Cardiac catheterization in Türkiye

Cardiac catheterization is a procedure to check how well the heart is working. A thin, hollow tube called a catheter is inserted into a large blood vessel that leads to the heart.

During a cardiac catheterization, your doctor places a long, narrow tube called a catheter in a blood vessel in your arm or leg and guides it into your heart with the help of a special X-ray machine. Doctors use contrast dye that they inject into blood vessels through catheters to create X-ray videos of the valves, coronary arteries, and heart chambers

Why would you need a cardiac catheterization?

Cardiac catheterization provides information about how well the heart is working, identifies problems and allows procedures to open blocked arteries. For example, during a cardiac catheterization, the doctor may:

Taking x-rays using contrast dye injected through the catheter to look for narrowed or blocked coronary arteries. This is called a coronary angiogram or coronary arteriogram.
Performing a percutaneous coronary intervention (PCI) procedure such as coronary angioplasty with stents to open narrowed or blocked parts of a coronary artery.
Check the pressure in the four chambers of the heart.
Taking blood samples to measure the oxygen content in the four chambers of the heart.
Evaluate the capacity of pumping rooms to operate.
Look for defects in the valves or chambers of the heart.
Removing a small piece of heart tissue for examination under a microscope (biopsy).

Common uses of cardiac catheterization

Your doctor can use cardiac catheterization to find and fix problems. Most of the time, you will have a procedure to open blocked arteries after the diagnostic part of the cardiac catheterization. Procedures that may be performed during cardiac catheterization include:

catheterization Your doctor inserts a catheter with a small balloon at the tip. When this balloon is inflated, it pushes plaque out and widens the artery.
biopsy Your doctor takes a small sample of your heart tissue.
Repair of heart defects. Your doctor closes a hole in your heart or stops a leak in a valve.
stent placement _ Your doctor places a small mesh tube, called a stent, in the artery to help keep it open.

Cardiac catheterization risks

Cardiac catheterization is generally safe. But as with any procedure that involves entering your body, there are risks. Your doctor will discuss the risks with you and will be careful to reduce the chances of them occurring.

Risks can include:

A hole passing through a blood vessel (perforation)
Air embolism (when air enters the blood vessels; this can be fatal)
Allergic reaction to the dye
bleeding
blood clots
a bruise
heart attack
infection
Kidney damage from the dye
Apoplexy
Arrhythmia

Prepare the cardiac catheterization

This procedure is usually done in the hospital. Most people will also need blood tests and an EKG. Some other things to keep in mind:

Your doctor or nurse will tell you what you can and cannot eat or drink before the procedure.
Tell your doctor about all the medicines you take, including herbal products and nutritional supplements.
Ask your doctor what medications you should take on the day of your catheterization. You may need to stop taking some of them, such as Coumadin (a blood thinner), for a few days before the procedure.
If you have diabetes, ask your doctor how to adjust your diabetes medications on the day of the test.
Tell your doctor and nurses if you are allergic to anything, especially iodine, shellfish, X-ray dye, latex, rubber products (such as rubber gloves or balloons), or penicillin-type medicines.
You may not be able to go home on the day of your procedure. Bring your personal items (eg robe, slippers, toothbrush) to make your stay more comfortable. Have someone else take you home.

What is the duration of cardiac catheterization?

A cardiac catheterization procedure usually takes about 30 minutes (and longer if you have an intervention), but preparation and recovery time add up to several hours. Plan to stay in the hospital all day.

What happens during a cardiac catheterization?

You will wear a hospital gown. The nurse will put a needle into a vein (IV) in your arm to give you medicines and fluids.

The cardiac catheterization room is similar to an operating room. You will lie on a special table. Above you will be a large camera and many TV screens. You can see the pictures of the cardiac catheterization on the monitors.

The nurse will clean and possibly shave the site where the catheter will be inserted (in your arm or groin). Sterile clothing will cover the area and help prevent infection. Keep your arms and hands at your sides so you don’t move the curtains.

The nurse will place electrodes (small, flat, sticky patches) on your chest. The electrodes are attached to an ECG machine, which charts the electrical activity of your heart.

Your doctor will give you a mild medication to help you relax, but you will be awake during the procedure. Your doctor will use a medication called a local anesthetic to numb the area where the catheter is inserted. This can be in the thigh (they’ll call this the femoral approach) or on your wrist (the radial approach).

Your doctor will make a small cut in the blood vessel. They’ll insert a device called a porthole sheath and thread the catheter through it into the arteries of your heart. You may feel some pressure, but you should not feel pain. If you feel any pain, tell the doctor about it.

When the catheter is in place, it dims the lights and a small amount of dye (also called contrast material) enters through the catheter into the arteries and chambers of the heart. The contrast material defines your vessels, valves, and chambers.

When the doctor injects dye into your heart, you may feel hot or flushed. This is normal and will disappear in a few seconds. Tell the doctor or nurses if you feel itching or tightness in your throat, nausea, chest pain, or any other symptoms.

The X-ray camera will take pictures of the arteries and chambers of the heart. Your doctor may ask you to take a deep breath, hold your breath, or cough during the procedure. You will need to hold your breath while the x-ray is taken. When all images are finished, the team will remove the catheter and turn on the lights.

What happens after cardiac catheterization?

If the catheter was placed in your wrist, your doctor will remove it and the sheath. They will close and bandage the wound. You will be able to walk around.

The doctor will watch you for a few hours to make sure you are okay. Tell your nurse if you think you are bleeding or feel any numbness or tingling in your fingers. You may be given medicine to help with the discomfort in your arm. You’ll also get instructions on how to care for your arm after you go home.

If the catheter goes into your groin, your doctor will remove the device and close the wound with stitches, a collagen seal, or pressure. Collagen seal is a protein substance that works with your body’s natural healing processes to form a clot in an artery. In some cases, your doctor may sew the insertion sheath in place and remove it after the bleeding has stopped.

To help prevent infection, the wound will be covered with a sterile dressing. You will need to lie down and keep your leg straight for 2 to 6 hours to prevent bleeding.

To avoid abdominal and groin strain, you’ll need to keep your head lower (no more than two pillows high). You will not be able to sit or stand during this time. The nurse will check the bandage regularly, but tell them if you think you are bleeding (feel warm and wet) or if your toes feel tingling or numb. You may be given medicine to help with your discomfort after the effect of the anesthetic wears off. Your nurse will help you get out of bed when it is convenient for you to get up.

Your doctor’s orders will tell you when you can get out of bed to go to the bathroom. The nurse will help you sit with your legs dangling over the side of the bed.

Drink plenty of fluids to remove the dye from your body.

You may feel the need to urinate more than usual. It’s normal. If you did not have a urinary catheter during the procedure, you will need to use a bed mat or urinal until you can get out of bed.

Your doctor will tell you if you can go home or will need to stay overnight.

Before you go home, your doctor will discuss treatment, including medications, dietary changes, exercise, and future procedures. They will also talk about how to care for the wound site, activity, and follow-up care.

Cardiac catheterization outcomes and home care

Your doctor will tell you what they found during the procedure and whether they need to do any other procedures, such as angioplasty or stenting.

Once you get home, follow all of your doctor’s instructions about your activity level and what medications to take. You may have a bruise at the wound site. Call your doctor if you have any other problems.