Examinations and procedures

Echocardiograms: techniques that use ultrasound to visualise the heart and its valves. There are several types of cardiac ultrasound: transthoracic, transoesophageal, stress and exercise echocardiograms, and microbubble tests.

Cardiac magnetic resonance imaging (MRI) and nuclear medicine imaging techniques (myocardial scintigraphy and cardiac PET scans) may be used to supplement the assessment, depending on the individual case.

Coronary angiography is an invasive X-ray examination of the heart’s arteries, which may be combined with a study of pressure levels in the heart and lungs known as cardiac catheterisation. A puncture is made in the artery in the thigh (femoral artery) or wrist (radial artery) under local anaesthetic. A catheter (flexible tube) is guided to the opening of the coronary arteries. An iodinated contrast agent is injected and X-rays are taken, enabling any narrowing of the arteries to be diagnosed. This examination is also necessary to screen for damage to the heart’s arteries prior to major surgery, such as an organ transplant, heart valve surgery or surgery on the large blood vessels.

Coronary angioplasty involves inserting a balloon into the narrowed or blocked artery and inflating it to restore sufficient width to the coronary artery. The cardiologist then almost always implants a stent (a small spring-like device), which helps to keep the artery open.

You can watch a video presentation of outpatient interventional cardiology at Sion Hospital here.

Percutaneous repair of congenital heart defects mainly involves the percutaneous closure of a patent foramen ovale (PFO) or an atrial septal defect (ASD). These are ‘holes’ in the wall between the heart’s atria. After puncturing the right femoral vein under local anaesthetic, a catheter is guided up into the right atrium of the heart. A double-umbrella-shaped device is then deployed across the opening between the atria to seal it.

Renal artery denervation involves inserting a radiofrequency probe into the renal arteries and ablating the nerve fibres responsible for refractory hypertension.

​​​La thermo ablation ou ablation par radiofréquence permet de supprimer par l’application d’un courant électrique la zone responsable du déclenchement des arythmies, notamment flutter, fibrillation auriculaire et tachycardie ventriculaire.

The implantation of a pacemaker and a defibrillator, or the replacement of a pacemaker’s housing, is carried out under local anaesthetic by a cardiologist or a cardiac surgeon. An incision of a few centimetres is made under the collarbone, after which the surgeon inserts one or two electrodes via a vein beneath the collarbone; these are then secured to the heart muscle. In some cases, a third electrode may be inserted to stimulate the left ventricle and perform cardiac resynchronisation. The defibrillator is implanted during a procedure similar to that for a pacemaker. In addition to its function as a pacemaker, the defibrillator is capable of interrupting an abnormally rapid heart rhythm, which could lead to loss of consciousness or even sudden death.