Cardiac catheterization
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Aortography
Coronary angiography
Left ventriculography
Right ventriculography
Cardiac catheterization (heart cath) is the insertion of a catheter into a chamber or vessel of the heart. This is done for both investigational and interventional purposes. Coronary catheterization is a subset of this technique, involving the catheterization of the coronary arteries.
A small puncture is made in a vessel in the groin, the inner bend of the elbow, or neck area (the femoral vessels or the carotid/jugular vessels), then a guidewire is inserted into the incision and threaded through the vessel into the area of the heart that requires treatment, visualized by fluoroscopy or echocardiogram, and a catheter is then threaded over the guidewire. If X-ray fluoroscopy is used, a radiocontrast agent will be administered to the patient during the procedure. When the necessary procedures are complete, the catheter is removed. Firm pressure is applied to the site to prevent bleeding. This may be done by hand or with a mechanical device. Other closure techniques include an internal suture. If the femoral artery was used, the patient will probably be asked to lie flat for several hours to prevent bleeding or the development of a hematoma. Cardiac interventions such as the insertion of a stent prolong both the procedure itself as well as the post-catheterization time spent in allowing the wound to clot.
A cardiac catheterization is a general term for a group of procedures that are performed using this method, such as coronary angiography. Once the catheter is in place, it can be used to perform a number of procedures including angioplasty, angiography, and balloon septostomy.
History
The history of cardiac catheterization dates back to Claude Bernard (1813-1878), who used it on animal models. Clinical application of cardiac catheterization begins with Werner Forssmann in the 1930s, who inserted a catheter into the vein of his own forearm, guided it fluoroscopically into his right atrium, and took an X-ray picture of it. Forssmann won the Nobel Prize for this achievement. During World War II, André Frédéric Cournand and his colleagues developed techniques for left and right heart catheterization.
Indications for investigational use
This technique has several goals:
- confirm the presence of a suspected heart ailment
- quantify the severity of the disease and its effect on the heart
- seek out the cause of a symptom such as shortness of breath or signs of cardiac insufficiency
- make a patient assessment prior to heart surgery
Investigative techniques used with cardiac catheterization
A probe that is opaque to X-rays is inserted into the left or right chambers of the heart for the following reasons:
- to measure intracardiac and intravascular blood pressures
- to take tissue samples for biopsy
- to inject various agents for measuring blood flow in the heart; also to detect and quantify the presence of an intracardiac shunt
- to inject contrast agents in order to study the shape of the heart vessels and chambers and how they change as the heart beats
External links
- eMedicine: Cardiac Catheterization (Left Heart)
- MedlinePlus Medical Encyclopedia: Cardiac catheterization
- Cardiac Catherization by Florida Institute of Cardiovascular Care
de:Herzkatheteruntersuchungfr:Cathétérisme cardiaque he:צנתור לב nn:Hjartekateterisering
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
