What is a cardiac catheterization?
A cardiac catheterization is an invasive procedure that is used to evaluate your heart. The procedure is done in the Cardiac Catheterization Laboratory by a doctor specially trained in cardiovascular invasive procedures and a team of cardiology fellows, nurses and technicians.
The information gathered from the catheterization can be used to make a decision about the best treatment for you, such as a stent, cardiac surgery or other treatment option. A catheterization is used to find out:
- If you have coronary artery disease that affects blood flow to your heart muscle.
- If you have valve disease.
- How well your heart muscle is working and if there is fluid build-up.
How is a catheterization done?
Before the catheterization
- You will get medication to make you sleepy, but you will not be asleep for the procedure.
- The catheter will be inserted through a small incision in your leg, arm, wrist or neck, depending on the type of evaluation you need. The area will be numbed before the incision is made.
During the catheterization
- The catheter is guided through the blood vessel to the coronary arteries, heart and/or lungs. A special X-ray machine helps the doctor see the catheter.
- A dye (contrast material) is sent through the catheter, and the X-ray machine captures video and pictures as the dye moves through the chambers of your heart (atria and ventricles), heart valves and major blood vessels. These images show any narrow or blocked areas in your coronary arteries. This part of the procedure is called a coronary angiogram/angiography.
- The catheterization itself takes about 30 minutes. Interventions can add time to the procedure. Please plan to stay at Cleveland Clinic the entire day.
IVUS and FFR
Your doctor may also use intravascular ultrasound (IVUS), instant wave-free ratio (IFR) or fractional flow reserve (FFR) to get more detailed images of the walls of your blood vessels. These procedures are only available in specialized hospitals and research centers.
IVUS
A tiny ultrasound probe (transducer) is placed on the tip of the catheter. As the catheter moves through your coronary arteries, high-frequency sound waves create detailed images of the inside walls of the arteries. These images show the location and amount of plaque in the arteries. Plaque is a sticky substance that builds up inside the arteries and causes coronary artery disease.
IFR/FFR
A special wire is threaded through your coronary artery. During FFR, medication may be used to expand the artery so the blood pressure in the artery can be measured. Medication is not used to take the measurements during IFR.
What happens after the procedure?
You will get information about your recovery, including restrictions, problems to look for and medications you need to take after your procedure. Please review this information before you leave the hospital and let your doctor or nurse know if you have any questions or concerns.
What are the risks of catheterization?
Your cardiologist will talk to you about the risks and benefits of catheterization before you give your consent to have the procedure. Some of the possible risks include:
- Allergic reaction to the medication or contrast material used during the procedure.
- Irregular heart rhythm.
- Infection.
- Bleeding at the catheter insertion site.
- Continued chest pain or angina.
- Mild-to-moderate skin reactions (like a sunburn) from X-ray exposure.
- Kidney failure.
- Heart attack, blood clots, stroke or death.
- Acute closure of coronary artery.
- Emergency coronary artery bypass graft (CABG) surgery.
Please make sure you understand the risks and benefits and share your questions and concerns with your doctor.
