Anesthesia for cardiac catheterization including coronary angiography and ventriculography (not to include Swan-Ganz catheter)
CPT4 code
Name of the Procedure:
Anesthesia for Cardiac Catheterization (including Coronary Angiography and Ventriculography)
Summary
Cardiac catheterization is a diagnostic procedure used to assess the function of the heart and its blood vessels. Anesthesia is administered to ensure patient comfort and immobility during the procedure, which involves inserting a catheter into the heart.
Purpose
This procedure helps diagnose heart conditions by visualizing the coronary arteries and the heart's chambers. It can help identify blockages, heart valve issues, and structural problems. The goal is to provide a clear understanding of cardiac health and guide further treatments if necessary.
Indications
- Symptoms like chest pain or shortness of breath suggesting heart disease
- Positive results from non-invasive heart tests (e.g., stress tests)
- Known coronary artery disease requiring detailed assessment
- Assessment before heart surgery
Preparation
- Patients are usually instructed to fast for 6-8 hours before the procedure.
- Certain medications may need to be paused or adjusted.
- Pre-procedure tests may include blood work, EKG, and imaging studies.
- Consent forms and allergy checks, especially for contrast dyes.
Procedure Description
- The patient is positioned on an examination table.
- An intravenous (IV) line is placed for medication administration.
- The anesthesia team administers sedatives and local anesthesia.
- A catheter is inserted into a blood vessel, typically in the groin or arm.
- The catheter is guided to the heart, and contrast dye is injected to visualize the coronary arteries and heart chambers using x-ray imaging.
- Coronary angiography focuses on the coronary arteries, while ventriculography assesses the heart's pumping ability.
- Once the imaging is complete, the catheter is removed, and the insertion site is bandaged.
Duration
Typically, 30 minutes to 1 hour, but may vary based on complexity and findings.
Setting
The procedure is performed in a hospital's cardiac catheterization lab, often on an outpatient basis.
Personnel
- Cardiologist or Interventional Cardiologist
- Anesthesiologist or Nurse Anesthetist
- Radiology Technologist
- Cardiac Nurse
Risks and Complications
- Common: Bruising or bleeding at the catheter insertion site
- Rare: Infection, allergic reaction to contrast dye, heart attack, stroke, or arrhythmias
- Management: Close monitoring, medication adjustments, and prompt treatment of any complications
Benefits
- Accurate diagnosis of heart conditions
- Aids in planning further treatments or surgeries
- Immediate relief in cases like angioplasty following angiography Benefits are often realized shortly after the procedure, especially if treatment is provided concurrently.
Recovery
- Patients are monitored for several hours post-procedure.
- Instructions include avoiding strenuous activities for a few days.
- Keeping the insertion site clean and dry is crucial.
- Follow-up includes an appointment with the cardiologist for results and further guidance.
Alternatives
- Non-invasive imaging methods like CT angiography or MRI
- Stress tests and echocardiograms
- Each alternative has pros and cons; for example, non-invasive tests may not provide as detailed information as a catheterization.
Patient Experience
- Patients might feel pressure but should not experience pain due to anesthesia.
- Post-procedure involves resting, with possible mild discomfort at the insertion site.
- Pain management is usually done with over-the-counter pain relievers unless otherwise prescribed.
By understanding this information, patients can be better prepared for what to expect and how to best manage their care before, during, and after cardiac catheterization.