Cardiac Service

Echocardiograms: An echocardiogram is a test that assesses the flow of blood through the heart and the heart valves using an ultrasound machine. This is a non-invasive test where an echo tech will use an ultrasound probe on the surface of the chest to take the images of the heart. 

Heart Monitors: A heart monitor is a device that will be placed on the surface of the chest to monitor a heart rhythm. The device will be worn for a designated length of time and will then be removed. 

Loop Recorder: A loop recorder is a small device that is inserted just under the surface of the skin on the chest. This device is used for long term monitoring of heart rhythms. 

Stress Tests: There are two main versions of cardiac stress tests. The first type is a treadmill stress test. During this procedure the Veteran will be hooked up to cardiac monitoring while they walk on a treadmill. The speed and incline on the treadmill are often increased gradually until the heart rate gets to a designated level. Your vitals will be monitored during and after the testing. Sometimes a transthoracic echocardiogram is performed immediately after getting off the treadmill. The other type of cardiac stress test is a nuclear stress test. During this test there will be images taken of the heart while at rest. After the first set of images are taken, a small amount of radioactive material and a medication to increase the heart rate is given via an IV. Following the administration of the medications, another set of images of the heart are taken to track the radioactive material throughout the heart.  Stress tests are performed to evaluate how blood flows through the heart at rest and during exercise. 

TEE’s: TEE stands for transesophageal echocardiogram. During this procedure the Veteran will be moderately sedated and an ultrasound probe will be inserted into the mouth and down to the esophagus by a physician. Once the probe is in place the physician takes several images of the heart and the heart valves. This procedure is done when more information/imaging is needed than what a traditional echocardiogram test can provide. 

LHC: A left heart catheterization is an invasive procedure that is performed to assess the vessels in the heart. During this procedure the Veteran will be moderately sedated and the physician will insert a catheter into an artery and then will proceed to take images of the heart vessels. 

RHC: A right heart catheterization is an invasive procedure that is performed to assess how well the heart is pumping. During this procedure the physician will insert a catheter into a vein and will use the catheter to obtain measurements from the different chambers of the heart.

PCI: A percutaneous coronary intervention is an invasive procedure that is performed to open blocked arteries in the heart. This helps to restore or increase blood flow through the heart. An elective PCI can be scheduled as an outpatient procedure. An urgent PCI can be done when clinically indicated. 

TAVR: A transcatheter aortic valve replacement is an invasive procedure that is done to replace the aortic valve in the heart. The new valve is delivered via a catheter that is inserted through the right femoral artery in the groin. The native valve is not removed during this procedure. 

Watchman: A watchman (left atrial appendage occlusion) is an implant that is placed in the left atrial appendage to prevent blood from pooling in the appendage. This procedure is typically done for patients who have chronic atrial fibrillation and cannot tolerate blood thinners. The implant is delivered via a catheter that is inserted into the right femoral artery. 

TEER/MitraClip: A TEER/MitraClip is a procedure that is performed on patients who have mitral regurgitation. During this procedure a catheter is inserted through a vein up to the mitral valve. The MitraClip device is then delivered through the catheter and is used to clip the flaps of the valve together. This helps improve the closure of the valve and reduces mitral regurgitation. 

PFO Closure: A patent foramen ovale (PFO) closure is a procedure that uses a medical device to close a hole between the two upper chambers of the heart. The physician will insert a catheter through the right femoral artery in the groin to deliver the closure device to the PFO. 

Permanent Pacemaker/Defibrillator Implant: A device implant is an invasive procedure where either a pacemaker or a defibrillator is placed in the anterior chest. The Veteran will be moderately sedated during this procedure. The physician will make an incision in the anterior chest and create a pocket for the device to be placed in. The physician will also obtain access in one of the veins in the anterior chest to place the leads for the device. The number of leads and where the leads are placed in the heart is dependent upon the type of device that is placed. 

Device Upgrade: A device upgrade is a procedure that is done when the current device isn’t providing sufficient support for the heart. The Veteran will be moderately sedated for this procedure. The physician will make a small incision at the site of the existing device. The physician will then obtain access in one of the veins in the anterior chest so that they can place additional leads in the heart. Typically, the generator/battery is also replaced during this procedure. 

Generator Change: A generator change is an invasive procedure that is done when the battery of the implanted device (either a pacemaker or a defibrillator) needs to be changed. The Veteran will be moderately sedated for this procedure. A small incision will be made at the site of the existing device. The current battery will be removed and the new battery will be inserted. 

Renal Denervation: Also referred to as a renal ablation, this procedure is done to treat resistant hypertension (high blood pressure.) During this procedure the physician will insert a catheter through the femoral artery in the groin and will then guide it into the renal arteries. The physician will then use ultrasound or radiofrequency energy to ablate in the artery. This energy destroys renal nerves without harming the artery. 

Cardiac Ablation is a procedure completed in the Cardiology department in the Electrophysiology Lab. This involves the Cardiologist using radio frequency energy or other sources to terminate or modify a faulty electrical pathway from sections of the heart of those who are prone to developing cardiac arrhinias such as atrial fibrillation, atrial flutter and Wolfe-Parkinson-White Syndrome.

The VAMC in Indianapolis strives to be the Comprehensive Cardiac  Center for Veterans across the state of Indiana, accepting Veterans from across the State of Indiana and surrounding regions outside of Indiana. Our center offers robust Cardiac Clinical Care that involves inpatient stays, outpatient procedures and clinic office visitations both in the West 10th street location as well as CBOC across the region. CVT and VCC clinic appointments ( video/remote visits) are also available. An interdisciplinary team of staff all focus on the unique care of each Veteran.  Clinical care of heart failure, heart disease, atrial fibrillation, and arrhythmias, valve disease, post-heart attack hospitalization, and more are all provided. Surgical treatments include CABG (including all- arterial and combined valve procedures), valvular (AVR, MVR, TVR), arrhythmia (MAZE, including Encompass and LAAO), aortic aneurysms, Bentall root replacements.