Cardiac catheterization: Difference between revisions

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==Overview==
==[[Cardiac catheterization overview|Overview]]==
 
==[[Cardiac catheterization historical perspective|Historical Perspective]]==
 
==[[Cardiac catheterization indications|Indications]]==
 
==[[Cardiac catheterization safety|Safety]]==


==[[Aortography]]==
==[[Aortography]]==
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==[[Coronary angiography]]==
==[[Coronary angiography]]==


==[[Left heart catheterization]]
==[[Left heart catheterization]]==


==[[Left ventriculography]]==
==[[Left ventriculography]]==


==[[Right heart catheterization]]
==[[Right heart catheterization]]==


==[[Right ventriculography]]==
==[[Right ventriculography]]==
'''Cardiac catheterization''' ('''heart cath''') is the insertion of a [[catheter]] into a [[heart chamber|chamber]] or [[Blood vessel|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==
{{main|History of invasive and interventional cardiology}}
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 disease|heart ailment]]
*quantify the severity of the disease and its effect on the heart
*seek out the cause of a symptom such as [[Dypsnea|shortness of breath]] or signs of [[Congestive heart failure|cardiac insufficiency]]
*make a patient assessment prior to [[Cardiac surgery|heart surgery]]
==Investigative techniques used with cardiac catheterization==
A probe that is opaque to [[X-ray]]s is inserted into the left or right chambers of the heart for the following reasons:
*to measure intracardiac and [[Circulatory system|intravascular]] [[blood pressure]]s
*to take tissue samples for [[biopsy]]<!--in French, the article literally says "to take blood samples", but that seems like a a complicated method just to draw blood. Maybe I'm missing something here.-->
*to inject various agents for measuring blood flow in the heart; also to detect and quantify the presence of an intracardiac [[shunt (medical)|shunt]]
*to inject [[Radiocontrast|contrast agents]] in order to study the shape of the heart vessels and chambers and how they change as the heart beats<!--here I think I've clarified the original French text, which refers to "morphological and kinetic studies"-->


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Latest revision as of 06:38, 15 March 2016



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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

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Aortography

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Left heart catheterization

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