Cardiac Catheterization Suite
Cardiac Catheterization
A catheterization is usually prescribed for people suffering from symptoms of heart disease such as chest pain, abnormal ECG or stress test, heart failure or rhythm disturbances. The most likely cause of these problems is an interruption of blood flow to the heart muscle, usually due to a narrowing or blockage in one or more of the coronary arteries. A catheterization allows us to directly visualize these arteries by injecting dye into them and simultaneously filming them using a type of X-ray. The number of arteries affected, or the size or location of the blockage in the artery, will determine the appropriate treatment.
Angioplasty/Stenting
If the cardiac catheterization reveals a blockage in a coronary artery that the physician feels is amenable to an angioplasty or stent Stent
A small, self-expanding, mesh-like tube inserted into a blocked or narrowed artery to restore blood flow , it will usually be done at the same time. A coronary stent is a small, mesh-like metal tube that is mounted on an angioplasty balloon. It is inserted into the artery and positioned at the site of the blockage. When the balloon is inflated, the stent expands and is pressed into the inner wall of the artery. The balloon is then deflated and removed with the stent remaining in place. The stent acts as a “scaffold” that helps to hold the artery open, which improves blood flow and relieves symptoms caused by the blockage. Some of the stents used also have a drug coating that is slowly released into the surrounding tissue to prevent scar tissue formation and decrease the likelihood of the stent “closing up.” Our doctors will determine which type of stent is best for you.
IVUS (Intra-Vascular Ultrasound)
IVUS is a diagnostic tool that has proven to be extremely helpful when used in conjunction with angioplasty and stenting. It is similar to the sonogram that pregnant women undergo to visualize the fetus. IVUS uses sound waves to create an image within the coronary artery, allowing direct visualization of the blockage and surrounding area. This enables the doctor to determine the actual percentage of the artery that is blocked, which will determine if an angioplasty or stent actually needs to be performed. The physician can also utilize IVUS to measure the diameter of the artery as well as the length of the blockage so he or she can choose the appropriate stent size. Finally, IVUS can be used at the end of the procedure to make sure the stent is fully expanded.
Closure Devices
The first part of a cardiac catheterization involves inserting a small tube in the femoral artery in the groin. Through this tube the catheters used to perform the catheterization are passed. At the end of the procedure, this tube must be removed. In the old days, the tube was removed and a nurse or doctor would manually apply pressure at the puncture site for approximately 20 minutes. The patient would then have to lie flat for 6–8 hours, sometimes with a 10-lb. sandbag over the site. We now regularly use closure devices that seal the arterial puncture by actually suturing it closed or deploying a plug. This allows the patient to sit up immediately and to be discharged in two hours.
Radial Artery Access
In order to gain access to the arteries in the heart, a catheter is threaded through an artery or vein in the leg or arm. The transradial Transradial
Route or access of the radial artery in the wrist approach utilized in both diagnostic and interventional cardiac catheterization is widely recognized and performed at The Heart Institute. The radial artery is located in your wrist and is used as the port of entry for the catheter during the cardiac catheterization procedure. With the radial artery approach, bleeding can be easily stopped, there is little discomfort, fewer vascular complications and earlier ambulation. Evaluation and testing are necessary to determine if patients are candidates for this approach. Although this can be beneficial for some patients, it may be contraindicated for others. A cardiologist will determine if this approach is right for you.
