Cardiovascular Services at University Health System

General Information

The Heart and Vascular Institute at University Health System is led by dozens of highly-trained cardiologists from UT Medicine San Antonio and UT Kids with decades of experience treating adults and children with cardiovascular disease, or conditions of the heart, arteries and veins. Ranked Best Hospital in San Antonio five years in a row by U.S. News and World Report, University Hospital is the only facility in South Texas staffed with a comprehensive heart team including emergency department physicians, interventional cardiologists, nurses and cardiovascular technologists, seven days a week to care for patients with heart disease.

Cardiovascular Program Highlights

  • Complete heart care – from diagnostic treatment, when you first become aware of a heart problem, to intervention, when expert treatment is needed and in an emergency
  • South Texas’ first cardiovascular hybrid suite – a cardiac cath lab and operating room all in one
  • Cutting-edge procedures, including TAVR (transcatheter aortic valve replacement) and pediatric/neonatal ECMO (extracorporeal membrane oxygenation)
  • Free, online heart health assessment
  • Groundbreaking cardiovascular research
  • The only Magnet healthcare organization in South Texas – the gold standard in quality nursing care
  • 2013 American Heart Association’s Mission: Lifeline® Bronze Receiving Quality Achievement Award
  • 2012 Platinum Performance Achievement Award

Adult Diagnostic Services

  • 3-D EP Mapping is a procedure where the electrical pathways of your heart are mapped to search for the “short circuit” that is causing your irregular heart rhythm. State-of-the-art, three dimensional imaging technology is used instead of the standard use of X-rays.
  • Adenosine Stress Test is an alternative procedure for patients with coronary artery disease who cannot exercise on a treadmill. An IV line will be started to administer the drugs Persantine and Thallium. The Persantine helps to expand the coronary arteries increasing the blood flow to the area – similar to what happens during exercise. Thallium is detected by the x-rays and shows which parts of the heart muscle are receiving enough oxygen. This test will help the doctor find irregular heart rhythms; find which areas of the heart are not getting enough blood and oxygen; and, how quickly the heart recovers after exercise.
  • Diagnostic Cardiac Catheterization or Coronary Angiography is an imaging process that allows your doctor to evaluate your heart function. A long, narrow tube (catheter) is inserted through a short, hollow tube that is inserted into a blood vessel in your arm or leg, and then positioned to the heart to allow for a dye to be used for x-ray and imaging. The procedure is used to confirm coronary artery disease, determine how your heart muscle is functioning, and to learn what treatments may be needed. It can be performed for both diagnostic and interventional purposes.
  • Stress Echocardiography is an ultrasound-based test that helps show how well your heart muscle pumps blood to your body. You will walk on a treadmill until you reach your peak heart rate. If you are unable to walk on a treadmill, you will be given a drug, such as Dobutamine, through a vein which will make your heart beat faster and harder – just like it would during exercise. Once your heart rate is increased, you will lay down for an ultrasound and we will take images of your heart’s reaction to the “stress” and determine if you have coronary artery disease.
  • Echocardiography is an ultrasound test that uses sound waves to take pictures of the heart. Sticky patches called electrodes are put on your chest to monitor your heart rhythm. The heart is imaged by an ultrasound transducer, which is held against the chest in different positions. These images allow the doctor to see your heart in motion to analyze the size, shape, and how it is working.
  • Electrophysiology Studies (EP Study) records the electrical activity of your heart. The study is used to determine the cause of an abnormal heart rhythm, locate the origin of an abnormal heart rhythm or arrhythmia; and assist in determining the best treatment for an abnormal heart rhythm. This test may be done to check how your pacemaker is working or where one should be implanted, what might be causing abnormal heart rhythms, how effective certain drugs are, or if more tests are needed.
  • Exercise Treadmill Testing is used to test the effect of exercise on your heart. A technician will place sticky patches called electrodes on your chest. These are attached to a monitor that follows the electrical activity of your heart while you walk fast. While you exercise, the activity of your heart is measured and your blood pressure readings are taken. The test will continue until you reach a target heart rate, you are too tired, or readings show that your heart muscle is not getting enough oxygen.
  • Heart Biopsy Heart Biopsy is a test in which small pieces of tissue are taken from the heart muscle, and examined under a microscope. By examining this tissue, your doctor may be able to diagnose a condition that will lead to a change in your medical therapy. One of the most common reasons to do a heart biopsy is to determine if a virus has attacked the heart muscle, causing a condition called myocarditis, or inflammation of the heart muscle. Another reason for undergoing a heart biopsy is to screen for signs of heart transplant rejection.
  • Holter Monitoring / Ambulatory Monitoring is a technique used to continuously record (24-48 hours) of heart activity to detect changes in the heart’s rhythm. Sticky patches called electrodes are placed on your chest and connected to a portable monitor worn while you continue your regular activities (eating, sleeping, working, etc.) You will keep a diary of activities while wearing the monitor. The monitor helps to detect an arrhythmia – a heart beating too fast, too slow, or irregularly. The readings also can check whether treatments are working.
  • Hypertrophic Cardiomyopathy Evaluations (HCM) is the diagnostic strategy used to detect this inherited disease of the heart muscle. HCM can cause the wall of the heart muscle to thicken. When the wall gets too thick, the heart muscle functions inefficiently, causing an obstruction to blood flow from the heart. This genetic heart disease is a cause of sudden cardiac death in the young, and heart failure at any age.
  • Intracoronary Doppler Ultrasound is a test in which a small ultrasound transducer is advanced through a narrowed blood vessel to measure the blood flow. It permits real-time viewing of blood flow that cannot be obtained by other methods. It is also used to test the results of a coronary angioplasty/balloon angioplasty, the need for a stent, or for monitoring purposes.
  • Intravascular Ultrasound or Intracoronary Ultrasound is performed with an ultrasound machine that has been adapted to create images of the heart and coronary arteries from the inside out. A tiny ultrasound camera sits on top of a flexible, long, thin tube (catheter) and provides detailed pictures to clearly identify areas of plaque or blockage.
  • Nuclear Chemical Stress Testing (Persantine-Thallium Stress Test) is a procedure for patients with suspected, or existing coronary artery disease, who cannot exercise on a treadmill. An IV line will be started to give a vaso-dialator drug and a nuclear radioisotope. The vaso-dialator drug helps to expand the coronary arteries which is similar to what happens during exercise. The radioisotope is detected by a nuclear scanner and shows which parts of the heart muscle are receiving enough oxygen. This test will help the doctor find irregular heart rhythms and show how quickly the heart recovers after exercise.
  • Nuclear Exercise Treadmill Test is done to see how well blood flows to the heart muscle at rest and during exercise. An IV line will be started to give a nuclear radioisotope and take pictures of your heart before exercising on the treadmill and after you finish exercising. The nuclear radioisotope helps the doctor see the images. This test can show how much coronary artery blockage there is and if medical, or surgical treatment, might be needed.
  • Optical Coherence Tomography is another imaging technology used to look inside the coronary artery. It is similar to Intravascular Ultrasound (IVUS) though it uses light instead of sound. It captures high-resolution, three-dimensional images from within the coronary arteries to give the doctor a clear image of the artery to identify areas of plaque or blockage.
  • Peripheral Angiography uses x-rays to help the doctor find narrowed or blocked areas in one or more of your arteries. A long, thin tube (catheter) is guided into the arteries and a dye, visible by x-rays, is injected into the blood stream. Any areas of narrowed or blocked arteries will be seen on a video screen and recorded.
  • Thallium Exercise Treadmill Testing is done to see how well blood flows to the heart muscle during rest and exercise. Heart images are taken at rest and immediately following exercise on a treadmill. Thallium is detected by the x-rays and helps the doctor see the images. The test can show how much coronary artery blockage there is and if surgical treatment might be needed.
  • Transesophageal Echocardiography (TEE) uses sound waves bounced off your heart to create an image. With this test, a long, flexible tube about the width of a little finger is inserted into your mouth and esophagus. A tiny transducer at the tip of the probe sends and records the sound waves. This test is done to detect blood clots inside the heart; assess the heart valves; assess how artificial valves are working; detect holes between the chambers of the heart; diagnose a dissection or tear in the lining of the aorta; and, detect infections of the heart valves.

Adult Interventional Services

  • Alcohol Ablations is used to treat abnormal heart rhythms, or arrhythmias. The doctor will insert a thin, tube (catheter) into the heart. A special machine delivers energy through the catheter to tiny areas of the heart. This energy “disconnects” the pathway of the abnormal heart rhythm. Ablation re-establishes a normal heart rhythm in people with certain arrhythmias and can help control the heart rate in people with rapid arrhythmias as well as reduce the risk of blood clots and strokes. 
  • ASD/PFO/PDA Closures is a corrective procedure where a device is inserted in the “hole” on the walls between the different chambers of the heart where blood is escaping instead of flowing through its normal route. The closure device is delivered through a small hole in your groin by a thin tube (catheter).
  • Atherectomy (Directional Atherectomy & Rotational Atherectomy) is a procedure used to cut away the blockage (plaque) responsible for narrowing in the artery. Atherectomy techniques: Directional Atherectomy uses a long, thin tube (catheter) with a sharp blade on the end to remove plaque from the artery. The blade shaves the plaque and stores it in a collection chamber. The plaque is removed from the artery when the device is removed. Rotational Atherectomy uses a special long, thin tube (catheter) with a diamond-coated tip. The tip spins at a high speed and grinds away the plaque on the artery walls. The small particles are washed safely away in your bloodstream and filtered out by your liver and spleen.
  • Atrial Fibrillation/Flutter Ablations is a procedure that locates and cuts off the abnormal electrical pathway in your heart that is causing your heart rhythm to quiver (a common irregular heart rhythm problem) and produce blood clots.
  • Bi-Ventricular Resynchronization Implantation is a procedure where pace leads are implanted in both pumping chambers of your heart to “re-synchronize or re-time” so both chambers pump at the same time. This helps move blood through the heart and more efficiently delivers blood to the organs of the body.
  • Coronary Angioplasty, Balloon Angioplasty or Percutaneous Transluminal Coronary Angioplasty (PTCA) opens narrowed arteries. A long, thin tube (catheter) with a small balloon on its tip is used. The balloon is inflated at the site of the blockage in the artery to flatten, or compress, the plaque against the artery wall. In many cases, balloon angioplasty is performed in combination with a coronary stenting or stent placement procedure.
  • Coronary Stenting or Stent Placement uses a small, mesh, metal tube (stent) that is placed inside the artery. It acts as support to keep the artery open and improve blood flow to the heart, and it reduces chest pain (angina). The stent is placed after an artery is cleared of blockage (Coronary angioplasty or Balloon angioplasty). It becomes a permanent part of your artery.
  • Catheterization or Coronary
  • Implantable Cardioverter Defibrillator (ICD) is a device that sends an electric current through the heart. It is for people who have an abnormal, fast heart rate that may cause fainting or their heart to stop pumping properly. When medicines do not work, an ICD Implantation is done. It is implanted beneath the skin and is about the size of a small cell phone.
  • Lariat Procedure
  • Interventional Cardiac Catheterization is a treatment used to open narrowed coronary arteries to improve blood flow to the heart. It can be performed during a diagnostic cardiac catheterization when a blockage is identified or it may be done after testing has confirmed there is coronary artery disease. Once the catheter is in place one of these interventional procedures may be performed to open the artery: Coronary Angioplasty or Balloon Angioplasty, Coronary Stenting or Stent Placement, or Directional Atherectomy and Rotational Atherectomy.
  • Mitral Valve Clipping is the latest available technology used to correct, or reduce, a severe “leaking” mitral valve. A “clip,” like a paper staple, is used to fuse the mitral valve leaflets to reduce the valve opening allowing the blood to flow through the left atrium to the left ventricle. Patients do not have to have an open-chest surgical procedure to get this done.
  • Permanent Pacemakers Implantation is the surgical procedure of placing a permanent pacemaker into the chest through a small incision. The pacemaker is attached to the heart through a wire that is threaded through a neck vein. A pacemaker is a small, battery-powered device that sends out weak electrical impulses that cause the heart muscle to contract. It replaces the function of the natural pacemaker of the heart when the heart is beating too slowly.
  • Radio Frequency Ablation is used to cut the abnormal electrical pathways in your heart by using “heat” transferred through the tip of a specialized thin tube (catheter) guided by either X-ray imaging or 3-D mapping.
  • Rheolytic Thrombectomy is a procedure for clot removal in the artery. A special pump delivers saline at a high pressure through a long, thin tube (catheter). The pump creates a vacuum and breaks the clot into pieces. The pieces are then suctioned out of the artery. This procedure is used when there are many clots as in the case of a heart attack.
  • Transcatheter Aortic Valve Replacement (TAVR)
  • Valvuloplasty is a procedure in which a small balloon is inserted and inflated to stretch and open a narrowed heart valve to facilitate the flow of blood through the valve. Valvuloplasty is some times done before heart surgery can be scheduled. In some patients it works for a long period of time with the result that open heart surgery is not needed.

Pediatric Cardiovascular Services

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