What is cardiac catheterization ?
Cardiac catheterization or coronary angiography (CAG), it is past means of a catheter as good as contrast mapping (angiography) of the coronary arteries of the heart. In addition, pressures inwards the pump tin dismiss alive measured past means of a right-catheterization.
The pump is supplied with oxygen past surrounding capillaries pump or coronary arteries (coronary).
There are two coronary arteries (arteries coronariae) which includes the left as good as right side of the pump with oxygen-rich blood. The left coronary artery branches into the circumflex ramus as good as the anterior interventricular (also referred to as the English linguistic communication linguistic communication holler left anterior descending (LAD)). In the groin, after on local anesthesia using a first off injection needle the left or right femoral artery (arteria femoralis) punctured. Through this an introducer needle is inserted. Through this introducer tin dismiss escape no blood, but it could alive what pushed inwards. It is through this arrangement with a catheter guide wire inserted through the artery to the heart.
The catheter is a type of plastic undercover with holes at the tip. The guidewire serves to ascendancy as good as to prevent harm to the aorta. In most cases, ane testament first off display the right coronary artery. The cardiologist moves the catheter upwards to the inmonding of this artery. The guide wire is removed, then that at that spot is at nowadays contrast agent tin dismiss alive injected. Through the catheter to slide on as far as the inmonding, as good as then (almost) all of the contrast inwards the right artery as good as not right away via the aorta to the remainder of the body. Different recordings are made with X-ray radiation, each 4th dimension inwards a dissimilar direction.
It as good as then follows the opacified artery. When at that spot are constrictions are present, they may properly alive imaged. At the location of a stenosis is the vascular lumen of the coronary artery existent small; inwards the lawsuit of a blockage of the vessel, the cavity does not run further.
After the flare-up ane wants to portray the left coronary artery. The guide wire is increased through the catheter. The catheter is as good as then taken out, then that the guide wire remains. Over the guidewire is a dissimilar catheter pushed inwards as far as the inmonding of the linkerkranslagader. The guide wire is removed as good as too then X-rays are ane fourth dimension over again made with contrast agent.
When a patient diversions, these diversions testament also recordings are made with dye.
After this series, if necessary, made a recording of the left bedchamber (ventricle). This is at nowadays rarely needed. There is as good as then a catheter inserted into the apex (center point), therefore, inwards the left ventricle. In a curt 4th dimension the bedchamber is filled with contrast agent, which is as good as then pumped away past the pump function. In this way, ane tin dismiss acquire an impression of the pumping concern business office of the heart. The catheter is removed as good as the introducer as well. The hurt is squeezed as good as at that spot is a pressure level degree bandage merely virtually the leg. Alternatively, an angio seal, a diversity of hypodermic cork, the femoral artery seal.
The patient has half dozen hours of bed remainder as good as may acquire habitation the side past side day. There are variations inwards the underlying assumptions; Nowadays at that spot are techniques to shut the artery inwards the groin apace then the patient after on a curt 4th dimension back inwards the leg. Most patients today are, therefore, no more than a dark to stay inwards the hospital. Nowadays it is also existent usual to behaviour out via the wrist (the arteria radialis), the investigation. The get got chances of post-operative bleeding is clear, therefore, smaller.
Indication for research
- unstable angina pectoris
- angina after on a pump assail (myocardial infarction), PTCA or CABG
- diagnostic (exclude coronary artery disease)
- heart valve abnormality
- disease of the pump muscle
Contraindications
- infections
- fever
- too high INR
- severe renal impairment
Cardiac catheterization complications
- a bleeding at the site of the puncture site
- a imitation aneurysm at the site of the puncture site
- an arteriovenous shunt at the location of the puncture site
- contrast nephropathy
- a dissection of the wall of the ostium of the coronary artery probed, peradventure resulting inwards an iatrogenic myocardial infarction, ventricular fibrillation as good as death
- a goal occlusion of the left primary stem at the 4th dimension when the catheter is placed inwards the utter (ostium) of the vessel. This solely occurs after on a severe stenosis which sits at the existent first off of the vessel (ostiumstenose). In the illustration of the left primary stem, this may, past acute lack of oxygen of almost 70% of the pump muscle, leading to therapy resistant ventricular fibrillation, as good as death.
