Duke’s specially trained cardiologists use catheter-based procedures to diagnose and treat heart disease, vascular disease, and valve disease in our high-volume cardiac catheterization (cath) labs. Our nine cardiac cath labs in Durham and Raleigh are regional referral centers that operate 24 hours a day, seven days a week, and provide immediate treatment for heart attack and other emergencies. Our cardiac catheterization team helps you manage your heart disease, and improve your quality of life.
Who Needs Cardiac Catheterization?
You may be referred for an invasive imaging procedure called cardiac catheterization to diagnose or treat coronary artery disease, valve disease, vascular disease, heart failure, arrhythmia, or a congenital heart defect. The procedures are performed by interventional cardiologists, who complete additional years of education and training in the use of thin, flexible tubes, called catheters, which are threaded through the arteries and veins that lead to your heart and brain. Using advanced imaging techniques, the doctors view and repair narrowed or damaged arteries and heart structures.
As a high-volume, regional referral center, Duke’s interventional cardiologists perform thousands of minimally invasive cardiac catheterization procedures each year. As leaders in research, we are constantly evaluating ways to improve your experience, maximize quality and safety, and reduce costs. Our efforts inform changes in how cardiac catheterization procedures are performed nationwide.
- Top-ranked care. U.S. News and World Report ranks Duke Heart Center 5th in the nation, based on our patients’ survival rates, the number of procedures we perform and the quality of our support services.
- High-volume centers. More than 7,000 cardiac catheterization procedures are performed annually at Duke University Hospital, Duke Regional, and Duke Raleigh hospitals. These include angiography, angioplasty, valve procedures such as TAVR and mitral clip placement, stem cell injections and more.
- Highest volume TAVR center in the region. We offer both commercially available and several new innovative minimally invasive valves, which being tested through clinical trials.
- National leaders. Our cath labs are training centers for interventional cardiologists from across the country, who travel here to learn from our experts about the latest techniques, and how to work with new devices and therapies.
- Faster treatment. Nearly all our heart attack patients are taken to the cardiac cath lab for angioplasty to open blocked arteries and minimize heart damage -- within 90 minutes or less after arriving at Duke.. This exceeds state and national averages. Duke Hospital has been recognized with the AHA Gold award for STEMI (acute myocardial infarction care).
- Hybrid surgery. When appropriate, interventional cardiologists and surgeons work together in our combination cath lab/operating room to perform multiple procedures. This shortens the procedure time and helps you recover faster.
- Access to clinical trials. We are involved in several studies that are exploring new diagnostic and treatment approaches. You may be eligible to participate in one or more of the dozens of clinical trials that are currently enrolling patients across our three hospitals.
- High-speed imaging. We use 3-D transesophageal echocardiography (TEE) to create highly detailed, close-up images of the valves and chambers, as well as the pumping action of your moving heart at lower radiation doses. We also have both optical coherence tomography and invasive ultrasound to evaluate the vessel wall.
A catheter is inserted through a small incision in your wrist or leg, and guided under ultrasound to a narrowed or damaged artery. A contrast dye lets your doctor visualize the catheter’s journey, and guides the placement of a balloon and a small, cylindrical mesh coil called a stent. Either the balloon, or the balloon and stent are fixed in place to open clogged arteries. Some stents are coated with a drug that is released slowly to prevent further narrowing. This procedure is also referred to as percutaneous intervention (PCI).
Similar to angioplasty, balloons and stents may be placed to repair or open carotid arteries leading to the brain, and lower stroke risk.
A burr with tiny particles or edges is attached to the tip of the catheter. It pulverizes arterial plaque that may build up during atherosclerosis.
Aortic and mitral valves may be repaired or replaced using TAVR or a mitral clip that are placed during catheter-based procedures.
A stent may be placed to reinforce weak spots and prevent an aortic rupture or aneurysm.
Small disks attached to the catheter are used to plug holes caused by congenital heart defects.
During this experimental therapy, stem cells are taken from your own bone marrow, and injected into the heart muscle. Studies suggest this procedure may improve the heart’s ability to pump blood when severe heart failure has been diagnosed.
This experimental procedure is being tested to determine its effectiveness in lowering blood pressure in people who take multiple medications and have been diagnosed with resistant hypertension. A catheter accesses the renal arteries, then a pulse of radiofrequency energy is delivered to deaden nerves that can be a main cause of hypertension when they become overactive.
A small, narrow catheter is thread from a small incision in your leg, groin, arm or wrist to your heart. When combined with an injection of contrast dye, images are created to assess the health of your arteries and heart valves, evaluate your heart muscle function, measure oxygen levels, and trace the movement of blood through your body. It may also be performed to diagnose congenital heart defects. Angiogram helps to determine the most effective treatment for your condition.
A catheter with a small tool at the tip is threaded to your heart, and used to extract a small sample of heart tissue. The tissue is examined under microscope to help diagnose heart failure, bacterial or viral infections. It is also used to evaluate heart tissue before and after a heart transplant.