Please click on the links below to learn more information about some of our patient care services:

Cardiovascular Services

• Cardiac Catheterization
• Cardiac Perfusion Scan
• Echocardiogram
• Electrocardiography
• Pacemaker
• Percutaneous Coronary Intervention

Cardiovascular Thoracic Surgical Services

• Abdominal Aneurysm Surgery
• Carotid Artery Surgery
• Coronary Artery Bypass Surgery
• Heart/Lung Transplant
• Heart Valve Surgery
• Lung Surgery
• Ross Procedure
• Vascular Surgery

Gastroenterology Services

• Colonoscopy
• Flexible Sigmoidoscopy
• Upper Endoscopy

Internal Medicine Services

• DEXA Bone Density Test

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.