What is a Cardiac Catheterization?

    Catheterization operation

    Cardiac catheterization is a medical procedure used to further investigate cardiac disease or actually treat a condition of the heart. It involves the insertion of a thin, flexible tube, referred to as a catheter, into an artery in an arm or leg. The catheter is routed to the heart, where your healthcare provider can see the vessels of the heart and note any disease.

    It is commonly used to investigate atherosclerosis within the arteries of the heart. If stenosis or blockage is noted during cardiac catheterization of the heart, certain procedures can be performed to open the arteries narrowed by atherosclerosis.

    How is a catheterization performed?

    The patient is brought to the catheterization laboratory and placed on a special examination table. After local anesthesia is given, a catheter is inserted into blood vessels in the groin, arm, or neck. (The catheter is inserted either through a small incision, or by means of a needle-stick.

    Sometimes, catheters are inserted from more than one site. The catheter is advanced through the blood vessels to the heart. Once in the heart, the catheter can be maneuvered to various locations within the heart, and the pressures within various chambers of heart are measured.

    Blood samples can be withdrawn from different locations in order to measure the amount of oxygen in the blood (unusual variations in blood oxygen can signal a “shunt,” or abnormal blood flow within the heart, often caused by congenital heart defects).

    Finally, by injecting dye through the catheter while a series of rapid x-ray images is recorded, “movies” can be made of the blood flowing through the cardiac chambers, or the through the blood vessels surrounding the heart – a procedure known as angiography (also called arteriography). Once the procedure is completed, the catheter(s) are removed. Bleeding is controlled by placing pressure on the catheterization site for 30 – 60 minutes.

    Cardiac catheterization and angiography can reveal vital information about overall cardiac function, about the function of the individual cardiac chambers, about the cardiac valves (whether they are too narrow (stenosis) or too leaky (regurgitation)), congenital heart defects, and about the location and severity of blockages in the coronary arteries (the arteries that supply blood to the heart muscle).

    What are the risks of having a catheterization or angiography?

    Cardiac catheterization and angiography are relatively safe, but because they are invasive procedures involving the heart, several complications are possible. Nobody should have a cardiac catheterization unless there is a reasonable likelihood that the information gained from the procedure will be of significant benefit. Minor complications of cardiac catheterization include minor bleeding at the site of catheter insertion, temporary heart rhythm disturbances caused by the catheter irritating the heart muscle, and temporary changes in the blood pressure.

    More significant complications include perforation of the heart wall (causing a life-threatening condition called cardiac tamponade), sudden blockage of a coronary artery (leading to a heart attack), extensive bleeding, stroke, or an allergic reaction to the dye used in angiography.

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