Know Cardiac Catherization Process by Expert Dr Ajit Menon

Interventional cardiology is a subspecialty of cardiology that focuses on the catheter-based treatment of structural heart problems. Following the invention of angioplasty by interventional radiologist Charles Dotter, Andreas Gruentzig is regarded as the founder of interventional cardiology. Dr Ajit Menon is India’s foremost reputed interventional cardiologist, having vast and skilful experience in this industry. 

He is currently associated as a Visiting Consultant, Interventional Cardiologist at Global Hospital, Mumbai, Maharashtra. He has expertise in all types of cardiac catheterization. He specializes in indoor adult and pediatric cardiology patients, cardiac emergencies including acute myocardial infarction, post-cardiac surgery patients and echocardiography, to name a few.

Dr Menon had previously worked as a Consultant, Cardiology at Cumballa Hill Hospital And Heart Institute. He is an eminent member of prestigious organisations like the Indian College of Cardiology, Cardiological Society of India and European Society of Cardiology.

What exactly is cardiac catheterization?

• Cardiac catheterization (also known as cardiac cath or coronary angiography) is an invasive imaging technique that allows your doctor to assess the function of your heart. Cardiac catheterization is used to:
• assess or confirm the existence of coronary artery disease, valve disease, or aortic disease.
• Assess the function of the cardiac muscle.
• Determine whether additional therapy (such as an interventional procedure or coronary artery bypass graft, or CABG, surgery) is required.

A long, thin tube called a catheter is placed through a plastic introducer sheath during cardiac catheterization (a short, hollow tube that is inserted into a blood vessel in your leg or arm). Sophisticated x-ray equipment is used to guide the catheter through the blood vessel to the coronary arteries.

As the contrast material travels through the heart's chambers, valves, and main arteries, x-ray movies are generated. This portion of the operation is known as a coronary angiogram (or coronary angiography).

The narrowing or blockage of the coronary (heart) arteries is referred to as coronary artery disease. The coronary artery is opened following an interventional treatment, boosting blood flow to the heart.

The digital pictures of the contrast material are utilised to pinpoint the location of the coronary artery constriction or blockage.

In some circumstances, additional imaging techniques such as intravascular ultrasonography (IVUS) and fractional flow reserve (FFR) may be done in conjunction with cardiac catheterization to acquire comprehensive pictures of the blood artery walls. Both of these imaging techniques are now available exclusively in specialist hospitals and research facilities.

A small sound-probe (transducer) is placed on the tip of a coronary catheter during IVUS. The catheter is inserted through the coronary arteries and provides detailed pictures of the interior walls of the arteries using high-frequency sound waves. IVUS provides an accurate image of the plaque's position and extent.

A specific wire is inserted through the artery during FFR, and a vasodilator drug is administered. This test performs a very high-quality stress test on a small section of the artery.

What is the definition of an interventional procedure?

An interventional procedure (also known as angioplasty) is a non-surgical therapy that is used to widen constricted coronary arteries in order to increase blood flow to the heart. When a blockage is found during a diagnostic cardiac catheterization, an interventional procedure can be done, or it can be planned after a catheterization has verified the existence of coronary artery disease.

Balloon angioplasty, stent insertion, rotablation, and balloon cutting are examples of interventional procedures.

Will I be able to stay awake during the procedure?

Yes. You will be given a little sedative to help you rest, but you will remain awake and alert throughout the operation. The doctor will numb the catheter insertion site using a local anaesthetic.

Cardiac catheterization is not considered a surgical operation because no major incision is made to access the chest and the recovery period is significantly shorter than that of surgery. Depending on the outcome of the treatment, surgery may be recommended in some situations.

Where is the catheterization done, and who does it?

The Cardiac Catheterization Laboratory is where cardiac catheterizations are conducted. A particularly trained cardiovascular invasive physician and a cardiovascular team of cardiology fellows, nurses, and technicians perform catheterizations.

How long will the process take?

The cardiac catheterization operation takes around 30 minutes, but the preparation and recuperation period adds several hours to your appointment time (five to nine hours or longer). Please plan on spending the entire day at Cleveland Clinic for the operation.

What are the potential hazards?

Your cardiologist will go through the procedure's particular dangers and possible advantages with you. The following are some of the potential hazards of cardiac catheterization:

• Response to the medicine or contrast material used during the operation that causes an allergic reaction
• Irregular heartbeat
• Infection
• Bruising at the site of catheter insertion
• Angina or persistent chest discomfort
• X-ray exposure causes mild to moderate skin responses (similar to a sunburn).
• Failure of the kidneys
• Heart attack, blood clots, stroke, or death are all possibilities.
• Acute coronary artery closure
• CABG (coronary artery bypass graft) surgery performed in an emergency

There might be other complications. Please seek information at your consultation with your physician to ensure that you understand why the surgery is being advised and what all of the possible hazards are.