Cardiac Catheterization

Patients may be referred to an interventional cardiologist for cardiac catheterization if they experience some or all of the following symptoms:

• Chest pain (angina)
• Difficulty breathing
• Dizziness or lightheadedness
• Extreme fatigue

In cardiac catheterization, a very small hollow tube, or catheter, is advanced from a blood vessel in the groin or arm through the aorta and into the heart. Once the catheter is in place, several diagnostic techniques may be used, including:

• Biopsy: Take blood or tissue samples from inside the heart
• Coronary angiography: Use a contrast dye to show blood flow through the heart and find blockages
• Fractional flow reserve: Measure the pressure and blood flow inside each heart chamber
• Intravascular ultrasound (or IVUS): View inside blood vessels with ultrasound, which uses sound waves

Cardiac catheterization is performed while a patient is awake and they may be asked to take a deep breath, cough or move positions. There is no pain during the procedure as the physician numbs the area where the catheter is inserted, and patients receive medicine to relax.

Once the catheter is in position, the interventional cardiologist can do a variety of tests and in some instances, can treat the condition at the same time.

Treatment capabilities include:

• Angioplasty and stent placements: a small, metal mesh tube called a stent is inserted to open the narrowed or blocked coronary artery.
• Coronary Artery Rotoblator: a long thin catheter is inserted into a coronary artery to “bore out” a narrowing that might not respond to stenting otherwise.
• Pacemaker Implantation: a medical device that uses electrical pulses to regulate your heartbeat
• Cardio Defibrillator Implantation: an implantable device that can help pace the heart and is capable of correcting even the most life-threatening cardiac arrhythmias
• Cardiac Resynchronization Therapy (Biventricular Pacing): this device uses small electrical impulses to make the lower chambers of the heart contract and treat delayed heart contractions that occurs in some patients with advanced heart failure
• Atherectomy: an alternative to angioplasty, this minimally invasive surgery removes atherosclerosis from blood vessels to treat peripheral artery disease
• Thrombectomy: a procedure to remove blood clots from a blood vessel, typically performed in the cerebral arteries
• Valvuloplasty: also known as balloon valvuloplasty, this procedure uses a catheter and small incisions to repair a heart valve with a narrow opening
• Intravascular Ultrasound (IVUS): a diagnostic imaging test that helps with pre-stent planning and post-stent optimization where sound waves are used to see inside blood vessels
• Intra Aortic Balloon Pumps: a mechanical device that consists of a cylindrical balloon placed into the aorta that helps the heart pump blood
• Peripheral Stent Procedures: these procedures consist of an angioplasty or stent placement used to open blocked peripheral arteries
• Carotid Stents: a metal-mesh tube is inserted into the carotid artery and expanded to assist with blood flow in the narrowed carotid artery in the neck
• Electrophysiology Ablations: your physician uses an electrophysiology study and catheter ablation to both evaluate and treat an abnormal heart rhythm

Cardiac catheterization usually takes about an hour, and patients rest in the recovery room for a few hours afterward. Most go home the same day, but that may depend on the condition and other factors. Patients can usually return to normal activities within a few days.

If the interventional cardiologist performs angioplasty or another treatment during the procedure, an overnight hospital stay may be required. The care team will provide more details about what to expect before, during and after the procedure.