Cardiac Catheterization

What is Cardiac Catheterization?

Cardiac Catheterization is a procedure where a thin, flexible tube (catheter) is inserted and threaded through your artery or vein in the groin (femoral or iliac), neck (carotid) or forearm either elbow or wrist (radial). The catheter reaches the coronary artery in the heart where it can monitor the function of the heart, measure pulmonary arterial pressure, inject contrast material in to the coronary blood vessels or the chambers of the heart. During the procedure of Cardiac Catheterization, angiograms or images are also recorded - this portion of the test is called Coronary Angiography. Radial approach Cardiac Catheterization (Trans-radial Cardiac Catheterization) is certainly advantageous as you will be mobilized quickly and there will be fewer vascular complications.

Where can I get a Cardiac Catheterization?

Why is Cardiac Catheterization performed?

Cardiac Catheterization is performed to assess the status of your coronary arteries. The procedure of Cardiac Catheterization helps your doctor to determine the site and extent of the blockage in your coronary arteries and to assess whether a minimally invasive surgical procedure like Coronary Angioplasty or Coronary Stenting is needed. Cardiac Catheterization also helps your doctor to decide whether a major procedure like Heart Bypass Surgery is needed or not to treat the problem. The procedure of Cardiac Catheterization has diagnostic as well as therapeutic value.

What does Cardiac Catheterization involve?

The procedure of Cardiac Catheterization is performed in the cath. lab. (Cardiac Catheterization laboratory) in a hospital as a scheduled procedure. However, Cardiac Catheterization may also be done in the emergency room if you are having a heart attack or a ruptured aortic aneurysm. The entire procedure of Cardiac Catheterization may take anywhere between 1 - 2 hours. Several small metal leads will be attached to your arms and legs which will record an electrocardiogram continuously during the Cardiac Catheterization procedure. The area where the catheter will be inserted will be numbed by a local anesthetic. The blood vessel will be exposed by a small incision, a catheter will be threaded in and guided through the vessel into the chambers of the heart. A small amount of contrast material will be injected through the catheter, images will be recorded and blood samples will be obtained for testing.

Who is an ideal candidate for Cardiac Catheterization?

If you have coronary artery disease with or without symptoms, or birth defect of the heart or if you have significant heart valve disease, then you are an ideal candidate for Cardiac Catheterization.

Who is not an ideal candidate for Cardiac Catheterization?

If you are allergic to the contrast dye, if you have severe heart failure or life-threatening heart rhythm problems, if you have advanced kidney disease or if you are pregnant, then you are not an ideal candidate for Cardiac Catheterization.

How do I prepare for Cardiac Catheterization procedure?

Make sure you inform your doctor if you have allergic reaction to any medications or dyes that might be injected during the procedure of Cardiac Catheterization. You will be asked to sign a consent before the Cardiac Catheterization procedure authorizing your doctor to perform the diagnostic as well as the therapeutic portion of this procedure. You will be required to come to the hospital the day of the Cardiac Catheterization and will probably be allowed to go home the following day. Do not eat or drink anything for at least 10 - 12 hours prior to the Cardiac Catheterization procedure. You will be given a mild sedative the night before the Cardiac Catheterization procedure to help you relax and sleep.

What to expect during the recovery period following Cardiac Catheterization?

After the Cardiac Catheterization procedure, you will be taken to your room where you will be instructed to lie flat, with your leg straight for at least for 4 - 6 hours. Your vital signs and heart function will be closely monitored. If the catheter insertion site was in your elbow, a few stitches will be used to close the wound. If the insertion site was in your wrist or groin, firm pressure will be applied to the area for about 10 minutes to stop the bleeding. Then a pressure dressing will be placed over the area. You should drink plenty of fluids to avoid dehydration and removal of the contrast dye (through your kidneys) that was injected during Cardiac Catheterization. The dressing will be removed 5 - 7 days following the procedure of Cardiac Catheterization.

What is the outcome of Cardiac Catheterization?

Cardiac Catheterization is a procedure that has tremendous diagnostic as well as therapeutic value however, this procedure has it's own risks. Keeping this in mind, Cardiac Catheterization is performed by your cardiologist preferably if he is considering Coronary Angioplasty or Heart Bypass Surgery for you.

B . R . A . N . D . of Cardiac Catheterization

Benefits of Cardiac Catheterization

• The freedom to perform Coronary Angiography and / or Coronary Stenting simultaneously during the Cardiac Catheterization procedure gives it a dual value to diagnose and if possible also treat mild coronary artery narrowing.

Risks of Cardiac Catheterization

• Heart attack or Stroke - If the clot in the coronary artery gets dislodged inadvertently during the procedure, it may get lodged in an artery feeding the heart and may result in heart attack or if it gets dislodged to the brain, then there is a danger of stroke.
• Arrhythmia's or irregular heart beat - This usually corrects itself or it can be treated with medications
• Infection - Infection at the site of insertion of catheter is pretty low as Cardiac Catheterization is carried out under stringent sterile conditions.
• Allergic reaction - Allergic reaction to the contrast dye can occur.
• Kidney Failure - People with diabetes and kidney disease are especially at risk for kidney damage due to the toxic effects of the contrast material.
• Heart problems - Other heart problems like endocarditis, puncture of the heart or one of it's blood vessels are rare complications of Cardiac Catheterization.
• Pneumothorax - Collapse of the lung due to injury to chest tissues.

Alternatives to Cardiac Catheterization

• Coronary Angiography - This procedure still remains to be primary procedure of choice to diagnose problems of the heart and blood vessels.

Now or Never

• Cardiac Catheterization is a minimally invasive procedure that can diagnose blockage in the coronary artery and treat it at the same time. During the procedure of Cardiac Catheterization, your surgeon has the option to perform Angioplasty and / or Coronary Stenting simultaneously.

Decision to have Cardiac Catheterization

• The risk of major complications during or following Cardiac Catheterization procedure outweighs it's benefits. The risk-to-benefit ratio strongly favors the performance of this procedure as part of the evaluation and treatment of potentially fatal or lifestyle-limiting cardiac disease in appropriately selected patients.