Cardiac catheterization, what and why it is performed, procedure details and potential risks, all you need to know about cardiac catheterization in Turkey.
Cardiac catheterization is an imaging procedure of the arteries that supply the heart muscle, called coronary or coronary arteries.
What is cardiac catheterization?
Cardiac catheterization (also called cardiac catheterization or coronary angiography) is a deep invasive imaging procedure of your heart's arteries that allows your doctor to evaluate your heart's function. Cardiac catheterization is used for:
- To assess or diagnose coronary artery disease or Valve diseases and their need for replacement or aortic disease.
- Assessment of myocardial function.
- Determining the extent to which the patient needs treatment (such as an interventional procedure or a Coronary artery bypass grafting surgery).
During cardiac catheterization, a long, narrow tube called a catheter is inserted through a plastic insertion sleeve (a small, hollow tube that is inserted into a blood vessel in the patient's leg or arm). The catheter is guided through the blood vessels to the coronary arteries with the help of a special X-ray machine.
Contrast material (diaphragm) is injected through the catheter and an X-ray video is taken as the contrast material moves through the heart's chambers, valves, and major vessels. This part of the procedure is called a coronary angiography.
Coronary artery disease is a narrowing or blockage of the coronary arteries. Therefore, the doctor may suggest invasive procedures to open the coronary artery, which increases blood flow to the heart.
Digital images of the contrast material are used to locate a narrowing or blockage in the coronary artery.
Additional imaging procedures — such as intravascular ultrasound (IVUS) and partial flow reserve (FFR) — may be done during cardiac catheterization in some cases to obtain detailed images of blood vessel walls. These two procedures are currently only available in specialized hospitals and research centers.
With IVUS, a miniature sound probe (transducer) is placed on the tip of a coronary artery catheter. The catheter is then passed through the coronary arteries, and using high-frequency sound waves, detailed images of the inner walls of the arteries are produced. This technique gives us an accurate picture of the location and size of the blockage.
In the FFR procedure, a special wire is passed through the artery and a vasodilator medication is given. This test measures the pressure difference across an artery to determine the extent and severity of the narrowing.
What interventional procedures may be performed during cardiac catheterization?
An interventional procedure (also called angioplasty) is a non-invasive treatment used to open narrowed coronary arteries to improve blood flow to the heart. This intervention can be done during diagnostic cardiac catheterization if blockage is identified, or it may be scheduled at a later time.
Interventional procedures include balloon angioplasty and stent placement.
During balloon angioplasty, a balloon is inserted into the narrowed blood vessel by catheter, which helps expand it and improve blood flow to the heart.
Will I be awake during cardiac catheterization?
Yes. You will be given a mild sedative to relax, but you will be awake and conscious during the entire procedure. The doctor will use a local anesthetic to numb the catheter insertion site.
Cardiac catheterization is not considered a surgical procedure because there is no large incision to open the chest, and the recovery time is much shorter than surgery. In some cases, surgery may be recommended afterward, depending on the results of the procedure.
Where is cardiac catheterization performed and who does it?
Cardiac catheterization is performed in the Cardiac Catheterization Unit in the Cardiac Surgery Department. The catheterization is performed by a doctor who specializes in cardiovascular surgery and is supported by a team of specialist cardiologists, nurses and technicians.
Learn more about The most important heart surgery hospitals in Turkey
How long does cardiac catheterization take?
Cardiac catheterization generally takes 30 minutes, but the preparation and recovery time adds several hours to the procedure time (five to nine hours or more).
What are the potential risks of cardiac catheterization?
Your cardiologist will discuss the potential risks and benefits of the procedure with you. Some of the potential risks of cardiac catheterization include:
- Allergic reaction to the medicine or contrast material used during the procedure.
- Having an infection.
- Bleeding at the catheter insertion site.
- Persistent chest pain or angina pectoris.
- Mild to moderate skin burns (eg sunburn) due to exposure to X-rays.
- Renal impairment due to contrast material.
- Heart attack, blood clot, stroke or death.
- Severe closure (spasm) of the coronary artery.
- Emergency coronary artery bypass grafting (CABG).
There may be other potential risks. When you meet with your doctor, please ask questions to make sure you understand why this procedure is recommended and what all the potential risks are.
How to prepare for a cardiac catheterization procedure in Turkey?
Please discuss all types of allergies you have with your doctor, especially those listed below.
- Allergy to IVP dye / contrast agent, Allergy to iodine
- Allergy to rubber/latex products
Discuss your medications with your doctor - he or she may want to stop or adjust doses several days before or on the day of the procedure, especially those listed below.
- Anticoagulant drugs
- diabetes drugs
Blood tests, ECG, chest X-ray:
Ask your doctor if all required pre-procedure tests have been completed or scheduled before the cardiac catheterization.
What do you bring with you to the cardiac catheterization procedure?
- We recommend that you bring a family member to wait with you before the procedure.
- Please bring a gown with you to wear while you wait for the procedure.
- We recommend wearing comfortable, easy-to-fold clothes.
- You may be admitted to the hospital after the procedure, so pack toiletries and any other things you may need to make your stay in the hospital more comfortable. Your family members can fetch these items from your car when you need them. Please leave all valuables at home or with a family member.
- There must be a responsible adult to drive you home after the procedure. You will not be discharged from the hospital unless someone is available to drive you home.
What to expect during a cardiac catheterization procedure?
- Please bring a list of your medications (including those you take without a prescription) and dosages. When you arrive for your appointment, please tell your nurse if you are taking Coumadin (warfarin), Plavix (clopidogrel), diuretics (water pills), or insulin. Also include information about whether you are allergic to anything, especially iodine, shellfish, X-ray dye, or Penicillin-type medications, latex, or rubber products (such as rubber gloves or balloons)
- They will give you a hospital gown to wear.
- The nurse will start inserting an intravenous (IV) line into your arm to provide you with medication and fluids during the procedure.
- The cardiac catheterization room is cold and dimly lit. The air must be kept cool to prevent damage to the X-ray machine used during the procedure. You will be offered warm blankets to make you more comfortable.
- You will lie on a special table. If you look above, you will see a large camera and many TV screens. You can see cardiac catheterization on the screens.
- The nurse will clean your skin where the catheter is to be inserted (the arm or groin). The cardiac catheter insertion site may be shaved.
- Sterile drapes will be used to cover the site and help prevent infection. It is important to keep your arms and hands at your sides, under sterile curtains.
- Electrodes, which are small, flat pads, will be placed on your chest. The electrodes are connected to an electrocardiogram (ECG), which monitors your heart rate and rhythm.
- You'll be given a mild sedative to calm you down, but you'll be awake and aware while the catheter is removed.
- In some cases, a urinary catheter may be needed during the procedure.
- The doctor will use a local anesthetic to numb the site. A plastic sheath (a short, hollow tube through which the catheter is placed) is inserted into a blood vessel in your arm or groin. A catheter will be inserted through the sheath and into the arteries of the heart. You may feel pressure when the entrance sheath or catheter is inserted, but you won't feel pain. Tell the nurse or doctor if you feel any pain.
- When the cardiac catheter is in place, the lights will dim and a small amount of contrast material will be injected through the cardiac catheter into your heart's arteries. Contrast material identifies vessels and valves.
- When the contrast material is injected into the heart, you may feel hot or red for several seconds. This is normal and will disappear in a few seconds.
- Please tell the doctor or nurses if you feel any complications:
- Allergic reaction (itching, tightness in the throat, shortness of breath).
- pain in chest
- any other symptoms
- An X-ray camera will be used to take pictures of your arteries and heart sections. You will be asked to hold your breath while the X-ray is taken. After all the pictures have been taken, the catheter will be removed and the lights turned on.
- An interventional procedure may be taken during cardiac catheterization.
- The cardiac catheter and sheath are removed.
- If a cardiac catheter has been inserted into the arm: The puncture site will be bandaged. You'll need to keep your arm straight for at least an hour, and you'll be able to move, but you'll be monitored for a few hours for any symptoms or side effects of the procedure. You will be given instructions on how to care for your arm when you return home. Tell your nurse if there is any bleeding or if you feel any numbness or tingling in your fingers.
- If the catheter has been inserted into the groin: The puncture site will be closed with pressure, a suture device, or a 'plug'. A "plug" is a substance that works with your body's natural healing processes to form a clot in an artery. You will need to lie down and keep the leg straight for two to six hours to prevent bleeding (less time is needed if a tampon is used). It is recommended that you do not raise your head more than 30 degrees (two pillows). Do not try to sit or stand. A sterile bandage is placed on the groin area to protect it from infection. The nurse will check the bandage regularly, but call your nurse if you feel bleeding or if your toes begin to tingle or feel numb.
- You will need to drink plenty of fluids to remove the contrast material from your body. You may feel the need to urinate frequently. It's normal. If you are lying in bed you will need to use a urinal.
- Your doctor will tell you if you are able to go home or if you will need to stay overnight. In either case, you will be monitored for several hours after the procedure.
- Treatment, including medications, diet and future procedures, will be discussed with you before you go home. Care of the wound site, activity, and aftercare will also be discussed.
Instructions for returning home after cardiac catheterization
Going home after cardiac catheterization
You must have someone drive you home. You will not be discharged from the hospital unless someone is available to drive you home.
If the way home takes more than 2 hours by car, we suggest you to stay in a hotel to have a better rest. The medical reception and advice service can help you make the necessary arrangements. Then ask a family member to drive you home the next morning, after you've rested.
While driving home, stop every hour and walk for 5 to 10 minutes. If you're flying home, stand up to extend your legs and walk down the aisle at least every hour.
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do not hesitate contact us, Bimaristan Family Center in Turkey. You can also read on our website about Replacement of the aortic valve by catheter.
Frequently asked questions and answers about cardiac catheterization in Turkey
Is cardiac catheterization dangerous?
Cardiac catheterization is not a dangerous procedure and studies indicate that if it is performed under the supervision of experienced doctors, the incidence of serious and fatal complications does not exceed 1%
How long does cardiac catheterization take?
Diagnostic cardiac catheterization generally takes 30 minutes, but if it is performed for therapeutic reasons, it takes about an hour or more.
After cardiac catheterization?
After the catheterization is performed, your doctor may give you several recommendations that you must adhere to, such as avoiding pulling heavy objects for 5-7 days after cardiac catheterization, avoiding any sexual practices for 2-5 days after cardiac catheterization, not exposing the area where the catheter was inserted in water during the first 1-2 days. Avoid swimming during the first week.
How is cardiac catheterization performed?
During cardiac catheterization, a specialized medical team inserts the cardiac catheter through the vessels of the thigh or arm into the coronary vessels supplying the heart. This procedure aims to x-ray the coronary arteries after injecting a contrast material that shows narrowing, if it is present.
What is the cost of diagnostic cardiac catheterization in Turkey?
The cost of cardiac catheterization in Turkey is about
What are the reasons for cardiac catheterization?
Catheterization is used to explore and evaluate the functioning of the heart valves.
Diagnosis of coronary atherosclerosis.
Expansion and installation of stents in the coronary arteries in case of narrowing.
Diagnosis of cardiomyopathy, evaluation and treatment of congenital heart disease for children.
Heart failure assessment.
What is the success rate of cardiac catheterization?
The latest studies indicate that cardiac catheterization is a relatively safe procedure with some complications that do not exceed 1%, and the success rate of cardiac catheterization in Turkish hospitals exceeds 90-99%.