Skip to Main Content

Interventional Cardiology

Interventional Cardiology

Dr. Tuckson's guest is interventional cardiologist Dr. Amir Piracha from UofL Health.
Season 16 Episode 2 Length 26:40 Premiere: 10/11/20

Here are key takeaways from an episode of Kentucky Health focusing on interventional cardiology. Host Dr. Wayne Tuckson welcomes Dr. Amir Piracha from U of L HealthCare to discuss how minimally invasive techniques that help treat and monitor coronary artery disease help patients live longer and better.

Advances in Surgical Techniques Benefit Patients

Coronary disease is the No. 1 cause of death in the U.S. “It’s so common, you don’t even know,” Piracha says. He explains that there are different degrees of coronary artery disease, from a person who has only partial blockage of an artery and is on medication to one who has had several stents put in over a period of time or has had bypass surgery.

Piracha says that rising rates of Type 2 diabetes and a trend toward sedentary lifestyles in the U.S. are causing more deaths from heart disease. “People used to eat (well), but they were out working on the farm or walking back and forth to school,” he says. “But now everyone’s sedentary – and of course, we’re in Kentucky, we still have a lot of smokers.”

Interventional cardiology treats arteries that have significant plaque buildup, which is caused by fatty deposits attaching to the arterial walls and then growing over time and hardening, a process called atherosclerosis.

“When we talk about a heart attack, we’re talking about the plaque, the actual blockage, rupturing,” Piracha explains. “And when it ruptures the problem is that the natural tendency for your body is to form a clot.”

Piracha has several different minimally invasive techniques he can use to open up an artery that has become restricted due to plaque buildup, and that also treat any clot formation that threatens to halt blood flow. He says that the science behind the breakthrough treatment – a balloon angioplasty invented by Dr. Andreas Gruntzig in Germany during the 1970s – still informs the technology and procedures used today.

“There’s three parts to this,” he says. “You have a rail which is your wire – a very thin wire, .014 inches in diameter, and then you have your balloon which basically makes space, and then you can put a stent in there.”

Piracha says that the stent became widely used in the 1990s. “It’s basically just a scaffolding,” he explains. “You’re not really removing the plaque – what you’re doing is getting it against the (arterial) wall, and the stent stays open and gives you flow through the artery.”

To keep blood clots forming on the stent, Piracha says that patients take aspirin combined with blood thinners such as Plavix. He adds that stent models introduced in the early 2000s have a drug coating that keeps them from closing due to scar tissue formation, which would happen roughly 25 percent of the time. After those new drug-coated stents were introduced, Piracha says that patients have to take an aspirin-blood thinner combination for a longer period of time.

Piracha shows a before and after photo of a coronary artery that was blocked and treated with a stent, but he cautions that treating one specific crisis does not cure the disease. “That’s why patients take blood pressure medication, their cholesterol pill, walk, get your sugars down, quit smoking – this is really what’s going to make you live longer” he says. “As interventionalists, we tell (patients) that, listen, if you don’t change your lifestyle, you’re going to be doing this over and over and over again.”

Treating Heart Failure with Drugs or Implanted Devices

Piracha says that there are two types of heart failure, a chronic condition where the heart’s ability to pump blood deteriorates. “One is called systolic heart failure, and what that means is that the heart does not squeeze (contract) properly,” he explains. “Diastolic failure is impaired relaxation – your heart squeezes well, but it has a hard time relaxing.” Piracha says that persons who have heart failure in the U.S. are roughly divided between systolic and diastolic.

Heart failure has many causes, Piracha says: prior heart attack, heavy drug and/or alcohol use, and a viral infection are three examples. Ischemic heart failure is due to a blockage of some sort, he says, while non-ischemic heart failure can arise from other causes such as those mentioned.

Piracha says that drugs such as betablockers, ACE inhibitors, and diuretics (water pills) are used for systolic heart failure. “And sometimes if the heart doesn’t get better, we put in a defibrillator,” he adds.

There are several types of defibrillators, from basic ones that shock the heart back into normal rhythm if it beats erratically to more complex ones that synchronize heart rhythm.

“We have newer technology where we’re actually doing invasive monitoring on patients 24-7,” Piracha adds. One tiny device he is using at Jewish Hospital in Louisville, called CardioMEMS, is inserted into the body via the femoral vein and snaked up into the heart and then implanted in the pulmomary artery, which brings deoxygenated blood from the heart to the lungs.

“What the CardioMEMS does is, it gets into the pulmonary artery and it monitors the fluid status,” Piracha explains. He says that he and his team set a baseline number for each patient’s blood flow pressure through the pulmonary artery. Then, they monitor the patients with the patients’ help using at-home technology, so the physicians can spot any deviation and make adjustments in medication, if needed.

“There’s been a dramatic decrease in patients being admitted to the hospital” after using the CardioMEMS device, Piracha says. He recalls a patient of his with heart failure that kept getting admitted to the hospital despite saying he felt fine, which confounded Piracha and his staff as they tried to adjust medications. After implanting CardioMEMS, the patient has not gone to the hospital once for heart failure, he says. “You have to have a patient that is compliant and will use (the device), and will also change their ways.”

Piracha also treats pulmonary embolisms, a very dangerous development where a blood clot enters the pulmonary artery and lodges in there, depriving the body of oxygen. If a person has a small embolism, Piracha says he may treat it with blood thinners, but if it’s large he will also use other, minimally invasive methods.

“We typically do an angiogram if we’re going to fish that clot out,” he says. “We can do two different things. We either do what we call a mechanical extraction – where you actually go in there and get that clot and suck it out – or we can actually put a catheter into the pulmonary artery and we use ultrasound to put blood thinner out, and it breaks up the clot.”

Sponsored by:

Comment on Kentucky logo and a "Check Schedule" button.A close-up of Comment on Kentucky host Bill Bryant smiling in a dark suit and purple tie against an image of Kentucky's capitol building. with a "Check Schedule" button.

Program Details

Kentucky Health

About Kentucky Health

Learn how to improve your health through education and increased awareness. Dr. Wayne Tuckson, a colorectal surgeon in Louisville, hosts.

TV Schedules

Jump to Recent Airdates

Upcoming

Nursing Shortages in the COVID Era and Beyond

Sonya Hardin, Ph.D., dean of the UofL School of Nursing and a nurse practitioner, discusses the nursing shortage, the pathway to become a nurse and opportunities in the field.

  • Sunday June 26, 2022 12:30 pm ET on KET
  • Sunday June 26, 2022 11:30 am CT on KET
  • Sunday June 26, 2022 5:30 pm ET on KETKY
  • Sunday June 26, 2022 4:30 pm CT on KETKY
  • Monday June 27, 2022 2:00 pm ET on KET2
  • Monday June 27, 2022 1:00 pm CT on KET2
  • Friday July 1, 2022 1:30 pm ET on KETKY
  • Friday July 1, 2022 12:30 pm CT on KETKY
  • Sunday July 3, 2022 12:30 am ET on KETKY
  • Saturday July 2, 2022 11:30 pm CT on KETKY
  • Sunday July 3, 2022 7:00 am ET on KET2
  • Sunday July 3, 2022 6:00 am CT on KET2
  • Sunday July 3, 2022 9:00 am ET on KETKY
  • Sunday July 3, 2022 8:00 am CT on KETKY

Changes in Physician-Patient Communication

In today's healthcare environment, communication between a provider and a patient extends beyond the exam room visit. Dr. Shannon Lynn, a primary care physician, talks about telehealth, online message centers and other emerging modalities of communication between providers and patients.

  • Sunday July 3, 2022 12:30 pm ET on KET
  • Sunday July 3, 2022 11:30 am CT on KET
  • Sunday July 3, 2022 5:30 pm ET on KETKY
  • Sunday July 3, 2022 4:30 pm CT on KETKY
  • Monday July 4, 2022 2:00 pm ET on KET2
  • Monday July 4, 2022 1:00 pm CT on KET2
  • Friday July 8, 2022 1:30 pm ET on KETKY
  • Friday July 8, 2022 12:30 pm CT on KETKY
  • Sunday July 10, 2022 12:30 am ET on KETKY
  • Saturday July 9, 2022 11:30 pm CT on KETKY
  • Sunday July 10, 2022 7:00 am ET on KET2
  • Sunday July 10, 2022 6:00 am CT on KET2
  • Sunday July 10, 2022 9:00 am ET on KETKY
  • Sunday July 10, 2022 8:00 am CT on KETKY

Hunting, Fishing and Eating Right

Tim Farmer, host of Tim Farmer's Country Kitchen, joins Dr. Tuckson for a discussion about "good fun, good eating and good health."

  • Sunday July 10, 2022 12:30 pm ET on KET
  • Sunday July 10, 2022 11:30 am CT on KET
  • Sunday July 10, 2022 5:30 pm ET on KETKY
  • Sunday July 10, 2022 4:30 pm CT on KETKY
  • Monday July 11, 2022 2:00 pm ET on KET2
  • Monday July 11, 2022 1:00 pm CT on KET2
  • Friday July 15, 2022 1:30 pm ET on KETKY
  • Friday July 15, 2022 12:30 pm CT on KETKY
  • Sunday July 17, 2022 12:30 am ET on KETKY
  • Saturday July 16, 2022 11:30 pm CT on KETKY
  • Sunday July 17, 2022 7:00 am ET on KET2
  • Sunday July 17, 2022 6:00 am CT on KET2
  • Sunday July 17, 2022 9:00 am ET on KETKY
  • Sunday July 17, 2022 8:00 am CT on KETKY

Obesity, Diabetes, Lung Diseases and Other Healthcare Problems in Kentucky

Dr. Steven Stack, the commissioner of the Kentucky Department for Public Health, has helped lead the state through the COVID-19 pandemic, but his priorities don't end there. Dr. Tuckson talks with Dr. Stack about other urgent public health concerns in Kentucky and how his office is addressing them.

  • Sunday July 17, 2022 12:30 pm ET on KET
  • Sunday July 17, 2022 11:30 am CT on KET
  • Sunday July 17, 2022 5:30 pm ET on KETKY
  • Sunday July 17, 2022 4:30 pm CT on KETKY
  • Monday July 18, 2022 2:00 pm ET on KET2
  • Monday July 18, 2022 1:00 pm CT on KET2
  • Friday July 22, 2022 1:30 pm ET on KETKY
  • Friday July 22, 2022 12:30 pm CT on KETKY
  • Sunday July 24, 2022 12:30 am ET on KETKY
  • Saturday July 23, 2022 11:30 pm CT on KETKY
  • Sunday July 24, 2022 7:00 am ET on KET2
  • Sunday July 24, 2022 6:00 am CT on KET2
  • Sunday July 24, 2022 9:00 am ET on KETKY
  • Sunday July 24, 2022 8:00 am CT on KETKY

Battling Food Insecurity in Kentucky

Food insecurity, meaning not having a stable supply of healthy, nutritious food, has been associated with depression and lower nutrient intake. Dr. Tuckson welcomes Annette Ball, programs director for Dare to Care Food Bank in Louisville, to discuss how the organization is addressing food insecurity.

  • Sunday July 24, 2022 12:30 pm ET on KET
  • Sunday July 24, 2022 11:30 am CT on KET
  • Sunday July 24, 2022 5:30 pm ET on KETKY
  • Sunday July 24, 2022 4:30 pm CT on KETKY
  • Monday July 25, 2022 2:00 pm ET on KET2
  • Monday July 25, 2022 1:00 pm CT on KET2
Jump to Upcoming Airdates

Recent

LGBTQ Healthcare: Removing the Stigma, Improving the Outcome - S17 E13

  • Sunday June 26, 2022 9:00 am ET on KETKY
  • Sunday June 26, 2022 8:00 am CT on KETKY
  • Sunday June 26, 2022 7:00 am ET on KET2
  • Sunday June 26, 2022 6:00 am CT on KET2
  • Sunday June 26, 2022 12:30 am ET on KETKY
  • Saturday June 25, 2022 11:30 pm CT on KETKY
  • Friday June 24, 2022 1:30 pm ET on KETKY
  • Friday June 24, 2022 12:30 pm CT on KETKY
  • Monday June 20, 2022 2:00 pm ET on KET2
  • Monday June 20, 2022 1:00 pm CT on KET2
  • Sunday June 19, 2022 5:30 pm ET on KETKY
  • Sunday June 19, 2022 4:30 pm CT on KETKY
  • Sunday June 19, 2022 12:30 pm ET on KET
  • Sunday June 19, 2022 11:30 am CT on KET

Orthopedic Oncology: Bones Get Cancer Too - S17 E12

  • Sunday June 19, 2022 9:00 am ET on KETKY
  • Sunday June 19, 2022 8:00 am CT on KETKY
  • Sunday June 19, 2022 7:00 am ET on KET2
  • Sunday June 19, 2022 6:00 am CT on KET2
  • Sunday June 19, 2022 12:30 am ET on KETKY
  • Saturday June 18, 2022 11:30 pm CT on KETKY
  • Friday June 17, 2022 1:30 pm ET on KETKY
  • Friday June 17, 2022 12:30 pm CT on KETKY
  • Monday June 13, 2022 2:00 pm ET on KET2
  • Monday June 13, 2022 1:00 pm CT on KET2
  • Sunday June 12, 2022 5:30 pm ET on KETKY
  • Sunday June 12, 2022 4:30 pm CT on KETKY
  • Sunday June 12, 2022 12:30 pm ET on KET
  • Sunday June 12, 2022 11:30 am CT on KET

ICU Care: The Care That You Hope You Don't Need - S17 E11

  • Sunday June 12, 2022 9:00 am ET on KETKY
  • Sunday June 12, 2022 8:00 am CT on KETKY
  • Sunday June 12, 2022 7:00 am ET on KET2
  • Sunday June 12, 2022 6:00 am CT on KET2
  • Sunday June 12, 2022 12:30 am ET on KETKY
  • Saturday June 11, 2022 11:30 pm CT on KETKY
  • Friday June 10, 2022 1:30 pm ET on KETKY
  • Friday June 10, 2022 12:30 pm CT on KETKY
  • Monday June 6, 2022 2:00 pm ET on KET2
  • Monday June 6, 2022 1:00 pm CT on KET2
  • Sunday June 5, 2022 5:30 pm ET on KETKY
  • Sunday June 5, 2022 4:30 pm CT on KETKY
  • Sunday June 5, 2022 12:30 pm ET on KET
  • Sunday June 5, 2022 11:30 am CT on KET

Otitis Media: Impact on Hearing and Learning - S17 E10

  • Sunday June 5, 2022 9:00 am ET on KETKY
  • Sunday June 5, 2022 8:00 am CT on KETKY
  • Sunday June 5, 2022 7:00 am ET on KET2
  • Sunday June 5, 2022 6:00 am CT on KET2
  • Sunday June 5, 2022 12:30 am ET on KETKY
  • Saturday June 4, 2022 11:30 pm CT on KETKY
  • Friday June 3, 2022 1:30 pm ET on KETKY
  • Friday June 3, 2022 12:30 pm CT on KETKY
  • Monday May 30, 2022 2:00 pm ET on KET2
  • Monday May 30, 2022 1:00 pm CT on KET2
  • Sunday May 29, 2022 5:30 pm ET on KETKY
  • Sunday May 29, 2022 4:30 pm CT on KETKY
  • Sunday May 29, 2022 12:30 pm ET on KET
  • Sunday May 29, 2022 11:30 am CT on KET

Lung Health: Breathing Does a Body Good - S17 E9

  • Sunday May 29, 2022 9:00 am ET on KETKY
  • Sunday May 29, 2022 8:00 am CT on KETKY
  • Sunday May 29, 2022 7:00 am ET on KET2
  • Sunday May 29, 2022 6:00 am CT on KET2
  • Sunday May 29, 2022 12:30 am ET on KETKY
  • Saturday May 28, 2022 11:30 pm CT on KETKY
  • Friday May 27, 2022 11:30 pm ET on KET
  • Friday May 27, 2022 10:30 pm CT on KET
  • Friday May 27, 2022 6:00 pm ET on KET
  • Friday May 27, 2022 5:00 pm CT on KET
  • Friday May 27, 2022 1:30 pm ET on KETKY
  • Friday May 27, 2022 12:30 pm CT on KETKY
Top

Season 16 Episodes

Emergency Departments in Rural Kentucky

S16 E27 Length 27:19 Premiere Date 5/2/21

Public Health: Where Do We Go From Here?

S16 E26 Length 27:50 Premiere Date 4/25/21

Telemedicine: Better Than Dr. Google

S16 E25 Length 27:13 Premiere Date 4/17/21

Hospice and Palliative Care: The Bridge Over Troubled Waters

S16 E23 Length 26:56 Premiere Date 4/11/21

The Impact of Racism on Health Outcomes

S16 E22 Length 27:43 Premiere Date 4/4/21

A Tribute to Health Care Providers

S16 E21 Length 28:46 Premiere Date 3/28/21

Sepsis: The Serious Side of Infections

S16 E20 Length 28:04 Premiere Date 3/21/21

The Future of Long-Term Care in Kentucky

S16 E19 Length 27:14 Premiere Date 3/14/21

Addiction and Recovery in the Time of COVID-19

S16 E18 Length 27:43 Premiere Date 2/21/21

Infections of the Brain and Nervous System

S16 E17 Length 27:00 Premiere Date 2/14/21

Rural Healthcare: Who Pays and Who Benefits

S16 E16 Length 27:39 Premiere Date 2/7/21

Pancreatic Cancer: Uncommon But Deadly

S16 E15 Length 26:53 Premiere Date 1/31/21

Crohn's Disease: When Surgery is Required

S16 E14 Length 26:23 Premiere Date 1/24/21

Visualizing a Smoke-Free Kentucky

S16 E13 Length 27:33 Premiere Date 1/17/21

COVID-19 Vaccine: Ready for Prime Time

S16 E12 Length 26:56 Premiere Date 1/10/21

Contact Tracing: Knowing Keeps Us All Safe

S16 E11 Length 27:37 Premiere Date 1/3/21

Reducing the Burden of Diabetes in Kentucky

S16 E10 Length 27:02 Premiere Date 12/20/20

The Impact of Race-Based Trauma

S16 E9 Length 28:17 Premiere Date 12/13/20

Planning a Healthy and Nutritional Diet

S16 E8 Length 27:02 Premiere Date 11/22/20

The Immune System: Not Just Fighting Infections

S16 E7 Length 26:52 Premiere Date 11/15/20

New Approaches to Shoulder Replacement

S16 E6 Length 27:02 Premiere Date 11/8/20

Oral Healthcare: Our Teeth Should Last a Lifetime

S16 E5 Length 27:00 Premiere Date 11/1/20

Gun Violence: It is a Public Health Issue

S16 E4 Length 26:52 Premiere Date 10/25/20

Strengthening the Immune System Through Diet

S16 E3 Length 26:51 Premiere Date 10/18/20

Interventional Cardiology

S16 E2 Length 26:40 Premiere Date 10/11/20

The Importance of Preventive Cardiology

S16 E1 Length 26:18 Premiere Date 10/4/20

Explore KET