Cardiac Catheterization is a medical procedure used to assess the functioning of the heart and check for any cardiovascular problems. Cardiac catheterization is also known as cardiac cath, heart cath or a coronary angiogram. The procedure basically evaluates how well are the blood vessels of the heart functioning. A cardiac catheterization is done by inserting a catheter into an artery or a vein in the groin, neck or arm; a catheter is a long, flexible, narrow tube which is guided through the blood vessels (via special X-Ray machines) to the heart to assess its functioning. Once the catheter is in position, it can be used to run various diagnostic tests by injecting a contrasting dye through the catheter into the blood vessels. This dye enables the doctor to assess the valves, coronary arteries and chambers of the heart by creating X-Ray videos. Moreover, in certain cases, cardiac catheterization is also used in heart procedures such as a coronary angioplasty and coronary stenting.
Technically, a cardiac catheterization is performed in an authorized medical specialty by a certified cardiologist, along with expert team of nurses, technicians and other medical professionals.
Purpose of Cardiac Catheterization
The main purpose of a cardiac catheterization is to assess the functioning of the heart and diagnose any heart conditions. However, in many cases, cardiac catheterization is also performed as a part of larger procedure to correct heart problems. Hence, cardiac catheterization is used both to find and fix heart problems and conditions.
Some problems and issues that can be easily identified via cardiac catheterization include:
- Congenital heart defects
- Narrowed, blocked or damaged blood vessels in the heart
- Heart valve problems
- Oxygen level and processing inside the heart
- Heart muscle functioning
A cardiac catheterization can also be used to collect tissue to perform a biopsy. It is also a great method to assess and determine the need for further treatment. That said, cardiac catheterization is also used to fix some heart problems. Some of the procedures that can be performed via cardiac catheterization are:
Angioplasty: In an angioplasty, a catheter is placed in the heart mounted with a tiny balloon. Once in place, the balloon is inflated that pushes the plaque out, causing the arteries to open and widen leading to effective flow of blood and oxygen.
Repairing Heart Defects: Heart defects such as a hole in the heart or leakage in the valve – can be corrected through cardiac catheterization.
Stent Placement: Stent placement is usually followed after an angioplasty, where a tiny mesh tube –known as stent – is placed in the narrowed or blocked artery to prevent it from narrowing or being blocked again.
Heart Ablation: In this procedure, multiple catheters will be placed in the arteries and veins to direct the radiofrequency energy to correct abnormal heart rhythms.
Valve Replacement: This procedure will involve the usage of catheter to implant an artificial valve in place of a narrowed heart valve.
Procedure of Cardiac Catheterization
Before beginning the procedure, the doctor will advise the patient on certain medications that need to be avoided and if there is a need to fast before the procedure. Usually, the patient is not allowed to eat or drink anything following the midnight of the procedure. Also, all health conditions such as diabetes high blood pressure, etc. need to be discussed prior to the procedure. This is done to avoid any complications.
Once all pre-procedure rules are followed, the patient will then be required to change into the hospital gown and lie down; post this, an intravenous line (IV) will be placed which will supply food and fluid to the patient during and after the surgery. The nurse will then remove hair from the site where the catheter is supposed to be inserted into. The patient might be kept under the influence of local anaesthesia to avoid any pain and problems. The procedure is about 30 minutes long; however the preparation and recovery might take longer.
The doctor will insert the catheter into the groin, neck or arm by making minor cut over the blood vessel. Once done, the cardiologist will insert an introduce sheath (a short, hollow, plastic cover), which will be used to thread the catheter into the arteries of the heart. Once the catheter is in place, the lights of the operating room will be dimmed to allow the cardiologist to assess the functioning of vessels, valves and chambers of the heart – by inserting a special contrasting dye into the arteries and heart chambers via the catheter. Once, the dye is placed, the patient might feel some discomfort which should fade away within seconds; in case it persists, the cardiologist must be informed.
The X-Ray machines will then be used to take images of the heart’s arteries, valves, vessels, and chambers. During the process, the patient might be asked to hold cough, sneeze and breath. Once, the X-ray images are taken, the catheter will be then removed from the body. The cut will be closed and bandaged and the patient might be monitored for some hours to check for any bleeding, numbness, pain or any other issue. The doctor might also prescribe some medications to help with pain, if any. The closing procedure, the resting and supervision time also depend on the place of insertion of the catheter and the condition of the patient.
Post the procedure, depending on the condition of the patient, the doctor will suggest the further plan, which will include taking care, avoiding infections, medications, dietary changes, exercise and any other procedures that might need to be performed.
Risks of Cardiac Catheterization
A cardiac catheterization is a very safe and guarded procedure; however like any procedure related to the heart, it too can develop some complications. Though risks in cardiac catheterization are rare, they might arise sometimes, especially in patients that have diabetes and kidney disease or are beyond a certain age such as 75 years or more.
Some of the rare risks involved in cardiac catheterization are:
- Allergic reaction to the dye
- Allergic reaction to medicines used in the procedure
- Bleeding, swelling pr bruising at the insertion site
- Blood clots that might cause heart attack or stroke
- Damage to the surrounding arteries from where the catheter was guided to the heart
- Damage to the arteries at the site of insertion of catheter
- Irregular heart rhythm
- Damage to the kidneys due to the dye used
- Low blood pressure
- Scarred heart tissue
- Hole in the blood vessel
- Air embolism
Results of Cardiac Catheterization
Post a cardiac catheterization, the cardiologist will be able to assess the functioning of the heart and detect any heart conditions and problems such as narrowed or blocked arteries, damaged valves, heart defects, and more. In addition to this, cardiac catheterization can also be used as a part of some procedures such as heart biopsy, balloon angioplasty, stenting, heart defect repair, balloon valvuloplasty, valve replacement and heart ablation.
Overall, a cardiac catheterization is a very safe and useful procedure to detect and correct heart conditions and problems.