Coronary interventional cardiology is a subspecialty within cardiology that addresses issues arising from the heart arteries. This is commonly associated with the lay-man term of "heart attack" where there is narrowing of the heart artery. Heart artery narrowing is a common medical issue and can result in chest pain or damage to the heart with consequent heart failure. It is therefore an important condition to diagnose and treat.
Traditionally, the diagnosis of heart artery narrowing is confirmed with an invasive coronary angiography procedure where a fine tube, known as a catheter, is inserted to the heart artery from either a hand or leg artery. This allows for injection of contrast and visualization of the vessel lumen with X-ray. In the past 10 years, however, limitations of this previous "gold standard" is increasingly realized and the diagnostic procedure may now include functional evaluation and intravascular imaging. These adjunct procedures involve passage of a special wire into the heart artery or an imaging device that looks directly into the heart artery.
In the case of functional evaluation, the special wire allows for direct measurement of blood flow as well as calculation of new indices such as the microvascular resistance. This allows for the diagnosis of microvascular angina, a recently recognized entity where impairment of the microscopic vessels result in abnormal blood flow. Coronary vasospasm study can also be performed and this allows for the diagnosis of chest pain syndromes without apparent high grade blockages. Intravascular imaging also allows for the direct visualization of the heart arteries and this can be helpful in guiding the coronary angioplasty or stenting procedure.
Our patients are increasingly elderly with more complex issues, and our institution has the capability to perform challenging procedures in these patients, including the use of heart support devices. This is particularly helpful in patients deemed to have high surgical risk.
We treat a range of conditions, from full diagnostic evaluation of the heart arteries, to complex percutaneous coronary intervention, in both an elective and emergency setting. We also have access to the Impella left ventricular assist device to support ill patients with poor heart function, and also collaborate with the cardiothoracic surgeons in hybrid procedures.
Diagnostic procedures including conventional coronary angiography to full functional evaluation of the heart arteries in patients with chest pain syndromes inadequately defined by conventional tests. We are a pioneer in the use of functional evaluation, including coronary vasospasm study, in this part of the world.
We also offer the full suite of interventional coronary procedures from routine coronary stenting to complex high risk procedures deemed to be too high risk by conventional open heart bypass surgery.
