Dr. Glen S. Van Arsdell, MD

For visualization, bronchoscopy can be done alone, or it can be combined with ultrasound. Endobronchial ultrasound (EBUS) allows real-time imaging of the airway and is used for diagnosing and staging lung cancer, as well as for determining where the cancer has spread. EBUS can be performed with TBNA, a procedure known as endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA).

Doctors can also use bronchoscopy as a treatment for lung problems. For example, if a foreign body is trapped in the airway, doctors can insert forceps through the bronchoscope to remove it. If the airway has become narrowed - which may occur if patients have an infection, cancer, or some other inflammatory issue - bronchoscopy can be used to place a device called a stent in the area of constriction. The stent will keep the airway open, allowing the patient to breathe properly.

During a bronchoscopy, patients will be given medication (sedative) to help them relax. If it is only a diagnostic bronchoscopy, patients will be kept awake, but if the bronchoscopy is for therapeutic purposes, patients will be put to sleep by general anesthesia. After the procedure, patients will need to stay in the hospital for a few hours. They will not be able to eat or drink for about 2 hours. Some patients may experience discomfort, such as a sore throat or pain while swallowing. Throat lozenges and gargling may help alleviate these symptoms, which should go away after a few days. Patients will need to have someone drive them home once their doctor determines that they are ready.

Heart disease is the leading cause of death in the United States for both men and women. This includes coronary artery disease, heart attacks, congestive heart failure, and congenital heart disease. Some conditions, such as genetics, cannot be controlled. But there are many other things one can do to lower their risk for heart disease. Controlling high blood pressure and cholesterol levels, reducing or stopping smoking, exercising more and losing weight if needed, and eating a diet low in sodium can all protect the heart.

Angina is a squeezing type of chest pain that happens when the muscles around the heart don't get enough oxygen. It can be regular or infrequent. Usually, angina is caused by coronary heart disease. However, not all chest pain is angina. Chest pain can also be caused by a lung infection or panic attack, for example, so it is important to have any sudden pain checked.

Arrhythmia is the word for when the heart beats too fast, too slow, or irregularly with skipped beats. It can feel frightening, and depending on the type it can be dangerous, but in most cases arrhythmia is not serious and can be treated. It is very common, especially in older adults.

Heart valve problems can happen in any one of the the heart's four valves that keep blood flowing where it needs to go. Babies can be born with problems in their heart valves, or valves can be damaged by infections. The valves can stiffen and become less mobile, or they can stop closing properly and 'leak' when the heart beats. Valve problems can usually be repaired surgically.

To implant the device, a long, flexible tube, called a catheter, is inserted into a large vein in the groin and advanced to the heart. Once the tube reaches the left side of the heart, X-ray is used to guide a thinner catheter into the left atrial appendage. The tiny device is then passed through the tube and into the appendage. When the doctor has made sure it is in the right place, she takes the catheter out, and the procedure is completed.

This minimally invasive procedure usually requires a hospital stay of at least one day. Normal activities may be resumed within a few days. About 45 days following implantation, a test will be done to determine whether the device has closed the left atrial appendage. Check-ups have to be performed every year to make sure the device is in place.