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Operations and Catheterizations

Cardiac catheterization – invasive procedure, which is made for treatment and diagnostic in cardiovascular system diseases. Procedure is executed by doctor- cardiologist, specialized on vessels and heart diseases treatment.
In procedure execution a cardiologist administers a thin flexible pipe (catheter) through one of arteries on hand, neck or in inguen. Then catheter under control of X-rays (fluoroscopy) is traced along blood flow and achieves a heart. With the help of contrast agents insert, the cardiologist receives image of blood vessels (angiogram), and the examination process is called: heart angiography.

What is the aim of cardiac catheterization execution?

Heart angiography — cardiac catheterization, executed with the aim of cardiac disease diagnosis. Cardiac catheterization also can be executed for treatment- for removal of existing abnormality, confirmed earlier.
In the process of diagnostic cardiac catheterization the cardiologist has a possibility to:
• Determine localization of block or arctation of blood vessels, i.e. in other words, to diagnose the reason of pain in chest. The heart angiography is executed particularly for this aim
• Measure the oxygen concentration of intracardiac blood (circulatory dynamics status assessment)
• Measure intracardiac pressure of blood
• Take for the following analysis the heart tissues samples (biopsy)
• Diagnose presence of congenital abnormality of heart development (defect)
• Assess conditions of cardiac valves
If a cardiac catheterization is executed with the aim of cardiac disease treatment, the following actions may be implemented:
• Angioplasty with/without stent implantation. During the angioplasty procedure an insufflation bulb is temporary inserted into coronary vessels. In place of vessel blocking air is moved into the bulb, and the bulb is expanded in volume and moves apart the arterial walls. Usually angioplasty is executed together with installation of metallic spring –stent. Stent supports walls of earlier blocked artery in open condition and prevents secondary arctation of artery opening (re-stricture formation).
• Closing of openings in heart walls. Some congenital heart diseases, for example openings, may be treated during catheterization procedure without open heart operation.
• Plasty or cardiac valve replacement. Cardiac catheterization is applied for plasty or replacement of cardiac valves. Such treatment is put for patients with arctation of valve’s opening or valve leaflets closing non-tight and passes blood inversely. Sometimes, earlier implanted valve’s prosthesis if its leaks were revealed.
• Bulb valvuloplasty. A procedure consists of expanding of narrowed opening of the heart valves using of insufflation bulb. The bulb is placed at the end of catheter, which is traced to stenotic valve. The bulb is inflated and expands the valve’s opening.
• Treatment of heart rhythm disorder (ablation). Ablation- cauterization of cardiac muscle, a swordcut is formed as a result. The swordcut present change the route of electrical pulse distribution in the muscle, inducing its contraction. Ablation procedure may be executed by high-frequency waves (radiofrequency ablation), by laser or by liquid nitrogen, i.y. by freezing (cryoablation). Influence in made through catheter, traced to abnormal tissue section in heart, inducing rhythm disorder. The targeted section causing an arrhythmia is destroyed by one the abovementioned methods.
• Removal of thrombus (thrombectomy). During this procedure a doctor brings catheter to a blood vessel, blocking by thrombus. By using of special tools, connecting to catheter, the thrombus will be removed.

Cardiac catheterization procedure
Procedure is executed in specially equipped room of cardiac catheterization with X-ray apparatus and different video devices which are usually absent in standard treatment rooms.
After procedure
• Rehabilitation process after cardiac catheterization usually takes several hours. Upon finishing of the procedure you will be carried to special room on wheelbarrow where you will stay until anxiolytic effect ending (about an hour).Canula, fixed in place of catheter insertion (on neck, in inguen or on hand) is removed immediately after procedure completion, except cases when you need to continue reception of drugs, thinning the blood.
• Then you will be carried to ward or short-term hospitalization unit. After catheter and canula removal, a compressing bandage will be applied for prevention of blood escape from artery in which the catheter was inserted. A bed rest will be prescribed for you in order to recover the artery wall. The bed rest can take from 1 to 6 hours.
• Eating and drinking are permitted after cardiac catheterization. Hospitalization period depends on your health conditions. In some cases a patient is dismissed in the evening of the procedure day. Possibly, you will be needed to stay in hospital until next day. Longer staying in hospital is necessary in case of more serious procedures execution during cardiac catheterization: angioplasty and stent implantation.

Heart angiography- results
• If cardiac catheterization was executed for diagnosis (heart angiography), a doctor will tell you about received results. Possibly, you will be recommended a surgical operation or other treatment of diagnosed cardiac disease on its basis.
• Heart vessels angiography allows to cardiologist to make a decision on the basis of collected data on necessity of angioplasty, stent implantation or large operation on open heart, which is called coronary artery bypass surgery. Often the cardiac catheterization result conclusively gives evidences for angioplasty execution. In such cases a doctor executes an immediate angioplasty (together or without stent implantation), and you won’t be needed to held repeated catheterization. Your doctor shall discuss such possibility with you before starting.