Interventional Cardiology Expert Witness

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INTERVENTIONAL CARDIOLOGY, or Invasive Cardiology, is a branch of Cardiology that deals specifically with structural cardiac conditions such as coronary heart disease (CAD) or congenital heart disease. Interventional Cardiology offers diagnostic tests such as cardiac catheterization (also called “cardiac cath” or “coronary angiogram”), myocardial biopsy, intravascular ultrasound, coronary flow reserve (CFR), and optical coherence tomography (OCT). Interventional Cardiology also offers non-surgical (“interventional”) treatments such as stents, angioplasty, intravascular ultrasound, valve repair, and/or transaortic valve replacement (TAVR). Angioplasty (also known as Percutaneous Transluminal Coronary Angioplasty, or PTCA) is the standard of care for an acute myocardial infarction (MI, heart attack). PTCA involves the insertion of a catheter into an artery in the wrist (radial approach) or the groin (femoral approach) followed by the dilation of a coronary vessel with a balloon to restore blood flow. A cardiac stent may be placed during the procedure to ensure the coronary artery remains patent. Arteries with high-grade blockage or total occlusion may require special techniques including laser (photoablation), cutting balloons, and drills (rotablation). Interventional Cardiologists are medical doctors who have completed an Internal Medicine residency, a Cardiology fellowship, and an Interventional Cardiology fellowship. An Interventional Cardiologist may see patients in a hospital or office setting, but the interventions are performed in a cardiac cath lab with specialized monitoring and equipment.

Negligence claims against Interventional Cardiologists are infrequent but typically stem from complications of interventions such as bleeding, coronary artery perforation, and valve injury. Complications at the femoral entry site can result in pseudoaneurysm or massive retroperitoneal hemorrhage and shock. Since cardiac disease is sometimes mistreated by primary care providers, Interventional Cardiologists are often called as causation experts to discuss the natural course of cardiac disease when treated in a timely manner.