Cardiac catheterization is an invasive procedure performed to evaluate coronary artery disease, valvular heart disease, congestive heart failure, and/or certain congenital heart conditions.
The procedure begins with a small hollow tube, known as catheter, which is advanced from a blood vessel in the groin or arm into the heart. The use of fluoroscopy (X-ray) assists the physician in locating any blockages in the coronary arteries. A catheter may also be placed to measure the pressures and flow of blood within various chambers of the heart and the lungs.
Depending on your condition and the results of the diagnostic catheterization, optimal treatment may be provided by utilizing a variety of interventional procedures that can be performed in the cardiac cath lab as well. These include balloon angioplasty, cardiac stent, laser, and arthrectomy which can be based on other techniques such as IVUS, FFR, and OCT as needed. These additional techniques are used to enhance the assessment of the coronary arteries.
Percutaneous Transluminal Coronary Angioplasty (PTCA) and Stent Placement
Percutaneous transluminal coronary angioplasty (PTCA) is performed if a coronary artery, a blood vessel that supplies the heart muscle blood, is significantly blocked or narrowed. A balloon catheter is advanced into the narrowed region and then inflated to widen the blocked areas where blood flow to the heart muscle has been slowed or interrupted. After widening the vessel, the balloon is then deflated and removed allowing for improved blood flow. Your physician may also decide to insert a device called a stent into the opened artery.
A stent is a tiny, expandable metal coil that acts like a tunnel support. It is inserted into the newly-opened area of the artery to help keep the artery from recoiling, narrowing or closing again. It will be necessary to take certain types of blood thinners after the insertion of the stent(s). In general, there are two different types of stents—medicated (coated) or non-medicated (non-coated). The type of stent that is best for you will be determined by your physician with consideration of your overall health.
An arthrectomy (rotoblator) removes hard plaque with the use of a “burr” which spins at a very high speed like a dentist’s drill to break up the hard plaque.
A laser procedure is similar to a balloon angioplasty but instead the device has a laser at the tip of the catheter. The lasers beam of light vaporizes the calcified plaque.