HEART
The Division of Cardiovascular Medicine, is a dynamic and innovative center dedicated to excellence in clinical care and research. Our division is driven by over 25 specialists who are the pillar of strength in the Division’s ongoing efforts into the prevention, and treatment of cardiovascular disease. Our goal is to provide excellence in clinical care. The Division of Cardiovascular Medicine is one of the most acclaimed clinical units in Southern Iran, providing clinical services to more than 50,000 patients annually through Fars Heart Foundation and Shiraz Kowsar Hospital. We deliver compassionate and cutting edge preventive, diagnostic and therapeutic services to patients with coronary artery disease, valvular heart disease, arrhythmia, aortic disease and heart failure. Shiraz Kowsar Hospital’s cardiac catheterization lab features 4 individual labs with 24/7 staffing. They are all fully-equipped and wired for real-time electronic information transfer, image and video sharing to support patient care before, during and after procedures.
Coronary and peripheral angiography and angioplasty, percutaneous closure of septal defects, mitral and aortic valve repair, various electrophysiological studies and ablation procedures, intra-cardiac defibrillator and pacemaker insertion, endovascular repair of aortic diseases are among the procedures that our interventional cardiologists perform regularly. Cardiac surgery unit also performs all kinds of open heart surgery as well as minimally invasive cardiac and vascular operations.
You can meet and get to know our full-time interventional cardiologists as well as cardiac and vascular surgeons at their personal page in the website under the section: Doctors.
Heart Disease
Coronary artery bypass graft surgery (CABG) is a procedure used to treat coronary artery disease. Coronary artery disease (CAD) is the narrowing of the coronary arteries – the blood vessels that supply oxygen and nutrients to the heart muscle. CAD is caused by a build-up of fatty material within the walls of the arteries. This build-up narrows the inside of the arteries, limiting the supply of oxygen-rich blood to the heart muscle.
One way to treat the blocked or narrowed arteries is to bypass the blocked portion of the coronary artery with a piece of a healthy blood vessel from elsewhere in your body. Blood vessels, or grafts, used for the bypass procedure may be pieces of a vein from your leg or an artery in your chest. An artery from your wrist may also be used. Your doctor attaches one end of the graft above the blockage and the other end below the blockage. Blood bypasses the blockage by going through the new graft to reach the heart muscle. This is called coronary artery bypass surgery.
The angiography procedure
You'll usually be awake for an angiogram, although general anaesthetic (where you're asleep) may be used for young children.
For the test:
you'll be asked to change into a hospital gown and lie down on a special table
a small cut is made in the skin over one of your arteries, usually near your groin or wrist – local anaesthetic is used to numb the area so it doesn't hurt
a long, thin, flexible tube (catheter) is inserted into the artery and is carefully guided to the area being examined – you may feel some pushing and pulling when this is done, but it shouldn't be painful
a special dye (contrast agent) is injected through the catheter – you may feel warm, flushed and as though you need to pee for a few seconds after this is done
a series of X-rays are taken as the dye flows through your blood vessels
resourse: https://www.nhs.uk/conditions/angiography/what-happens/
Most people who have angioplasty also have a stent placed in their blocked artery during the same procedure. The stent is usually inserted in the artery after it's widened by the inflated balloon.
The stent supports the walls of your artery to help prevent it from re-narrowing after the angioplasty. The stent looks like a tiny coil of wire mesh.
Coronary artery stent
Here's what happens:
- The stent, which is collapsed around a balloon at the tip of the catheter, is guided through the artery to the blockage.
- At the blockage, the balloon is inflated and the spring-like stent expands and locks into place inside the artery.
- The stent stays in the artery permanently to hold it open and improve blood flow to your heart. In some cases, more than one stent may be needed to open a blockage.
- Once the stent is in place, the balloon catheter is removed and more images (angiograms) are taken to see how well blood flows through your newly widened artery.
- Finally, the guide catheter is removed, and the procedure is completed.
After your stent placement, you may need prolonged treatment with medications, such as aspirin or clopidogrel (Plavix) to reduce the chance of blood clots forming on the stent.
Resource: https://www.mayoclinic.org/tests-procedures/coronary-angioplasty/about/pac-20384761
Catheter ablation is a procedure that uses radiofrequency energy (similar to microwave heat) to destroy a small area of heart tissue that is causing rapid and irregular heartbeats. Destroying this tissue helps restore your heart’s regular rhythm. The procedure is also called radiofrequency ablation.
What happens during catheter ablation?
A doctor with special training performs the procedure along with a team of nurses and technicians. The procedure is done in a hospital EP or cath lab.
- A nurse will put an IV (intravenous line) into a vein in your arm so you can get medicine (anesthesia) to prevent pain. You may also get a medicine (sedative) to help you relax but you will be awake throughout the procedure.
- The nurse will clean and shave the area where the doctor will be working. This is usually in your groin.
- The nurse will give you a shot — a local anesthetic — to numb the needle puncture site.
- The doctor will make a needle puncture through your skin and into the blood vessel (typically a vein, but sometimes an artery) in your groin. A small straw-sized tube (called a sheath) will be inserted into the blood vessel. The doctor will gently guide a catheter (a long, thin tube) into your vessel through the sheath. A video screen will show the position of the catheter. You may feel some pressure in your groin, but you shouldn’t feel any pain.
- The doctor inserts several long, thin tubes with wires, called electrode catheters, through the sheath and feeds these tubes into your heart.
- To locate the abnormal tissue causing arrhythmia, the doctor sends a small electrical impulse through the electrode catheter. This activates the abnormal tissue that is causing your arrhythmia. Other catheters record the heart’s electrical signals to locate the abnormal sites.
- The doctor places the catheter at the exact site inside your heart where the abnormal cells are. Then, a mild, painless, radiofrequency energy (similar to microwave heat) is sent to the tissue. This destroys heart muscle cells in a very small area (about 1/5 of an inch) that are responsible for the extra impulses that caused your rapid heartbeats.
