Cardiac Catheterization / Coronary Angiography
Cardiac catheterization is an invasive technique used to evaluate for blockages of the coronary arteries. Valve function and heart function can also be assessed using this technique. The procedure involves passing a small hollow tube through an artery in the leg or wrist to the heart where a dye is injected and xray pictures are taken. This allows for very accurate assessment of any blockages that may be present.
The procedure generally takes 20-30 minutes and is often performed as an oupatient. Light sedation and a local anesthetic are usually administered for patient comfort. Risks are generally small, although serious complications occur in approximately 1 out of 1000 patients.
Please notify your physician of any previous allergic reactions to iodine containing contrast as this is used during the procedure.
Coronary Stent Placement / Balloon Angioplasty
Blockages found at the time of cardiac catheterization can frequently be treated using less invasive methods such as coronary stenting. Once a blockage is identified, a balloon is used to stretch open the narrowed artery. A stent (a tiny metal tube used to scaffold the artery) is frequently implanted following balloon angioplasty to keep the artery from collapsing.
Two basic types of stents are used, bare metal and drug-coated. Drug-coated stents are often preferred as they are 50% less likely to re-narrow. Drug-coated stents require you to take a special blood thinner (Plavix or Effient) for at least a year following the procedure to make sure that no blood clots form inside the stent.
Other techniques such as rotablation (a high speed diamond tipped drill) are also used to remove plaque from coronary arteries. Patients are generally hospitalized overnight following a stent procedure. Complications such as vessel perforation or tearing are rare (1 out of 500) in which case an emergency open heart surgery may be required.
Please notify your physician if you have an allergy to aspirin or Plavix, or are prone to excessive bleeding when taking blood thinners.