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UIHC sees increase in cardiac catheterization procedures

BY JENNY EARL | APRIL 25, 2012 6:30 AM

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Catheters are becoming a popular alternative to invasive surgery at the University of Iowa.

"Nowadays, we do much more interventions here," said Thomas Scholz, a UI professor of pediatric cardiology. "We can diagnose and identify problems — there's a lot more we can do in the cath lab to fix these problems."

The UI Hospitals and Clinics catheterization lab saw more than 500 cases in 2011, 150 more than usual.

Scholz said he's seen a steady increase in the past five years in the amount of cardiac catheterization. In the procedure, a catheter — a long, flexible tube — is placed in the leg and groin area to reach the chamber or vessels in the heart to intervene in heart problems or ensure the heart is working properly.

"Catheters are smaller than the straw that you'd be using in your milkshake," Scholz said. "Fitting a device into something smaller than a beverage straw, it sneaks its way around vessels into chambers of the heart. These special materials are needed in order to scrunch down a device to be positioned into that tube and be re-inflated or expanded in a way that allowed some of these interventions to take place."

Devices that look like umbrellas pass through small catheters and expand — allowing the wings of the umbrella to hold it up on either side of the heart.

"This option wasn't available 10 years ago; 10 years ago, it would have to be done in an operating room," Scholz said.

Following the increase in catheterization at the UIHC, hospital officials plan to expand the procedure to a second site in the hospital this summer for use twice a week.

Heart experts agreed advances in technology and technique have led to a widespread increase in cardiac catheterization.

Mark Menegus, an interventional cardiologist at Montefiore Medical Center for Heart and Vascular Care in New York City, said much has changed since he first became a cardiologist 27 years ago — such as catheters allowing doctors to do heart repairs without opening someone up.

"Miniaturizing technology, working inside coronaries — we're doing things now that were not even conceived a few years ago, and this is continuing," he said.

These advances have also aided patients who received heart transplants and need to receive check-ups for the rest of their lives, Scholz said.

"One technique we use [to check that their new heart is functioning properly] is to sample a small portion of the heart muscle itself to see if there's any rejection of the heart muscle," he said.

Interventional procedures have seen the most growth at the UIHC.

"Most conditions we deal with are conditions that patients are born with," Scholz said. "I think the improved technology as well as the operating room have allowed a greater number of kids born with these abnormal problems to survive."

Organizations such as the American Heart Association have expanded education on different heart treatments, including catheterization.

"I think it's something that people don't really think about until they need it," said Alexson Calahan, communications director at the American Heart Association. "Anytime we can use technology and research to make the impact a little bit less, especially when we're talking about kids, that's great — it relieves a huge burden on families, leading to a quicker recovery."


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