Dr. Andrew Keller, one of the region's most respected interventional cardiologists, leads a team of experienced interventional cardiologists, cardiac specialized nurses, and cardiovascular technicians in the Reston Cardiac Cath Lab.

Additionally, RHC has affiliated with Washington Hospital Center, a national leader in cardiovascular care, for cardiac surgery backup and medical transport services-if a patient needs emergent heart surgery, MedSTAR helicopters will fly him or her directly to the Hospital Center, where he or she will be met by the cardiovascular team. Washington Hospital Center is home to the nation's busiest cardiac catheterization center, performing more than 20,000 cases annually, and served as a training site for the RHC team. Diagnostics and procedures in the cardiac cath lab include:

Cardiac Catheterization (Angiogram)
A cardiac catheterization is a diagnostic procedure, which provides a detailed assessment of heart performance, including the functioning of the heart, its valves, and the coronary arteries. During a catheterization, a flexible hollow plastic tube (a catheter) is inserted in the patient's groin or arm. This tube is then guided through a vessel until it reaches the heart. Once in place, a contrast dye is injected into the catheter to enable clinicians to visualize the heart and the blood vessels in motion and to allow them to take pictures.

PCI/ Balloon Angioplasty
To open a blockage or narrowing of a coronary artery, cardiologists perform percutaneous coronary intervention (PCI), a technique which uses small balloons that are threaded through the coronary arteries. As a sheath is placed in the artery and vein, a catheter is inserted through the sheath and is threaded up the aorta where the coronary arteries branch off to the heart. This catheter, which is seen with a fluoroscope (a type of X-ray) acts as a conduit through which the angioplasty equipment (including the balloon catheter) is passed. A small guide wire, which functions as a rail over the balloon catheter, is advanced through the artery across the blockage until the catheter is positioned. The balloon is then inflated to split, compress, and mold the plaque into the wall of the artery reestablishing adequate blood flow. It is then subsequently deflated and removed as the blockage is reduced.

Carotid Stenting
Carotid stenting, a non-surgical alternative to treat carotid artery disease, is used to open the carotid artery as a stent is implanted. First, a sheath is placed in the artery and vein, usually through the femoral artery in the groin. A catheter is then inserted through the sheath and threaded up to the carotid artery which acts as a channel through which the rest of the angioplasty equipment is passed. Next, a small guide wire which is attached to a special filter or balloon is advanced through the artery across the blockage. The guide wire functions as a rail over which the balloon catheters and stents are advanced. The balloon catheter is positioned across the plaque and inflated to mold the plaque into the wall of the artery. Then the stent is positioned across the area of blockage and expanded with the aid of a balloon into the wall of the artery.

Coronary Stents
A stent is an expandable stainless steel metal coil that is implanted in the narrowing portion of the coronary artery. It is used to keep the vessel open. Before a stent is mounted via an angioplasty, physicians perform an angiogram to determine the size of the specific stent needed. Once the balloon and stent are positioned across the narrowing vessel, the balloon is inflated, deflated, and withdrawn, but the stent which remains in place is attached to the surface of the treated vessel. In addition to opening narrowing vessels, a coronary stent is considered a treatment of choice when an angioplasty does not work, to decrease the incidence of renarrowing off the artery or bypass graft, to fix damage from an angioplasty, or to restore an open channel in an abruptly closed artery, or for lesions in diseased bypass grafts.

Drug Eluting Stents
To decrease the likelihood of stenosis or narrowing of the coronary vessels from reoccurring, drug eluting stents - stents which are coated with a drug that is bonded to the stent for a slow and steady release into the surrounding tissue of the artery -- are commonly used. While the stent functions to keep the artery walls open, the drug works to slow the growth of unwanted cells and helps to prevent the artery from "restenosing" (renarrowing).

Electrophysiology
Electrophysiology is the cardiac specialty dedicated to the diagnosis and treatment of irregularities of cardiac rhythm (arrhythmias). In our EP Lab, our cardiovascular team performs diagnostic to determine the source of the arrhythmia and procedures to resolve irregular heartbeats, and procedures to help keep the rhythm of your beating heart. Learn about the Reston Hospital Center EP Procedures.