Cardiac catheterization allows us to treat a wide range of conditions without open-heart surgery. These procedures are performed by interventional cardiologists who specialize in coronary interventions.
What is a Cardiac Catheterization?
Cardiac catheterization is a minimally invasive procedure that use flexible, hollow tubes (catheters) to access the heart and blood vessels. In a cardiac catheterization (heart catheterization), an interventional cardiologist places a catheter through a blood vessel in your wrist or groin and uses imaging to guide it to the blood vessels in your heart. We may use cardiac catheterization to diagnose problems with your heart muscle, blood vessels or valves. This technology can help us learn more about your heart structure and function, including:
- Whether blood clots are blocking blood vessels in the heart
- How well your heart pumps blood
- If pressure in your heart chambers is normal
- Whether coronary arteries are blocked
What is Cardiac Catheterization used for?
Cardiac catheterization (cath) procedures are used to perform heart tests and procedures including:
Contrast dye is injected into the coronary arteries (blood vessels supplying blood to the heart). This dye highlights the heart and blood vessels and allows the interventional cardiologist to evaluate how blood flows through the heart.
An interventional cardiologist places a balloon and a small, mesh tube (stent) on the end of the catheter. When positioned in the coronary artery, they inflate the balloon and expand the stent to open a blocked coronary artery.
The interventional cardiologist uses catheterization to obtain a small sample of heart tissue. This tissue sample is analyzed in a lab to help diagnose or monitor heart conditions.
A small ultrasound probe is attached to the end of the catheter. This allows cardiologists to perform a heart ultrasound from the inside of the body.
Interventional cardiologists use catheter techniques to treat many conditions affecting the heart's structure. They may repair a narrowed or leaky heart valve, replace a heart valve or close a hole in the heart.
The WATCHMAN is a small device implanted in a portion of the heart called the left atrial appendage (LAA). People with an irregular heart rhythm called atrial fibrillation have a high risk of blood clots in the LAA. The WATCHMAN device closes the LAA, reducing the risk of blood clots and stroke.
Who might need a Heart Catheterization?
You might need a heart catheterization to diagnose heart or blood vessel disease if you have symptoms of a heart problems, such as chest pain or shortness of breath.
A cardiac catheterization procedure may also be used to treat existing heart problems. Cardiologists use heart cath procedures to diagnose and treat conditions such as:
Preparing for Cardiac Catheterization
Your care team gives you specific instructions to prepare for a cardiac catheterization. You may need to temporarily stop taking certain medications, such as blood thinners, before the procedure. If you have diabetes, make sure your care team understands your diabetes medication regimen. The contrast dye used during cardiac catheterization may increase the side effects of some diabetes medicines.
The care team will likely instruct you to stop eating or drinking by midnight the day of the procedure. On the day of the catheterization, you should remove all jewelry, eyeglasses or dentures.
What to Expect During a Cardiac Catheterization Procedure
Cardiac catheterization is often performed in an outpatient cath lab, a facility specialized designed for these procedures. You receive anesthesia to keep you comfortable during the procedure. You are connected to monitors that measure your heart's electrical activity, your heart rate, blood pressure and oxygen levels. An interventional cardiologist, interventional echocardiographer and an anesthesia specialist work together to perform the procedure.
During a cardiac catheterization, an interventional cardiologist:
- Makes a small incision in your groin, neck or wrist to access a blood vessel
- Inserts a hollow, plastic tube (sheath) through the blood vessel
- Threads a catheter through the sheath
- Guides the catheter through the blood vessel to your heart
- Injects a contrast dye through the catheter to highlight your blood vessels and get a better view of how blood flows through your heart
- Places tools through the catheter to view your blood vessels, measure pressure, take a tissue sample or treat heart diseases
Cardiac Catheterization Recovery
You usually spend a few hours in a recovery room after a cardiac catheterization. You may need to lie on your back for a period to prevent bleeding at the catheter insertion site. Depending on the type of cardiac catheterization, you may return home the same day, or you may stay in the hospital for several days. Your provider will tell you when you can resume your usual activities, often within a day or two.
You may have some mild pain or bruising at the catheter insertion site for a few days. This is normal. Tell your doctor if you notice any signs of complications, including:
- Bleeding, temperature changes or swelling around the catheter insertion site
- Chest pain or pressure
- Dizziness or fainting
- Excessive sweating
- Fever or chills
- Nausea or vomiting
Benefits and Risks of Cardiac Catheterization
Cardiac catheterization gives your provider a detailed view of your heart's structures without the need for open-heart surgery. This minimally invasive approach offers a faster recovery with less pain and fewer complications. People generally also spend less time in the hospital than with open-heart procedures.
Complications from cardiac catheterization are rare, especially when the procedure is performed by an experienced interventional cardiologist. If they do occur, possible risks of cardiac catheterization include:
Cardiac Catheterization: The Penn Medicine Advantage
Penn Medicine's Interventional Cardiology Program leads the way in cardiac catheterization techniques. We offer a full range of catheter-based tests and treatments, often before they're widely available. When you choose our team, you benefit from:
- Deep experience: We were among the first in the nation to offer several treatments now used across the country, including transcatheter aortic valve replacement (TAVR), balloon valvuloplasty for mitral stenosis and MitraClip™. Our interventional cardiologists have participated in clinical trials for decades, performing common procedures years before they're approved with the Food and Drug Administration (FDA).
- Excellent outcomes: Our patient outcomes are among the best in the country. We have the highest ratings for TAVR in the Transcatheter Valve Therapy Registry, a national outcomes database from the Society of Thoracic Surgeons and the American College of Cardiology. Our angioplasty and stenting success rates are above 95 percent, positioning us among the top teams in the nation.
- State-of-the-art technology: We perform cardiac catheterizations in our state-of-the-art catheterization laboratory (cath lab). The cath lab houses the latest technology in a comfortable, patient-friendly environment.
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