Interventional Cardiology

What is interventional cardiology?

Interventional cardiology uses catheters to diagnose and treat heart disease. Catheters are very small tubes (similar to IVs) that healthcare providers put through your blood vessels. This is why you don’t need an incision for a procedure that uses a catheter.

Healthcare providers working in this type of cardiology help people with vascular (blood vessel) and coronary (heart) diseases. They also help people who have structural heart disease. These diseases include heart valve defects and septal defects — abnormalities in the walls separating your heart chambers.

Some interventional cardiology providers spend their careers working with babies and children who have congenital (since birth) heart issues. Others focus on adult patients who need interventions as a result of a congenital heart issue.

Interventional cardiology vs. cardiothoracic surgery

An interventional cardiologist uses catheters to perform minimally invasive procedures on your heart or blood vessels. This means they don’t need to make a large incision called a sternotomy. However, they don’t perform open-heart surgery.

A cardiothoracic surgeon is a provider who operates on the organs in your chest, such as your heart, lungs and esophagus. They use open-heart surgery for these operations, as well as other methods that use several small incisions instead of one long one.

It often takes both specialties to determine the best treatment plan for each individual.

What does a provider in interventional cardiology specialize in?

An interventional cardiologist specializes in doing heart and blood vessel procedures with a catheter. They use some of these procedures to diagnose an issue and others to treat it.

What kind of tests does an interventional cardiologist do or order?

In interventional cardiology, the focus is on making sure the blood in your body flows the way it should. Providers in this area of cardiology identify and fix issues that get in the way of your blood flow. For example, they may check the blood flow and pressure in your coronary arteries and heart chambers.

Interventional cardiology tests may include:

• Computed tomography (CT) of coronary arteries.
• Intracardiac echocardiogram.
• Heart MRI.
• Chest X-ray.

What is an interventional cardiac procedure?

A provider performs an interventional cardiac procedure on your heart with a catheter. They do this instead of making incisions (cuts in your skin) and doing surgery. A heart valve replacement or repair a provider does with a catheter is one example of an interventional cardiac procedure.

What procedures does an interventional cardiologist do?

Interventional cardiology procedures include:

• Cardiac catheterization.
• Angiogram (peripheral or coronary).
• Angioplasty.
• Coronary atherectomy (plaque removal).
• Fractional flow reserve (FFR) measurement.
• Intravascular ultrasound (IVUS).
• Optical coherence tomography (OCT).
• Stent placement.
• Heart valve replacement and repair.
• Left atrial appendage closure.
• Atrial septal defect closure.
• Alcohol septal ablation.
• Patent foramen ovale closure.
• Renal denervation (damaging renal artery nerves to lower blood pressure).
• Thrombolysis.

What is the most common procedure performed by interventional cardiologists?

The most common procedure an interventional cardiologist does is angioplasty and stent placement in your coronary (heart) artery. With this minimally invasive procedure, they can use a catheter to find a blockage in one of your heart’s arteries. Then, they make a path for your blood using a tiny balloon that pushes cholesterol buildup against your artery wall. They can keep that pathway open with a stent (wire mesh device) if needed. Restoring blood flow to your heart is a life-saving procedure for a heart attack.

What diseases or conditions does interventional cardiology treat?

An interventional cardiologist treats a number of conditions that affect your heart and blood vessels, such as:

• Heart valve disease.
• Atherosclerosis.
• Heart attack.
• Carotid artery disease.
• Coronary artery disease.
• Hypertrophic cardiomyopathy.
• Coronary artery fistula (unusual connection to another blood vessel or part of your heart).
• Peripheral artery disease.
• Chronic venous (vein) disease.
• Aortic valve stenosis.
• Thromboembolic disease (blood clots).
• Aneurysm.
• Atrial septal defect.
• Ventricular septal defect.

Do I need a referral to see a provider in interventional cardiology?

Yes, you’ll probably need a referral to see a healthcare provider in interventional cardiology. Another provider may refer you to one in interventional cardiology because they have the specialized training to do the test or procedure you need.

Where do providers in interventional cardiology work?

Interventional cardiologists work in hospitals, private practice and medical schools. Depending on their position, they may do research and teach in addition to performing procedures.

Interventional cardiologists are often on call to treat people experiencing an emergency, such as someone having a heart attack.

What is the training for interventional cardiology?

People spend many years training before working in interventional cardiology. After finishing medical school (four years), people in this subspecialty spend three years in an internal medicine residency and three years in a general cardiology fellowship.

Next, they spend at least one year in an interventional cardiology fellowship that focuses on using catheters. Then, they get certification from a medical board.

An interventional cardiologist may become a member or fellow of the Society for Cardiovascular Angiography and Interventions (SCAI). A fellow in this organization has performed more than 1,000 procedures.

What can I expect at an interventional cardiology appointment?

Unless it’s an emergency, an interventional cardiologist will talk with you about your heart or blood vessel issue at an appointment. They’ll ask you about your symptoms and how long you’ve been having them. Be sure to bring a medication list so they can see what you’re taking. This includes medicines or supplements you buy without a prescription.

A provider will listen to your heart. They’ll ask if you use tobacco products or drink alcohol. They’ll also ask you about your family’s history of heart and blood vessel issues. They may do simple tests at your appointment, such as checking your blood pressure.

If you need diagnostic tests and/or procedures, you’ll need to schedule a separate appointment for another day. Your interventional cardiologist will discuss the risks and benefits associated with the interventional procedure they think would benefit you. Your interventional cardiologist will tell you how to prepare for any procedures you may need. For example, they may tell you not to eat for eight hours before a test or procedure.

A note from Cleveland Clinic

Knowing you have a heart or blood vessel procedure coming up can cause some anxiety. But when you have an interventional cardiology procedure, a highly trained specialist will be caring for you. An interventional cardiologist can gather the information they need to make a diagnosis. Then, they can fix the issue without doing open-heart surgery.