Cardiac Catherization
Cardiac catherization is a medical procedure where a long, thin, flexible tube called a catheter is inserted into the arteries or veins of your body. This catheter is then carefully guided through your arteries or veins until it reaches your heart. With the help of X-ray equipment, your physician monitors the movement and location of the catheter at all times.
With cardiac catherization, your physician can obtain accurate and detailed information about your heart that is not available through other tests. Cardiac catherization is a major part of many cardiac interventional procedures such as coronary angioplasty, atherectomy, cardioversion and valvuloplasty.
What to Expect if You Are Having Cardiac Catherization.
Preparation - The following general guidelines for cardiac catherization do not replace the specific instructions given by your cardiologist. There may be certain circumstances unique to each patient where different instructions are necessary. Always follow your physician's instructions and contact your physician if you have any questions. Because cardiac catherization is a component for many different invasive techniques, some of the events during the procedure may be slightly different than described here.
- Do not eat or drink anything six to eight hours before the procedure. Small sips of water are allowed to take medications.
- Do not drive to and from the hospital. Someone else should give you a ride.
- Your physician may decide to keep you overnight so you should pack a small bag with a robe, pajamas, slippers and toiletries.
- Make a list of all your medications including the exact name of the medication, the dosage and how often you take them.
- Inform the nurse or physician if you have any allergies to medications or have had allergic reactions to X-ray dye (contrast), iodine or have a history of bleeding problems.
- Before the procedure, stop at the restroom and empty your bladder.
When You Arrive at the Hospital
Usually you will arrive at the hospital in the morning and be able to return home later that day. Various lab tests will be performed and may include an EKG and blood tests. Your physician will take a medical history, perform an examination and explain the procedure allowing time to ask questions and express concerns.
During the Catherization Procedure
The procedure is performed at the hospital in a cardiac catherization laboratory, also called a "cath lab." You will be dressed in a hospital gown and lie on an X-ray table that has a large camera above it and several television screens close by. Other equipment, such as a heart monitor, will be in the room.
An assistant, a nurse and one or two technicians typically assist your cardiologist. They will be dressed in gowns, caps and masks and assist your cardiologist and monitor your status.
The insertion site for the catheter is either an artery in the groin area or your arm. The insertion site is shaved and cleansed by a nurse, making the insertion process easier and reducing the risk of infection. A local anesthetic is given at the insertion spot to numb the area before the catheter is inserted. This may cause a brief stinging sensation. A small IV will be inserted into your arm to deliver medications, fluids and a sedative to help you relax.
After a small incision is made, the catheter is inserted and slowly advanced through the artery or vein to your heart. The physician and staff monitor the progress of the catheter on the television screens.
For some catherization procedures, you may be awake and may be able to watch some of the pictures on the television screens. Generally, the catherization is not painful, but there may be some discomfort during the initial insertion of the catheter. You will not feel the catheter moving through your blood vessels or your heart.
Depending on the type of procedure being performed, different actions may be taken once the catheter is in place. If X-ray dye (contrast) is being used, you may feel some temporary discomfort when it is injected into your coronary arteries. This usually lasts a minute or two. If dye is injected into the ventricle as part of the procedure, you may experience a warm sensation over your body for 10 to 20 seconds. Other catherization procedures may involve the removal of plaques, placement of a stent or the application of a small electrical shock to your heart. Some of the different procedures that use cardiac catherization are described below. Your cardiologist will review the specific procedure with you and discuss the expected outcomes and risks prior to scheduling the appointment.
After the Catherization
The complete catherization procedure typically lasts one to two hours. When the cardiologist is finished and the catheter is removed, a nurse will apply pressure to the insertion site for several minutes to prevent bleeding. You will then be brought to the recovery room and a dressing will be applied to the insertion site.
You must lie flat in bed for four to six hours. This ensures that a good seal is formed over the insertion incision. During that time, you must lie still and not bend or lift your leg. Your pulse and blood pressure will be checked often and a nurse will tend to the dressing.
Soon after the procedure is completed, you will be allowed to eat and are encouraged to drink plenty of liquids. Your cardiologist may visit with the preliminary results of the test. A full analysis will take more time.
Back Home
Before you are sent home, you will be given some instructions. The first instruction is to be sure to have someone else drive you home. In addition, you will be told to limit activity for at least 24 hours, leave the dressing on the insertion point in place for at least one additional day. The nurse will tell you how to remove the dressing.
Often a bruise or bump will form at the insertion point. This will disappear within a few weeks.
Call the doctor if:
- The insertion site starts to bleed
- The bruising or swelling increases
- The leg in which the catheter was inserted feels cold or numb
- The insertion site becomes painful or warm to the touch
- A fever over 100 degrees develops
Cardiac catherization is a safe invasive procedure. If any complications arise they are typically minor and not long lasting. These can include temporary nausea and vomiting, rash and heartbeat irregularity. Your cardiologist will review the procedure and risks with you before the operation.
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