Cardiac Catheterization

Cardiac catheterization is a procedure that enables physicians to identify and treat cardiovascular problems. It involves inserting a catheter into the vein or artery located in the neck, groin, or arm and threading it via the blood vessels towards the heart.

With the catheter, doctors can perform diagnostic tests and procedures as part of cardiac catheterization. For instance, they can inject a dye through the catheter to make it easier to examine the veins and heart chambers under a special x-ray machine.

In addition, cardiac catheterization is helpful in several heart disease therapies, including coronary stent and coronary angioplasty. A cardiologist with a team of doctors, technicians, nurses, and other healthcare professionals usually performs a cardiac catheterization in a hospital.

Reasons for Cardiac Catheterization

Cardiac catheterization purpose is to determine if you have a heart condition. It could also be performed as part of a treatment operation to address existing heart disease. If you undergo a cardiac catheterization as a diagnostic test for heart problems, the physician will do the following;

Angiogram: Finding the blockages or narrowing within the blood that may be causing chest pain
Hemodynamic assessment: Measuring your heart's pressure and the levels of oxygen in various areas
Right or left ventriculogram: Examining your heart's ability to pump blood
A biopsy: Taking a small sample of your heart tissue for further analysis
Diagnosing heart abnormalities that have existed since birth (congenital heart defects)
Examining your heart valves for any issues.

Additionally, cardiac catheterization is beneficial in the treatment of heart disease in some cases. These procedures include the following;

Angioplasty; the procedure to widen a narrowed artery with or without the use of a stent.
Closing heart holes and correcting other congenital abnormalities
Heart valve repair or replacement
Balloon valvuloplasty; reopening the blocked or narrowed heart valves
Ablation to treat irregular heart rhythms.
Preventing blood clotting by covering up a portion of the heart

Preparing for Cardiac Catheterization

Before the cardiac catheterization procedure, the cardiologist will inform you whether you can eat and drink anything. However, you should not eat or drink after midnight on the scheduled day of the procedure in most situations.

The presence of food and fluids in the system during the treatment can make you more vulnerable to various complications. If you are unable to fast, then you may have to reschedule the operation. Furthermore, before you take any drugs a few days or hours before the treatment, consult your doctor.

Cardiac Catheterization Procedure

The cardiologist will ask you to undress and wear a hospital garment before the cardiac catheterization starts. After that, you will lie down while the nurse administers an intravenous (IV) line. It will be used to deliver drugs and other fluids during and even after the treatment. The IV is commonly put in the arm or hand.

If necessary, the provider will shave the hair around the site of catheter insertion. Also, before inserting the catheter, you may be given an injection of anesthetic to numb the region.

Cardiac catheterization is normally performed in a surgery room equipped with specialized x-ray and other imaging equipment. The catheterization laboratory, like a surgical area, is a sterile environment.

In most cases, the cardiologist will conduct the procedure while the patient is conscious but under sedatives. On the other hand, some treatments, like valve repair, ablation, and valve replacement, can be done while you are fully unconscious (under general anesthesia).

The next treatment step will depend on the primary reason for undergoing cardiac catheterization. The cardiologist can therefore conduct one of these catheterization procedures;

Coronary angiogram

During a coronary angiogram, the cardiologist will inject a contrast dye or content through the catheter. To assess the narrowing within the arteries or the blockages, he or she can use an x-ray device to monitor the dye that goes through arteries, valves, heart chambers, and blood vessels.

Heart biopsy

Heart biopsy involves inserting the catheter into the vein around the neck to remove a sample of heart tissue. In most cases, the catheter is put in the groin. The doctor will then obtain a small sample of heart tissue using a catheter with a tiny, jaw-like tip. Although you might feel pressure while the doctor uses this catheter, you are unlikely to feel any tissue being clipped.

Balloon angioplasty (either with or with no stent placement)

Doctors often use this procedure to open or repair a narrowed or blocked artery within the heart. Normally, it involves placing the catheter in either the wrist or groin while performing the operation.

To reach the narrowed artery, a long, elastic catheter is put through the vein or arteries. The flexible catheter will then feed a smaller balloon catheter. The balloon will be inflated at the obstructed location to open it. In most circumstances, a mesh coil known as a stent is placed at the narrowest section of the artery to maintain it open.

Balloon valvuloplasty

The purpose of this procedure is to open up the blocked or narrowed heart valves. The site of the catheters will be determined by the type of valve issue you have.

During the procedure, the valve is threaded with a catheter. The valve is then inflated with a balloon to make it easier to open. You might experience pressure during the placement of the catheters into your body. However, the balloon approach itself should not be painful.

Heart defects repair

To repair a hole in the heart like an atrial septal defect or patent foramen ovale, the cardiologist can suggest this approach. He or she will insert the catheters in the arteries and veins of the neck and groin. To seal the hole, a gadget is put implanted in the heart. A plug or a clip can be used to halt the leak when repairing a heart valve.

Ablation of the heart

The heart ablation procedure involves inserting several catheters into the arteries and veins located in the groin or the neck. This allows the radiofrequency radiation to be directed to the region of your heart, triggering irregular heart rhythms.

If you are conscious during cardiac catheterization, the doctor will ask you to do the following;

Hold your breath
Take deeper breaths
Cough
Move your arms in different ways

Sometimes, the operation table may be tilted. However, you will be secured to it with a safety strap. It should not be uncomfortable to thread the catheter, and you will not feel it traveling inside the body. Lastly, if you have any concerns, let your doctor know.

What Happens After Cardiac Catheterization?

Cardiac catheterization is a brief operation that usually takes less than one hour to complete. Even if it is done quickly, it will take many hours for you to get better. You will be transferred to the recovery area once the operation is completed to rest as the sedative effect fade off. A suture made from a special fabric that works well with the body to generate a natural clot within the artery can be used to seal the catheter insertion area.

After the procedure, you should rest to avoid major bleeding and enable the vessel to mend fully. You'll probably return home on that same day. But if you are a hospital patient and have a catheterization as part of the diagnosis or treatment, you will return to your room to heal. If you undergo an additional operation during the cardiac catheterization, like angioplasty or ablation, you will need to stay longer in the hospital.

Cardiac Catheterization Results

Immediately following the procedure, the doctor will discuss with you the outcome of your cardiac catheterization. The results might take some time to get back if you undergo a heart biopsy. In addition, your provider will give you the treatment or procedure recommendations based on the findings.

Your results from a coronary angiogram may indicate that you require angioplasty or a cardiac catheterization stent. If the cardiologist discovers this, angioplasty with or without a stent may be performed immediately to avoid the need for another catheterization. Before this procedure commences, talk to your doctor to known if this is a possibility.

Furthermore, the cardiac catheterization test will likely reveal that you require coronary bypass surgery. This is a type of open-heart procedure.

Risks of Cardiac Catheterization

All forms of operations involving the heart carry a certain set of dangers. Generally, cardiac catheterization is regarded to be a low-risk procedure with very few complications. If you have conditions like kidney disease and diabetes or are 75 years old, you're at a higher risk of complications.

Overall, cardiac catheterization carries the following risks;

An adverse reaction to anesthesia, the contrast dye, or drugs
Bleeding, bruising, and infection at the catheter site
Clots in the bloodstream, which can lead to stroke, heart attack, or other major conditions
Artery damage
Irregular heartbeats (arrhythmias)
Reduced blood pressure
Kidney damage

Conclusion

Cardiac catheterization is a treatment and diagnostic procedure that enables the cardiologist to analyze the heart function. This procedure is also used to check how well the blood vessels transport blood towards the heart.

The type of catheterization procedure you undergo usually depends on the underlying medical condition. Therefore, discuss with your doctor beforehand the benefits and associated risks of the procedure, including cardiac catheterization recovery.