Interventional Cardiology

Coronary Artery Disease

Coronary artery disease is the narrowing of the coronary arteries. This narrowing of the arteries is caused by atherosclerosis – a buildup of fatty deposits, cholesterol, calcium, and plaque on the inner surface of the arteries. Atherosclerosis restricts blood flow to the heart, which can lead to heart attack or other heart problems. Symptoms may include angina (intermittent chest pain), shortness of breath, sweating, nausea, and/or weakness.

Coronary angioplasty is a minimally invasive procedure used to open blocked or narrowed coronary arteries caused by arteriosclerosis- to restore blood flow to the heart – often avoiding the need for surgery.

Since Dr. Robert Greene first performed coronary angioplasty on East Bay patients in 1982 there have been many medical advances in this branch of cardiology, known as interventional cardiology.  Today interventional cardiologists are treating coronary artery disease, peripheral vascular disease and valvular heart disease. Primary angioplasty is the gold standard care for the patient with acute myocardial infarction (STEMI). Our program at ABSMC was the first and is now the largest STEMI (Receiving Center in the Alameda County Emergency Medical Services Agency.

In addition we are treating complex, high risk coronary blockages using Abiomed's Impella™ left ventricular assist device and revascularizing chronic total occlusions (CTO) using Boston Scientific's CrossBoss™ and Stingray™ system.

HEART VALVE DISEASE

Heart Valve Disease involves heart valves that are not working correctly to regulate the flow of blood through the heart chambers. This can arise from birth defects, bacterial infection, or they can degenerate with the normal aging process. To compensate, your heart must pump harder, and may be unable to supply adequate blood circulation to the rest of your body. One common form of heart valve disease is aortic valve stenosis. Symptoms may include shortness of breath, chest pain, and/or fainting.

TAVR is a minimally invasive surgical procedure that repairs the aortic valve without removing the old, damaged valve. Instead, it wedges a replacement valve into the aortic valve's place. TAVR delivers a fully collapsible replacement valve to the old valve site through a catheter. Once the new valve is expanded, it pushes the old valve leaflets out of the way and takes over the job of regulating blood flow.
This procedure is FDA approved for people with symptomatic severe aortic stenosis who are considered a high-risk for standard valve replacement surgery. Surgical valve replacement requires an open-heart procedure with a “sternotomy” in which the chest is surgically opened. TAVR is performed using one of two different approaches. The valve is placed either through the femoral artery, called the transfemoral approach; or a small incision in the chest known as the transapical approach. We are currently implanting the Edwards’ XT Sapien™ and Medtronic‘s CoreValve™. Your cardiologist and cardiac surgeon will choose which valve and approach provides the best and safest way to treat your condition.
At this time the procedure is reserved for those people for whom an open-heart procedure is too risky. For that reason, most people who have this procedure are in their 70s or 80s and often have other medical conditions that make them a better candidate for this type of surgery.

PERIPHERAL VASCULAR DISEASE

Peripheral Vascular Disease involves the other arteries that run throughout your body. Like the coronary arteries in your heart, these vessels can become clogged and hardened through atherosclerosis, and can increase your risk for high blood pressure, stroke, or limb loss. Symptoms may also include pain in the leg muscles (particularly calves and thighs) and/or severe aching pain in your toes or feet at night.