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Please click on the links below to learn more information about some
of our patient care services:
Cardiovascular Services
Cardiovascular Thoracic Surgical Services
Gastroenterology Services
Internal Medicine Services
Imaging Services:
- CT (Computed Tomography)
Coronary CT, CT’s of the head, sinus, soft tissue, C-Spine, T-Spine, L-Spine Chest, Abdomen & Pelvis
- Angiography
Coronary CT, CT’s of the head, sinus, soft tissue, C-Spine, T-Spine, L-Spine, Chest, Abdomen & Pelvis
What is a Cardiac Catheterization?
A cardiac catheterization is
a test that evaluates the heart and coronary arteries.
This test is used to determine whether the patient has
any disease in the coronary arteries. If there is disease,
the test can also help to pinpoint the size, location and
determine what treatment would be appropriate.
For this test, a thin flexible
tube called a catheter is threaded through a blood vessel
in the arm or groin and into the heart. An X-ray shows
the catheter passing through the chambers of the heart.
Once in the heart, pumping and chamber pressure can be
measured. The doctor can also take samples of blood, inject
dye into the heart chambers to see their movement, as well
as other diagnostic tests.
During a cardiac catheterization,
a dye is injected into the coronary arteries to trace the
movement of blood through the arteries. This portion of
the test is called a coronary angiography. The doctor watches
the movement of the dye through the hearts chambers and
blood vessels to see whether the coronary arteries are
narrowed or blocked.
If the coronary arteries are
blocked, the doctor can use the catheter to open them and
restore normal blood flow to the heart. This is called
percutaneous coronary intervention or “PCI”.
What is a Cardiac Perfusion Scan?
A cardiac perfusion scan is a test that
is used to estimate the amount of blood reaching the heart
muscle during rest and exercise.
For this test, a radioactive substance called
a tracer is injected into a vein in the arm. A special
camera is used to view the amount of tracer that reaches
the heart muscle.
Stress scans involve making two sets of
images: rest images and stress images. Rest images are
taken while the patient is at rest and stress images are
taken after the heart has been stressed either through
exercise or by using medication to induce stress.
What is an Echocardiogram?
An echocardiogram or “echo” is a test that
takes “moving pictures” of the heart.
High-frequency sound waves, called ultrasound,
produce pictures of the heart's valves and chambers. These
pictures allow the doctor to evaluate the pumping action
of the heart.
Echo is often combined with Doppler ultrasound
and color Doppler to evaluate blood flow across the heart's
valves.
There are several types of echocardiograms.
Transthoracic echocardiogram is the standard. The doctor
will evaluate the patient for the appropriate test.
A transthoracic echocardiogram, generally cause no discomfort and usually takes
less than 45 min to 1 hour.
What is Electrocardiography?
An electrocardiography or “EKG or ECG” is
a test that is used to measure the electrical signals that
control heart rhythm. The test measures how electrical
impulses move through the heart as it contracts and relaxes.
During the test, small electrodes are attached
to the skin on the chest, arms and legs. The electrodes
are also connected to a machine that translates the electrical
activity into line tracings on paper. These tracings, called
an electrocardiogram, are carefully reviewed by a doctor
for abnormalities.
An exercise electrocardiography or “stress
test” is done during exercise to evaluate how well the
heart handles physical activity.
What is a Pacemaker?
A pacemaker is a small device that sends
electrical impulses to the heart muscle to help the heart
beat more regularly.
The pacemaker keeps track of the heartbeat
and when necessary, generates electrical signals similar
to the heart's natural signals. These signals keep the
heart beating at the right pace.
Pacemakers only work when needed. The pacemaker
is set with a minimum heart rate, if the heart rate drops
below the set rate the pacemaker “fires” an impulse that
passes through the wire to the heart muscle. This causes
the heart to contract, creating a heartbeat.
The pacemaker is checked on a regular basis
to evaluate the battery function.
Pacemakers usually last several years before
replacement is necessary.
What is a Percutaneous Coronary Intervention?
A percutaneous coronary intervention
or “PCI” is a procedure used to open blocked arteries.
There are three common types
of PCI: angioplasty, coronary stenting and coronary atherectomy.
- Angioplasty: The arteries
of the heart can become blocked from a buildup
of cells, fats and cholesterol called plaque. This is
called atherosclerosis. Angioplasty opens
blocked arteries and allows blood to flow to the heart
muscle. Angioplasty is done during cardiac catheterization
by attaching a small balloon to the catheter. The catheter
is then guided to the blockage in the coronary
artery and the balloon is then inflated. The pressure
from the inflated balloon presses the plague against the
wall of the artery to improve blood flow.
- Stenting: Stenting is usually
done along with angioplasty. Once the
plaque is compressed using angioplasty, a small expandable
wire tube called a stent is inserted into
the artery to hold it open.
- Atherectomy: Atherectomy
is done during cardiac catheterization to
open partially blocked coronary arteries. Once the catheter
reaches the narrowed portion of the artery, a cutting
device, a whirling blade or a laser beam is used to remove
the plaque.
What is Abdominal Aneurysm Surgery?
When a large artery in the abdomen expands
like a balloon, it's called an aortic aneurysm, which is
caused by the weakening of the artery wall, which can leak,
or burst without warning unless treated surgically.
There are two forms of surgery to treat
an abdominal aneurysm:
The standard treatment is conventional surgery.
The surgery is performed to replace the section of the
vessel where the aneurysm has formed with a synthetic graft.
The surgeon clamps the aorta to prevent bleeding and then
opens and cleans the aneurysm. Next, the graft is sewn
to the aorta at one end and to the two iliac arteries at
the other.
A new technique called endograft repair
or “endovascular stent grafting” is available in a select
few cases. Endovascular stent grafting is a procedure where
a stent graft, which is woven polyester tube (graft) covered
by a tubular metal web (stent), is placed inside a diseased
vessel without surgically opening the tissue surrounding
the diseased vessel. Instead of conventional surgery, which
requires a longer hospital stay and recovery, the endograft
is placed inside the aneurysm using a delivery catheter.
The delivery catheter is advanced through the iliac vessel
to the aneurysm site in the abdomen through a small incision
made in the upper thigh. When the stent graft comes onto
contact with blood, it expands to a preset size. The stent
graft, therefore, excludes the aneurysm from the normal
flow of blood. However, since the diseased vessel is not
replaced there is a small risk that the aneurysm could
still rupture.
What is Carotid Artery Surgery?
Carotid artery surgery called carotid endarterectomy
is done to reopen a narrowed carotid artery. The two carotid
arteries are the blood vessels in the neck that supply
oxygen-rich blood to your brain. When one of these vessels
becomes narrowed by a build up of plaque (cells, fats and
cholesterol) your brain can't get enough oxygen, which
can lead to stroke.
When a carotid endarterectomy is performed,
the fatty plaque is removed from the narrowed carotid artery.
This in turn reopens the carotid artery and increases blood
flow.
Carotid endarterectomy has been shown to
significantly reduce the risk of stroke.
What is a Coronary Artery Bypass Surgery?
Coronary Artery bypass surgery
is a common treatment for coronary artery disease and usually
requires open-chest surgery.
The blocked portion of the
artery is bypassed using a blood vessel taken from elsewhere
in the body (generally from the chest or leg). This procedure
is also called coronary bypass grafting (CABG).
An artery may be detached from
the chest wall and the open end attached to coronary artery
below the blocked area.
A piece of long vein can be
taken from the leg. One end is sewn onto the aorta, and
the other end is attached or “grafted” to the coronary
artery below the blocked area.
Blood can now flow through
the bypass to the heart.
A patient may undergo one,
two, three or more bypasses, depending on how many coronary
arteries are blocked.
What is a Heart / Lung Transplant?
A heart / lung transplant is
the replacement of a patient's diseased heart with a healthy
donor's heart. The donor heart comes from a person who
has died and whose family has agreed to donate their loved
one's organs.
A heart / lung transplant is
done when the patients heart failure is so severe that
it does not respond to all other therapies, but the patient'
health is otherwise good.
In order to get a heart / lung
transplant, the patient must first be placed on a transplant
waiting list. Before being placed on the transplant list,
the patient must go through a careful screening process.
Teams of doctors, nurses, social workers and bioethicists
must review the patients medical history, diagnostic test
results, social history and psychological test results
to determine if the patient will be able to survive the
procedure and then comply with the care needed to live
a healthy life.
Once approved, the patient
must wait for a donor to become available.
What is Heart Valve Surgery?
The heart has four chambers. Each chamber
has a valve that opens and closes as they keep blood flowing
through your heart. Valve disease keeps a valve from opening
or closing the way it should and cause the heart to work
harder. This extra work can cause the heart muscle to tire
and weaken.
Valve disease may several causes, such as
a birth defect, aging, coronary artery disease (blocked
blood vessels in the heart), and certain diseases that
can scar or destroy a valve.
A diseased heart valve can be repaired or
replaced during heart valve surgery.
A heart valve that cannot be repaired may
be replaced with a prosthetic (substitute valve) valve.
Two kinds of prosthetic valves are available:
Mechanical valves made from manmade materials.
Biological (tissue) valves taken from pig,
cow, or human donors.
A patient may expect to take an anticoagulant
(“blood thinner”) depending on the type of valve replacement.
What is Lung Surgery?
Lung surgery involves entering the chest
wall to get at the lung to treat certain lung conditions.
There are two methods of entering the chest
wall:
Thoracoscopy uses several small incisions.
The surgeon places a small camera through one of the incisions
and can view the lungs on a video monitor. The surgeon
can perform procedures through the remaining incisions.
Thoracoscopy is often used to repair a collapsed lung;
to examine, biopsy, and stage a mass in the lung; or to
drain fluid from around the lungs.
Thoracotomy uses a larger incision in the
chest. This opening allows the surgeon to see the lungs
directly and to perform procedures such as removing part
or all of a lung if a mass is present.
Either procedure may be done alone, or a
thoracoscopy may be done to help decide whether a thoracotomy
is needed.
What is the Ross Procedure?
The Ross Procedure also known as pulmonary
valve translocation, was developed by Dr. Donald Ross in
1967. The procedure is a specialized aortic valve surgery
where a patient's diseased aortic valve is replaced with
his or her own pulmonary valve (the autograft). The pulmonary
valve is then replaced with a donor tissue valve (the homograft).
The Ross Procedure offers several advantages
over traditional aortic valve replacement with manufactured
prostheses.
Biological tissue valves such as pig valves
have shown poor durability as replacements for an aortic
valve.
Mechanical valves do not always provide
optimal performance and require the lifelong use of anticoagulants
(blood thinners) to prevent the formation of blood clots.
This is especially important for women of child-bearing
age needing aortic valve replacement, as anticoagulation
is contraindicated in pregnancy.
When a mechanical valve is used in a young
child, the valve will not grow as the child grows. Children
who have had the Ross Procedure have shown growth in the
autograft.
What is Vascular Surgery for Peripheral
Arterial Disease of the Legs?
Peripheral arterial disease is a progressive
condition that results from narrowing of the vessels that
supply oxygen-rich blood to the legs as well as other locations
in the body. The most common cause of peripheral arterial
disease is the buildup of plaque (cells, fats and cholesterol)
on the inside of the arteries.
Surgical procedures used to treat peripheral
arterial disease in the legs include:
Angioplasty is a catheter-based procedure
in which a balloon-tipped catheter is inserted through
a blood vessel in the groin and guided to the affected
artery. The balloon is then inflated and deflated several
times to crack the plaque and press it against the artery
wall. In some cases a stent is placed inside the artery
to hold the walls open or atherectomy is performed to cut
away plaque from the artery wall.
Bypass surgery can treat blocked arteries
in the leg by creating a path around the blockage using
a graft made from either a leg vein or a manmade (synthetic)
tube. A graft is stitched into the artery above and below
the blockage, creating a new passage for blood to flow.
The blocked section of the artery is usually not removed.
What is a Colonoscopy?
A colonoscopy is a test used to look at
the interior lining of the large intestine through a thin, flexible instrument
called a colonoscope which is inserted into the rectum
and slowly guided into the colon.
A small video camera is attached to the
colonoscope so that photographic, electronic, or videotaped
images of the large intestines can be made.
This test is used to detect polyps, tumors,
and inflammation or bleeding. If abnormalities are detected,
the doctor can remove all or part of it using tiny instruments
passed through the scope. That tissue (biopsy) is usually
sent to a lab for testing. If there is bleeding in the
colon, the doctor can perform other procedures to stop
the bleeding.
Colonoscopy may also be used to monitor
the growth of polyps that can not be completely removed,
monitor the treatment of inflammatory bowel disease and
screen for the recurrence of colon cancer in those patients
who have had surgical treatment for colon cancer.
What is a Flexible Sigmoidoscopy?
Flexible sigmoidoscopy is a test used to
look at the inside of the large intestine from the rectum
through the last part of the colon. The doctor will insert
a short, flexible, lighted tube called a sigmoidoscope
into the rectum and slowly guide it into the colon. A small
camera at the end of the sigmoidscope transmits images
to a television monitor so the doctor can get a clear view
of the colon.
Physicians may use this procedure to find
the cause of diarrhea, abdominal pain, or constipation,
as well as to look for early signs of cancer in the descending
colon and rectum.
If abnormalities are seen, such as polyps
or inflamed tissue, the doctor can remove a sample of the
tissue (biopsy). That tissue will then be sent to a lab
for further testing.
What is an Upper Endoscopy?
An upper endoscopy or “EGD” is a procedure
that lets a doctor look inside the esophagus, stomach,
and the duodenum (first part of the small intestine) through
a thin, flexible, lighted tube called an endoscope. The
doctor will insert the endoscope through the mouth and
then gently advance down the throat into the esophagus,
stomach, and duodenum.
A small video camera is attached at the
end of the endoscope, which transmits images to a television
monitor so the doctor can get a clear and detailed view
of the upper digestive system.
EGD can be very helpful in the evaluation
and diagnosis of various problems, including difficult
or painful swallowing, pain in the stomach or abdomen,
and bleeding, ulcers, and tumors.
What is a DEXA Bone Density Test?
A DEXA bone density test measures bone thickness.
Can help predict a patient's risk of breaking
a bone associated with having a medical condition called
osteoporosis.
DEXA is often done as part of a routine
physical examination depending of the age and risk factors
for osteoporosis.
What is a CT Scan?
Computed tomography (CT) combines the use of X-rays with the latest computer technology.
Using a series of X-ray beams, the CT scanner creates cross-sectional images. A computer reconstructs
these “slices” to produce the actual pictures. Considering that some slices are as thin as half a millimeter,
a CT scan offers much more image detail than a traditional X-ray. Plaza Medical Group was the first to
purchase the 64-slice CT scanner, the newest CT technology in the state of Oklahoma.
CT scans are recommended when there is a need to evaluate soft tissue, such as the internal organs.
CT also helps to identify tumors and cysts, as well as diagnose diseases of the liver, lungs, coronary arteries
and other internal organs.
What is Angiography?
Angiography is a test that uses an injection of a contrast medium or liquid dye to make the arteries
easily visible on X-rays. Narrowing of the arteries (or stenosis) of the heart, legs, kidneys, aorta and
carotids can be identified. It may also reveal aneurysms. The results of an angiogram can help determine
if surgery or other interventions are indicated.
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