Cardiac Catheterization

Cardiac Catheterization

Cardiac catheterization is one of the most common procedures performed to monitor heart function. It helps to measure cardiac output, vascular resistance, and assess oxygenation of blood in various chambers of the heart. It can be either a diagnosis or treatment depending on the clinical need.

Indications to perform cardiac catheterization include:

  • Unstable angina or chest pain (uncontrolled with medications or after a heart attack)
  • Heart attack
  • Presurgical work-up before a bypass surgery
  • Abnormal treadmill test results
  • Determine the extent of coronary artery disease
  • Disease of the heart valve causing symptoms (syncope, shortness of breath)
  • To monitor rejection in heart transplant patients
  • Syncope or loss of consciousness in patients with aortic valve disease

This procedure is performed in a cardiac catheterization laboratory (cath lab). Therapeutic catheterization procedures include patent ductus arteriosus (PDA) closure, balloon valvuloplasty, and temporary or permanent cardiac pacemaker implantation.

How do you prepare for the surgery?

A review of medical history followed by a detailed examination is done before the procedure. It also includes routine laboratory work such as complete blood picture (CBP), basic metabolic panel (BMP), prothrombin time (PT), electrocardiogram (ECG), and a chest X-ray. Iodinated contrast dye is injected during the procedure, hence the patients with a history of allergies to iodinated contrast and chronic kidney disease require adequate planning before performing the procedure. Contrast agent increases the visibility of vascular structures and organs.

What happens during the procedure?

In this procedure, catheters are placed via a sheath in the artery of the groin (femoral artery) or arm (radial or brachial artery), advanced in the heart, and pictures are taken with injectable contrast dye and X-ray. The catheter is guided and positioned in the appropriate position with the help of ultrasound or fluoroscopy (medical imaging techniques).

What happens after the procedure?

The patient will be discharged on the same day after the procedure if the condition is stable. Complete recovery after the procedure takes about 5 to 7 days. Keep the area where the catheter was inserted (groin or arm) dry for at least 24 hours. Avoid vigorous physical activities for first few days after the procedure. If you notice any signs of infection, consult your doctor right away.

Complications of cardiac catheterization:

It is generally a well-tolerated and safe procedure with very minimal complications such as tenderness or bruising at the operated site.

FAQs

1. How long does cardiac catheterization procedure take?
The procedure itself takes 30 minutes but including the preparation time, procedure, and observation time after the procedure, it usually takes around 4 to 5 hours or longer depending on the patient’s condition.

2. Is cardiac catheterization and angiography the same?
Cardiac catheterization is used to evaluate the structure and function of the heart. Coronary angiogram is used to identify any narrowing in the coronary arteries. Both procedures are done with the use of X-ray and can be performed together.

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