Cardiac Catherisation
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This procedure is used to gain detailed knowledge about the heart, heart valves and coronary arteries (the heart's blood vessels). This is done by passing a catheter (a long, hollow, flexible, thin, plastic tube), through the main artery of the body up into the different heart chambers or vessels of the heart.
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Description of Cardiac Catherisation
Local anaesthetic is injected into the point of entry for the catheter which is directly above a blood vessel. This is usually the groin although sometimes the arm is used. A small incision is then made and the catheter introduced through this wound, into the blood vessel and up through the main vessel of the body until the catheter tip reaches the heart itself. The progress of the catheter can be monitored by x-rays displayed on a screen. There is no pain involved with this although you may feel an occasional thumping sensation in the chest as the heart skips a beat. This is not harmful. During the whole procedure, the heart is monitored by an ECG.
The most common reason for this process is for coronary angiography. This is explained in detail under the section entitled "Angiography".
However, there are several other uses for this procedure as outlined;
1. For measuring blood pressure inside the heart chambers. A tiny blood pressure monitor can be fitted to the catheter tip so that pressures on both sides of a heart valve can be measured accurately. This is crucial in determining how well the valves are working.
2. For measuring the contraction of the hearts ventricles (the lower, larger chambers which pump blood to the lungs and body). This is done by injecting dye into the ventricles and x-raying the blood flow and hence the flow of dye through the chambers and into the blood vessels.
3. To sample blood from various parts of the heart to determine its oxygen content.
4. To perform many corrective procedures on the valves or coronary arteries. This includes a "valvoplasty" where a balloon on the catheter tip is inflated to widen a narrowed heart valve; an "angioplasty" where a balloon is inflated to widen a narrowed coronary artery; or catheter ablation (destruction) treatment where a special device at the catheter tip destroys tiny areas of the heart muscle. This technique is sometimes used to treat abnormal heart rhythms (arrhythmias) where an abnormal or damaged source of electrical activity can be identified and then destroyed.
5. A new use for cardiac catheterisation is where a tiny ultrasound scanner is located at the catheter tip and detailed scans of the inside of the heart or coronary vessels can be obtained.
All these procedures can also be used in babies with congenital heart disease or in older children, although a general anaesthetic is usually required in this age group.
Medical Facts
Compliactions are usually mild and transient as described above, including bruising and discomfort. However, infections at the entry site may occur. Other problems include chest pain through the procedure, a hot and flushed sensation, an allergic reaction to the dye, and rarely, serious problems arise such as heart attacks during the procedure, damage to a coronary vessel, stroke or very rarely, death due to one of the above complications.
How You Will Feel:
This is usually done as a day case but in more complex problems involving several procedures, an overnight stay in hospital may be required.
After the procedure, patients ara normally asked to rest for a few hours and accompanied home by a relative or friend. There may be some bruising and swelling at the catheter entry site which may also cause some discomfort but simple pain killers such as paracetamol are usually advised. If stitches were inserted to close the wound, these would usually be removed after 7 days.
How Long Will you stay in Hospital after your Cardiac Catherisation?
Single Day In-patient Care
What to do next:
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