Cardiology

What is a Hybrid OR?

The Hybrid OR Surgical Suite is the most innovative approach to vascular and heart care available in our region. This unique operating room blends the technologies of advanced surgical approaches with crisp, high-tech imaging services. The Hybrid OR is a cardiovascular catheterization lab with immediate surgical capabilities, designed to enable cardiologists and cardiovascular surgeons to work side by side in the same room, at the same time, in the best interest of their patients. 

Cardiac Rehabilitation

The Cardiac Rehabilitation program is designed for individuals who have experienced a heart attack, bypass surgery, angioplasty/stent, chest pains, valve disease or individuals with multiple risk factors for developing heart disease.

The Cardiac Rehabilitation Unit will assist you in setting achievable goals for resuming a healthier lifestyle through exercise, and education. With your physician, an exercise prescription will be provided for you by the Cardiac Rehab staff that is tailored for your individual needs and goals. 

Pulmonary Rehabilitation

The Pulmonary Rehabilitation program is designed for individuals who have chronic lung diseases. All pulmonary rehab programs consist of two areas; exercise and education. 

At your first visit, our pulmonary rehab team will evaluate your overall physical condition and then develop a comprehensive treatment program. Your individual program may include exercises specific to your needs, physical and/or respiratory therapy, education about your condition, medications, nutrition, and one – on – one or group counseling. 

Transcatheter aortic valve replacement (TAVR)

What it is

The aortic valve is located between the pumping chamber on the left side of the heart and the aorta, which is a major artery. The aorta carries oxygen-rich blood from the heart to the rest of the body. The valve should be closed while the heart is filling with blood. When the heart chamber squeezes to push blood into the aorta, the valve should open fully to allow blood flow.

Transcatheter aortic valve replacement (TAVR) is a means of replacing your aortic valve that is narrowed by a method which is much less invasive than traditional aortic valve replacement surgery.

Reasons for Procedure
TAVR allows physicians to replace a severely narrowed aortic valve due to aortic stenosis without a conventional chest incision.

Aortic stenosis is a condition that results from narrowing of the aortic valve in the heart. When this narrowing occurs it can put increased stress and pressure on the heart muscle. This can lead to many symptoms,  including chest discomfort or pain, shortness of breath, leg swelling, fatigue, or fainting. Left untreated, the heart muscle can weaken over time resulting in worsening of symptoms and premature death. The most common cause of aortic stenosis is degenerative (age related calcium deposits).

Alternatives to TAVR

1. Medical Therapy – There are certain medications that may be prescribed to alleviate some of the symptoms of aortic stenosis. These do not stop the progression of the disease.
2. Conventional Aortic Valve Replacement – Your aortic valve is replaced through a large incision on the front of your chest while on a heart-lung machine.
3. Balloon Aortic Valvuloplasty – A balloon is inserted into your aortic valve through a catheter which temporarily enlarges the valve opening. This may result in a three to six month improvement of symptoms but has not been shown to prolong your life.

Possible Complications
If you are planning to have a valve replacement, your doctor will review a list of possible complications, which may include:

• Infection
• Bleeding
• Irregular heart rhythm
• Scarring
• Blood clot formation resulting in a stroke or kidney damage
• Valve does not function correctly
• Complications from anesthesia

Some factors that may increase the risk of complications include:

• Other heart conditions
• Lung conditions
• Chronic illness, including high blood pressure and diabetes
• Increased age
• Infections
• Smoking
• Obesity 

What to Expect

Prior to Procedure
Before your procedure you will meet with one or more of the physicians to discuss your history. You will then likely be referred for further testing which may help determine if the TAVR procedure is right for you. This testing may include:

• Cardiac Catheterization. A small catheter is threaded into your heart from a blood vessel in your arm or leg. This is done to obtain images of your coronary arteries.
• Transesophageal Echocardiogram. A small camera is passed through your esophagus to obtain high quality images of your heart.
• Computerized Tomography (CT) of chest, abdomen and pelvis. Contrast solution is injected into a vein followed by CT scan images to determine the best approach and valve size.

Talk to your doctor about your medication. You may need to stop taking certain medication for one week before surgery, such as:

• Blood-thinning drugs, such as warfarin (Coumadin)
• Anti-platelet drugs, such as clopidogrel (Plavix) 
• Diabetes medications, such as metformin (Glucophage)

Your doctor may also ask you to:

• Do not eat or drink anything after midnight, unless told otherwise by your doctor.
• Arrange for a ride to and from the hospital.
• Arrange for help at home after the procedure.

Anesthesia
TAVR is done with general anesthesia. You will be asleep.

Description of the Procedure
The most common approach for the TAVR procedure is:

• Transfemoral – A catheter is inserted through the artery in your groin area and carefully passed up into the heart. Your new valve is then implanted through this catheter inside the narrowed valve.

  

After the Procedure
You will be monitored in an intensive care unit after the procedure. When you wake up, you will notice that you are attached to a number of devices, which may include:

• Monitors to track your heart rate, breathing rate, blood pressure, and the percentage of oxygen in your bloodstream
• A catheter in your bladder to drain urine
• An IV to provide fluids, electrolytes, and pain medicines directly into a vein

How Long Will It Take?
The procedure can take anywhere from 2 to 4 hours.

How Much Will It Hurt?
Anesthesia will block pain during the surgery. You will be given pain medicine to help manage the pain after the surgery.

Average Hospital Stay
The usual length of stay is one night. The length of stay will depend on your overall health and your recovery progress.

Postoperative Care
You will be taken to the Intensive Care Unit (ICU) after your TAVR, where you will be cared for by skilled critical care physicians, physician assistants, nurse practitioners, nurses, therapists and technicians.  The nurses will assist you with coughing, deep breathing and getting out of bed. These are important keys to your recovery. When you are ready to leave the ICU you will move to a hospital bed for your continued recovery.

Recovering after Surgery/What to Expect
It is important for you to remember that the full recovery from your TAVR will take time. All patients take their own course, and some make faster or slower progress than others. Most patients have improvement of symptoms within one week. 

A follow-up appointment will be made about a week after your procedure.

In case of an emergency, call for medical help right away. 

Learn more about TAVR.

To learn more about TAVR, contact Jaclyn Green, BSN, RN, Glenwood TAVR Coordinator.  Call Jaclyn at 318-329-4462 or by email at [email protected].

Heart View Scan – Coronary Artery Calcium Scoring

Coronary Artery Calcium Scoring is a convenient and non-invasive way of evaluating whether you may be at an increased risk for a heart attack. Using the CT, information is obtained about the presence, location, and extent of calcified plaque in the coronary arteries – the vessels that supply oxygen containing blood to the heart muscle. This disease of the vessel wall is also known as Coronary Artery Disease (CAD). The goal is to determine if CAD is present and to what extent, even if there are no symptoms. The entire procedure including the actual CT scanning is completed in about 15 minutes and requires no injection of contrast material.

Who should get screened?

• Family history of heart disease
• High cholesterol
• High blood pressure
• Smoking
• Lack of physical activity
• Older than age 55
• Diabetic
• Overweight
• Postmenopausal women

Cash Price: $125 
Fee must be paid at the time of the exam. * Screening is not covered by insurance.

THE CORONARY ARTERY CALCIUM SCORING IS OFFERED AT:

Glenwood Imaging – North
3995 Sterlington Road, Monroe, LA 71203

Once you have your physician order, call to schedule your appointment at 318-329-8585.  
Physician Order