What is a cardiac catheter?
For the treatment of heart diseases, especially deposits in the coronary vessels, a cardiac catheter intervention is often performed. This is a system of thin and flexible tubes that can be inserted into the heart via large blood vessels. This is possible because all the blood vessels are interconnected. It is a minimally invasive procedure.
For severe narrowing or plaque formation, a flexible wire can be inserted into the catheter to act as a guide. Various treatment methods can be carried out along this wire.
Cardiac catheterisation steps
The cardiac catheter requires an access site in the groin or arm. This is where the catheter is inserted and advanced. The patient remains awake throughout the entire treatment. Before starting, the incision site is shaved and local anaesthesia is applied. Throughout the treatment, the heart function is monitored via ECG so that the smallest changes in heart activity can be detected immediately.
During the procedure, the attending doctor can follow the position of the catheter via X-ray images and thus place it precisely in the diseased coronary vessel. In addition, the doctor can see the extent to which deposits have narrowed the coronary vessel and whether further treatment is necessary. A cardiac catheterisation procedure is therefore a very precise procedure.
Is a cardiac catheter painful?
Advancing the catheter to the heart is painless. Your doctor will explain to you exactly when you are allowed to eat and drink for the last time before the intervention, and what medication you should take in preparation for it. If you are allergic to certain drugs, be sure to tell your doctor.
Diagnostic workup: Examination with the cardiac catheter
As described, a cardiac catheterisation procedure can provide an accurate picture of the condition of the coronary arteries. Deposits become visible on the X-ray image following administration of a contrast medium. Contrast medium appears black on X-ray images and thus contrasts with the different shades of grey of the heart and blood vessels. In this way, any narrowing or anatomical peculiarities can be made directly visible.
In addition, special sensors can be used to measure different values directly on the heart. The attending doctor uses all of these methods to decide whether treatment is necessary.
What treatments can be performed using a cardiac catheter?
The narrowed coronary vessel can be widened, for example, using a balloon catheter. For this purpose, a deflated balloon of a few millimetres in size is fed into the narrowed area and inflated to a predetermined pressure under X-ray monitoring. The vessel becomes dilated and blood flow is improved. This procedure is an option for angioplasty, i.e. the reshaping of vessels.
For a brief moment, however, the local blood supply is completely interrupted by the inflated balloon. This procedure is therefore often unsuitable for high-risk patients, as part of the heart muscle is not sufficiently supplied with oxygen during this time.
If the narrowing is severe, a small cannula made of metal mesh can be inserted into the narrowed vessel. This is a wire mesh that is unfolded at the desired site with the help of the balloon and ensures that the coronary vessel remains open in the long-term.
How safe is a cardiac catheterisation procedure?
A cardiac catheterisation procedure is very safe. The radiation exposure from the X-rays is also minimal. Nevertheless, complications can occur, such as bleeding at the puncture site in the groin or arm, allergic reactions or inflammation at the access site. To prevent this, a pressure bandage is applied to the puncture site for several hours after the treatment. During this time, patients must not move around too much. Other possible undesirable effects, such as cardiac arrhythmias or allergic reactions, are usually temporary. The stay in hospital is kept to a maximum of a few days, provided that no complications occur. High-risk patients may not be able to have a cardiac catheterisation procedure because their heart is too weak. Newer technologies, such as Impella, support the weakened heart and ensure that some of these patients can also be treated.