Cardiac Catheterization, Here's What You Should Know

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Cardiac Catheterization, Here's What You Should Know
Cardiac Catheterization, Here's What You Should Know
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Cardiac catheterization is a procedure that aims to detect and treat various heart diseases using a catheter, which is a device resembling a long thin tube that is inserted into a blood vessel, then directed towards the heart

Heart catheterization is performed by a cardiologist. One of the most common types of cardiac catheterization is the examination of blood flow in the heart's blood vessels (coronary) or also known as coronary angiography.

Cardiac Catheterization, Here's What You Should Know - Alodokter

Aside from being an examination procedure, cardiac catheterization can also be performed to treat coronary and heart problems. This procedure can also be combined with several other examinations, such as X-rays, dye (contrast), and ultrasound.

Indications of Cardiac Catheterization

Catheterization of the heart can be done for the purposes of diagnosis and treatment of heart disease. Examples for diagnostic purposes are:

  • Checking for narrowing or blockage of coronary arteries (coronary heart disease) that causes chest pain
  • Take a sample of heart muscle tissue (biopsy) to look for cardiomyopathy or myocarditis
  • Checking for heart valve problems
  • Checking for a decrease in the ability of the heart chambers to pump blood, in a state of heart failure
  • Checking the pressure and oxygen levels in the heart, which is often problematic in conditions of pulmonary hypertension
  • Checking for congenital heart disease in babies

Meanwhile for treatment, cardiac catheterization is used for:

  • Perform angioplasty, which is the widening of blocked blood vessels using a balloon, with or without a stent (heart ring)
  • Improve abnormally thickened heart muscle in patients with hypertrophic obstructive cardiomyopathy
  • Repair heart valves or replace them with artificial valves
  • Closing the hole in the heart due to congenital heart defects
  • Treat arrhythmia with ablation

Cardiac Catheterization Alert

If the patient suffers from any of the following conditions, the patient may not be allowed or need special consideration to undergo cardiac catheterization:

  • Acute kidney failure
  • Blood clotting disorders
  • Stroke
  • Allergy to contrast agents
  • Active bleeding in the digestive tract
  • Arrhythmia in the chambers of the heart
  • Uncontrolled hypertension
  • severe anemia
  • Electrolyte disturbance
  • Congestive heart failure
  • Untreated fever or infection

Before planning cardiac catheterization, the doctor will perform a series of examinations to ensure that the patient is fit for this procedure. If any of the above conditions are found, the doctor may prioritize treating them first.

Patients who are pregnant, planning a pregnancy, or breastfeeding should inform their doctor of their condition before performing cardiac catheterization. This is because radiation exposure to cardiac catheterization is at risk of causing miscarriage.

Patients also need to tell their doctor if they are taking any medications, including herbal products and supplements. If possible, patients should bring the drug packaging to show the doctor, so that the information is clearer and more detailed.

Preparing for Cardiac Catheterization

Patients who will undergo cardiac catheterization will be asked to fast for 6-8 hours before the catheterization procedure is carried out. The goal is to reduce the risk of side effects from the anesthetic. Hair around the blood vessels where the catheter will be inserted will also be shaved

After cardiac catheterization, patients generally need to be hospitalized. Therefore, the patient must prepare for the need to stay at the hospital, as well as invite family or relatives who can pick up and accompany you while in the hospital.

Before cardiac catheterization is performed, the patient may also undergo several supporting examinations. The tests that are usually carried out are blood tests, examination of the heart record (ECG), or chest X-ray.

Cardiac Catheterization Procedure

The procedure for cardiac catheterization is carried out in a special room equipped with scanning devices. Before starting, the patient will be asked to remove all jewelry that might interfere with the procedure, such as necklaces.

Patients also need to change into hospital clothes that have been provided. After changing clothes, the patient will be asked to lie down on a special table where the procedure will be carried out.

Patients are expected to remain calm and relaxed. However, if needed, the doctor can give a sedative to make the patient feel relaxed during the procedure.

Patients will be put on an IV line to deliver drugs during the cardiac catheterization procedure. The patient will also have electrodes attached to the chest so that the doctor's heart condition can be monitored.

The location of the catheter insertion can be in the neck, arm, or leg. Before the catheter is inserted, the area will be given an anesthetic to numb it.

The anesthetic given is usually a local anesthetic, so the patient will remain conscious during the procedure. However, if needed, the patient can be given general anesthesia, especially for patients who will undergo heart valve repair or replacement.

To insert a catheter, the cardiologist will make a small incision in the skin as an entry point. Through the incision, the catheter is inserted into the artery with a special plastic wrap first.

After that, the catheter will be pushed and directed towards the heart. This process is not painful, but may make the patient feel uncomfortable or tense.

The next cardiac catheterization procedure can be different, according to the patient's needs. The following is an explanation of some of the actions in cardiac catheterization:

1. Coronary angiography

After the catheter reaches the heart, the doctor will perform a scan with X-rays to see if there is a blockage or narrowing of the coronary arteries. To make the resulting image clearer, the doctor can inject a dye (contrast).

2. Heart biopsy

This action is done by taking a sample of heart tissue and then observing it using a microscope. The catheter used for heart biopsy is equipped with special clamps to remove heart tissue.

This catheter is usually inserted through a vein near the neck or in the groin area. The patient will not feel anything when the heart tissue sample is taken.

3. Coronary Angioplasty

The purpose of this procedure is to widen the narrowed or blocked coronary vessels. The doctor will insert a catheter along with a special balloon that is still deflated into the narrowed or blocked coronary vessel.

Once the catheter is in place, the doctor will inflate the balloon, so that the blood vessels will dilate and blood flow will return to normal. To keep the dilated vessels from narrowing or becoming blocked again, the doctor may place a heart ring.

4. Balloon valvuloplasty

The purpose of this procedure is to repair a narrowed heart valve using a balloon. The procedure is similar to coronary angioplasty, but here the target is the heart valves.

In the process, a special balloon is attached to the catheter, which is then inserted through the blood vessels to the heart valves. Arriving at the heart valve, the balloon will be inflated, so that the heart valve will widen again.

If needed, narrowed or leaking heart valves will be fitted with an artificial heart valve through a heart valve replacement procedure.

5. Repair of congenital heart defects

The purpose of this procedure is to correct abnormalities due to congenital heart disease, such as holes in the septum between the chambers of the heart (patent foramen ovale). This procedure is different from other cardiac catheterization, because it will use 2 catheters that are inserted through the arteries and veins.

A special device will be attached to the catheter to correct heart defects. If the abnormality is a leaky heart valve, the doctor can install a special plug to stop the leak.

6. Heart tissue ablation

The purpose of this procedure is to treat arrhythmias caused by heart tissue abnormalities. Through the inserted catheter, the doctor will destroy abnormal tissue that causes irregular heart rhythms. This procedure usually requires more than one catheter.

7. Thrombectomy

This procedure is done to destroy blood clots that have the potential to block blood vessels or move to other organs, for example to the brain and cause a stroke.

In a thrombectomy, a catheter will be inserted into the vein until it reaches the location of the blood clot. Arriving at the location, the doctor will destroy the blood clot.

During the catheterization procedure, the doctor may ask the patient to hold his breath, take a deep breath, cough slightly, or shift the position of the hand to make the procedure easier. The whole process of cardiac catheterization generally takes less than 1 hour.

After the procedure is complete, the catheter will be removed from the vein. The incision where the catheter is inserted will be closed with thick sutures and bandages to prevent bleeding.

After Cardiac Catheterization

After cardiac catheterization, patients need to be hospitalized to help with recovery. The length of stay in the hospital depends on the type of cardiac catheterization procedure performed and the patient's overall condition.

Early after cardiac catheterization is done, the patient's movement needs to be limited, especially in the area where the catheter is inserted. Generally, new patients are allowed to move more freely after 6 hours.

To help the process of removing contrast substances from the body, patients are advised to drink more water. Patients are allowed to go home after making sure they can walk on their own without help from others.

After going home, the patient is still required to rest and not undergo strenuous activities for 2–5 days. This is done to prevent bleeding at the catheter insertion site.

If the patient undergoes cardiac catheterization for medical procedures, such as heart tissue ablation or angioplasty, the healing time may take longer. If the patient undergoes a heart tissue biopsy or angiography, the doctor will explain the results a few days after the examination is complete.

Risks of Cardiac Catheterization

Cardiac catheterization rarely causes complications. However, the risk of complications is greater in patients who are elderly, have diabetes, or have kidney disease. The following are some of the complications that can occur as a result of cardiac catheterization:

  • Heart tissue damage
  • Allergic reaction to the contrast agent or drugs used during the catheterization procedure
  • Formation of blood clots that can trigger heart attacks and strokes
  • Arrhythmia
  • Kidney damage due to the contrast material used
  • Low blood pressure
  • Damage to the artery where the catheter is inserted, or in the area where the catheter is passed
  • bruising, bleeding, or infection at the catheter insertion site
  • Low body temperature during catheterization, especially in children

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