Cardiac Catheterization; A final solution to heart problems

Cardiac catheterization, or what is called cardiac catheterization, is a minimally invasive procedure, and it is considered a final solution to many heart problems. Turkey has developed through catheter significantly lately.

cardiac catheterization is an imaging procedure of the arteries supplying the heart muscle called coronary arteries, and it has two goals or two types: Diagnostic catheterization and therapeutic catheters.

Cardiac catheterization can be performed from the hand and thigh symmetrically, according to the doctor’s choice. so Is cardiac catheterization dangerous? and when The patient needs a cardiac catheterization? What is the success rate of cardiac catheterization for the elderly? Get to know more in this article.

Cardiac catheterization and general information about this procedure

Cardiac minimally invasive catheterization (also called cardiac catheterization or coronary angiography) is a deeply invasive imaging procedure of the arteries of the heart that allows your doctor to evaluate your heart's function. Cardiac catheterization is used to:

• 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 insert casing (the tube is small, hollow inserted into a blood vessel in the patient's leg or arm); the catheter is guided through the blood vessels into the coronary arteries with the help of a special X-ray machine.

Contrast material 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 coronary angiography.

Coronary artery disease is narrowing or blockage of the coronary arteries, so your doctor may suggest interventional 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.

In some cases, additional imaging procedures such as intravascular ultrasonography (IVUS) and Fractional flow reserve (FFR) may be performed during cardiac catheterization to obtain detailed images of the blood vessel walls. These two procedures are currently available only in specialized hospitals and research centers in Turkey.

Reasons for cardiac catheterization

The reasons for cardiac catheterization are many, it may be to diagnose or rule out a disease, or for a therapeutic reason, and among these reasons we mention:

• Knowing the cause of heart arrhythmias and whether the patient needs treatment Heart battery installation or to defibrillator and to find out why slow heart rate is occuring in the patient.
• Investigate the cause of non-parietal chest pain.
• Cardiac catheterization helps diagnose cardiomyopathy, aortic stenosis, mitral valve regurgitation or pulmonary hypertension (high blood pressure in the lungs).
• Evaluation of heart valves and if the patient needs Mitral valve replacement or fixing it, or aortic valve replacement through a catheter or without a catheter or fixing it only, or to Coronary artery bypass without a pump.
• getting ready for anHeart transplant, or Artificial heart transplantation.
• Taking Biopsy from the heart muscle by cardiac catheterization.
• getting ready for anopen heart surgery, AndLaparoscopic heart surgery.

Read more on our site about: Robotic mitral valve replacement surgery.

What interventional procedures may be performed during cardiac catheterization?

An interventional procedure (also called angioplasty) is a non-surgical treatment used to open narrowed coronary arteries to improve blood flow to the heart. This intervention may be done during a diagnostic cardiac catheterization if the blockage is identified, or the procedure can be scheduled later.

Interventional procedures include:

• Balloon angioplasty
• Stent placement

During balloon angioplasty, a balloon is inserted into the narrowed blood vessel by a catheter, which helps expand it and improve blood flow to the heart.

Cardiac catheterization is not considered an invasive procedure because there is no large incision or chest opening; it is minimally invasive, and the recovery time is much shorter than surgery. In some cases, surgery may be recommended afterward, depending on the procedure's results.

Where is cardiac catheterization performed and who does it?

Cardiac catheterization is performed in the Cardiac Catheterization Unit in the Department of Cardiology and Cardiosurgery. The catheterization is performed by a physician specializing 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.

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).

Preparations before cardiac catheterization in Turkey

The doctor must conduct some tests before proceeding with the cardiac catheterization process, in order to ensure the patient’s readiness and the ability of his body to bear the consequences of this operation, and the medications that the patient is taking must also be known.

Allergy tests

Please discuss all allergies you have with your doctor, especially those listed below:

• Allergy to IVP dye/contrast agent
• Allergy to iodine
• Allergy to rubber/latex products

Drugs

Your doctor may want to stop or adjust your doses several days before or on the day of the procedure, especially:

• Anticoagulant drugs
• aspirin
• diabetes drugs

Blood tests, electrocardiograms, and chest X-rays are also routinely performed.

Cardiac catheterization procedure

Before the operation, you will be given a hospital gown to wear, and after that, you will enter the operating room and:

• 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 cool and dimly lit. The air must be kept cool to prevent damage to the X-ray machine used during the procedure.
• The nurse will clean your skin where the catheter will be inserted (arm or groin). The insertion site for the heart catheter may be shaved.
• The electrodes, which are small, flat patches, will be placed on your chest. The electrodes will then be connected to an electrocardiogram (ECG), which monitors your heart rate and rhythm.
• You will be given a mild sedative to calm you down, but you will be awake and aware during the cardiac catheterization procedure.
• 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 heart's arteries. You may feel pressure as the entrance sheath or catheter is inserted, but you will not feel pain.

When the cardiac catheter is in place, the lights will be dimmed, and a small amount of contrast material will be injected through the cardiac catheter into the arteries of the heart. The contrast material lines the vessels and valves.

When the doctor injects the contrast material into the heart, you may feel a feeling of warmth or redness for a few seconds. This is normal and will go away after a short time.

Instructions after cardiac catheterization

Plenty of fluids should be drunk to eliminate the contrast material. Otherwise, nephrotoxicity and necrotic nephritis will occur.

Also, creatinine and urea should be checked several times after the operation to ensure no renal damage occurred after cardiac catheterization due to the contrast material.

Someone must drive you home. You will not be discharged from the hospital unless someone is available to drive you home.

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.

At home the patient must follow Instructions after cardiac catheterization which are:

• The wound location must be carefully observed, and stressful work should be avoided, so the wound does not open or bleed.
• The wound site should be monitored, and the doctor should be informed of any redness, swelling, or bleeding at the site.
• Bed rest should not be less than four or five hours a day.
• Follow the doctor's instructions for showering and cleaning the wound site (depending on the method of closure of the wound).
• Take medications regularly and do not stop them without a doctor's order.

Appropriate diet after cardiac catheterization

The patient can eat light foods, and he must stay away from fatty foods with high fat percentages, so as not to strain his heart and worsen the problem of atherosclerosis if he has it.

You should not consume excessive sugars or any stimulants such as coffee and tea in the first period, especially if the patient has diabetes.

After cardiac catheterization, the patient should eat more foods rich in fiber, grains, healthy fats, and nuts.

Vegetables and fruits should be increased in all cases, especially after heart catheterization.

Sports after cardiac catheterization

Highly strenuous actions or work should not be done after the operation for a period determined by the doctor (often several weeks), and the patient can return to his regular work almost on the same day, with the preference of resting entirely for two or three days.

Light exercises such as jogging and brisk walking can be performed away from strenuous sports that put a load on the heart.

In the event that you feel pain or anything strange, you must stop the exercise and see your doctor immediately.

Side effects after 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:

• An allergic reaction to the medication or contrast material used during the procedure
• Arrhythmia
• Infection
• Bleeding at the catheter insertion site
• Persistent chest pain or angina
• Mild to moderate skin burns (such as sunburn) due to exposure to X-rays
• Renal failure due to contrast material
• Heart attacks, blood clots, stroke or death
• Severe closure (spasm) of a coronary artery
• Emergency coronary artery bypass surgery (CABG)

In the end, we can say that cardiac catheterization is a safe procedure with several indications. Cardiac catheterization helps the doctor diagnose and treat many heart diseases. The catheterization process is inexpensive compared to open heart surgery, its complications are few, and the recovery period is significantly shorter.

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Sources:

1. Stanford Medicine
2. Cleveland Clinic
3. Mount Sinai