Cardiac Catheterization

What is cardiac catheterization?

Cardiac catheterization, commonly referred to as cardiac cath or heart catheterization, is a medical procedure that is used to detect and treat certain heart diseases. It allows doctors to examine the heart in detail to detect abnormalities and perform other tests or operations by inserting a thin, flexible tube (catheter) into a blood artery and guiding it to the heart.

Does it require general anesthesia?

During cardiac catheterization, a patient will usually be awake, but they will be given drugs to help them relax. Cardiac catheterization has a rapid recovery period and a minimal risk of complications

Why do patients need cardiac catheterization?

Usually, this procedure is done to diagnose and treat many heart conditions. If a patient has arrhythmias, angina, or cardiac valve issues.

Cardiac catheterization may be used to diagnose or treat the following conditions:

  • Congenital heart disease (CHD)
  • Coronary artery disease (CAD)
  • Heart valve disease
  • Heart failure
  • Microvascular heart disease

What can doctors do during a cardiac catheterization?

During the procedure, a doctor can:

  • Take samples of the heart tissue (biopsy)
  • Check for blood clots in the blood vessels
  • Diagnose congenital heart defects
  • Check for heart valve disease
  • Perform a right or left ventriculogram to examine the heart’s ability to pump blood
  • measure the heart’s pressure and oxygen levels (hemodynamic assessment)
  • Locate any blood vessel narrowing or obstructions that may be causing chest pain (angiogram)

Can a doctor do cardiac catheterization at the same time as other procedures?

Many procedures can be done along with cardiac catheterization, such as:

  • Angioplasty, for widening a narrowed artery with or without the using a stent
  • Cardiac ablation to treat irregular heartbeats using cold or heat energy
  • Treating some congenital heart abnormalities such as closing holes in the heart
  • Balloon valvuloplasty, to open narrowed heart valves
  • heart valve surgery, for heart valve repair or replacement

What are its risks?

Cardiac catheterization has little or no major complications, however, it carries some complications like most operations involving the heart and blood arteries. These complications can be infection, bleeding, blood clots, bruising, cardiac or artery damage to the catheter implantation area, arrhythmia, heart attacks, and medications or contrast dye used in the procedure might cause allergic reactions.

Caution should be taken in case of pregnancy or even if the patient is planning for pregnancy.

Preparation for cardiac catheterization

The patient will be instructed to fast for six to eight hours before the cath procedure and given instructions on what to eat and drink before that.

After having the full medical history, a doctor may ask the patient to stop some of these medications before the procedure.

During the procedure

A nurse will insert an IV line into the patient’s vein in the arm before the cath procedure for the sedative administration. The patient may stay awake.

After using local anesthesia, the doctor will use a needle to insert it into a large vessel so that he can insert the sheath into that vessel to guide the catheter through it. This step is usually painless but the patient may feel some pressure in the groin.

for measuring blood pressure in each heart chamber and blood arteries, many tools can be placed at the tip of the catheter. They can be used to see the inside of blood vessels, take blood samples from various sections of the heart, or remove a tissue sample (biopsy) from the heart.

Using a catheter, a doctor can inject a dye to be seen on an X-ray, in a process called angiography.

A doctor can also use it to clear a restricted or blocked artery, in a process called angioplasty or PCI.

If a doctor used it to widen a narrowed heart valve opening, this procedure is called valvuloplasty.

After removing the catheter and sheath, a nurse should apply some pressure to the insertion site to reduce the risk of bleeding and usually, they use a closing device.

The whole procedure takes around an hour.

After the procedure

After going to the recovery room, a patient will be asked to stay in bed for a while and keep his leg straight.

If the patient showed any signs of chest pain or bleeding, they should inform the doctor.

The patient should receive written instructions to follow when they leave the hospital.

After getting home, a patient should follow the doctor’s instructions and take the mediations as directed, they should follow up with the doctor if they noticed any abnormalities or complications to the cardiac catheterization.

Complications

The multivessel disease has several side effects, including the following:
●Acute coronary syndrome (ACS)
●Acute coronary syndrome (ACS)
●In-stent restenosis
●In-stent thrombosis
●Stent embolization
●Side branch occlusion
●Stent fracture
●Graft failure
●Complications of surgery (bleeding, wound dehiscence, infection, pulmonary complication, stroke, myocardial infarction, arrhythmia, acute kidney injury, transfusion-related reactions)
●Complications of PCI (bleeding, pseudoaneurysm, retroperitoneal hematoma, infection, arterial dissection, distal arterial embolization, coronary perforation, stroke, acute kidney injury, reperfusion injury)

Sources

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