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WITH THE RIGHT
equipment and
training, a cardiologist can safely find
and fix many heart problems from the
inside—with no chest incision required.
One such method is cardiac catheter-
ization. It involves the use of a catheter—
a long, thin, flexible tube that’s inserted
into a blood vessel in the groin or arm.
From there, the catheter is carefully ad-
vanced to the heart, where it can be used
to do a number of tests and treatments.
Cardiac catheterization can help your
doctor determine if you’ve coronary heart
disease or valvular heart disease. It’s often
used to diagnose and treat chest pain—a
symptom of coronary artery disease that
occurs when blood vessels that feed the
heart become narrowed or blocked.
To identify problem blood vessels, the
catheter is advanced to the heart and dye
is injected into the arteries that are illus-
trated on a monitor using x-rays known
as fluoroscopy.
If a narrowed vessel is found, the cath-
eter can be used to do an angioplasty—a
procedure in which a tiny balloon is
moved to the blockage and inflated to
expand the artery.
What to expect
If you need cardiac catheterization, your
doctor will explain how to prepare for
the procedure. Usually it’s done as an
outpatient procedure at the hospital.
You’ll be awake, but will be given medi-
cine to help you relax.
Under local anesthesia, a small inci-
sion is made in the femoral artery in the
groin, and a tapered tube called a sheath
is inserted. Aided by special x-rays, the
doctor threads a thin, flexible guide
wire through the sheath to the heart.
The catheter is fitted over the wire and
positioned so that the coronary artery
anatomy can be delineated.
After the procedure, the catheter, wire
and sheath are removed and pressure is
held over the blood vessel to mitigate the
bleeding. In some cases, closure devices
are used to assist with minimizing bleed-
ing and speeding recovery time. You’ll
be monitored for two to three hours. If
intervention is performed, a balloon or
stent will be used.
Serious complications are very rare.
Common side effects may include bruis-
ing in the groin at the site of the catheter.
If you have an artery in your heart that
is partially blocked, your doctor may
suggest angioplasty, a procedure using a
balloon or stent to reduce the blockage in
the artery. More than 600,000 angioplas-
ties are done each year in the U.S., which
makes them common—but not necessar-
ily routine.
“Informed consent is necessary because
of the seriousness of the procedure,” said
John Williams, MD, cardiologist. “Despite
the fact that most people are back to
work within a few days after angioplasty,
it still doesn’t negate the fact that it is a
life-threatening procedure.”
After it’s over
The major benefit of being able to
successfully perform angioplasty is
that it delays or obviates the need
for coronary artery bypass grafting
(CABG). In general, angioplasty is a
temporizing procedure. Statistically
speaking, a high percentage of people
who undergo angioplasty at one time in
their lives will ultimately have CABG.
This latter procedure does reduce the
need for multiple interventions, which
are sometimes required when using
angioplasty.
CABG is the most common type of
open-heart surgery in the U.S. It’s also
known as bypass surgery, heart bypass
surgery and coronary artery bypass
surgery.
“Traditionally, open-heart surgery
requires the chest to be opened, and the
patient is placed on a heart/lung ma-
chine,” said Dr. Williams. “There are many
new alternatives to this type of surgery,
one being minimally invasive. This can be
used when certain arteries are amenable
to being bypassed without the chest be-
ing opened.”
Y O U R W I N T E R
SAY GOODBYE TO
HEART WORRIES