Cardiac Catheterization
(Coronary Angiography)

This is a test in which a small catheter [hollow tube] is guided through a vein or artery into the heart. An iodine containing compound is given through the catheter and moving x-ray pictures are made as the dye travels through the heart and its chambers or other arteries. The test detects narrowing of the arteries, abnormalities and functions of certain valves, and the pumping ability of the heart. The test can be done on an out patient basis and sedation is given through an intravenous line. The procedure is done under local anesthesia in a room called the cardiac cath lab. The patient is typically alert but sedated during the procedure so he or she can talk to the doctor. A sheath or short tube is placed typically in the groin but occasionally in the arm. The sheath will provide an access port to advance other equipment to the heart and blood vessels.

Typically the test takes from 30 to 60 minutes. The sheath and catheters are removed and the patient is usually able to ambulate in 4 to 6 hours. If a closure device is used, ambulation can be done as early as one hour after the procedure.

At the time of discharge, instructions are given regarding groin care and activities. Typically patients are able to resume their normal activities in 2 to 3 days.

Angioplasty

Atherosclerosis is an entity that produces discreet or scattered areas of blockage within an artery. If the blockage is significant enough, blood supply is reduced to the heart muscle, and symptoms can occur. In the coronary circulation, symptoms include chest pressure or shortness of breath. In the carotid circulation, symptoms include weakness, double vision, difficulty with speech, and leg pain. Blockages in the kidney arteries can result in uncontrolled high blood pressure and decreased kidney function.

Angioplasty is the procedure by which blockages from atheriosclerosis are treated. The procedure was first introduced to the world by Dr. Andreas Gruentzig in the mid ‘70’s. The first patient treated by Dr. Gruentizig underwent angioplasty on September l6, l977. Twenty three years later an arteriogram showed that the artery was still widely open.

Angioplasty is, therefore, a technique used to dilate an area of arterial blockage with the help of a catheter that has an inflatable small sausage-shaped balloon at its tip. The procedure is very similar to an arteriogram except that in addition to obtaining an intervention is performed. Once a blockage has been identified, the blockage is crossed with a flexible wire over which a balloon catheter is advanced. The balloon catheter is simply a long pliable soft plastic tube advanced through a larger catheter. At the tip of the plastic tube a balloon of variable length and size  can be inflated to different pressures in areas of arterial narrowing. Dye is used to measure the efficacy of the test.

A balloon-like device is inflated to open a passage in the artery.