Interventionskardiologi

Interventionskardiologi, or interventional cardiology, is a medical subspecialty of cardiology that uses catheter-based methods to diagnose and treat heart and blood vessel diseases. The field focuses on percutaneous approaches to coronary, valvular, and peripheral disorders and includes structural heart interventions in selected patients. It originated with percutaneous coronary angioplasty in the late 20th century and has expanded to a broad range of devices and techniques.

Common procedures include diagnostic coronary angiography and percutaneous intervention (PCI) with balloon angioplasty and stenting for coronary artery disease, management of acute myocardial infarction, and peripheral vascular interventions such as angioplasty and stenting of the peripheral arteries. In structural heart disease, transcatheter therapies such as transcatheter aortic valve replacement (TAVR) and transcatheter mitral repair or replacement are increasingly performed by interventional cardiologists in collaboration with surgeons and imaging specialists. Catheter-based therapies for left atrial appendage occlusion and other congenital or acquired defects are also used in selected cases.

Training and practice: Interventional cardiology is pursued after a general cardiology residency, followed by a dedicated interventional fellowship or formal certification in interventional techniques. Practitioners work in academic medical centers, tertiary hospitals, and specialized cardiovascular institutes. Complex cases often involve a Heart Team approach to determine optimal treatment.

Technology and safety: Procedures are guided by fluoroscopy and, increasingly, intravascular imaging modalities such as IVUS or OCT. Equipment includes guidewires, catheters, balloons, and various stents. Antithrombotic therapy is tailored to the procedure and patient risk. Risks include vascular complications, bleeding, contrast-induced nephropathy, stroke, and myocardial infarction; outcomes improve with careful patient selection and guideline-directed therapy.