Services

The Wellmont CVA Heart Institute offers a full scope of heart and vascular services to residents of Northeast Tennessee and Southwest Virginia – and for other patients who travel to our facilities for heart care.

These services can be grouped into several main categories based on the type of procedure being performed.

  • Interventional

    Heart catheterization

    Heart catheterization is a procedure in which a narrow, flexible tube called a catheter is inserted through a blood vessel into the veins and arteries and chambers of the heart. Heart catheterization typically takes between 45 minutes and three hours to complete.

    Heart catheterization can allow x-ray pictures (angiograms) to be taken of the heart chambers and coronary arteries utilizing a special dye, record blood pressure in the vessels of the lungs and heart, measure blood flow and oxygen content of blood in different parts of the heart and take tissue samples (biopsies) of the heart muscle utilizing an instrument passed through the catheter.

    Heart catheterization may be used with open-heart surgeries, artificial heart valves, biopsies, balloon angioplasty or stenting or to help determine and treat coronary artery disease. Take a virtual tour of a cardiac catheterization lab. 

    Hospitals and facilities offering heart catheterization 

    Bristol Regional Medical Center
    Holston Valley Medical Center 

    Balloon angioplasty/stents

    More premature deaths are caused by coronary artery disease than any other disease process in North America. Coronary artery disease is the narrowing or obstruction of the vessels that supply blood and oxygen to the heart. This narrowing is caused by fatty deposits called plaque on the walls of the arteries.

    When plaque builds in the arteries, it can cause a marked reduction of blood and oxygen to the heart. If the blood flow is significantly reduced, medical treatment becomes necessary.

    Balloon angioplasty and stenting procedures reopen blocked coronary arteries and improve the flow of blood to the heart. During balloon angioplasty, a tiny balloon is inflated and deflated to help break up and remove plaque buildup inside a diseased artery. Then a small mesh tube called a stent can be placed inside the artery to prevent it from collapsing or being obstructed again by plaque.

    Directional coronary atherectomy

    Directional coronary atherectomy is a catheter intervention that can shave out specific types of narrowing in the coronary arteries. This procedure may be preferable to balloon angioplasty based on the location of the blockage, the size of the artery and the type of blockage.

    Brachytherapy

    Brachytherapy involves the placement of tiny radioactive "seeds" inside cancerous tissue to provide localized treatment of various conditions. These seeds are typically the size of a grain of rice and emit radiation that travels only a few millimeters, offering extremely precise areas of treatment. Brachytherapy is sometimes used to treat coronary artery disease.

    ASD/PFO closures

    Atrial septal defect (ASD) and patent foramen ovale (PFO) are congenital abnormalities within the heart that can lead to other problems and complications if not treated. Surgery is used to implant a closure device that "patches" these holes in the heart.

     
  • Heart rhythm

    Electrophysiology

    Electrophysiology (EP) involves the electrical functioning of the heart. EP tests may be used to help diagnose arrhythmias or to determine a plan of treatment for identified arrhythmias. Specialized areas in the field of electrophysiology include pacemakers and implantable cardiac defibrillators (ICDs), diagnostic electrophysiology, radiofrequency ablation, atrial fibrillation, cardiac resynchronization therapy and syncope.

    Biventricular pacing

    Biventricular pacing devices are used when the chambers of a person's heart are beating in an unsynchronized rhythm. Using an implantable device that sends electrical signals to the chambers of the heart, a normal pace and rhythm can be restored.

    Cardioversion

    During electrical cardioversion, a low dose of electrical current is briefly delivered to a person's heart through electrode patches on the chest and back, restoring the heart to normal rhythm in the event of atrial flutter or atrial fibrillation, two common heart rhythm disturbances.

    Radiofrequency ablation

    Radiofrequency ablation is performed to correct abnormal heart rhythms when they are caused by specific problems, including birth abnormality or a heart injury from heart attack, surgery or infection.

    Pacemaker implantation

    Pacemakers are implanted for chronic conditions that can cause persistent or intermittent slowing of the heart rate. Once a pacemaker is implanted, individuals may typically resume all the normal functions of their daily lives, since the pacemaker will adjust automatically to varying circulatory needs.

    ICD implantation

    Implantable cardiac defibrillators (ICDs) are electronic devices used inside the body to regulate life-threatening arrhythmias. These small devices are implanted beneath the skin and are connected to the heart with small wires. They send an electrical impulse to the heart muscle to restore a regular heartbeat.

    Tilt table testing

    Tilt table testing may be used to help determine causes of fainting or dizziness. During this type of test, a patient is secured on a table that tilts from flat to upright. Blood pressure and heart rate are monitored during the process to aid in diagnosis.

  • Peripheral vascular

    Arterial, venous, carotid and abdominal duplex studies

    Arterial, venous, carotid and abdominal duplex studies are tests performed to examine blood flow in different parts of the circulatory system utilizing ultrasound.

    Arterial Doppler study

    An arterial Doppler study is performed to evaluate arterial blood flow using blood pressure cuffs placed at different points around the legs or arms. It helps determine if the arteries being tested are narrowing or obstructed.

    Vascular screening

    Vascular screenings are used to detect problems that can lead to strokes and other vascular disorders. Vascular disease is among the leading causes of death in the U.S. but is generally asymptomatic prior to a catastrophic event, such as a stroke. That is why vascular screenings are key in determining a person's risk.

    Endovenous laser treatment (EVLT)

    Endovenous laser treatment is a laser procedure for painful varicose veins in women and men. The non-surgical technique, performed in an outpatient setting, is both safe and effective.

  • Diagnostic

    Cardiac stress testing

    Cardiac stress testing is a non-invasive diagnostic procedure used to assess problems with the heart's blood supply. This test can be peformed using an exercise treadmill, echocardiography or a pharmacologic stress medication.

    Echocardiograms

    Echocardiograms are safe and painless tests using ultrasound to create images of the heart. During an echocardiogram, a small transducer is held against the chest and emits ultrasound waves that bounce off the heart. The resulting data is sent to a computer that displays an image of the heart in motion. These images can assist physicians in diagnosing many different types of heart problems.

    Holter monitoring

    Holter monitoring is used to study heart rhythm activity over a period of hours or days. A holter monitor, approximately the size of a pager, is worn by a person for a period of 24, 48 or 72 hours. During this time, the monitor records EKG data that can be analyzed by a cardiologist for diagnosis and treatment.

    Event monitoring

    Event monitoring continuously records the rhythm of a person's heart for an extended period of time, typically 30 days. Many patients experience symptoms of heart problems that do not occur regularly. Wearing an event monitor for 30 days results in a greater likelihood of detecting heart rhythm abnormalities.

    Cardiac CT angiography (CTA)

    Cardiac CT utilizes a contrast dye containing iodine to help visualize the heart and blood vessels, producing a three-dimensional image.

    HeartSHAPE® coronary calcium scoring

    HeartSHAPE® coronary calcium scoring focuses on early identification of coronary artery disease and heart attack prevention. The painless screening test takes less than five minutes to perform and produces pictures of the coronary arteries from outside the body using a 64-slice CT scanner. From those images, a coronary calcium score is determined.

    ICG testing

    ICG testing is a noninvasive test that provides information about the heart's ability to deliver blood throughout the body, the opposing force a person's heart must pump against and the amount of fluid in a person's chest.

  • Surgical

    Off-pump bypass surgery

    Off-pump bypass or "beating-heart" surgery keeps a person's heart beating during and after heart surgery, typically resulting in less blood loss, lower risk of stroke and shorter hospital stays. According to the American Heart Association, approximately 30 percent of the 500,000 coronary artery bypass surgeries performed in the U.S. annually are off-pump procedures, and that number is growing.

    Heart valve repair and replacement

    Heart valve repair and replacement helps correct problems when a person's heart valves are not closing correctly or completely. These problems may be due to congenital defects or valve damage.

    Coronary artery bypass grafting (CABG)

    Coronary artery bypass grafting is a type of surgery that helps improve blood flow to the heart. It is used for individuals who have severe coronary artery disease, when plaque builds inside a person's coronary arteries and restricts blood flow.

    Repair of thoracic aneurysm

    Thoracic aortic aneurysm is an abnormal bulge in a weakened wall of the aorta. If left unrepaired, it can cause a variety of symptoms and often life-threatening complications.

    Homografting

    Homografting replaces an organ using a donor's organ. Aortic homografting, one type of this procedure, replaces a problematic aorta with a healthy valve.

    Pacemaker and cardioverter defibrillator (AICD) implants

    Pacemaker and cardioverter defibrillator implants are surgically placed inside the body to help regulate, maintain and stimulate normal heart rhythm. Pacemakers may be used to treat syncope, congestive heart failure and hypertrophic cardiomyopathy.

    Pulmonary surgery

    Pulmonary surgery is performed to repair pulmonary arteries, the vessels supplying blood to the lungs.

    Aortic dissection

    Aortic dissection is a potentially life-threatening condition in which there is bleeding into and along the wall of the aorta. It is sometimes treated with medication, but surgery may also be required to repair the damaged aorta.

    Endovascular aneurysm repair

    Endovascular aneurysm repair uses a stent to reline a blood vessel, thereby decreasing the probability of an aneurysm rupturing.

    Repair of congenital defects in adults

    Congenital heart defects are problems with the structure of the heart. They are present at birth and can often be repaired by surgery.

    Cardiac and thoracic trauma

    Cardiac and thoracic trauma is common following accidents, and surgery is often required to repair the damage to critical organs and systems.

    Transmyocardial revascularization

    Transmyocardial revascularization is a surgical procedure that improves blood flow to areas of the heart not treated with angioplasty or surgery. It is used to treat inoperable coronary artery disease patients with angina.

  • Clinics

    Device clinic

    The device clinic is a specialty clinic that helps follow up on and assure proper functioning of various medical devices, including pacemakers and implantable defibrillators (ICDs). Through maintenance and periodic interrogation of these devices, information can be obtained and correlated to a patient's clinical condition to help tailor medication choices, cardiac testing and potential future interventions.

    Lipid clinic

    The lipid clinic is offered to patients who experience abnormal cholesterol or triglyceride levels. Each patient is initially evaluated by a cardiologist or physician extender and given medications to treat his or her condition. Regular follow-up visits help evaluate patient response to and tolerance of treatments. Dietary counseling and lifestyle recommendations may also be offered, providing the necessary tools for patients to achieve their goals for lipid values and decrease their risk levels for cardiovascular disease.

    Coumadin clinic

    The coumadin clinic provides follow-up care for patients taking anticoagulant medications, or blood thinners. These types of drugs require close monitoring of lab work by trained clinical professionals to help ensure success.

    Heart failure clinic

    The heart failure clinic provides medication maintenance and treatment of heart failure. Medications and treatment options are provided and adjusted as needed, and patients are followed closely to evaluate their responses to treatment and to prevent and help treat worsening heart failure symptoms.