Cardiac Catheterization

A cardiac catheterization is a minimally invasive test that offers clear, accurate information about the heart, the coronary arteries located on the surface of the heart and the aorta. Cardiac catheterization offers an excellent method for obtaining critical information that helps a cardiologist make a diagnosis. It is one of the most accurate tests for diagnosing coronary artery disease (CAD) and over a million cardiac catheterizations are done each year.

During cardiac catheterization, a thin tube called a catheter is guided through a blood vessel to a part of the body that needs to be assessed; in this case, the heart. The catheter is inserted into an artery through a very small cut made in the groin, arm or wrist, then guided up through the artery to the heart. The cardiologist tracks the course of the catheter by watching it on a fluoroscope, which displays the blood vessels on a viewing monitor similar to a television screen. As the catheter moves toward the heart, the cardiologist can explore the vessels for problems in the arteries leading to the heart. This procedure helps identify narrowed or clogged arteries, helps assess congenital heart defects and helps the cardiologist evaluate the four heart valves.

Cardiac catheterizations can be performed as either an inpatient or an outpatient procedure. After some recovery time, most patients are free to go home the same day as the procedure.

Coronary Angiogram

A coronary angiogram is an x-ray of the arteries on the surface of the heart, which are called the coronary arteries. An angiogram helps identify any of those arteries that are blocked. An angiogram is often conducted along with other catheter-based tests. An angiogram is performed by injecting a contrast medium, which is a special dye, into the arteries. The dye is injected by inserting a thin tube called a catheter through a blood vessel, all the way up to the heart. When the catheter is in place, the cardiologist injects the dye through the catheter and into the coronary arteries. Once the dye is injected, the x-ray can be taken.

Balloon Angioplasty

Balloon angioplasty is one of three standard treatments for coronary artery disease, a condition which occurs when the blood flow to the heart and the body is restricted because of a hardening of the arteries. The other standard treatments for CAD are medication and bypass surgery. Balloon angioplasty is used to push the fatty build-up (plaque) back to make more room for blood to flow through the artery. This improved blood flow reduces the risk of heart attacks and even death. The balloon is inserted through a thin tube called a catheter. The uninflated balloon is attached to the tip of the catheter and is passed through the artery to the heart. Once the catheter is at the site of the blockage, the balloon is inflated and the plaque is pushed back against the wall of the artery. The catheter is then removed.

Stenting

Stenting is a catheter-based procedure in which a wire mesh tube is inserted through a thin tube called a catheter and is used to hold an artery open. This small, expandable, wire mesh tube called a stent is inserted into a diseased artery and holds the artery open. Stenting is most often performed in conjunction with other catheter-based procedures, such as balloon angioplasty. The other procedures are used to partially reduce the narrowing of the artery and the stent typically allows for the final result to be obtained with little to no narrowing remaining within the coronary arteries. By doing a stent insertion along with these other procedures, the risk of restenosis or a re-narrowing of the artery, is reduced, and it greatly reduces the risk of abrupt vessel closures during or within 24 hours after the procedure. The development of drug-coated or drug eluting stents has helped to reduce the rates of re-narrowing over the long-term, as well. Within one month after the procedure, the stent becomes covered with a thin layer of the artery's inner lining cells. It will not be affected by a metal detector or most mechanical equipment. The success of a stenting procedure can be threatened by risk factors such as smoking, high cholesterol, etc which could lead to new blockages in the coronary arteries. People who receive stents are strongly encouraged to learn and practice healthy lifestyle behaviors for good heart health.

In addition to treating the coronary arteries, stents may be inserted in many other arteries in the body, such as those affected by plaque accumulation occurring in the course of peripheral artery disease (PAD). Peripheral artery disease most often occurs in the primary arteries of the brain, legs and kidneys. Stenting in PAD, for example, can be used to support and hold open arteries in the brain (carotid arteries) or the iliac arteries that supply blood to the legs. Special stents (stent grafts) are also used to treat aneurysms, including abdominal aortic aneurysms.