What Are Cardiac Catheterization Procedures?

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Gaining access to the heart through a vessel has become a state of the art tool for diagnosing and treating heart conditions in the body. A long, thin, flexible tube called a catheter is put into a blood vessel in your arm, groin (upper thigh), or neck and threaded to your heart. Through the catheter, your doctor can do diagnostic tests and treatments on your heart.

History

For the last 4 centuries, mighty men of medicine have been intrigued by defining ways to gain access to the heart through minimally invasive procedures that would change the course of history in cardiac treatments of various kinds. Men like Carl Ludwig, Etienne-Jules Marey and Claude Bernard contributed much to the golden progression of cardiac catheterization. Werner Forssmann performed the first cardiac catheterization on himself in 1929. In the early 1940s, diagnostic cardiac catheterization was again introduced by Andre’ Cournand and Dickinson Richards. In the early ‘60s, Mason Sones brought selective angiography to the forefront.

In the late 1970s, Andreas Gruentzig made much progress with the expansion and refinement of cardiac catheterization techniques. Currently, a form of these techniques are still embraced by using radial and femoral vein points of entry for catheterization purposes.

Procedures

Angiography is the best available method today for diagnosing coronary artery disease. As the catheter passes along the vein, contrast, or dye, is injected along the way to map the path of the catheter as it travels. The dye flows through the bloodstream and directly into the heart. With state of the art fluoroscopy methods, the cardiologist can see the coronary arteries and other structures in and around the heart and may be able to make assessments while watching the procedure as he goes. This test can show plaque buildup or narrowing of coronary arteries.

Once these problems are diagnosed, the cardiologist will make decisions about treatment plans to reduce the risk of heart attack for the patient. Quite often, a simple stent through these restricted places may be able to buy the patient some time and decrease the chance of heart attack as well as deterring an open procedure for coronary artery bypass grafts.

What to Expect

During cardiac catheterization, the patient is awake. There may be a slight sting and burn when the local anesthetic is place in the operative area. Pressure from an 18-gauge needle going into deep veins may cause some discomfort. A small entry sheath is then exchanged with the needle. The cardiologist then passes a guide wire up, under fluoroscopy, up to the area where he wants to work. At this point, dye or contrast is injected and any treatment that may be needed is performed under fluoroscopy. Heart tissue or blood samples may be taken from the heart while the procedure is performed.

After this procedure, because of the nature of point of entry, the patient should remain still for at least an hour or two after surgery. The risk of bleeding through the catheterization site is a true consideration. There should be steady pressure applied to this area via human hands and/or a small sand bag. The patient is encouraged to stay still. A post catheterization hematoma can be truly uncomfortable and detrimental to blood flow of the extremities.