Interventional Cardiology

Chief: Caterina Gandolfo

The Unit specializes in the treatment of complex coronary diseases, transcatheter treatment of valve diseases, and acute aortic syndrome.

The unit has a Cardiac Cath Lab and a hybrid room with state-of-the-art angiographs.

Coronary angioplasty is performed after the coronarography or, if possible, in the same session. In addition to balloon angioplasty, the Unit is provided with the latest-generation devices (Rotablator, intracoronary ultrasound, FFR, i-FR) and a wide range of medicine-releasing coronary prostheses (stents) to treat any type of coronary pathology. Reabsorbable stents allow maintenance of the maximum opening of the vessel after the angioplasty, but one year later they are completely reabsorbed, and the vessel remains patent and with no metal prostheses within.

The Unit can ensure emergency and/or urgent exams for any cardiac pathology.

In the case of acute infarction, the team is able to disobstruct the artery very rapidly with the use of modern systems, such as microsuctions (they suction thrombuses, which are always present in the obstructed coronary arteries) or filters (placed distally to the occlusion to prevent the circulation of thrombuses when the vessel is reopened).
In addition, they perform emergency thoracic endovascular aortic repair (TEVAR) in the case of acute aortic dissection type B and traumatic rupture of thoracic aorta.

The Unit is specialized in the diagnosis and treatment of patients with congenital and valve diseases. Transcatheter aortic valve transcatheter replacement (TAVR) in severe aortic stenosis with high surgical risk, percutaneous replacement with a new surgical bioprosthesis for degenerated valves both in the aortic, mitral, and tricuspid areas (valve in valve) are also performed.

For patients with serious functional mitral failure and dilation of a hypokinetic left ventricle due to primitive or ischemic cardiomyopathy, interventional radiology can provide the percutaneous treatment of the mitral failure with the insertion of one or more clips between the two valve edges that contain, and most of the time, remove regurgitation.

In patients with interatrial and interventricular septal defect, frequently congenital, the closure of solution of continuity is done percutaneously with several devices shaped like small umbrellas according to the type and anatomy of the defect assessed with cardiac MRI and 3D transesophageal ultrasound. The dilation of the pulmonary arteries and aorta (in case of aortic coarctation) is possible with various types of stents, also covered.

Interventional cardiology also helps in the prevention of ischemic stroke, in collaboration with neurologists, through the percutaneous closure of the patent foramen ovale in the case of cryptogenic ischemic stroke (lack of other causes of stroke) with significant right/left shunt. The percutaneous closure of the left atrial appendage, a site of thrombus formation and collection during atrial fibrillation, occurs with a plug device, which closes the appendage and prevents the output of thrombuses in patients who have problems with chronic anticoagulation treatment.

Invasive diagnostics

  • Cardiac catheterization of the right and left cavities for detection of blood pressure, oxygen measurement, contrastographic study
  • Cardiac catheterization on effort
  • Coronarography with intravascular ultrasound (IVUS) and fractional flow reserve (FFR) to verify the ischemizing capability of coronary narrowings, apparently not significant when the angina symptoms are present
  • Angiography of the venous and pulmonary circle (by right catheterization); angiography of the large arteries, district circles, peripheral arteries, epiaortic trunks
  • Myocardial biopsy
  • Catheterization for the study of pulmonary hypertension with reversible pharmacology tests
    Interventional cardiology
  • Coronary angioplasty with balloon, medicated balloon (drug-eluting balloon [DEB])
  • Coronary angioplasty with implant of metal or medicated stent (bare-metal stent [BMS], drug-eluting stent [DES])
  • Coronary angioplasty with rotational atherectomy (Rotablator)
  • Percutaneous insertion of assistance device, intra-aortic balloon pump
  • Peripheral ileo-femoral and carotid district angioplasty
  • Transcatheter aortic valve implant (TAVI)
  • Percutaneous mitral valve repair (MitraClip)
  • Aortic, pulmonary, and mitral valvuloplasty
  • Percutaneous closure of the patent foramen ovale (PFO)
  • Percutaneous closure of the atrial septal defect ostium secundum
  • Percutaneous closure of interventricular septal defect
  • Percutaneous closure of paravalvular aortic leaks
  • Thoracic endovascular aortic repair (TEVAR)
  • Percutaneous closure of the left atrial appendage