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Cardiovascular Institute

Coronary Artery Disease

The link between tobacco and heart disease

Coronary artery disease is the most common type of cardiac disease and the leading cause of death for both men and women in the United States. A national leader in the diagnosis and treatment of heart disease, the Cardiovascular Institute uses the latest technologies and cardiac care strategies to treat coronary artery disease.

Diagnosis

We examine the heart—inside and outside—to pinpoint the cause and location of each patient’s coronary disease. Our cardiac imaging program provides physicians with every conceivable tool to accurately diagnose heart disease, including state-of-the-art nuclear stress testing, stress echocardiography, PET/CT, coronary angiography, cardiac MRI and cardiac catheterization.

Through our comprehensive cardiac catheterization program, our team continues to play a dominant role in the development of breakthrough interventional procedures for the treatment of coronary artery disease. Allegheny General Hospital features six integrated catheterization suites with digitally enhanced imaging and computerized post-processing, with support by cardiac surgeons 24 hours a day.

A cath lab team is available around the clock for emergent cases. Critical patients with acute myocardial infarction, such as those transported by LifeFlight, are immediately sent to the cath lab upon arrival at AGH for assessment and treatment. This timesaving pathway helps physicians institute treatment sooner, thereby minimizing damage to the heart muscle and improving survival. Allegheny General is a benchmark hospital for the core measures initiatives related to acute MI, exceeding the national standards.

Medical Treatment

Our physicians tailor pharmacologic management to the individual patient, using best-practice drug regimens and carefully selected new and cutting-edge agents. Novel therapies, such as enhanced external counterpulsation may be added to complement drug treatment. Our cardiologists offer a complete array of procedures, from the traditional to the novel:

Balloon angioplasty and coronary stenting
Our interventional cardiologists are regional leaders in their experience and expertise in percutaneous coronary intervention.

Drug-eluting stents
In some patients, the biological processes causing restenosis require more sophisticated drug-coated or drug-eluting stents. Our physicians employ these devices to deliver time-released pharmacologic agents via the stents to the area of the artery vulnerable to restenosis.

Distal protection devices
Our cardiologists were among the early principal investigators in clinical trials of distal protection devices. These devices reduce the risk of heart attack among patients undergoing balloon angioplasty and stent placement to open blocked coronary arteries. The device protects patients from distal embolization, in which tiny blood clots and plaque debris break free and flow toward smaller vessels in the heart, potentially leading to heart attack. During this procedure, doctors inflate a balloon on the catheter's tip that temporarily blocks blood flow from the diseased artery into the heart's smaller vessels during the stenting procedure. After the stent has been placed, trapped blood or debris is vacuumed out through an export catheter before the balloon is deflated.

Adjunctive thrombolysis
We are at the forefront of applying anti-clotting medications to minimize the damage of acute myocardial infarction, offering patients drugs considered the industry standard as well as investigational medications.

Balloon valvuloplasty for aortic and mitral valve stenosis
Our physicians are considered among the nation's elite in using balloon-tipped catheters to repair and restore optimal blood flow in the aortic and mitral valves of the heart. In some patients with congenital disease or disease that develops later in life, balloon valvuloplasty offers a minimally invasive means to open these critical heart valves without the need for open-heart valve surgery.

Rotational and Directional Atherectomy
These procedures attack stubborn plaques that are not treatable with traditional balloon angioplasty. Rotational and directional atherectomy are two different methods of reducing plaque size by either drilling or shaving the plaque. In both procedures a special protective shield placed around the area captures the debris and removes it from the artery via the catheter.

Surgical Therapy

Our surgeons handle the most complex, high-risk cases and consistently demonstrate the lowest mortality rates among hospitals in the region. They are among the most experienced in the United States in coronary artery bypass grafting (CABG), especially in the treatment of ischemic cardiomyopathy. In addition, they are among the most technically skilled in offbypass coronary artery bypass surgery (OPCAB) — a technique involving the use of the standard sternotomy incision followed by placement of one or more bypass grafts on the beating heart. The advantages of OPCAB include shorter hospital stays, less blood transfusion and a reduction in some types of post-operative complications.

Following surgery, patients have around-the-clock access to doctors who help them manage the critical post-operative care period. Our patients also benefit from nurses who have sophisticated experience caring for a large, often critically ill patient population.

Cardiac surgeons at Allegheny General use a comprehensive coronary artery bypass program emphasizing detailed preoperative patient education, leading surgeons with highly experienced teams that focus on long-term results, patient care designed to bolster the recovery process and follow-up care that includes "house calls" by telephone and email, as well as the extensive services available through the hospital's lifestyle management services.


Learn more about Coronary Artery Disease in our Health Library.

Learn more about Interventional Cardiology in our Health Library.

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