Background & Scope
Interventional cardiology is a branch of cardiovascular medicine that deals with the diagnosis and treatment of heart and blood vessel conditions using minimally invasive procedures. These procedures, known as interventional procedures, are typically performed using catheters (long, thin tubes) inserted into the blood vessels through a small incision or puncture in the skin.
The main goal of interventional cardiology is to improve patient outcomes by reducing the need for open-heart surgery, which is much more invasive and carries a higher risk of complications. Interventional procedures can often be performed on an outpatient basis, allowing patients to recover at home rather than in a hospital setting.
The scope of interventional cardiology includes a wide range of procedures and techniques, including angioplasty, stenting, transcatheter aortic valve replacement (TAVR), and atherectomy. Angioplasty is a procedure that involves using a balloon-tipped catheter to widen narrowed or blocked blood vessels. Stenting is a similar procedure in which a metal mesh tube is placed in a blood vessel to keep it open. Atherectomy involves the removal of plaque (a buildup of fatty deposits) from the blood vessels. TAVR involves delivering a collapsible replacement valve--without removing the old, damaged valve--to the valve site via catheter so it can be placed inside the diseased valve.
Other interventional cardiology procedures include thrombectomy (removal of blood clots), valvuloplasty (repair of heart valves), and percutaneous coronary intervention (PCI), which is used to treat coronary artery disease.
Interventional cardiologists are specially trained cardiologists who use these techniques to diagnose and treat heart and blood vessel conditions. They work closely with other members of the cardiovascular care team, including (general) cardiologists, cardiovascular surgeons, and nurses, to develop individualized treatment plans for patients.
In addition to treating heart and blood vessel conditions, interventional cardiologists may also treat conditions in areas other than the heart.
Overall, the definition and scope of interventional cardiology encompasses the use of minimally invasive procedures to diagnose and treat a wide range of cardiovascular conditions, with the goal of improving patient outcomes and reducing the need for open-heart surgery.
Qualifications, Training, and Certifications
To become an interventional cardiologist, after medical school, a physician must complete a 3-year residency in internal medicine, then a 3-year cardiovascular medicine fellowship, then a 1-year fellowship in interventional cardiology.
During their interventional cardiology fellowship, a fellow receives extensive training in the use of interventional procedures, including angioplasty, stenting, and atherectomy.
Conditions, Diseases, Treatments, and Procedures
Some of the conditions and diseases that may be diagnosed and treated by interventional cardiology include:
Coronary artery disease: A condition in which the coronary arteries (which supply blood to the heart) become narrowed or blocked by plaque, a buildup of fatty deposits. Interventional cardiology procedures such as angioplasty and stenting may be used to widen narrowed or blocked blood vessels and improve blood flow to the heart.
Heart valve problems: Interventional cardiology procedures such as TAVR, valvuloplasty, and valvotomy can be used to repair or replace damaged or diseased heart valves.
Aortic aneurysm: An aneurysm is an abnormal bulge in a blood vessel. Aortic aneurysms can occur in the aorta, the main artery that carries blood away from the heart. Interventional cardiology procedures such as stenting or endovascular repair may be used to treat aortic aneurysms.
Peripheral artery disease: This condition occurs when the arteries that supply blood to the limbs become narrowed or blocked. Interventional cardiology procedures such as angioplasty and stenting may be used to improve blood flow to the limbs.
Pulmonary embolism: This is when a blood clot becomes lodged in the pulmonary artery (which carries blood from the heart to the lungs) or one of its branches or subbranches. Interventional cardiology procedures such as thrombectomy (removal of blood clots) may be used to treat pulmonary embolism.
Varicose veins: Interventional cardiology procedures such as sclerotherapy and endovenous laser ablation may be used to treat varicose veins, which are swollen, twisted veins that typically occur in the legs.
Some of the interventional cardiology procedures that may be used to diagnose and treat these conditions include:
Angioplasty: A procedure in which a balloon-tipped catheter is inserted into a blood vessel and inflated to widen the vessel.
Stenting: A procedure in which a metal mesh tube is placed in a blood vessel to keep it open.
Atherectomy: A procedure in which plaque (a buildup of fatty deposits) is removed from the blood vessels.
Valvuloplasty: A procedure in which a damaged or diseased heart valve is repaired.
Valvotomy: A procedure in which a narrowed heart valve is widened.
Transcatheter valve replacement: The replacement of damaged heart valve.
Thrombectomy: The removal of a blood clot.
Sclerotherapy: A procedure in which a chemical solution is injected into a vein to shrink it.
Endovenous laser ablation: A procedure in which a laser is used to destroy the inner lining of a vein.
Endovascular repair: A procedure in which a stent or other device is used to repair an aneurysm.
Overall, interventional cardiology is a specialized field that involves the use of minimally invasive procedures to diagnose and treat a wide range of cardiovascular conditions. Interventional cardiologists use these procedures to improve patient outcomes and reduce the need for open-heart surgery.
Related Medical Specialties
Interventional cardiologists work closely with other medical specialties, including cardiology, cardiovascular surgery, and radiology.
Cardiology is the medical specialty that deals with the diagnosis and treatment of diseases and conditions of the heart and blood vessels. They use a variety of diagnostic tools and technologies, such as electrocardiograms (ECGs), echocardiograms, and stress tests, to assess the health of the heart and blood vessels. Cardiologists often work closely with interventional cardiologists to develop treatment plans for patients.
Cardiovascular surgery is the specialty that involves the surgical treatment of the heart and its blood vessels. Cardiovascular surgeons perform procedures such as coronary artery bypass surgery, heart valve surgery, and aortic aneurysm repair to treat conditions such as coronary artery disease, heart valve problems, and aortic aneurysms. Interventional cardiology procedures may be used as an alternative to open-heart surgery in some cases.
Radiology is the medical specialty that involves the use of imaging technologies such as X-rays, CT scans, and MRIs to diagnose and treat diseases and conditions. Interventional radiologists are physicians who specialize in the use of these technologies to perform minimally invasive procedures in other areas of the body.
Other related medical specialties to interventional cardiology include vascular surgery, which involves the surgical treatment of diseases and conditions of the veins and arteries and, as noted, interventional radiology, which involves the use of minimally invasive procedures.
Medical-Legal Cases Involving Interventional Cardiology
Examples of medical-legal cases involving interventional cardiology may include allegations of:
Failure to properly diagnose or treat a cardiovascular condition
Improperly performed interventional cardiology procedures
Failure to obtain informed consent
Failure to properly manage complications following an interventional cardiology procedure including post-procedure bleeding from the access site or post-procedure bleeding caused by damage to a cardiac blood vessel