Cardiac Catheterization

Cardiac catheterization is a minimally invasive procedure used to diagnose and treat heart conditions. During the procedure, a catheter (a long, thin tube) is inserted into a blood vessel in the arm, groin or neck, and guided to either the right or left side of the heart. When the catheter reaches the heart, it can be used to perform a number of diagnostic tasks and, in the case of left heart catheterization, repairs.

Left Heart Cardiac Catheterization

During left heart catheterization, a catheter is inserted into an artery in the left side of the heart in order to take real-time images of the heart and coronary arteries.

Reasons for Left Heart Cardiac Catheterization

This procedure is performed to diagnose and evaluate a number of conditions, including heart function, valve disease, heart tumors, an congenital heart defects. Certain repairs, such as opening a constricted heart valve or repairing a particular congenital defect, may also be possible.

When performed in conjunction with coronary angiography, this procedure may also be used to open blocked arteries, collect blood samples from within the heart, and perform bypass grafts.

The Left Heart Cardiac Catheterization Procedure

During this procedure, which takes place in a hospital, the patient is sedated, but remains able to cooperate with instructions. Local anesthesia is administered at the incision site, usually in an artery of the groin. The catheter is then threaded through the incision into the aortic valve and into the left side of the heart. Contrast dye is injected to provide the surgeon with clearer visualization.

Left heart catheterization can last from less than an hour to several hours. While not considered painful, it may cause some discomfort, usually in the form of pressure.

Diagnoses Obtained Through Left Heart Cardiac Catheterization

Since the test is performed to assess the heart's size, thickness, contraction and pressure, and the condition of the heart's arteries, left heart catheterization helps to diagnose the following:

  • Aortic insufficiency or stenosis
  • Coronary artery disease
  • Enlargement of the heart
  • Valve disease
  • Mitral stenosis or regurgitation
  • Ventricular aneurysms

Risks of Left Heart Cardiac Catheterization

Although usually a safe procedure, as with any surgical intervention, cardiac catheterization carries some risks. Complications rarely occur, but include heart attack, arrhythmia, tamponade, embolism, infection, stroke and adverse reaction to contrast dye.

Left heart catheterization, in spite of its risks, can be a necessary and even lifesaving procedure.

Right Heart Cardiac Catheterization

Right heart catheterization, also known as Swan-Ganz catheterization, is most frequently performed on very ill patients in the intensive care unit (ICU) of a hospital.

Reasons for Right Heart Cardiac Catheterization

This procedure is performed to detect and evaluate any abnormal blood flow between the chambers of the heart. It is used to diagnose conditions that include the following:

  • Congenital heart disease
  • Valve disease
  • Shock
  • Heart failure
  • Kidney disease
  • Cardiac tamponade
  • Pulmonary hypertension
  • Cardiomyopathy
  • Abnormal blood pressure within the heart

Right heart cardiac catheterization may also be performed on heart-attack patients to monitor the extent of damage, and the effectiveness of prescribed medications.

Diagnoses Obtained Through Right Heart Cardiac Catheterization

Abnormal results of Swan-Ganz catheterization can indicate blood-flow problems, valve disease, structural problems in the heart itself and serious lung disease.

The Right Heart Cardiac Catheterization Procedure

Like the left heart cardiac procedure, this catheterization takes place under sedation and local anesthesia so that the patient remains able to respond to instructions. The patient may experience some uncomfortable pressure during the process. For extremely ill patients, the catheter may have to remain in place for several days.

The catheter is inserted into a vein, rather than an artery as in the left heart procedure. X-ray images help the surgeon to guide the tube into the right atria (upper chamber) of the patient's heart. The patient is monitored throughout the procedure with an electrocardiogram (EKG).

Risks of Right Heart Cardiac Catheterization

The most common risks of this procedure are injury to the affected vein, or accidental puncture of the lung, which may result in pneumothorax (lung collapse). Very rarely, an infection or embolism occurs, or the patient suffers cardiac tamponade or serious arrhythmia.

Though similar, left and right heart cardiac catheterization differ somewhat in purpose and technique. The cardiologist determines which version of the catheterization is appropriate.

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