tissue by inserting a catheter through a vein in the neck or groin. The biopsy samples are microscopically analyzed and the information obtained will assist your doctor in the diagnosis and management of various heart conditions.
  
• Heart Rhythm Ablation - a procedure that applies a special type of energy to the heart. It puts small burns inside the heart to stop some irregular heartbeats.
• Heart Transplantation - a surgical procedure that replaces a damaged heart with a healthy heart from a person whose heart has been donated after they have died.
• Holter Monitoring - acontinuous recording of the heart rhythm, typically for 24-hours while one goes about normal daily activities. It helps diagnose abnormal heart rhythms.
• Implantable cardioverter defibrillator - a device that monitors a person’s heart rate. If it records a life threatening irregular rhythm, it will shock the heart back into a normal rhythm. It is usually implanted into the chest under the skin near the shoulder.
• Intra-coronary ultrasound - a procedure that involves threading a tiny ultrasound "camera" into the coronary arteries to give a valuable cross-sectional view from the heart arteries inside-out, showing the physician where the normal artery wall ends and the plaque begins.
• Left ventricular assist device - a battery-operated, mechanical pump-type device that's surgically implanted. It helps maintain the pumping ability of a heart that cannot effectively work on its own.
• Pacemakers (single chamber, dual chamber, bi-ventricular) - a surgically-implanted electronic device that regulates a slow or erratic heartbeat. An insulated wire called a lead is inserted into an incision above the collarbone and guided through a large vein into the chambers of the heart. Depending on the configuration of the pacemaker and the clinical needs of the patient, as many as three leads may be used in a pacing system.
• Pacemaker (Bi-Ventricular) - a pacemaker that helps the two bottom chambers of the heart to beat together instead of separately.
• Pulmonary hypertension - high blood pressure in the blood vessels that supply blood to the lungs.
• Radionuclide ventriculogram (stress MUGA) - a medical test that uses a radioactive substance, known as a tracer, to assess the flow of blood to the heart muscle. Can be performed at rest or with exercise.
• Rotoblator - coronary atherectomy (or rotablator) removes plaque from the arteries supplying blood to the heart muscle. It uses a laser catheter, or a rotating shaver ("burr" device on the end of a catheter). The catheter is inserted into the body and advanced through an artery to the area of narrowing.
• Stress echo - a treadmill or bicycle stress test, which includes echocardiography while the heart is being stressed; used to assess heart function.
• Tilt table testing - a test performed on people who have a history of passing out or almost passing out. The patient lies on a special table, which tilts to an almost standing position while monitors are used to record heart rate and rhythm, blood pressure and oxygen levels.
  
• Signal averaged electrocardiogram - this is called a high-resolution ECG or late potential study. Computers are used to amplify and enhance the ECG signal. Small electrical currents, called ventricular (ven-TRIK'u-ler) late potentials, can be recorded with a signal-averaged ECG. This test may help identify people at risk of a dangerous rhythm in the heart's lower (pumping) chambers. This is called ventricular arrhythmia (ay-RITH'me-ah) and it can lead to sudden cardiac death.
  
• Transesophogeal echo (TEE) - is a special type of echocardiogram. A tube with an echocardiogram transducer on the end of it is passed down a person's throat and into the esophagus. (This is the tube connecting the mouth to the stomach.) The esophagus is right behind the heart, and images from TEE can give very clear pictures of the heart and its structures.
• Treadmill testing - a stress test, sometimes called a treadmill test or exercise test, helps a doctor find out how well your heart handles work. As your body works harder during the test, it requires more oxygen, so the heart must pump more blood. The test can show if the blood supply is reduced in the arteries that supply the heart. It also helps doctors know the kind and level of exercise appropriate for a patient.
• T- wave alternans - a special ECG test to find out if a patient is at risk for having a dangerous heart rhythm that originates from the bottom chambers of the heart.
• Valve surgery - replaces a abnormal or diseased heart valve with a healthy one. The replacement valve can be mechanical (synthetic) or bioprosthetic (from an animal or human).
• Valvuloplasty – a catheter-based procedure that uses a large balloon catheter that is inflated at the opening of a diseased heart valve, in an effort to improve blood flow through the valve.
• Vascular surgery - various procedures used to repair blood vessels that are damaged as a result of trauma or disease.
• Vascular angiography/intervention - a diagnostic procedure which examines blood flow in vessels supplying blood to various parts of the body. One or more catheters are inserted through a peripheral blood vessel in the arm (antecubital artery or vein) or leg (femoral artery or vein) with x-ray guidance. If a blockage is found it can be corrected with balloon catheters, and/or stents (self-expanding, stainless steel mesh tube that is placed within the blood vessel in the area where blockages exits in order to keep the vessel open).
  
• Vascular ultrasound - ultrasound using high-frequency sound waves to look at blood vessel structures and function.
• Ventricar septal defect (VSD) – a hole or defect in the wall that separates the lower chambers of the heart.