cardiac catheterization:

Did you know . . .
. . . angioplasty balloons have to be able to withstand air pressure about eight times greater than the pressure in the typical automobile tire, but they have to be thin enough to inflate inside an artery, which is at the largest only a third the size of an ink pen.

Cardiac Catheterization

Your doctor has referred you to Queen's Heart for cardiac catheterization and possibly a percutaneous coronary intervention (PCI) or angioplasty.

A cardiac catheterization or coronary angiography is a diagnostic procedure that allows the doctor to take a moving picture of the arteries of your heart and check the inside of the arteries for narrowing. Your doctor can also take a look at your heart valves and how well they are working. It also can detect any heart muscle damage.

During the catheterization your doctor can also determine how well your heart is working by measuring the ejection fraction. Ejection fraction is how much blood your heart pushes out of the left ventricle with each beat. A good ejection fraction is 55%, that means 55% of the blood in that chamber is being pushed out with each beat.

A coronary angiography refers to when the doctor uses a special dye to highlight your arteries and check your ejection fraction on a video X-ray.

Two possible outcomes of angiography include:
1. No blockage is found, additional testing may be done.
2. Blockage is found and treatment options will be discussed.

1. Treatment with medications.
2. Treatment with angioplasty and stent placement, or artherectomy.
3. Coronary artery bypass sugery.

Angioplasty and stent placement are done at the same time as the cardiac catheterization or angiogram.

Angioplasty

Angioplasty is also known as Percutaneous Transluminal Coronary Angioplasty (PTCA) or Percutaneous Coronary Intervention (PCI). This technique uses a tiny balloon which is inflated to press the plaque against the artery wall. You may feel chest pain when the balloon is inflated as this will decrease blood flow to your heart.

Stents

Stents are made of stainless steel wire mesh in the shape of a tube. They are inserted in the artery after angioplasty to hold it open. They are left in the artery permanently. Coronary artery stents have been shown to be useful in decreasing the change of re-narrowing or the artery.

Sometimes drug eluting stents are used. These stents are coated with medicine that is released over time into the surrounding tissue of the vessel. The medicine prevents scars from forming.

The major risk factor after stent placement is a blood clot forming at the site of the stent. To prevent this, your doctor will have you on aspirin and Plavix everyday for at least a year from the date of your procedure. These drugs are necessary to prevent clot formation in the area of the the stent which could result in a heart attack or even death. If a physician recommends that you stop one or more of the above drugs, please call your cardiologist.

Artherectomy

Artherectomy is a procedure used to cut away the plaque or blockage that is narrowing the artery. There are several different types used, and your doctor will determine the best one based on their findings.

Thrombectomy

A thrombectomy is the surgical removal of a blood clot (thrombus) from a blood vessel. This procedure is performed using a balloon catheter that is either pressed against the walls in order to restore at least part of the open space in the vessel; or the balloon is 'opened' after the thrombus and then carefully moved backwards so that the clot can be drawn out of the vessel.