Congenital or acquired cardiovascular diseases are the leading cause of mortality in the world. The most widespread and disabling diseases in this field are myocardial infarction, acute coronary syndrome, ischaemic heart disease, heart valve diseases and cardiomyopathies
Due to the low degree of invasiveness and the modest possibility of complications, endovascular surgery is the new frontier in the treatment of these diseases; GVM is undoubtedly among the more important specialists in Italy and in the world in this field, with more than 40.144 procedures in a year.
When it comes to diagnosis, investigative methods range from the baseline and pharmacologic stress echocardiogram to the Holter Monitor, from continuous electrocardiographic monitoring to the stress ECG, from morphological cardiac MRI to the CT coronary angiogram, and from vascular ultrasound to overall vascular diagnostics.
Coronary and peripheral vascular procedure
If coronary artery stenosis is found during coronary angiography, treatment can be carried out through a non-surgical interventional procedure called angioplasty. This invasive procedure involves bringing to the level of the stenotic (restricted) segment a system consisting of a small balloon which, inflated at high pressure (10-12 ATM), dilates the artery. In the same procedure, a stent is then placed, i.e. a tubular structure consisting of a mesh which, when released inside the coronary artery, allows the treated coronary segment to be kept open for a long time and, therefore, the blood to flow normally as before the plaque formed. Currently, medicated stents are implanted which are coated with a drug that significantly reduces the risk of subsequent narrowing.
Percutaneous angioplasty can also be used to treat narrowing affecting the peripheral arteries. Therefore, also for the carotid, vertebral and subclavian arteries. For the renal and lower limb arteries, an angioplasty procedure with balloon and implantation can be performed.
Structural interventional activity
The continuous scientific research that revolves around interventional cardiology allows treatment of an increasing number of clinical cardiac conditions affecting the structure of the heart and heart valves.
These procedures are referred to as structural cardiac interventional procedures.
- TAVI: TAVI stands for Trans Aortic Valve Implantation. The procedure consists of percutaneous implantation of an aortic valve prosthesis in patients with severe aortic stenosis. In fact, this method allows the insertion of a system containing an aortic valve prosthesis through femoral vascular access and the placing of the prosthesis under the guidance of X-rays, without the need for surgical cutting and extracorporeal circulation. This procedure, initially reserved only for patients at high risk for conventional surgery, is now also offered to patients considered at intermediate risk and/or very elderly.
- MitraClip™: In patients with severe mitral insufficiency, a clip is implanted percutaneously. This allows the mitral flaps to be brought closer to the point most responsible for valve insufficiency and allows mitral valve disease to be corrected.
- Treatment of PFO and ASD: For a patent foramen ovale or an atrial septal defect, an interventional procedure to correct these congenital heart diseases can be performed by placing an “umbrella”, which allows communication between the two atria to be closed through the PFO or ASD. In many cases, closure of the patent foramen ovale can also be carried out by means of a transcatheter suture and therefore without inserting a permanent foreign body (NobleStitch™).
- Closure of the Left Atrial Appendage: Atrial fibrillation is an arrhythmia that carries an increased risk of clot formation (thrombi) within a structure of the left atrium called the appendage. To lower this risk, anticoagulant drugs are used that make the blood more fluid and therefore less likely to form thrombi inside the appendage. These drugs carry a risk of bleeding and haemorrhaging. For patients considered at risk of bleeding while taking anticoagulant drugs, an interventional procedure called appendage closure can be performed. During this procedure, a “plug” is placed inside the appendage, which prevents new clots forming, without the need to take anticoagulant drugs.