Cardiac Catheterization and Coronary Angiography

Coronary Angiography and Left Heart Catheterization are common terms for the same procedure that is also commonly referred to as the “Dye Test”. This procedure is the best test to define the exact location and severity of narrowings or blockages in the coronary arteries and is necessary before performing any coronary intervention such as Angioplasty, Stenting or Bypass Surgery. This test also provides information about left ventricular function (the strength of the heart muscles pumping action) and information about the valves on the left side of the heart. This procedure is usually performed as an outpatient and frequently may be performed at the Cardiovascular Diagnostic Center Cardiovascular Diagnostic Center, a free-standing outpatient Cath Lab adjacent to our offices

Description: After being prepped and draped in a sterile fashion and placed on the catheterization table, a small amount of numbing medicine is injected under the skin. This usually causes burning and stinging but will numb the area to prevent pain during the rest of the procedure. A needle is then inserted into the femoral artery (large artery going down each leg) and then exchanged for a wire that is used to place a small sheath, which then provides access for the catheters without further punctures. A series of catheters (small plastic tubes) are then inserted through the sheath and under x-ray guidance placed first within the heart and then at the mouth of each coronary artery where dye is injected and x-ray movie pictures are taken to obtain pictures of the coronary arteries. Several different angles will be taken of each coronary artery allowing the various branches to be seen.

The Coronary Flow Wire is another adjunctive test used with Coronary Angiography. In this test, a small wire is placed across an area of blockage and the pressures are measured as well as an estimate of the coronary flow in order to help determine the severity and physiological significance of a particular narrowing. This helps us decide whether an intervention is necessary or appropriate.

RISKS: Although this is a very safe procedure there are, of course, some risks. There is a slight chance of bleeding or infection. There is a very slight chance of damage to the artery, which could even require surgery to repair. Rarely people will have an allergic reaction to the x-ray dye or have kidney problems from the x-ray dye. The really bad things that can happen are stroke, heart attack and death. Although these are extremely bad, these outcomes are extremely rare. The chance of any major complication is less than 1 in 1,000.

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