Cardiac catheterization

Cardiac catheterization is one of the most common diagnostic and therapeutic procedures for various heart diseases; also it is a quick procedure and includes few side effects in most cases. This type of surgeries is performed by a cardiovascular/ cardiac surgeon, who inserts a very thin, hollow tube through the blood vessels, located either in the neck, arm or groin area (upper thigh) and then withdraws to reach the heartarteries.

The cardiac surgeon may decide cardiac catheterization because of the following reasons:

Diagnostic purposes:

• Check the efficiency of the valves and detect any defects in any of them.
• Detection of any congenital malformations of the heart.
• Detection of arterial blockage which is often causes chest pain.
• Evaluating blood circulation by checking oxygen levels and measuring blood pressure inside the heart.
• Check the efficiency of the heart muscle in pumping blood through the arteries.
• Taking a biopsy of heart tissue for laboratory testing.
• Measuring the internal volume of arteries by using ultrasound.

Therapeutic purposes (interventional heart catheterization):

• Angioplasty in order to expand it and improve blood flow through it.
• Installation of cardiac stents to keep the arteries opens for bloodstream.
• Close the holes in the heart or repair deformities that may exist.
• Repair and replace heart valves.
• Open closed valves by inserting a balloon into the catheter.
• Repairing some of the heart muscle malfunctions, includes high myocardium thickness, by injecting the heart muscle with alcohol, which leads to shrinkage.
• Treatment of arrhythmias.

Cardiac catheterization is not considered a serious procedure, and it is considered a safe one which does not include significant complications, but in some rare cases it may have some side effects; such as:

• A bruise and infection on the skin at the site of catheter insertion.
• Feeling unwell and uncomfortable in the stomach and itching sometimes because of the dye used to facilitate clear vision to the surgeon.
• Tearing of some of the heart and arterial tissue.
• Irregular heartbeat.
• Bleeding.
• Decrease blood pressure.
• Blood clots, which may trigger heart attacks or strokes.
• Kidney dysfunction caused by the use of radioactive material.

Cardiac catheterization includes three main stages, as following:

• Patient preparation:

The cardiovascular surgeon usually advises the patient of some pre-cardiac catheterization instructions, requiring the patient to refrain from eating and drinking for approximately 6 to 8 hours prior to the procedure, and to stop the use of blood thinners such as warfarin or non-steroidal anti-inflammatory drugs such as ibuprofen and others.

• During the surgery:

1. Anesthetize the area from the arm or thigh and insert a catheter (very thin tube) into the artery.
2. The catheter is thread through the arteries until it reaches the heart.
3. The cardiovascular surgeon monitors the patient's heartbeat during the catheterization process by connecting it to the special device.
4. Perform the necessary examination or treatment according to the patient's condition.
5. Remove the catheter.

The heart catheterization process takes less than an hour and is performed in an operating room equipped with an x-ray device so that the surgeon can monitor the catheter in the heart and arteries.

• After the surgery:

Closing the incision from which the catheter was inserted by pressing it with cotton to avoid bleeding. Cardiovascular surgeons often prefer to keep the patient in hospital for monitoring, most patients can leave the hospital on the same day after cardiac catheterization, but in some cases that requiring treatment with more surgical procedures they remain longer in hospital until treatment is completed.

As with most surgical procedures, a patient's recovery after the operation and a return to normal activities requires a series of tips that may help him to return to his former life faster, and these tips depend on the purpose of the cardiac catheterization if it is diagnostic or therapeutic. However, the common advice in most cardiac catheterization surgeries is to rest in the days following the procedure to avoid any symptoms or complications.