93453 Combined right and left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed

Name of the Procedure:

Combined Right and Left Heart Catheterization with Intraprocedural Injection(s) for Left Ventriculography, Including Imaging Supervision and Interpretation

Summary

In this procedure, catheters are inserted into both the right and left sides of the heart to measure pressure and blood flow. It also includes an injection of contrast dye into the left ventricle to obtain detailed images. Doctors use these images and measurements to assess heart function and structure.

Purpose

This procedure is used to diagnose and evaluate various heart conditions, including coronary artery disease, heart valve problems, and heart failure. It helps determine the precise cause of your heart issues and the best treatment plan.

Indications

• Unexplained chest pain or discomfort
• Symptoms of heart failure
• Suspected congenital heart defects
• Abnormal results from non-invasive heart tests (e.g., ECG, echocardiogram)
• Pre-surgical evaluation for heart conditions

Preparation

• Follow your doctor's instructions, which may include fasting for a certain period.
• Inform your doctor about any medications you're taking; you may need to adjust them.
• Undergo any required diagnostic tests, such as blood work or an ECG.

Procedure Description

1. A local anesthetic is administered to numb the insertion site (usually the groin, arm, or neck).
2. A catheter is inserted into a blood vessel and guided to the heart using imaging techniques.
3. Measurements of pressure within the heart chambers are taken.
4. Contrast dye is injected into the left ventricle, and X-ray images are captured for ventriculography.
5. The catheters are then removed, and pressure is applied to avoid bleeding.
6. The data collected are reviewed and interpreted.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

This procedure is performed in a hospital catheterization lab (cath lab).

Personnel

• Interventional cardiologist
• Nurses
• Radiology technologist
• Possible support from an anesthesiologist

Risks and Complications

• Common: Bruising or bleeding at the catheter insertion site, arrhythmias
• Rare: Blood vessel damage, infection, allergic reaction to contrast dye, heart attack, stroke

Benefits

• Provides detailed information about heart function and structure
• Helps identify the cause of heart symptoms
• Aids in determining the most effective treatment plan
• Can directly guide interventions if needed

Recovery

• You may need to lie flat for a few hours after the procedure to prevent bleeding from the insertion site.
• Follow-up instructions will include medication management, activity restrictions, and signs of complications to watch for.
• Recovery time varies; most patients can return to normal activities within a few days.

Alternatives

• Non-invasive imaging tests like echocardiography, MRI, or CT scans
• Each alternative has its own pros and cons, such as less detail or longer duration.

Patient Experience

• You may feel pressure but not pain due to the local anesthetic.
• During the dye injection, some patients report a brief warm or flushed sensation.
• After the procedure, mild discomfort at the insertion site is common; pain management will be provided if necessary.