Cardiology

Cardiology

Cardiology

Our Cardiology Department is a unit where the current diagnosis and treatment methods in all fields of cardiology are implemented. There are an intensive care unit, the service where the patients subjected to coronary angiography operation are followed, a cardiology polyclinic, a cardiology laboratory where non-invasive examinations (ECG, effort test, echocardiography, rhythm holter and blood pressure holter) are conducted in the Adult Cardiology Department.

Angiography

There are 2 angiography units in our hospital and all arterial imaging processes such as coronary angiography (imaging cardiac veins), peripheral angiography (imaging leg and foot veins) and Carotid angiography (imaging carotid artery), renal angiography (imaging renal artery) and etc. are conducted.

Radial angiography (angiography through your arm)

This is the angiography process conducted by placing the angiography drape through the radial artery on your elbow. This process can be implemented on the patients with 2 mm or larger elbow vein diameter. What is the advantage of radial angiography through arm compared to pubic region? After, an angiography conducted through pubic region, the patient has to lay down on his/her back for 6 hours and a sand bag/weight/close pet application on the pubic region is necessary. Whereas, upon angiography through arm, the patient can stand up easily and can even be discharged to his/her home in the same day of operation. In addition, even it is rarely observed, hemorrhage, swelling, bruising and etc. symptoms can be developed (4-5%) in the pubic region after an angiography conducted through the pubic region. This risk is eliminated through the angiography conducted through arm. As, some patients' veins at their pubic region are clogged, it is impossible to intervene through their pubic region and angiography through their arms becomes the sole method. Balloon and Stent (percutaneous angioplasty) through cardiac arteries, carotid veins, leg veins and kidney veins: The stenosis over 70% frequently causes symptoms either for cardiac arteries/veins and other veins and needs intervention. At first, the contracted section is accessed through plastic tubes called catheter, the stenosis is passed through very fine wires and the balloon is slid on that wire and then it is inflated at the narrowest section of the artery/vein. Then, the balloon is retracted and the stent is pushed through the stenosis and then the stent is opened and inflated at the appropriate region.

What is a drug-eluting stent? Why is it required?

The drugs which retard or significantly prevent contraction of stents in years are applied on them through various technologies. As the length of stenosis of cardiac arteries increase and the arteries become thinner, contraction possibility of an administered stent increases and for some patients, this possibility may rise up to about 30% for drug-free stents. This rate can be reduced fewer than 10% for drug-eluting stents. In the world, the studies which will eliminate the possibility of any recontraction have still been continuing rapidly. The stents coated with various drugs and stents with various metal meshes are tested. Unfortunately, it has not been possible yet to develop the perfect stent. However, it is obvious that a long way has been covered compared to bare metal stents. While, the drug-eluting stents with fine diameters are compensated by the state; the ones with 3.5 and larger diameters are out of the scope of state compensation.

What is a soluble stent?

These stents are the ones, which become highly-disintegrated by biologically absorbing by your body within 2-3 years. Their advantage is not to create any permanent metal load inside your veins. Even, your vein becomes contracted again in time, as there is not any metal part, it allows treatment as if it has not been subjected to any treatment before. Their disadvantages are that they are highly expensive and they are not compensated by the state.

The pacemakers and ICDs

Pacemakers as single-wire, double-wire and 3-wire are devices which are used for various purposes. In some models, one of these wires has defibrillation functionality (ICD). The pacemaker is completely implanted subcutaneously and it has a size approximately like a matchbox. The ones with defibrillation functionality have a size of two matchboxes. The entire device is activated when the heart nerds it otherwise it waits like a fuse. Some pacemakers are activated when the heart rate in other words pulse goes under 60 in a minute. The ones with defibrillation functionality are usually activated when the heart rate rises up to 170-180/min. and they regulate the rhythm and rate of heart at normal levels. Three-wire pacemakers are used in some patients with cardiac deficiency and they ensure that the cardiac systole is more harmonic and efficient. The pacemakers are administered subcutaneously after skin is anaesthetized and patient's conscious is kept opened during the procedure. When, the procedure is completed, the skin is closed by putting 4-5 stitches. The patient and the device are decided as a result of a thorough analysis of your cardiac physician. All pacemaker and ICD types can be applied in our hospital.

Mitral Balloon Valvuloplasty

The mitral balloon valvuloplasty is a treatment option for the patients with rheumatismal mitral valve contraction who experience shortness of breath and restriction in daily activities in order to gain time for the patients before surgical operation. This procedure is preferred for the patients with valve structure including low calcification and without any clot in their heart. How young the patient and how less calcification the valve has, the success rate increases. Laceration of the valve and serious mitral valve leakage during the procedure are some of the most important risks. In this case, the patient is directed to a valve surgery. A hole is punctured by a needle between the right and left auricles of the heart by entering from the pubic region and passing through the vena and then the rheumatismal contracted valve is accessed by passing through that hole and the valve is enlarged. The patient has to be completely awake during the procedure.

Closing congenital atrial/ventricular septal defects and patent ductus arteriosus (ASD/VSD/PDA)

After, a painkiller injection administered on the skin through the pubic region, the vein is accessed, then interior of the heart is accessed and when the defected area is reached, the hole is closed by using occluders. The success rate of this procedure is over 90% for selected cases.

Heart Catheterization

This is an important test for examining the cause in pulmonary hypertension cases. This is a procedure where the resistance calculations and response of pulmonary artery pressure to medications after, the real and the most accurate measurement of the pulmonary artery is done, are evaluated in the angiography laboratory (vasoreactivity test). After, a painkiller injection administered on the skin through the pubic region, the vena is accessed, then right side of the heart and pulmonary artery are accessed and pressure measurement and blood gas analysis can be conducted from several parts where the catheter passes through.

Services of the cardiology polyclinic

The Tension Holter Device for optimum diagnosis of hypertension and evaluating response to treatment, 24-hour rhythm holter for determining arrhythmia, effort test for diagnosing the patients suspected to have embolism and evaluating efficiency of treatment and echocardiography (heart ultrasound), an indispensable method for diagnosing several diseases and disorders such as heart deficiency, atrial/ventricular septal defects, pericardium and myocardium diseases and disorders, aneurysm and etc. are used and conducted in our polyclinic.

 

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