Hemodynamics and Interventional Cardiology

The Departmental Simple Operative Unit for Hemodynamics and Interventional Cardiology specializes in cardiovascular diagnostics and interventions, performed both electively and in emergency settings.
The unit’s primary focus lies in two clinical areas: ischemic heart disease and structural heart disease.
In the field of ischemic heart disease, coronary angiographies and percutaneous coronary interventions (PCI) with stent implantation are performed, often supported by advanced imaging techniques such as intravascular ultrasound (IVUS), optical coherence tomography (OCT), and coronary physiology assessment using pressure wire-guided fractional flow reserve (FFR). For high-risk patients, ventricular assist devices are utilized. For the treatment of more complex coronary artery disease, the lab is equipped to perform rotational atherectomy and intravascular lithotripsy. This allows for the management of high-risk patients and the execution of highly complex procedures, including the treatment of calcified lesions, coronary bifurcations, left main coronary artery disease, and chronic total occlusions (CTOs). In the field of structural heart disease, percutaneous closure procedures are performed for patent foramen oval (PFO), atrial septal defects (ASD), and patent ductus arteriosus (PDA). Since the establishment of the onsite Cardiac Surgery Unit, the team has actively collaborated in a hybrid operating room for transcatheter aortic valve replacement (TAVI) and percutaneous correction of other valvular diseases, such as mitral and tricuspid insufficiencies.
Right heart catheterization is routinely performed for the diagnosis and treatment optimization of pulmonary hypertension—a condition for which the unit serves as a referral center—and congenital heart defects. Additionally, pericardiocentesis procedures are conducted.

Emergency Care

The Hemodynamics Lab serves as a Hub Center within the Foggia Province Network for managing acute myocardial infarction via primary angioplasty. A 24/7 on-call team—including a physician, a radiology technician, and a nurse—is available to respond to emergencies.

Advanced Imaging

Cutting-edge coronary and cardiac imaging technologies enhance procedural accuracy and reduce risks, particularly in complex cases. The lab is equipped with optical coherence tomography (OCT), two intravascular ultrasound (IVUS) systems, and two intracardiac echocardiography systems (Ultra ICE and AcuNav), ensuring precise guidance for structural heart interventions. This array of tools, combined with the team’s expertise, allows for highly individualized patient care.

Ventricular Support Systems

For critically ill patients experiencing severe myocardial infarction or undergoing high-risk interventions, temporary mechanical circulatory support systems are utilized to reduce cardiac workload and improve performance. The lab employs intra-aortic balloon pumps for basic support and Impella devices for advanced support, both inserted percutaneously. In collaboration with the Cardiac Surgery Unit, extracorporeal membrane oxygenation (ECMO) is available for the most critical cases.

Rotational Atherectomy and Intravascular Lithotripsy

Calcified coronary lesions pose significant challenges to PCI, often leading to suboptimal outcomes. The lab specializes in managing such lesions using advanced imaging-guided techniques. Rotational atherectomy, performed with diamond-tipped burrs of varying sizes, removes superficial calcium deposits in coronary arteries. Additionally, intravascular lithotripsy utilizes balloon catheters that emit mechanical pulse waves to fracture deep calcium deposits, facilitating stent implantation.

Chronic Total Occlusions (CTOs)

Chronic total occlusions represent one of the most advanced challenges in interventional cardiology. Using specialized tools—including dedicated coronary wires, microcatheters, and imaging systems—the lab restores blood flow to chronically occluded arteries, ensuring effective revascularization.

Doctors

Dr. Vigna Carlo