Mercy expands stenting treatment options for patients with coronary artery disease
Mercy was the first hospital in Iowa to utilize a new stent system to treat patients with large coronary arteries.
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Cardiac catherization involves passing a catheter (a thin flexible tube) into the right or left side of the heart. In general, this procedure is performed to obtain diagnostic information about the heart or its blood vessels or to provide treatment in certain types of heart conditions.
Cardiac catheterization can be used to determine pressure and blood flow in the heart chambers, collect blood samples from the heart, and examine the arteries of the heart.
How It Works
You will be given a mild sedative prior to the test to help you relax. An intravenous (IV) line is inserted into one of the blood vessels in your arm, neck, or groin after the site has been cleansed and numbed with a local anesthetic.
A catheter is then inserted through the IV and into your blood vessel. The catheter is carefully threaded into the heart using an X-ray machine that produces real-time pictures (fluoroscopy). Once the catheter is in place, contrast material is injected and pictures are taken.
Test Preparation
Food and fluid are restricted 6 to 8 hours before the test. The procedure takes place in the hospital and you will be asked to wear a hospital gown. Sometimes, admission the night before the test is required. Otherwise, you will be admitted as an outpatient or an inpatient the morning of the procedure. Your healthcare provider should explain the procedure and its risks. Tell your doctor about all your medicines and allergies.
Let your doctor know if you are allergic to shellfish or if you have had a bad reaction to contrast material in the past. Notify your doctor if you are taking Viagra, Cialis or Levitra, or if you might be pregnant.
The Procedure
The study is carried out in a laboratory by a trained cardiologist. You will be awake and able to follow instructions during the catheterization. A mild sedative is usually given before the procedure to help you relax. The procedure generally lasts one hour. Local anesthesia will be used to numb the IV site, so the only sensation should be one of pressure at the site.
After the test, the catheter is removed. You might feel a firm pressure at the insertion site, used to prevent bleeding. If the IV is placed in your groin, you will usually be asked to lie flat on your back for a few hours after the test to avoid bleeding. This may cause some mild back discomfort.
Information obtained from the procedure Cardiac catheterization is usually performed to evaluate heart valves, heart function and blood supply.
Therapeutic catheterization may be used to repair certain types of heart defects, open a stenotic heart valve, and open blocked arteries or grafts in the heart.
Abnormal Results
The procedure can identify heart defects or disease, such as coronary artery disease, valve problems, ventricular aneurysms, or heart enlargement. The procedure also may be performed for the following: heart valve abnormalities, heart artery abnormalities and heart function abnormalities.
Risks of the procedure
Cardiac catheterization carries a slightly increased risk when compared with other heart tests. However, the test is very safe when performed by an experienced team. Generally, the risk of serious complications ranges from 1 in 1,000 to 1 in 500. The risks include the following: stroke, heart attack, vascular injury and death.
Considerations associated with any type of catheterization include the following: In general, there is a risk of bleeding, infection, and pain at the IV site. There is always a very small risk that the soft plastic catheters could actually damage the blood vessels. Blood clots could form on the catheters and later block blood vessels elsewhere in the body. The contrast material could damage the kidneys (particularly in patients with diabetes).
CT Coronary Angiography
Ultrafast computed tomography (CTA) is a non-invasive imaging technique used to create three-dimensional pictures of your beating heart. The electron-beam CT uses a scanning electron beam that can take very rapid pictures of the heart, timed to coordinate with your heart beat. This speed allows the cardiologist to actually see the working heart, and to measure the size and volume of the right and left ventricles, the muscle mass in the left ventricle, and the status of the coronary arteries.
Coronary CTA is used to detect the earliest of heart artery narrowings, before symptoms occur. The scan is sensitive enough to identify the early stages of coronary plaque formation.
Ultrafast CT scans are also being used to rapidly diagnose other cardiac related conditions, including aortic dissection, pulmonary embolism, restenosis after angioplasty, and the effectiveness of heart surgery or medical therapy. Additionally, ultrafast CT scanning is valuable in an emergency room setting because of its speed.
Studies have shown that these tests may be of some value in predicting future risk for heart attack, especially when combined with other markers of cardiac risk such as the Framingham coronary risk profile. Evidence for early coronary plaque might lead a physician to recommend additional testing, such as a nuclear stress test, coronary angiography, or exercise stress test.
Because the test involves radiation exposure, women who are or may be pregnant should not have the test done.
Patient Story: Acing Heart Care
After being dealt a heart attack, Melvin Kummerfeldt, 80, is "all in" today. When he and his wife, Marietta, went to Mercy's ER, tests showed he had had a heart attack and was in the middle of one. Read the rest of the story on page 18.
