Cardiac Catheterization

During a cardiac catheterization, doctors use a thin, flexible tube — called a catheter — to reach the left or right side of the heart. From there, your doctor collects blood samples and measures pressure, blood flow and oxygen levels inside your heart’s chambers. Your doctor may also use the catheter to inject dye into your coronary arteries and aorta, which can provide valuable information regarding heart artery blockages. Heart and vascular surgeons at Ohio State offer cardiac catheterizations, close to you in Columbus.

Conditions treated

Physicians use cardiac catheterization to diagnose and possibly treat heart conditions. Doctors can perform this procedure on an outpatient basis or even during emergency situations, such as after a heart attack.

What to expect during a cardiac catheterization

A cardiac catheterization (also called a cardiac cath or cath) requires the placement of a catheter into an artery or vein in your arm, leg, groin or neck. Physicians guide the catheter to the heart using a specialized camera called a fluoroscope. In addition to studying the blood flow of your heart, your doctor may perform other procedures during a cardiac catheterization: 

• Coronary angiogram – an X-ray procedure that identifies problems with coronary arteries 
• Coronary angioplasty – a procedure used to open blocked arteries

Preparing for your procedure

Your physician will provide fasting instructions before your cardiac catheterization procedure. Tell your technician about all the medicines you take, as well as any allergic reactions you’ve had to medication. Your cardiac catheterization test is performed in a hospital setting in a cath lab. You may need to stay overnight before or after your procedure, but in general, a cardiac catheterization is done on an outpatient basis.

During your procedure

During a cardiac catheterization, you’ll lie on a table and take a sedative to help you relax during the procedure. In addition, you’ll receive a local anesthetic at the site of the catheterization. You may feel some pressure but shouldn’t feel any pain during the procedure.

During the test, a large camera head will move around your chest, taking pictures of your heart arteries from different directions. In addition to a cardiologist, other technicians and nurses help administer this test. The length of time a cardiac cath takes depends on a variety of factors, including whether additional procedures are done:

• A cardiac angiogram requires that a contrast dye be administered through the catheter and into your heart before X-rays are taken. This portion of the test may give you a warm feeling throughout your body. 
• A cardiac angioplasty is when your doctor uses a balloon-like device to open a blocked artery. Your doctor then inserts a wire mesh tube, called a stent, into the artery to keep it open. 
• Your doctor may need to perform additional procedures prior to an angioplasty to confirm the degree of narrowing of your heart artery, including the coronary ultrasound procedure or artery flow measurements.

After your procedure

Depending on a variety of factors, you may need to stay overnight in the hospital after your cardiac catheterization procedure for close monitoring. Some patients can go home the same day. In addition, depending on your personal situation, your doctor may prescribe blood thinners for you after the procedure.

Upon discharge from the hospital, you’ll receive a complete set of instructions regarding the site of your catheterization. Depending on the results of your tests, your physician may recommend lifestyle changes to prevent any heart conditions from getting worse. These lifestyle changes may include eating a heart-healthy diet, getting regular exercise and quitting smoking. In most cases, you should take it easy for two days after you return home from the procedure.

Caring for your catheter insertion site

Your incision site may be in your femoral artery (groin area) or your radial artery (arm). When you go home from the hospital, this site will be covered with a bandage. Here are some tips for caring for the wound: 

• Take the bandage off the morning after you return home from the hospital. The easiest way to remove the tape may be in the shower, under warm running water. 
• After you’ve removed the bandage and patted the area dry with a clean cloth, cover the area with a small adhesive bandage (Band-Aid). You may notice some bruising, mild swelling and pink color around the skin at the wound site. This is normal. You may also notice a small, quarter-size lump at the wound site, which is also normal and will go away on its own with healing. 
• Once each day, use a washcloth to gently clean the wound site with water and antibacterial soap. Be gentle and don’t rub the wound. 
• In addition to daily washing and showering, keep the wound site clean and dry. 
• Don’t apply lotions, creams or ointments to the wound area. 
• Don’t wear tight-fitting clothing (including undergarments) over the wound area. 
• Avoid taking a bath, soaking in a tub or Jacuzzi, or swimming in a pool for at least one week after the cath.

Your medications

Your doctor will review your medications with you before you leave the hospital. Be aware that they may change after you’ve undergone the cath. Ask questions if you’re unclear about what to take, when you’ll take it or the dosage.

If you have diabetes, your doctor may adjust your diabetes medication for one or two days following your cath. Be sure to ask for specific directions about your diabetes medication.

Ask your doctor about when you can:

• Go back to work 
• Resume sexual activity 
• Start driving (usually within 24 hours after returning home)

Special instructions for femoral cardiac cath

• Avoid straining during bowel movements for the first three or four days after the procedure, as doing so could cause the cath insertion site to bleed 
• Avoid lifting anything over 10 pounds, or pushing or pulling heavy objects for a week after the procedure 
• Avoid participating in strenuous activities, sports or exercise for five days after the procedure (activities to avoid include jogging, golfing, playing tennis or bowling) 
• Take stairs slowly 
• Slowly increase your activity level after you go home, returning to your normal activity level one week after your cath

Special instructions for radial cardiac cath

• Avoid participating in strenuous activities, sports or exercise for two days after the procedure (activities to avoid include jogging, golfing, playing tennis or bowling) 
• Slowly increase your activity level after you go home, returning to your normal activity level two days after your cath

Why choose Ohio State for cardiac catheterization?

The Ohio State University Wexner Medical Center exceeds national standards regarding the “door to balloon time” (the time between arrival in the emergency department to treatment in the cath lab) for acute cardiac events. Our team of interventional cardiologists aren’t only dedicated to patient care, they’re also on the leading edge of both clinical and basic science research.

Ohio State Ross Heart Hospital performs more than 5,000 procedures a year, making it one of the highest volume centers in the area. Because we’ve done so many procedures, our staff is well equipped and very experienced in handling even the most difficult cases.

We’re putting our cath lab to good use and using it for more than just normal heart catheterizations. We’re developing monitoring methods and treatments for heart failure that can be performed in the cath lab. We’re researching stem cell treatments for heart attack.