This is a technique using a contrast medium to outline blood vessels. The procedure may be done in a variety of ways, depending on the indications. Examples include coronary angiography, performed in the cardiac catheterisation laboratory, by an interventional cardiologist to examine the heart for blockages; peripheral angiography, done by a vascular surgeon also performed in a cardiac catheterisation laboratory, to look for blockages in the arteries to the lower limbs and CT angiography, performed by a radiologist in the X-ray department to look at a number of different organ systems.

Stenting involves stretching a narrowed area of the artery with a small cylindrical balloon. Once the narrowing has been stretched a stent is inserted (a fine mesh cylinder usually of stainless steel) that supports that part of the artery.

From stress echo cardiograph (an ultrasound test to measure how well your heart is pumping while using a treadmill) through to sleep apnoea testing, Transthoracic Echocardiogram, Trans Oesophegeal Echocardiogram, ECG monitoring via Loop Recorders and or Holter Monitors.

The world’s first commercially installed Radiation Dose Tracking System was installed in the St George Private Cardiac Cath Laboratory in 2014. Providing exquisite image clarity, RDTS can pinpoint radiation doses more accurately than ever before, improving patient outcomes and safety.

Coronary Artery Bypass Surgery restores blood flow to the heart muscle by adding a graft (vein or artery) to bypass the blocked area. The procedure may be done with the help of the heart-lung machine, or without ("off-pump") depending on the patient's circumstances and the surgeon's approach.

A minimally invasive procedure that assesses the electrical activity and conduction pathways of the heart.

This is an operation to repair or replace one of the four valves inside the heart. Sometimes these valves may become narrowed, causing obstruction to blood flow, or the valve may leak causing the blood to flow backwards within the heart which affects the efficiency of the heart's function.

A small, battery-powered electrical impulse generator that is implanted in patients who are at risk of sudden cardiac death due to ventricular fibrillation and ventricular tachycardia

A medical device that uses electrical impulses, delivered by electrodes that contract heart muscles, to regulate the heart beat.

A treatment for atrial fibrillation- an abnormal heart rhythm that originates in the top chambers of the heart.

A medical procedure in which part of the electrical conduction system of the heart, tumour or other dysfunctional tissue is ablated using the heat generated from high frequency alternating current.

TAVI is an innovative way to treat severe AS. It is minimally invasive and is performed in our Cardiac Catheter Lab. It is most suitable for older patients at too high surgical risk for SAVR. It also allows patients to recover post operatively more quickly, with less pain and a shorter hospital stay.

In the TAVI procedure, the valve is squeezed down onto a balloon, inserted into the body via a catheter, and tracked to the heart for implantation. This can be done without opening the chest or using the heart-lung pump. The catheter may be inserted through the femoral artery or through a small incision in the chest over the heart. When the valve is positioned inside the faulty aortic valve, the balloon is inflated and the new valve is precisely positioned.

See our specialist Dr James Roy.

TAVI device

The Transcatheter Heart Valve

• A valve made from the heart tissue of a pig
• The valve tissue is held by a Nitinol (nickel-titanium) metal frame
• Three valve leaflets control the flow of blood like your natural valve

After a transcatheter heart valve procedure, there is potential to start feeling better right away. This is because the heart is now able to pump the right amount of blood to the body. Some patients may take longer to feel better. Potential benefits may include:

• Feeling more energetic
• Better breathing
• Experiencing less pain
• Feeling less anxious

TAVI procedure

In the transcatheter procedure, a thin, flexible tube (catheter) is inserted into one of several “access routes”

An artery in the leg (1) An artery in the neck

(2) An space between the ribs

(3) Other Anesthesia or sedation will be provided throughout the procedure. A temporary pacemaker will be inserted to allow the doctor to control the heart rate as needed.

 

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TAVI recovery & discharge

After surgery the recovery process will begin.

• There is potential to be up and walking around within a few days after having the procedure.
• There may be a 3-10 day hospital stay for this procedure, but this varies by patient
• At discharge, the doctor will determine the best next steps for aftercare.
• Information about medications, activities, and follow-up visits will be provided

TAVI continuing care

When leaving the hospital, patients may either be discharged home or, alternatively, to a cardiac rehabilitation facility. Exercise-based cardiac rehabilitation, supervised by doctors and cardiac rehabilitation specialists, may be part of a recovery plan.

• The doctor will also provide instructions for care:
• Use of medications, including blood thinners
• Restrictions on activities
• Plans for follow-up appointments
• Other special instructions (MRI, dentist, etc.)

A patient card with transcatheter heart valve patient information will be provided. Patients must keep hold of this card and show it to any doctor treating them.

TAVI follow ups

Patients may be asked to return to the heart valve clinic to have the heart valve checked at 30 days and 1 year after the procedure. The doctor will set up regular follow-up appointments to check how the new heart valve is doing.

Copyright ©2020 Medtronic. All rights reserved. Reprinted with permission

A minimally invasive video-assisted technique to examine the lungs and interior of the chest. Some procedures including pleurodesis, lung biopsy and lung resection may be performed using the technique.

A procedure performed using minimally invasive video techniques to block nerves causing excessive sweating of the hands and arms.

This operation removes the diseased part of the lung

A radical surgical procedure that involves the removal of the whole lung, usually to remove tumorous tissue.

Treatment for a collapsed lung.

A thymectomy is an operation to remove the thymus. It usually results in remission of myasthenia gravis with the help of medication including steroids. However, this remission may not be permanent.

VATS is a minimally invasive technique that uses small incisions and eliminates the need to spread the ribs. During VATS, the surgery is performed through a one-inch incision and is aided by a miniature camera inserted through one of the three 1/4 to 1/2" incisions. The VATS approach has significantly less pain than a large thoracotomy along with a reduced hospitalization period. Patients usually do not require a stay in the intensive care unit.

Interventional Cardiologists

• Dr James Roy - 9553 7344

Non-Interventional Cardiologists

• Dr Nicholas Cunio - 9553 7477
• Dr Peter Robinson - 9588 6611

Diagnostic Angiography

• Dr Raj Brahmbhatt - 9570 5666
• Dr Garry Helprin - 9796 2266

Diagnostic and Interventional Cardiology

• Maurits Binnekamp - 9587 7584
• Queenie Lo - 9531 2476
• Ananth Prasan - 9588 5335
• Mark Nallaratnam - 9526 8820
• David Ramsay - 9553 7344
• James Weaver - 9553 7344

EPS (Intracardiac Electro Physiology Study)

• Rahn Ilsar - 9888 6636
• Suresh Singarayar - 9588 6636

• Rebecca Dignan - 8738 3006
• Gary Fermanis - 9553 9162
• Matthew Horton - 9587 8229
• Con Manganas - 9587 8229
• Sheen Peeceeyen - 9587 8229
• Kalhara Perera - 8850 8100