Cardiac Catheterization / Coronary angioplasty and stent

For invasive procedures, you would be under the best of care with our physicians who have served as Directors of the Cardiac Catheterization Laboratories at Northside Hospitals Forsyth and Cherokee where they pioneered coronary angioplasty and stenting. Our specialists perform the following procedures at Northside Hospital Forsyth, Northside Hospital Cherokee, Emory Johns Creek Hospital, and St. Joseph’s Hospital of Atlanta.

Heart Catheterization / Coronary Angioplasty and Stenting

Traditionally this procedure is performed through the groin or femoral artery, but now there is a less invasive, safer, and more comfortable technique for doing these procedures: using the wrist or radial artery. The physicians at Heart and Vascular Care are experts at performing these procedures through a single needle stick in the blood vessel of the wrist (radial artery).

What does a heart catheterization do?

Heart catheterization is a diagnostic tool used by doctors to look for heart muscle disease, heart valve disease and coronary artery disease. It can be used to determine strength of the heart muscle, measure heart valve disease and look for any blockages in the coronary or heart arteries. A catheter is placed in the artery of the wrist of the groin. This catheter reaches from there to the area of the heart. Contrast dye is injected through the catheter and into the coronary arteries and heart chambers. A special x-ray technique called fluoroscopy then shows the dye as it flows through the arteries and heart.

What is coronary angioplasty and stenting?

Once a heart catheterization is performed if a severe heart blockage is found the cardiologist can immediately proceed to a coronary angioplasty and stenting. Coronary angioplasty is a technique where a small balloon is used to treat and open a blockage in the artery of the heart. In most patients, after a balloon angioplasty a metal scaffold called a stent is deployed in the artery to keep the artery open. These stents are permanent and become part of the patient’s body after about 1 year.

What is the procedure like?

When a patient and their cardiologist decide to perform a cardiac catheterization they will discuss the method and location of accessing or entering one of the blood vessels of the body. Most commonly this is done in either the femoral artery in the groin or the radial artery in the wrist. From this access site the cardiologist can insert catheters that go to the heart and are able to look for heart artery blockages and also treat those blockages with balloon angioplasty and stents. These procedures are done at a hospital in the Cardiac Catheterization Laboratory (Cath Lab). After the patient arrives at the Cardiac Cath Lab they are changed into a hospital gown and then placed on the procedure table. They are given light or moderate sedation with usually intravenous Fentanyl and Versed but are not under full anesthesia typically. If a radial or wrist artery procedure is planned the cardiologist gives local anesthetic agent to the wrist and then using a small needle is able to place a sheath in the wrist. The area that is going to be worked on is then cleaned and shaved to minimize infection. From that access site they are able to image all the arteries of the heart and perform balloon angioplasty and stents. A video screen allows the doctor to see where the catheter is going as it travels through the blood vessel to the heart. The procedure usually takes about 30 minutes to determine if there is a blockage and if a stent is necessary another approximately 30 minutes.

What is the recovery like?

After the procedure is complete, you will be taken to a recovery room for a few hours. If the catheter was inserted in the wrist the patient can sit upright right after the procedure. If the catheter was inserted in your leg, you will need to keep it straight. If an angioplasty or stent was done then most patients stay in the hospital overnight. One week after the procedure, you will be able to return to normal activity. If you should find that the entry site begins to bleed or develop a large bruise, please inform your cardiologist.

Who is a likely candidate for heart catheterization?

Since heart catheterization is an invasive procedure, it’s not the first test doctors run to diagnose a problem. It is often performed in patient that are having heart attacks but also in patients that have chest pain or angina and those who have abnormal results on their stress test. If the doctor suspects you have a blockage or narrowing of an artery, you may benefit from a heart catheterization to prevent angina or chest pain and also prevent heart attacks.

What are the risks?

Those who have a heart catheterization performed may notice bruising around the entry site and along the artery. The most common risk is bleeding can also occur at the entry point. The risk for bleeding is greatly reduced when the procedure is done from the wrist rather than the groin. More serious side effects include a heart attack, stroke, or damage to the artery at the entry point. Some may have an allergic reaction to the medication used, so be sure to let your doctor know about any allergies you have ahead of time. This would include allergies to medicines as well as foods.