[8]
Cardiac catheterization (also called heart catheterization) is a diagnostic procedure that allows a comprehensive examination of the heart and surrounding blood vessels. It enables the physician to take angiograms, record blood flow, calculate cardiac output and vascular resistance, perform an endomyocardial biopsy, and evaluate the heart's electrical activity. Cardiac catheterization is performed by inserting one or more catheters (thin flexible tubes) through a peripheral blood vessel in the arm (antecubital artery or vein) or leg (femoral artery or vein) under x-ray guidance.
A coronary angiogram specifies the nature and severity of coronary artery stenoses, or blockages.
The procedure itself takes about an hour, during which time the patient is sedated and comfortable. A local anaesthetic is given to numb the area of catheter insertion.
Angioplasty and stenting
During Angioplasty a very thin wire and then a small balloon are passed across the blockage in your heart vessel. The balloon is inflated to compress the plaque (cholesterol buildup). The balloon is then deflated and the blockage is improved. While the balloon is inflated, you may feel some chest pain much like angina. This pain is only temporary and will go away once the balloon is deflated.
Most patients who undergo angioplasty also have a metal tube, or stent, placed within the artery to hold it open. These stents remain permanently within the artery after the procedure. Most stents now have a medication on their surface which is gradually released from the stent during the first few days or weeks. This medication greatly reduces the scarring that follows stent placement, and therefore keeps the stent open better and longer. Special medications to prevent blood clots within the stent will be started before or right after your procedure, and continued for at least several months. These mild blood-thinners are of great importance to take regularly. Every effort should be made not to miss or skip even a single dose.
The total time needed for your procedure and hospital stay will depend on what procedure is done. If you do have a coronary intervention (such as PTCA, stent or atherectomy) you will be transferred to a cardiology ward and must lie flat on your back for 4-12 hours, depending how long then entry site takes to heal and whether or not a “closure device” is used. Your doctor may choose to use a stitch or collagen plug to seal the artery in the leg. If such a “closure device” is used, the time you must lie on your back will likely be shortened.
If the procedure is done through the radial artery in the wrist, a device called a “hemoband” is applied to hold pressure and prevent bleeding at the site and will remain on for 2 to 4 hours. If the procedure is done through the wrist or arm, you may sit up shortly after the procedure but must keep the arm still for at least 4 hours.
