Cardiology

Haemodynamics and Interventional Cardiology Unit

Diagnosis procedures:

• Coronariography.
• Right heart catheterisation: haemodynamic study of right heart cavities in relation to heart failure, heart transplants, or the study of pulmonary arterial hypertension.
• Combined right-left catheterisation, in the context of heart failure: myocardiopathy, pericardial pathology. Endomyocardial biopsy.
• Functional study of the coronary arteries: vasoreactivity test with acetylcholine.
• Functional study of the coronary arteries through the study of intracoronary flow using the Doppler technique.
• Functional study of coronary stenosis: FFR.
• Anatomical study of the coronary arteries: intravascular ultrasound (Boston and Volcano).
• Anatomical study of the coronary arteries:
• Optical Coherence Tomography (OCT, StJude and Terumo).
• Angiography to assess vascular access: aortoiliac axis, subclavian.

Procedure support:

• Percutaneous insertion of a transvenous pacemaker. Intraortic counterpulsation balloon pump implant. Impella 2.5 ventricular support system implant. The Impella CP system with a 4.0 L support has been in use since October 2014.

Therapeutic procedures:

• Coronary pathology:
• Coronary angioplasty with or without stent implant.
• Drug-coated balloon coronary angioplasty.
• Primary angioplasty for acute infarction.
• Coronary angioplasty with rotablation.
• Valvular pathology: Mitral valvuloplasty.
• Aortic valvuloplasty.
• Pulmonary valvuloplasty (scarce in our environment due to access from paediatric cardiology).
• Transcatheter pecutaneous aortic valve implant, CoreValveSystem® (transfemoral, trans-subclavian, direct aortic access).
• Angioplasty for pulmonary vein stenosis.
• Stent implant in pulmonary vein stenosis.
• Structural Pathology:
• Closure of interauricular defects (CIA) such as Ostium Secundum, using the Amplatzer® device.
• Closure of Patent Foramen Ovale (PFO) using the Amplatzer® device.
• Left auricular appendage closure to prevent stroke.
• Refractory hypertension treatment:
• Renal denervation using the Symplicity® system.

Others:

• Closure of coronary fistulae through Coil implantation.
• Closure of coronary-cavitary fistulae or other structures with the Amplatzer Cardiac Plug.

Electrophysiology and Arrhythmia Unit

• Special arrhythmia outpatient service.
• Specific genetic arrhythmia service (long QT syndrome, right ventricular arrhythmogenic dysplasia, Brugada syndrome, etc.).
• Syncope study (Holters of different kinds, tilt table test, electrophysiological studies).
• Primary sudden death prevention studies. Secondary sudden death prevention studies.
• Palpitation study (Holters, electrophysiological studies).
• Study and treatment of supraventricular tachycardia (including radiofrequency ablation).
• Study and treatment of atrial flutter (including radiofrequency ablation).
• Study and treatment of persistent or permanent paroxysmal atrial fibrillation (including radiofrequency ablation or cryoablation).
• Study and treatment of ventricular tachycardia (including radiofrequency ablation, or implantable defibrillators).
• Electrical cardioversion.
• Implanting and monitoring of all types of pacemaker.
• Implanting and monitoring of all types of implantable defibrillator.
• Implanting and monitoring of resynchronising devices to treat heart failure.

Non-Invasive Cardiology Unit

• Transthoracic echocardiography.
• Transesophageal echocardiography.
• Contrast echocardiography.
• Physical stress echocardiography.
• Pharmacological stress echocardiography: dobutamine and dipyridamole.
• Echocardiography, functional assessment.
• 3D transthoracic echocardiography.
• 3D transesophageal echocardiography.
• Monitoring of haemodynamic procedures: structural cardiomyopathy.
• TAVI, closure of septal defects, left auricular appendage closure, septal ablation in hypertrophic cardiomyopathy.
• Monitoring in electrophysiological unit procedures.
• Pre-operative echocardiography.
• Cardiac MRI.
• Morphological and functional study.
• Angiography CAT scan (coronary, heart and main vessels).
• Convention stress tests on treadmill.
• Perfusion gammagraphy (in collaboration with the Nuclear Medicine Department).
• Holter ECG monitor.

Heart Failure and Transplant Unit

Heart failure

• “De novo” systolic and diastolic HF diagnosis.
• Administering of intravenous diuretics, inotropes and iron at the Day Hospital.
• Assessment of patients with advanced HF and cardiogenic shock.
• Specific treatment of group 2 pulmonary arterial hypertension.
• Myocarditis protocol.
• Specialist consultation for genetic cardiomyopathies and hereditary cardiomyopathies.
• Specialist consultation with the Multidisciplinary Familial Amyloidosis Unit (MFAU).
• Cardiac rehabilitation and secondary prevention programme.

Heart transplantation

• Assessment and study of candidate patients.
• Post-operative control of transplant patients.
• Assessment of the degree of pulmonary arterial hypertension.
• Monitoring of post-HT complications: heart transplant rejection, infections, neoplasms and allograft vasculopathy.
• Implementation of different immunosuppression regimes.
• Treatment of cellular and humoral heart transplant rejection.
• Plasmapheresis.
• Immunoabsorption.
• Renal clearance treatments.
• Short-term mechanical ventricular assistance: ECMO, Centrimag-Levitronics and Impella. Medium/long-term mechanical ventricular assistance: BerlinHeart- Excor and Heartware-HVAD.

Other units

• Cardiovascular Intensive Care Unit.
• Cardiovascular Intermediate Care Unit.
• Post-Interventional Procedure Unit.
• Conventional Hospitalisation Unit.
• Integrated Heart Fault Programme for the Southern Metropolitan Area.
• Short Stay Unit - Day Hospital.
• Hospital and Out-of-Hospital Outpatient Services.
• Clinical Research Unit and Cardiovascular Research Lab

Healthcare procedures

• Acute coronary syndromes (including AMI with and without ST elevation).
• Heart failure and heart transplantation.
• Syncope and arrhythmias.
• Valvulopathies.
• Aortic pathology.