What Is Cardiac Catheterization?
This procedure involves inserting a thin, flexible tube into the body to reach your heart.
Cardiac catheterization – sometimes called heart catheterization – is a common way to diagnose and treat heart conditions.
In this procedure, a doctor inserts a catheter (a thin, flexible tube) into an artery or vein in your groin, arm, or neck.
The catheter is threaded through your blood vessels to your heart.
When cardiac catheterization is used as a diagnostic tool, doctors can:
- Locate blockages or narrowing in your blood vessels (known as an angiogram)
- Perform a biopsy of your heart (take a small tissue sample)
- Check how your heart is pumping
- Measure pressure and oxygen levels in the heart and lungs
- Diagnose heart defects or problems with heart valves
When cardiac catheterization is used as a treatment tool, doctors can:
- Perform angioplasty (a procedure to open blocked arteries by inflating a tiny balloon)
- Insert a stent (a device that helps prop an artery open)
- Close holes in the heart
- Fix congenital (present since birth) heart defects
- Replace or repair heart valves
- Perform ablation (a procedure to treat heart rhythm disorders)
- Close off parts of the heart to prevent blood clots
The Catheterization Procedure
Cardiac catheterization is usually done in a hospital while you’re awake, but sedated.
The procedure is typically performed by a cardiologist.
You’ll receive medicine to help you relax through an IV in your arm, and a local anesthetic to numb the area where the needle is inserted (in the groin, arm, or neck).
Your doctor will make a small needle puncture through your skin and into a large blood vessel. A plastic sheath is inserted into the vessel.
Next, your doctor will insert a catheter into your heart through the sheath.
Live X-rays can serve as a guide to see where the catheter should be placed. Your doctor may inject a contrast dye through the catheter to see where arteries are blocked.
Once the catheter is in the right spot, your doctor can look at your heart or perform any necessary procedures.
Don’t eat or drink anything for at least six hours before a cardiac catheterization.
Tell your doctor ahead of time about all medicines you take, and ask if you should take them the day of your procedure.
Also, let your doctor know in advance about all medical conditions you have. Be sure to tell your doctor if you might be pregnant before having this procedure.
It typically takes a few hours to recover from a cardiac catheterization.
You may need to lie flat for several hours after the procedure.
You should be able to eat and drink after a cardiac catheterization. You might experience some discomfort where the catheter was placed.
You may be able to go home on the same day.
However, if you’ve had another procedure such as angioplasty, you’ll need to stay in the hospital.
The length of stay will depend on your condition and the treatment you received.
Risks of Catheterization
Potential risks of a cardiac catheterization include:
- Bleeding or bruising
- Heart attack or stroke
- Damage to the artery where the catheter was inserted
- Irregular heart rhythm (arrhythmia)
- An allergic reaction to the dye or medication used
- Kidney damage
- A blood clot
- Tearing of tissue in your heart or artery
Cardiac catheterization – discharge
In general, people who have angioplasty can walk around within 6 hours or less after the procedure. Complete recovery takes a week or less. Keep the area where the catheter was inserted dry for 24 to 48 hours. If the catheter was inserted into your arm, recovery is often faster.
If the doctor put the catheter in through your groin:
- Walking short distances on a flat surface is OK. Limit going up and downstairs to around twice a day for the first 2 to 3 days.
- DO NOT do yard work, drive, squat lift heavy objects, or play sports for at least 2 days, or until your health care provider tells you it is OK.
If the doctor put the catheter in your arm:
- DO NOT lift anything heavier than 10 pounds (4.5 kilograms). (This is a little more than a gallon of milk).
- DO NOT do any heavy pushing, pulling, or twisting.
For a catheter in your groin or arm:
- Avoid sexual activity for 2 to 5 days. Ask your doctor when it will be OK to start again.
- You should be able to return to work in 2 to 3 days if you DO NOT do heavy work.
- DO NOT take a bath or swim for the first week. You may take showers, but make sure the area where the catheter was inserted does not get wet for the first 24 to 48 hours.
You will need to take care of your incision.
- Your provider will tell you how often to change your dressing.
- If your incision bleeds, lie down and put pressure on it for 30 minutes.
Many people take aspirin, often with another medicine such as clopidogrel (Plavix), prasugrel (Efient), or ticagrelor (Brilinta), after this procedure. These medicines are blood thinners, and they keep your blood from forming clots in your arteries and stent. A blood clot can lead to a heart attack. Take the medicines exactly as your provider tells you. DO NOT stop taking them without talking to your provider.
You should eat a heart-healthy diet, exercise, and follow a healthy lifestyle. Your provider can refer you to other health experts who can help you learn about exercise and healthy foods that will fit into your lifestyle.
Cardiac catheterization is a minimally invasive procedure generally employed to diagnose and treat certain heart conditions. It involves threading a thin flexible tube through a blood vessel to the heart. Your doctor can perform diagnostic tests and some procedures on your heart with the help of the catheter. This procedure is typically performed through the groin or femoral artery. Because the femoral artery is larger and offers a direct route to the heart, it has become the dominant approach to cardiac catheterization. However, recently, the use of radial artery for cardiac catheterization procedure has increased drastically. The radial artery approach is safer for patients as it is associated with less bleeding and fewer complications compared to the femoral approach.
Advantages of radial artery catheterization
Radial artery catheterization offers several benefits such as:
Less risk of nerve injury
Lower rate of complications
More comfortable for patients as they can move around immediately after the procedure, instead of staying in the bed for several hours
Before the procedure, the blood supply of the radial artery of the patient’s hand is assessed through an Allen test. There are 2 arteries (radial artery and ulnar artery) that supply blood to the hand. The catheterization procedure is safe to proceed only if both arteries are working properly. This approach is not appropriate for patients who are extremely thin or have small or twisted arteries.
The common steps involved in radial artery catheterization are as follows:
You will be asked to lie flat on the operating table and a medicine will be given to help you relax.
A local anesthetic will be injected to the wrist to numb the area.
A small tube (sheath) is inserted into the radial artery.
Medications are given through the tube to help relax the radial artery. This may cause a temporary burning sensation in the hand and arm.
Blood thinners are also administered to help prevent the formation of blood clots within the artery.
Then the catheters are moved through the tube and guided to the heart.
If required, a coronary angiogram and stent placement may be performed.
After the completion of the procedure, the catheters and tubes are removed from the radial artery.
The patient is advised to wear a compression device on the wrist, usually for 2 hours following the procedure. Patients are able to sit up and eat after the procedure. Patients can resume their normal activities after 48 hours.
Common post-operative instructions after radial artery catheterization are as follow:
Avoid placing any undue stress on the radial artery, to aid in healing.
Avoid lifting heavy weights with your hands.
Radial artery catheterization is generally a very safe procedure. However, as with any medical procedure, there may be some risks and complications involved. Possible risks and complications associated with radial artery catheterization include:
Although rare, spasm of the muscles lining the wall of the radial artery can occur.
Occlusion of the radial artery caused by blood clot formation within the artery may occur. This is usually harmless and may be prevented by using blood thinners.