EMMC offers a wide range of interventional procedures in order to provide comprehensive and effective heart care. Although several hospitals in our region can tell you what's wrong with your heart, only EMMC can tell you what's wrong and fix it, often in the same visit, saving you worry, time, and money. We offer everything from angioplasty to open heart surgery. We also offer pacemaker and defibrillator implants.
Heart Catheterization ("cath")
A heart catheterization is a very serious, but common medical procedure used to diagnose heart disease. In this procedure, a catheter, or a small tube, is inserted into an artery in the groin. The tube is guided directly into the heart's arteries, where a liquid contrast agent is injected. The doctor watches an x-ray monitor as the contrast liquid travels through the arteries of the heart. If arteries are blocked or damaged, the doctor will be able to see it very clearly. Throughout this procedure, patients are awake but medicated for comfort.
Angioplasty is a procedure in which a blocked artery is opened by using a balloon catheter (small tube). The catheter is inserted into an artery in the groin and guided into an artery in the heart. At the end of this catheter is a "deflated balloon". When the balloon is inflated, it squeezes the blockage back against the artery wall and opens the artery for proper blood flow.
- Percutaneous Coronary Intervention (PCI): EMMC is one of only three centers in Maine able to perform emergency cardiac catheterization during a heart attack. EMMC’s cardiac teams measure success by nationally recognized quality standards and are proud to be among the best performers in New England. We quality standards rate very highly across the U.S. and the state of Maine, please review our quality measures here.
- Radial Artery Access: EMMC doctors have been performing many PCI and cath procedures using radial artery access. By entering the catheter through the wrist instead of the groin patients have a much more comfortable and safe procedure. EMMC began using radial artery access as standard procedure in 2010; approximately 50 percent of our cases are performed through a radial artery. We are the leading center in the Northern New England Cardiovascular Disease Study Group (NNE) for radial access procedures.
A stent is a tiny, metal mesh tube that is positioned inside a narrowed or blocked artery and opened with the inflation of an angioplasty balloon. When the balloon is deflated and removed, the stent stays behind, propping the walls of the artery open so that blood can flow more easily. EMMC offers both drug-coated and uncoated stents dependent on the patient’s specific needs.
Rotoblator (percutaneous transluminal coronary rotoblator angioplasty – PTCRA) is a procedure similar to an angioplasty but instead of using a balloon, the catheter has a microscopic diamond crystal burr at the tip. The catheter is attached to a high speed motor that rotates the burr to grind the blockage away.
Electrophysiology helps determine if a patient has an abnormal heart rhythm. If appropriate, a physician can use a specialty catheter that delivers radio frequency signals to destroy or cryoablation to freeze and destroy the tissue in the abnormal area and restore normal heart rhythm. This procedure is called an ablation.
Pacemakers are used with patients whose hearts are not beating properly. A normal heart beats about 60 – 80 times every minute. But, for some people, the heart has difficulty creating the normal number of beats, and they must rely on a pacemaker for help. Similar to an implantable cardioverter defibrillator (ICD) (described below), a pacemaker is a small device that is implanted under the skin with wires connecting it to the heart. Many years ago, pacemakers controlled the heart with continual, electric impulses to keep the heart beating at about 70 to 75 beats per minute. Today's, pacemakers are much more sophisticated and can be programmed to closely imitate the heart's normal rhythm and varying rate.
An implantable cardioverter defibrillator (ICD) is a small device that is used with patients who have dangerously irregular heart rhythms. The ICD is implanted under the skin below the left collarbone and continually monitors the rhythms of the heart. When a specific abnormal heart rhythm occurs, the ICD sends a tiny electrical shock to the heart in order to stimulate a normal rhythm again. These shocks are often not even noticed by the patient. During this time, they record all unusual heart rhythms and the number of shocks administered so physicians will know how the heart has functioned since the last check-up. Biventricular pacing and ablation are other methods used to restore normal rhythm.
The human heart has four chambers that work together to pump blood through the arteries and veins of the body. As one chamber squeezes to push blood out, a valve opens to bring the blood into another chamber, and then immediately closes to prevent blood from flowing backward. If a valve becomes damaged, it does not open and close as it should and this results in decreased blood flow, and the heart has to work harder to pump the body's blood. EMMC ranks very highly among leading hospitals in the U.S. and in Maine.
Cardiovascular surgery specialties:
- Valve Repair and Replacement: Patients with valve problems can have valvular stenosis (narrowing of the valve) or insufficiencies (valve leakage). These cardiovascular disorders are often dealt with surgically. Valves may be repaired or replaced with artificial valves.
- Coronary Artery Bypass Graft Surgery (CABG): When a patient has a severely blocked artery in the heart, the doctor may choose to perform "bypass surgery". In this procedure, the surgeon uses a healthy artery from the chest (mammary artery), a vein from the leg (saphenous vein), or vein from the arm (radial artery) to reroute the blood flow around the blocked artery, thus bypassing the blockage. The body will compensate for the removal of the healthy artery or vein, as other blood vessels will adapt to keep blood flowing to the area.
- Aortic Valve Replacement: Aortic valve replacement is a procedure in which a patient’s aortic valve is replaced using either a mechanical or biological tissue valve. Aortic valve replacement requires open heart surgery, but newer technologies on the horizon may allow for a less invasive approach.
- Mitral Valve Replacement and Repair: Mitral valve replacement operations are performed through a median sternotomy incision. The mitral valve is replaced using either a mechanical or biological tissue valve. In many situations, the mitral valve is repaired rather than replaced. EMMC has been performing valve replacement and repair since 1987.
- Coronary Artery Bypass Graft (CABG) Surgery: CABG Surgery is one of the most commonly performed operations in the United States. CABG surgery creates new routes around narrowed and blocked arteries, allowing sufficient blood flow to deliver oxygen and nutrients to the heart.
On the leading-edge of new techniques for cardiac patients, EMMC has instituted a hypothermia protocol. Cooling patients to a precise temperature using special equipment allows us to preserve brain function in the hours after cardiac arrest. When the heart stops, circulation of oxygen to the brain is reduced. Cooling decreases the risk of permanent neurologic damage. More information can be viewed at the Maine Cardiac Arrest Survival Project website.
Blood Management and Conservation
Eastern Maine Medical Center’s world recognized blood management and conservation program focuses on reducing the need for transfusions during surgery and medical emergencies. This method is much safer than a blood transfusion and is available to cardiac surgery patients. Read more about our blood management and conservation program here.