Treatments

Doylestown Health's Heart and Vascular Center is a nationally-recognized program with capabilities ranging from patient education and preventive heart health programs to technically-advanced minimally-invasive valve replacements and delicate open-heart surgeries to a robust cardiac rehabilitation program.

Our board-certified heart and vascular experts specialize in an array of non-invasive procedures, as well as complex minimally-invasive and open surgical treatment options.

• Angioplasty

  Reopens arteries which are narrow or blocked due to a buildup of fatty deposits (plaque) on the inner artery wall. A catheter (flexible tube) with a balloon tip is threaded through a tiny incision in the arm or groin, then guided through a blood vessel to the affected area. The tiny balloon inflates, pushing the plaque against the artery wall, which opens the channel to restore blood flow.

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• Aortic Reconstruction

  Repairs or replaces a blocked, weak, bulging (aneurysm) or damaged aorta.

  To replace the aorta, a surgeon implants a graft (tube-like vessel). It can be synthetic or tissue (blood vessel donated or harvested from the patient). Implanted either with open surgery (cutting out the diseased section and stitching the graft into place) or in an endovascular procedure via a catheter through an artery in the groin.

  An endovascular stent graft (mesh, fabric covered tube) can treat or replace an aneurysm. The stent graft both props open and lines the inside vessel wall like a sleeve, creating a strong channel for blood flow. This can also be an open surgical procedure.

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• Aortic Valve Surgery

  Aortic valve surgery is done to replace the aortic valve in the heart. Blood flows out of the heart and into the aorta through the aortic valve. The aortic valve opens so blood can flow out and closes to keep blood from flowing backwards. If your aortic valve does not open or close all the way, it may require surgery. Minimally invasive aortic valve surgery is done using small incisions.

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• Atherectomy

  An endovascular treatment performed in a cardiac catheterization lab to remove a buildup of fatty deposits (plaque) from a blood vessel. The physician threads a catheter (flexible tube) through the blood vessel and uses a diamond tip burron the end of the catheter to remove the plaque.

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• Atrioventricular Node (AVN) Ablation

  This procedure helps treat an irregular heartbeat. The AVN regulates electrical signals that control pumping action from the upper chambers (atria) to the lower chambers (ventricles) of the heart. When faulty signals cause an irregular heartbeat, the physician threads a catheter through a blood vessel in the groin to the AVN, then delivers radiofrequency (heat) energy through the catheter to sever or alter the AVN. This permanently stops atrial signals from reaching the ventricle, so the patient will need a pacemaker to maintain an adequate heart rate.

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• Bi-Ventricular Implantable Cardioverter Defibrillator (ICD)

  This option allows for a more balanced method of controlling a rapid heartbeat for patients with severe left ventricular heart failure. An ICD device regulates heart rate and rhythm. It is implanted in patients at risk for sudden death due to recurrent, sustained ventricular fibrillation (abnormal heart rate). The biventricular ICD leads (wires) are attached in the right atrium, right ventricle and left ventricle. When the ICD detects that the ventricles are beating too fast, it sends an electrical shock to restore a normal heart rate.

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• Cardiac Catheterization

  In the Cardiac Catheterization Lab, a long, thin, flexible tube (catheter) is threaded through a vein or artery in the leg or arm up to the heart. Live x-rays guide the medical team as they perform diagnostic tests and treatments.

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• Cardiac Resynchronization Therapy (CRT) Device

  A CRT device helps monitor abnormal heart beats and restore normal heart rhythm. See Pacemakers and Defibrillators

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• Cardioversion

  A corrective procedure performed in a hospital or clinic to convert, or change, an abnormal heart rhythm back to normal rhythm. This may be accomplished with medication (pharmacologic or "chemical" cardioversion), or via an electrical shock to the heart (electrical cardioversion). Patients are sedated for electrical cardioversion. One paddle is placed on the chest and another on the back and a quick, electrical current delivered through the paddle resets the heartbeat to normal.

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• Carotid Endarterectomy (CEA)

  On each side of the neck is a carotid artery carrying blood to the brain and face. If the brain does not get enough blood, a stroke can occur. Carotid endarterectomy surgery removes fatty deposits (plaque) from the carotid artery wall to restore normal blood flow. The surgeon makes an incision over the artery and places a catheter (flexible tube) so that blood flows through the catheter around the blocked area during surgery. Then, the surgeon cuts open the artery, removes the plaque and closes with stitches.

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• Convergent Ablation

  Convergent means coming together – in this case an electrophysiologist (EP) and cardiothoracic surgeon combine skills for a minimally-invasive treatment for chronic atrial fibrillation, an irregular heartbeat caused by faulty electrical signals. The physicians block abnormal signals using radiofrequency ablation (focused heat) to scar problem areas. The surgeon uses a video-assisted scope to work on the heart's exterior and the EP treats from inside the blood vessels by threading a catheter (flexible tube) through a vein to the inside of the heart.

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• Convergent Maze Procedure

  Convergent means coming together – in this case an electrophysiologist (EP/heart rhythm expert) and cardiothoracic surgeon combine skills for a minimally-invasive procedure to restore a normal heart rhythm for patients with a long history of arrhythmia, including patients with structural heart disease who may have previously failed one or more other treatments. The convergent maze procedure uses radiofrequency ablation (focused heat) to create a pattern (maze) of scar tissue in problem areas of the heart's upper chambers. The scar tissue blocks the abnormal electrical signals.

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• Coronary Bypass Surgery

  Coronary artery bypass grafting, or CABG (pronounced "cabbage"), is also called bypass surgery. The most common type of open-heart surgery, it creates a new route (a bypass) for blood and oxygen to reach the heart. The surgeon uses a blood vessel from the patient's own body to bypass a blockage in one or more of the arteries supplying blood to the heart. This improves blood flow to the heart. CABG is used to treat patients who have severe coronary heart disease.

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• Cryoablation

  Cryoablation is used to restore normal electrical conduction in the heart. A balloon-based technology ablates (destroys) heart tissue through the use of a coolant for freezing.

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• Endovascular Repair of Abdominal and Thoracic Aortic Aneurysms

  Endovascular (from inside the blood vessel) repair is minimally invasive. With x-ray guidance, a wire is threaded through tiny incisions in the groin through the femoral artery to the aorta. Then, following the same path, a catheter is used to deliver a stent-graft (mesh tube) to lines the inside of the artery, creating a strong channel for blood flow.

  EVAR - Treatment for abdominal aortic aneurysm

  TEVAR - Treatment for thoracic aneurysm

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• Endovascular Repair of Blocked or Narrow Arteries and Veins

  Blood vessels may become narrow or blocked due to a build-up of fatty deposits (plaque) on the inner artery walls. Endovascular means that the physician is treating the condition from inside the blood vessel, making a tiny incision and threading a catheter into the vessel to the treatment area. A tiny tool on the catheter is used to clear the plaque. Tools include a balloon that inflates to push plaque against the vessel wall and blades or lasers that cut away the plaque to restore normal blood flow.

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• Epicardial Ventricular Tachycardia (VT) Ablation

  Electrophysiologists (EP) target abnormal rhythms on the outside of the heart without open-heart surgery. Placing a small needle through the chest wall and into the pericardium, they thread special catheters through the needle to deliver radiofrequency (heat energy), scarring problem areas of the heart. Scar tissue does not conduct electricity, so the erratic signals that cause dangerous arrhythmia can no longer get through.

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• Fenestrated Endovascular Aneurysm Repair (FEVAR)

  Sometimes, an aneurysm occurs in the section of the aorta where the kidney arteries or intestinal arteries branch off. Fenestrated stent grafts are custom designed using enhanced imaging to place holes in the stent graft at the exact locations of the kidney or intestinal arteries.

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• Fistula Creation

  Kidney failure treatment involves hemodialysis - drawing blood through a tube into a machine where it is cleansed and returned to the patient via another tube. This involves repeated needle punctures which can be made easier with a minor surgery to create a large, strong vein for dialysis access in the arm (or leg). The surgeon creates a connection (fistula) that causes blood to flow from the artery directly into a vein, increasing blood volume which causes the vein to expand and thicken.

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• Heart Catheterization (Cardiac Catheterization)

  See Cardiac Catheterization

• Heart Surgery

  Open heart surgery involves opening the chest to operate on the heart muscle, heart valves, arteries or other parts of the heart. This requires stopping the heart and using a heart-lung bypass machine to divert the flow of blood. Minimally invasive heart surgery is performed through small incisions in the right side of the chest between the ribs and may or may not use a heart-lung bypass machine.

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• Iliac branched endoprosthesis (IBE)

  The Iliac branched endoprosthesis (IBE) procedure is a cutting-edge therapy that treats an iliac artery aneurysm while preserving quality of life for the patient. The iliac arteries carry blood to the pelvis and legs, and the IBE device enables surgeons to treat iliac artery aneurysms while preserving blood flow in both branches of the iliac arteries (external and internal). Before IBE, the procedure involved intentionally covering one or both internal iliac arteries with the stent graft(s), often leading to insufficient blood flow to the buttocks (resulting in pain with walking), insufficient blood flow to the colon, and sexual dysfunction. With IBE, surgeons no longer need to cover the iliac arteries. Instead, the IBE is used to create channels that support blood flow through the aorta and the iliac arteries.

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• Implantable Cardioverter Defibrillator (ICD)

  An implantable cardioverter defibrillator (ICD) device regulates heart rate and rhythm. It is implanted in patients at risk of sudden cardiac death due to recurrent, sustained ventricular fibrillation (abnormal heart rate). When the heart's ventricles are pumping faster than normal, the ICD sends an electrical shock to restore a normal heart rate.

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• Inferior Vena Cava Filter Placement

  This filter is designed to prevent clots that are traveling through the blood stream from entering the lungs where they can block blood flow (pulmonary embolism). The filter is delivered via a catheter (flexible tube), threaded through a vein in the groin or neck to the inferior vena cava (IVC). The IVC carries blood from the lower body back to the heart, where it is pumped into the lungs to be replenished with oxygen. Once attached to the IVC wall, the filter allows blood to flow into the lungs while blocking clots.

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• Intra-Arterial Thrombectomy (IAT)

  IAT is treatment for ischemic stroke, which typically results from clogged arteries. An interventional cardiologist threads a catheter (flexible tube) and specialized mechanical stent through the groin artery to the blockage. The surgeon uses the retrievable stent to remove the clot and stop the stroke.

  Learn more about IAT

• LifeVest

  Unlike implantable cardioverter defibrillators, a LifeVest defibrillator is worn in a fabric vest outside of the body. Electrodes track the heart rate, while a monitor collects data which can be sent to the physician through a modem. When the LifeVest detects a life-threatening, irregular heartbeat, an alarm alerts the patient and a shock delivered through electrodes restores normal heart rhythm.

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• Limb Salvage

  Vascular therapies are a key part of a multidisciplinary approach to reduce amputations caused by decreased blood flow to the limb. Endovascular (catheter-based) procedures and open surgeries offer options to repair, replace and open narrow or blocked arteries. Advanced, hybrid procedures combine endovascular and open surgical techniques to open, repair and reconstruct blood vessels, restoring blood flow to the extremities.

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• Lower­ Extremity Arterial Reconstruction

  Treating the arteries of the lower extremities including the hips, thighs, legs, ankles, feet and toes. Endovascular (catheter-based) procedures and open surgeries offer options to repair, replace and open narrow or blocked arteries. In addition, advanced, hybrid procedures combine endovascular and open surgical techniques to restore blood flow.

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• Maze Surgery

  To treat atrial fibrillation (irregular heartbeat caused by faulty electrical impulses), the surgeon makes small cuts or burns in the atria, the chambers of the heart where the misfires originate. These cuts or burns leave a pattern or "maze" that blocks the faulty impulses because scar tissue does not conduct electricity. This procedure requires open-heart surgery.

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• Mechanical Valve

  During a valve replacement procedure, the surgeon removes the diseased heart valve and replaces it with an artificial heart valve, either mechanical or tissue, that works much like a normal heart valve. Mechanical valves are made of strong material such as titanium or carbon. Tissue valves are obtained from human donors or animal tissue that is strong and flexible.

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• Medications

  Your cardiologist may prescribe medications to help manage your condition.

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• Mitral Valve Repair

  When possible, it is best to repair a valve rather than replace it. A procedure called a balloon valvuloplasty can relieve valve tightness. This is done as part of a cardiac catheterization, and is less invasive than general surgery or open-heart surgery. A catheter with a balloon tip is threaded to the valve. When inflated, the balloon stretches and opens the valve. Then, the balloon is deflated and removed.

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• Mitral Valve Replacement

  The surgeon removes your diseased heart valve and replaces it with an artificial heart valve that works much like a normal heart valve. An artificial heart valve is either a mechanical valve or a tissue valve. Mechanical heart valves are made of a strong material such as titanium or carbon. Tissue heart valves are obtained from human donors or animal tissue that is strong and flexible.

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• Mitral Valve Surgery

  Repairing or replacing the mitral valve to restore optimum function. Minimally invasive procedures such as balloon valvuloplasty can open a tight valve during cardiac catheterization. A balloon, guided through a catheter, is inflated inside the valve. This stretches the tissue so blood flows more easily.

  Surgical repair offers many options to reshape the valve to improve function. If repair is not possible, the surgeon may remove and replace the valve with a mechanical, human donor or animal tissue valve.

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• Pacemakers and Defibrillators

  Patients with abnormal heart rhythms often have implantable devices to help the heart beat more efficiently. A pacemaker generates electrical impulses to treat irregular heartbeats. Implanted near the collarbone, the pacemaker's leads (wires) are threaded through a blood vessel into the heart. The device can retrieve and share information about the heart with the physician. New, leadless micro-pacemakers are wireless capsules, one-tenth the size of a traditional device, and are implanted directly into the heart.

  Defibrillators detect and treat life-threatening arrhythmia by pacing the heart to restore normal rhythm. If this fails, this device can deliver a life-saving shock.

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• Patent Foramen Ovale (PFO) Closure

  A Patent Foramen Ovale (PFO) is an abnormal opening that allows venous blood to leak from the right atrium to the left, increasing the chances that a blood clot could pass through and raising the risk for stroke. Not all PFOs require closure; however, the opening can be closed in an open heart surgical procedure or a catheter-based procedure in patients who qualify.

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• Percutaneous Coronary intervention (PCI) (formerly referred to as angioplasty)

  PCI or angioplasty reopens arteries which are narrow or blocked due to a waxy build-up (plaque) on the artery wall. A catheter (flexible tube) with a balloon tip is threaded through a tiny incision in the arm or groin, then guided through a blood vessel to the affected area. The tiny balloon inflates, pushing the plaque against the artery wall, which opens the channel to restore blood flow.

  Find a Cardiologist

• Percutaneous Epicardial Ventricular Tachycardia (VT) Ablation

  Electrophysiologists target the abnormal rhythms on the outside of the heart without open-heart surgery. They use a small needle placed through the chest wall and into the pericardium. Special catheters are placed through the needle and radiofrequency ablation (focused heat) is used to create scarring outside of the heart to eliminate the dangerous arrhythmias.

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• Pericardiectomy

  The pericardium is the sac around the heart. It can become stiff, which leads to problems when it can't stretch to hold the amount of blood it needs. Pericardiectomy is a surgical procedure to removes the sac or a portion of the sac so the heart can move freely. The surgeon cuts through the breastbone to reach the heart and removes the pericardium. Then wires the breastbone together and closes with stitches.

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• Pericardiocentesis

  A procedure to remove fluid from the pericardium, the sac around the heart. Also called pericardial tap, this procedure can be an emergency treatment for a life-threatening buildup of fluid as well as a diagnostic technique to test for infection, blood or cancer. A needle is placed through the chest wall and into the pericardial sac. A catheter is threaded through the needle and fluid is removed.

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• Premature Ventricular Contraction Ablation (PVCs)

  The most common type of irregular heartbeat, PVCs are caused by faulty electrical signals that cause extra heartbeats. To treat patients who have long-term PVCs, radiofrequency ablation uses focused heat delivered in a catheter-based procedure to create scarring. This blocks abnormal electrical signals because scar tissue does not conduct electricity.

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• Radial Artery Access

  During a cardiac catheterization procedure, an interventional cardiologist places a catheter in the radial artery in the wrist instead of in the femoral artery in your groin. Radial artery access offers you many advantages which include less bleeding, fewer complications and a shorter hospital stay.

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• Radiofrequency Ablation or RF Ablation

  RF Ablation is a minimally invasive procedure used to eliminate faulty signals in the heart's electrical system cause an erratic heartbeat. The physician threads a guided catheter (flexible tube) through a vein to the heart. Then uses radiofrequency (heat energy) to scar the problem tissue which stops the faulty signals because scar tissue does not conduct electricity.

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• Renal Reconstruction

  Repairs or replaces a blocked, weak, bulging (aneurysm) or damaged blood vessel where the renal (kidney) arteries branch off from the aorta.

  To replace the aorta, the surgeon implants a graft (tube-like vessel). It can be synthetic or tissue (donated or taken from the patient).

  Grafts are implanted with either open surgery (cutting out the diseased section and stitching the graft into place) or in an endovascular procedure delivered via catheter through the femoral artery in the groin.

  An endovascular stent graft (mesh, fabric covered tube) both props open and lines inside aortic wall like a sleeve. Fenestrated stent grafts are custom designed with openings to accommodate the kidney artery branches.

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• Revascularization

  Restoring blood flow to a specific area or organ of the body that is affected a severe blockage of the arteries (ischemia) due to a buildup of fatty deposits (plaque) on the inner artery walls. A variety of surgical options are available including angioplasty and vascular bypass.

  Angioplasty employs a catheter to deliver and inflate a tiny balloon inside a blocked artery wall. The balloon opens the channel to restore blood flow by pushing the plaque against the artery wall.

  Vascular bypass creates a detour using a graft (tube) to "bypass" blockage caused by plaque so blood can flow through the graft and around the blockage.

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• Septal Ablation

  The septum is a muscle wall separating the heart's left and right ventricles. In patients who have an inherited condition called hypertrophic cardiomyopathy, the wall can thicken, causing the heart to pump inefficiently. A technique called alcohol septal ablation involves injecting a tiny dose of pure alcohol through a catheter (flexible tube) into the artery that flows to the thickened area. This creates a reaction that thins the muscle.

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• Stent Procedure

  Tiny, wire tubes that prop open an artery like scaffolding help restore blood flow where a plaque buildup has caused a narrowing or blockage. Stents are delivered via a guided catheter through a blood vessel to the blockage. Some stents deliver medications to keep arteries open, then absorb into the blood stream.

  Endovascular stent grafts, covered with mesh fabric, treat weak or bulging arteries (aneurysms) by both propping open and lining the inside aortic wall. Fenestrated stent grafts are designed with openings for the kidney artery branches.

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• Supraventricular Tachycardia Ablation (SVT)

  SVT is a rapid heart rhythm that originates at or above the atrioventricular node. Catheter ablation of SVT is an option for patients who have significant side effects from medication. The procedure uses radiofrequency ablation (focused heat) to create scarring which blocks abnormal electrical signals that cause the rapid heartbeat because scar tissue does not conduct electricity.

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• Temporal Artery Bypass

  Bypass surgery creates a new route for blood and oxygen to reach the brain. The surgeon uses a branch of the superficial temporal artery (STA) and connects it to a branch of an artery inside the brain. The procedure is also called extracranial to intracranial bypass graft.

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• Thoracic Endovascular Aneurysm Repair (TEVAR)

  Thoracic endovascular aneurysm repair (TEVAR) is a minimally invasive repair of aneurysms in the part of the aorta located in the chest (thoracic). This therapy significantly reduces the recovery and risks associated with open chest incisions that were the mainstay of treatment in the past.

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• Thoracic Surgery

  Thoracic surgery or chest surgery is a specialty involving the treatment of diseases of the chest, including lung, esophagus, trachea, rib cage and breast bone.

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• Thoracotomy

  A surgical procedure that involves an incision into the chest wall to examine the lungs; remove a lung or part of a lung; remove a rib; examine, treat or remove organs in the chest cavity; remove tumors and metastatic growths; or biopsy or take a tissue sample to examine for evidence of abnormal cells.

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• Tissue Valve

  During a valve replacement procedure, the surgeon removes the diseased heart valve and replaces it with an artificial heart valve. This artificial valve works much like a normal heart valve. An artificial heart valve is either a mechanical or a tissue valve. Mechanical heart valves are made of titanium or carbon. Tissue heart valves are obtained from human donors or animal tissue that is strong and flexible.

  Find a Heart and Vascular Specialist

• Transcarotid Artery Revascularization (TCAR) Procedure

  Minimally invasive transcarotid artery revascularization (TCAR) is used to treat a blocked carotid artery in high risk patient. Through a small incision at the base of the neck, blood flow is redirected from the carotid artery through a tube and outside of the body using the advanced ENROUTE® Transcarotid Neuroprotection System. Once outside of the body, the blood passes through a filter to remove debris before it is returned to the body via the femoral artery in the groin. Once reverse blood flow is achieved, the blocked artery is opened by inflating a tiny balloon or placing a wire mesh stent to prop the artery open. Any debris that may break off during the procedure can be trapped in the filter instead of traveling to the brain and causing a stroke.

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• Transcatheter Aortic Valve Replacement (TAVR) Procedure

  Transcatheter Aortic Valve Replacement (TAVR) is a valve replacement procedure without open heart surgery. A collapsible heart valve is placed into the body via a catheter through the femoral artery in the groin (transfemoral approach) or through the chest (transapical approach). Once in place, the transcatheter heart valve functions like a normal, healthy valve with proper blood flow.

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• Valve Repair

  When possible, it is best to repair a valve rather than replace it. A procedure called a balloon valvuloplasty can relieve valve tightness. This is done as part of a cardiac catheterization and is less invasive than general surgery or open-heart surgery. A catheter with a balloon tip is threaded to the valve. The balloon is inflated to stretch and open the valve. Then, the balloon is deflated and removed.

  Find a Heart and Vascular Specialist

• Valve Replacement

  During a valve replacement procedure, the surgeon removes your diseased heart valve and replaces it with an artificial heart valve. This artificial valve works much like a normal heart valve. An artificial heart valve is either a mechanical or tissue. Mechanical heart valves are made of a strong material such as titanium or carbon. Tissue heart valves are obtained from human donors or animal tissue that is strong and flexible.

  Find a Heart and Vascular Specialist

• Valve Surgery

  Repairing or replacing the valve to restore optimum function. Minimally invasive procedures such as balloon valvuloplasty can open a tight valve during cardiac catheterization. A balloon, guided through a catheter, is inflated inside the valve. This stretches the tissue so blood flows more easily.

  Surgical repair offers many options to reshape the valve to improve function. If repair is not possible, the surgeon may remove and replace the valve with a mechanical, human donor or animal tissue valve.

  Find a Heart and Vascular Specialist

• Valvuloplasty

  A procedure called a balloon valvuloplasty can relieve valve tightness. This is done as part of a cardiac catheterization. A catheter with a balloon tip is threaded to the valve. The balloon is inflated, which stretches and opens the valve. Then, the balloon is deflated and removed, and blood flow through the valve is improved.

  Find a Heart and Vascular Specialist

• Vascular Bypass Procedure

  A treatment for peripheral arterial disease, vascular bypass creates a detour or "bypass" around a blockage caused by a buildup of fatty deposits (plaque) on the inner artery walls. The graft is a natural or synthetic tube that the surgeon stitches in place on each side of the blockage so blood can flow around the blockage through the graft.

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• Vascular Surgery-Complex Open, Hybrid and Endovascular

  Sometimes, a patient requires a hybrid (combination) of open vascular surgery and minimally invasive, endovascular treatments which are catheter based and x-ray guided treatments from within the blood vessels. These complex procedures are performed in the Endovascular Hybrid Operating Suite which features state-of-the-art imaging technologies and a fully integrated sterile surgical operating suite.

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• Visceral Reconstruction

  Involves treating the arteries of the visceral internal organs including heart, lungs, liver, pancreas and intestines. Endovascular (catheter-based) procedures and open surgeries offer options to repair, replace and open narrow or blocked arteries. Advanced, hybrid procedures combine endovascular and open surgical techniques to open, repair and reconstruct blood vessels, restoring blood flow to these organs.

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• Watchman™ Implant

  A new treatment option for atrial fibrillation (AFib) that helps prevent stroke in patients who cannot take blood-thinning medications due to bleeding complications. A fabric-covered device shaped like a parachute is a permanent heart implant that expands to close the opening of the left atrial appendage (LAA) — the site where most harmful blood clots form in AFib patients. By closing off the LAA, this device prevents blood clots from forming and leaving the heart, thus reducing risk of stroke.

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