Doc chat: in the cath lab with a “radial evangelist”

by Carolyn Thomas    @HeartSisters

Like most heart patients who get their blocked coronary arteries opened up (or revascularized) at Victoria’s Royal Jubilee Hospital, my stent was implanted by inserting a slim catheter into an artery in my wrist and threading it up, up, up into my heart, a procedure known in the cath labs of the world as a Transradial Intervention (TRI).

But if I had been in an American hospital, my cardiologist would have more than likely threaded that catheter through the larger femoral artery in my upper thigh instead of my wrist, despite growing evidence suggesting significantly safer results, less bleeding, fewer complications, superior outcomes, and resounding patient preference for the radial approach.(1) In fact, while cardiologists across Canada, Europe and Asia are moving towards using radial as a default access, American cardiologists lag behind. 

I just don’t get it. Canadian coronary arteries simply cannot be that much different from those of American heart patients. Continue reading “Doc chat: in the cath lab with a “radial evangelist””

10 things I didn’t know about angioplasty until I read this book

by Carolyn Thomas    ♥  @HeartSisters

heart-700141_1280 Being asked to write a book review is tricky. Authors hope you will be kind, while you hope the book at best might tell you something that every other book for heart patients hasn’t already told you. A review copy of the book Your Personal Guide: Angioplasty* sat on my coffee table for weeks, until one day, I finally got tired of looking at this latest addition to my living room decor and decided to give it a go.   And within a very few pages, I learned some fascinating things I didn’t know before.   Continue reading “10 things I didn’t know about angioplasty until I read this book”

How do patients know if their docs “will never be good”?

by Carolyn Thomas    @HeartSisters

It all started when cardiologist Dr. William Dillon of Louisville, Kentucky made this observation on his Twitter page about doing cardiac catheterization procedures:

As a two-time veteran of transradial (wrist) caths*, I felt just a wee bit alarmed by the last line of his tweet. We heart patients tend to get a wee bit alarmed by implications that those we trust may “never be good” at what they’ve just done to us, as described by the very people who work alongside them – those known as interventional cardiologists.

I felt similarly alarmed, by the way, during the recent FDA recall of defective Riata cardiac defibrillator leads when Dr. Laurence Epstein of Harvard’s Brigham and Women’s Hospital told Heartwire interviewers that ICD leads  are sometimes “implanted poorly”, bluntly adding:

“You can’t account for knuckleheads putting them in. Some lead failures are going to be expected . . . Others fail because people put them in in horrible ways.”   Continue reading “How do patients know if their docs “will never be good”?”

Inside your heart – as captured by National Geographic

Here’s how your heart looks during a coronary angiography procedure. The white/yellow blood vessels are bringing oxygenated blood to the working muscles of the heart.  (See link below to the whole slide show).

Coronary angiography (also called cardiac catheterization) is sometimes referred to as the ‘gold standard’ of diagnostics for heart patients. The procedure involves threading a tiny catheter through an artery in the wrist or groin and pushing it up, up, up right into the beating heart. It’s considered to be an invasive procedure, but not surgical. Patients are sedated, but usually awake throughout.

The catheter is guided through the artery with the aid of a special x-ray machine. Contrast material (dye) is injected through the catheter and x-ray movies are created as the contrast material moves through the heart’s chambers, valves and major vessels.

The interventional cardiologists in the ‘cath lab’ then watch your beating heart up on the monitor, where they can spot any coronary arteries that are blocked or narrowed, and evaluate your heart function. If significant blockages are seen, further procedures like balloon angioplasty, stent implants or coronary artery bypass graft (CABG) – commonly known as bypass surgery – may be attempted to restore blood flow to the threatened heart muscle.

I’ve undergone two of these invasive cardiac procedures – the first an emergency catheterization and stent implant when I was hospitalized for a heart attack, the second 15 months later to investigate ongoing cardiac symptoms. And I can tell you that it is freakishly fascinating to lie on the cath lab table, sedated yet very awake, and watch your own beating heart on the overhead monitor.   Continue reading “Inside your heart – as captured by National Geographic”