What is cardiac catheterization?

A cardiac catheterization is a procedure that involves inserting a catheter into a vein or artery, usually in the arm, groin, or neck, to reach the heart through a blood vessel. This procedure is used to diagnose or treat various cardiovascular conditions.

What Is a Catheterization and What Are the Risks?

A cardiac catheterization is a short-duration, low-risk procedure with a very high probability of success. For this reason, it is frequently used to perform actions such as:

• Angioplasty: A procedure that opens narrow or blocked coronary arteries.
• Treating congenital heart disease: An alternative to open-heart surgery for closing septal defects, dilating valvular or vascular stenoses, or closing a patent ductus arteriosus.
• Repairing or replacing valves: It allows for the repair or replacement of heart valves without the need for open-heart surgery.
• Balloon valvuloplasty: Treats valvular stenosis, which is the narrowing of a heart valve.
• Cardiac ablation: Used to treat cardiac arrhythmias like atrial fibrillation or supraventricular tachycardia.
• Preventing blood clots: Cardiac catheterization can prevent the formation of blood clots in patients with atrial fibrillation or a high thromboembolic risk.

In general, a cardiac catheterization is considered a safe procedure. However, like any other procedure or intervention, it can have complications such as:

• Hemorrhages and hematomas: Since it is a procedure that accesses the vascular system through an artery or vein, it is possible for hematomas, arteriovenous fistulas, or internal hemorrhages to occur.
• Infections: Although a cardiac catheterization is a minimally invasive procedure, there is always a risk of infection either at the puncture site or in the bloodstream.
• Blood clots: The catheter can damage the vascular endothelium, which can lead to the formation of thrombi.
• Heart attack: In some particular situations, there is a risk of an acute myocardial infarction due to the obstruction of a coronary artery, the detachment of an atherosclerotic plaque, or acute stent thrombosis, to name a few examples.
• Stroke: Since the catheter can drag embolic material to the brain, it could result in an ischemic stroke.
• Cardiac arrhythmias: Some procedures can alter the heart’s electrical conduction and cause temporary or permanent arrhythmias.
• Damage to the artery or heart from the catheter: A cardiac catheter can cause mechanical injuries to the blood vessels or the heart.

Before a Cardiac Catheterization

There are several instructions that must be followed before a cardiac catheterization, which will be provided by your doctor. The most common ones are:

• Food: You will be asked to fast for six to eight hours from food and liquids to avoid the risk of anesthesia complications. If you have diabetes or need to take medication, it is advisable to discuss it with your doctor to receive specific instructions.
• Anticoagulants: If your medications include anticoagulants, tell your doctor so they can tell you how to proceed.
• Diabetes: Some dyes used in a cardiac catheterization can cause side effects with diabetes medications, so you should notify your doctor about this condition.

Additionally, it is recommended that you bring all medications in their original packaging so that the doctor knows the exact dosage you take.

Finally, and depending on the reason for the cardiac catheterization, your blood pressure and pulse will be checked before the procedure. In some cases, you may even be asked to empty your bladder, as well as other specific instructions.

How a Catheterization Is Performed

A cardiac catheterization is performed in a hemodynamics room, where the patient is placed on a stretcher and monitored at all times. A local anesthetic is applied to the puncture area, which is usually the femoral artery in the groin or the radial artery in the wrist, and a thin catheter is inserted into the blood vessel.

With the guidance of real-time images from fluoroscopy—which is a moving X-ray—the catheter is carefully guided through the blood vessels until it reaches the heart.

Once the cardiac catheter is in the desired location, the specific maneuver is performed according to the objective of the procedure.

After the procedure is completed, the cardiac catheter is carefully removed, and pressure is applied to the puncture site to prevent bleeding.

The patient is taken to a recovery unit, where their vital signs are monitored for about an hour. Depending on the complexity of the cardiac catheterization, as well as the patient’s general condition, they may be discharged the same day or require a brief hospitalization for observation.

After a Cardiac Catheterization

Depending on your previous health status and the possibility of other additional procedures during the catheterization, you may stay one night in the hospital.

It is important to receive follow-up care and be aware of possible complications that could include chest pain, fever, uncontrollable bleeding, an irregular heart rhythm, etc.

For optimal recovery after a cardiac catheterization, the following general recommendations are made:

• Adopt a heart-healthy lifestyle.
• Ask your doctor for instructions on when you can return to physical activity and what level is appropriate.
• Follow all instructions for caring for the access site to prevent infections or other problems.
• Get all follow-up tests and attend all medical appointments.
• Use all indicated medications.

Once you are home, you can return to your usual activities unless your doctor tells you otherwise.

Thanks to its versatility, a cardiac catheterization has become a fundamental tool in multiple areas of medicine, allowing for precise procedures with a lower risk and shorter recovery times compared to procedures performed with conventional surgery.

Some medical subspecialties that may require the support of this procedure include interventional cardiology, pediatric cardiology, critical care medicine, pulmonology, nephrology, and even neurology.

At the Cardiovascular Center at ABC Medical Center, we have an area dedicated to cardiac catheterization called “Cardiovascular Catheterization Rooms (Hemodynamics / CATH LAB).” We can provide you with specialized care. Contact us!

Fuentes:

CardiopatiasCongenitas, KidsHealth, MedlinePlus