Cardiac catheterization is a common procedure — so much so that entire clinics are dedicated to catheterization alone. If you or someone in your family is scheduled to undergo this procedure, you are probably curious about how the procedure is performed and what it is used for.
Read on to find out more.
What is Cardiac Catheterization?
Cardiac catheterization — or a cardiac cath for short — is a procedure that doctors use both to diagnose problems with patients and in some cases to perform surgeries or repairs on the heart.
Why are Cardiac Caths Performed?
Some cardiac caths are performed when a patient has a history of a heart attack, unexplained chest pain or abnormal results from an EKG or stress test. The cath process can help to diagnose a variety of heart conditions, including:
- Congestive heart failure
- Coronary artery disease
- Cardiac amyloidosis
- Pulmonary hypertension
- Cardiac infections
- Tumors in the heart muscle
- Heart defects
How Do Patients Prepare for a Cardiac Cath?
Patients can prepare for a cardiac cath by learning about the procedure from their doctor or a reputable website and by informing their doctor of what medications they are on, what their medical history is (if for example they have a history of diabetes or kidney disease) and if they are allergic to seafood or iodine or if they have had reactions to contrast dyes in the past. Before the surgery itself, the patient must go without eating for 6-8 hours. It is important to ask the doctor if it is okay to take any prescription medications with a small amount of water before the procedure; otherwise, the patient should bring their medications with them to take afterwards.
How Do Doctors Perform a Cardiac Cath?
This procedure takes place in a specialized operating room and the patient will be sedated but not rendered unconscious. Staff at the clinic will start an IV, attach the patient to monitors and sometimes shave the area where the incision will take place. The patient will remain conscious throughout the procedure and will have to follow simple directions such as coughing or positioning the body in the certain way.
To perform a cardiac cath, a small incision is made in the patient’s groin, neck or arm and a long, thin tube is inserted into the vein and then threaded through that vein until it reaches the large vessels of the heart. This procedure can be used to either diagnosed or repair a variety of heart conditions.
Afterwards, the patient will be transferred to a recovery room to be monitored for complications; if all is clear, the patient will be sent home the same day since this is an outpatient procedure.
How are Catheters Used for Diagnosis?
Catheters are performed when doctors want to visualize the heart or to perform surgical repairs that are less invasive than other traditional surgical methods (such as open heart surgery). During a cath, a doctor can perform the following diagnostic tests:
- Hemodynamic assessment, to measure oxygen and pressure levels in different areas of the heart
- Left or right ventriculogram, which checks on proper heart function
- Biopsy, or the taking of small tissue samples of the heart for further testing and analysis
- Coronary angioplasty, where dye is injected into the heart and X-rays taken to form images of the heart used for diagnosis
- The doctor can also use this procedure to diagnose congenital heart defects.
What Surgical Procedures are Possible with a Cardiac Cath?
There are also several surgical procedures that may be performed during the course of a catheterization, including:
- Angioplasty, the insertion and expansion of a tiny balloon to expand a narrowed or blocked vessel
- Balloon valvuloplasty, or the opening of the narrowed area in the heart with the expansion of a balloon-tipped catheter
- Cardiac arrhythmia ablation, where heat, cold or laser energy delivered via the catheter is able to ablate the area of the heart that is causing it to be irregularly.
- The doctor can also close up holes in the heart, as is the case with atrial septal defects and repair and/or replace heart valves.
Risks Associated with Cardiac Caths
One of the advantages of a cardiac cath is that it carries with it a lower risk compared to other surgical procedures such as open heart surgery. However, it is not risk-free and possible complications stemming from this procedure include:
- Bruising and bleeding at the incision site
- Post-procedural infection at incision site
- Damage to the arteries or heart tissue from the catheter itself
- Irregular heartbeats and development of blood clots
- Allergic reactions to dyes or other compounds used in the cath procedure
- Heart attack or stroke
- Damage to the kidneys
In short, while cardiac caths are not without risk, they do present a less invasive option than other surgical procedures and can be used for both diagnosis and for surgical repair. And because of the growing number of cardiac cath clinics springing up around the country, access to facilities that perform this procedure is better than ever.