Cardiac catheterization

Cardiac catheterization is a minimally invasive procedure that uses flexible, hollow tubes (catheters) to access the heart and blood vessels. In 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

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.

You might need a heart catheterization to diagnose heart or blood vessel disease if you have symptoms of 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:

• Atherosclerosis, the buildup of a fatty substance (plaque) in arteries
• Cardiomyopathy, thickened or weakened heart tissue
• Congenital heart disease, one or more problems with the heart's structure that are present at birth
• Coronary artery disease, narrowing of the coronary arteries
• Heart failure, when the heart doesn’t pump blood as efficiently as it should
• Heart valve disease, narrowing or leaking in one or more heart valves, the tubes that control blood flow through the heart

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 on the day of the procedure. On the day of the catheterization, you should remove all jewelry, eyeglasses, or dentures.

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, heart rate, blood pressure, and oxygen levels. An interventional cardiologist, an interventional echocardiographic, and an anesthesia specialist work together to perform the procedure.

During a cardiac catheterization, an interventional cardiologist:

1. Makes a small incision in your groin, neck, or wrist to access a blood vessel
2. Inserts a hollow, plastic tube (sheath) through the blood vessel
3. Threads a catheter through the sheath
4. Guides the catheter through the blood vessel to your heart
5. Injects a contrast dye through the catheter to highlight your blood vessels and get a better view of how blood flows through your heart
6. Places tools through the catheter to view your blood vessels, measure pressure, take a tissue sample, or treat heart diseases

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:

• Allergic reaction to contrast dye
• Arrhythmias (irregular heart rhythms)
• Blood clots
• Blood vessel damage
• Heart attack
• Infection
• Stroke

Penn Medicine’s Interventional Cardiology 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 were approved by 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.