Cardiac Catheterization Program
ColumbiaDoctors's cardiac catheterization program is the largest program of its kind in New York state and provides treatment to patients with congenital and acquired heart conditions from birth into adulthood. We perform more than 1,200 diagnostic and therapeutic congenital cardiac catheterizations at the hospital each year, on infants who may be only minutes old to adult patients who have congenital heart disease and/or pulmonary hypertension. Approximately 20 percent of such procedures are performed on “grown-up” patients.
Cardiac catheterization is a specialized procedure performed in infants and children. It was originally used to provide additional diagnostic information and now serves as a therapeutic intervention to improve—and frequently correct—underlying congenital heart conditions, avoiding the need for open heart surgery.
Our internationally recognized interventional team of physicians perform all types of currently approved transcatheter therapies in three state-of-the-art, digital, OR-ready or “Hybrid” cardiac catheterization suites designed for and dedicated to patients with congenital heart disease. Two of these procedure suites are at the Morgan Stanley Children’s Hospital and the third is a dedicated suite for adults with congenital heart disease (ACHD) at Milstein Hospital. Advantages are:
- Hybrid catheterization suites accommodate surgical, trans-catheter, or any other collaborative hybrid procedures.
- Surgical and high-end trans-catheter equipment all in the same suite lets us coordinate specialized procedures and adjust our approach to the many forms of complex congenital heart disease.
- Digital capabilities include rotational angiography, a medical imaging technique used during procedures to acquire CT-like, 3-Dimension visuals.
Some of the common therapeutic catheterization procedures we perform in our specialized catheterization suites include:
- Balloon dilation or angioplasty of narrowed blood vessels such as narrowings in the pulmonary arteries (pulmonary artery stenosis) or narrowings of the thoracic aorta (coarctation of the aorta).
- Balloon dilation of valves in the heart (valvuloplasty) for valves that are congenitally “tight” or stenotic. Valves most commonly in need of dilation in patients with congenital heart disease include the pulmonary and aortic valves.
- Intravascular stent dilation or the placement of stents inside blood vessels to relieve narrowings of important arteries and veins in the body. Most commonly this therapy is performed for blood vessels that have become narrowed from scarring after surgery for congenital heart disease. Blood vessels most commonly requiring stent dilation include pulmonary arteries, recurrent coarctation of the aorta and the inferior and/or superior vena cava or large veins draining into the right side of the heart. Previously placed surgical conduits also are commonly stented to help prolong the longevity of a conduit and decrease the number of overall surgeries a patient with congenital heart disease may require over a lifetime.
- Implantation of trans-catheter heart valves. Notably, we have implanted more than 100 transcatheter heart valves in the pulmonary position. We have also implanted these catheter-based valves in the tricuspid and mitral valve positions in patients with congenital heart disease who would otherwise require surgical valve replacement procedures. Transcatheter closure therapies for holes in the atrial and ventricular walls (septal defects) and persistent or unwanted blood vessels like a persistent patent ductus arteriosus or PDA. Our team of physicians have been world leaders in the development and use of these technologies and have successfully closed more than 500 septal defects and 700 patent ductus arteriosus since such technology became available.
Furthermore, our Interventional Cardiologists have helped to pioneer the investigation of nearly every new catheter-placed device and therapeutic transcatheter procedure and have participated in nearly every major multi-center FDA trial for devices and transcatheter therapies performed in the United States over the past 15 years, including:
- Medtronic Melody® and the Edwards LifeSciences (Edwards-Sapien) transcatheter heart valve in the pulmonic position
- Use of covered Cheatham Platinum Stents for treatment of vascular wall injury involving the aorta, pulmonary arteries and surgical placed conduits between the right ventricle and the pulmonary arteries (COAST, COAST II, and PARCS)
- Post-market trial for Amplatzer® septal occluder device and ventricular septal occluder device
We contribute to national registries to enhance patient care by promoting quality improvements and to develop outcome assessment methods for pediatric catheterization. Registries include:
- National Cardiovascular Data Registry’s IMPACT Registry™ (Improving Pediatric and Adult Congenital Treatment)
- Congenital Cardiac Catheterization Project on Outcomes
- Congenital Cardiovascular Interventional Study Consortium