Cardiac catheterization (heart cath) is the insertion of a catheter into a chamber or vessel of the heart. This is done for both investigational and interventional purposes. Coronary catheterization is a subset of this technique, involving the catheterization of the coronary arteries. A small puncture is made in a vessel in the groin, the inner bend of the elbow, the wrist (palm side) or neck area (the femoral vessels or the carotid/jugular vessels), then a guidewire is inserted into the arterial puncture and threaded through the vessel into the area of the heart that requires treatment, visualized by fluoroscopy or echocardiogram, and a catheter is then threaded over the guidewire. If X-ray fluoroscopy is used, a radiocontrast agent will be administered to the patient during the procedure. When the necessary procedures are complete, the catheter is removed. Firm pressure is applied to the site to prevent bleeding. This may be done by hand or with a mechanical device. Other closure techniques include an internal suture. If the femoral artery was used, the patient will probably be asked to lie flat for several hours to prevent bleeding or the development of a hematoma. Cardiac interventions such as the insertion of a stent prolong both the procedure itself as well as the post-catheterization time spent in allowing the wound to clot.
A cardiac catheterization is a general term for a group of procedures that are performed using this method, such as coronary angiography, as well as left ventrical angiography. Once the catheter is in place, it can be used to perform a number of procedures including angioplasty, angiography, and balloon septostomy.
Prior to the procedure, you may be given a mild sedative to help you relax. An intravenous line (IV) may be started for administering medication. You will remain awake but comfortable throughout the procedure.
This procedure is done in a specially equipped room, called a cardiac catheterization (cath) lab. Normally you'll be taken to the cath lab on a movable bed and then shifted onto a table. This special table is also movable and has a large camera over it. This camera is a fluoroscope (fluoro) that takes video x-rays of your heart. There is other equipment in the cath lab, including viewing screens, heart monitors, and emergency equipment. Once on the table, you will be connected to several types of monitoring equipment and then covered with a sterile cloth.
A staff member will shave and cleanse the area where the catheters will be inserted. In most cases this will be the groin or right elbow area. To numb the area, a local anesthetic is injected into the skin with a tiny needle.
You may fall asleep during the procedure, but the staff will monitor you constantly