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During cardiac catheterization, a catheter is inserted into a blood vessel and gently guided toward your heart. This testing can be done for your doctor to determine whether you have coronary artery disease.

During the procedure, a local anesthetic is injected where the catheter will be inserted.  The anesthetic numbs the site so you will not feel pain.  You will be awake during the procedure.  A sheath (short tube) is put into the blood vessel at the insertion site.   The sheath may be inserted into the artery in your arm, wrist, or groin. The right groin is the most common site for sheath insertion at Medical Center Hospital. You may feel a little pressure, but this feeling should pass.  The catheter is inserted to your heart and an x-ray video screen shows the catheter’s progress.  You should feel no pain as the catheter moves through the blood vessel to your heart.  X-ray contrast fluid is injected through the catheter. This allows your doctor to see the artery on an angiogram (x-ray picture).  During the injection, you may be asked to hold your breath.  The fluid may cause a hot flush over your body for about 10 seconds. After the injection, you may be asked to cough.

Diagnostic heart catheterization is done first. If the doctor finds a stenosis or narrowing of the coronary artery during heart cath, the patient may undergo a balloon angioplasty or PTCA. The purpose of the PTCA is to improve blood flow to the heart and/or replace heart surgery.  These procedures in some cases may replace heart surgery and promise good results.

Balloon Angioplasty (PTCA)

Arterial sheaths are inserted in the femoral artery or arm similar to a heart catheterization. A pre-shaped guiding catheter is inserted through the arterial sheath and put into the diagnosed narrowed or blocked artery.  A guide wire is then inserted through the guiding catheter and moved to and beyond the narrowing or block in the artery. Next, a balloon tipped catheter is inserted and is threaded over the guide wire until it reaches the narrowed or blocked area.   The angioplasty balloon is inflated.  This compresses the plaque against the artery wall. The patient may feel a little chest discomfort when the balloon is inflated.   If the patient does feel chest discomfort, the doctor is at tableside to respond immediately.  The balloon is deflated after a short period of time (usually 15 – 60 seconds).

Coronary Stent

If the balloon does not correct the problem, the doctor may decide to place a stent at the narrowed area that was expanded. A stent is a small metal coil or mesh tube. This stent helps prevent the artery from narrowing again. The stent is mounted on a balloon-tipped catheter. The stent on a deflated balloon is placed in the narrowed area. The balloon is inflated to open (deploy) the stent.

After the stent procedure is complete, an angiogram is done to check the results and blood flow of the artery. If the doctor is satisfied with the results, all catheters and the guide wires are removed. The stent stays in place. It helps prevent the artery from narrowing again (restenosis).

Rotablation

Rotablator is a PTCA procedure that is used when a stent does restenose. A small football shaped tip catheter is placed at the narrowing and rotated at high speeds to remove or dissolve plaque within the artery.