heart and blood vessel disorders
Cardiac Catheterization and Coronary Angiography
Cardiac Catheterization
Cardiac catheterization is used extensively for the diagnosis and treatment of various heart disorders. Cardiac catheterization can be used to measure how much blood the heart pumps out per minute (cardiac output), to detect Overview of Heart Defects , and to detect and biopsy This procedure is the only way to measure directly the pressure of blood in each chamber of the heart and in the major blood vessels going from the heart to the lungs. In cardiac catheterization, a thin catheter (a small, flexible, hollow plastic tube) is inserted into an artery or vein in the neck, arm, or groin/upper thigh through a puncture made with a needle. A local anesthetic is given to numb the insertion site. The catheter is then threaded through the major blood vessels and into the chambers of the heart and/or into the coronary arteries. The procedure is done in the hospital and takes 40 to 60 minutes. Various small instruments can be advanced through the tube to the tip of the catheter. They include instruments to measure the pressure of blood in each heart chamber and in blood vessels connected to the heart, to view or take ultrasound images of the interior of blood vessels, to take blood samples from different parts of the heart, or to remove a tissue sample from inside the heart for examination under a microscope (biopsy). Common procedures done through the catheter include the following: Coronary Angiography : Ventriculography:Ventriculography is a type of angiography in which x-rays are taken as a radiopaque contrast agent is injected through a catheter into the left or right ventricle of the heart. With this procedure, doctors can see the motion of the left or right ventricle and can thus evaluate the pumping ability of the heart. Based on the heart's pumping ability, doctors can calculate the ejection fraction (the percentage of blood pumped out by the left ventricle with each heartbeat). Evaluation of the heart's pumping helps determine how much of the heart has been damaged. Percutaneous Coronary Intervention : Repairing or replacing a heart valve : Repairing or replacing a heart valve : If an artery is used for catheter insertion, the puncture site must be steadily compressed for 10 to 20 minutes after all the instruments are removed. Compression prevents bleeding and bruise formation. However, bleeding occasionally occurs at the puncture site, leaving a large bruise that can persist for weeks but that almost always goes away on its own. Alternatively, suture devices may be used to close the hole in the artery from the catheter. Because inserting a catheter into the heart may cause Overview of Abnormal Heart Rhythms , the heart is monitored with Cardiac catheterization may be done on the right or left side of the heart. Catheterization of the right side of the heart is done to obtain information about the heart chambers on the right side (right atrium and right ventricle) and the tricuspid valve (located between these two chambers) and evaluate the amount of blood the heart is pumping. The right atrium receives oxygen-depleted blood from the veins of the body, and the right ventricle pumps the blood into the lungs, where blood takes up oxygen and drops off carbon dioxide. In this procedure, the catheter is inserted into a vein, usually in the neck, arm, or the groin. Right-side catheterization is used to detect and quantify heart function and abnormal connections between the right and left sides of the heart. Doctors also use right-side catheterization when evaluating people for Heart Transplantation or placing a mechanical device to help pump blood or for diagnosing and treating Pulmonary Artery Catheterization , in which a balloon at the catheter's tip is passed through the right atrium and ventricle and lodged in the pulmonary artery (which connects the right ventricle to the lungs), is sometimes done during catheterization of the right side of the heart during certain major operations and in intensive care units. Catheterization of the left side of the heart is done to obtain information about the heart chambers on the left side (left atrium and left ventricle), the mitral valve (located between the left atrium and left ventricle), and the aortic valve (located between the left ventricle and the aorta). The left atrium receives oxygen-rich blood from the lungs, and the left ventricle pumps that blood to the body. This procedure is usually combined with coronary angiography to obtain information about the coronary arteries. For catheterization of the left side of the heart, the catheter is inserted into an artery, usually in an arm (near the elbow or wrist), neck, or the groin, and passed from that artery into the aorta, the large artery that carries blood from the heart. 