Name of the Procedure:

Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventricle.

Summary

This procedure involves placing a catheter into the coronary arteries and the left side of the heart. It includes injecting a contrast dye to visualize the heart and arteries on imaging. The purpose is to diagnose and treat coronary artery disease by assessing the blood flow and identify any blockages.

Purpose

This procedure addresses coronary artery disease and other heart conditions by allowing doctors to see how well blood is flowing through the coronary arteries and the left side of the heart. It helps in diagnosing blockages or other abnormalities that may need treatment.

Indications

The procedure is indicated for patients experiencing symptoms of coronary artery disease such as chest pain (angina), shortness of breath, or after an abnormal stress test. Other indications include suspected heart valve problems or congenital heart defects, and to evaluate heart function in patients with a history of heart attack.

Preparation

Patients are instructed to fast for at least 6-8 hours before the procedure. They may need to adjust current medications and undergo blood tests, electrocardiograms (EKG), and sometimes a chest X-ray to ensure they are fit for the procedure.

Procedure Description

1. The patient is prepped and draped in a sterile fashion.
2. Local anesthesia is administered to numb the catheter insertion site (usually in the groin or arm).
3. A thin, flexible tube (catheter) is inserted into the artery and guided to the coronary arteries and left ventricle using fluoroscopic (X-ray) guidance.
4. Contrast dye is injected through the catheter to highlight the heart's structures and arteries on the imaging screen.
5. Multiple X-ray images are taken to assess blood flow and identify any blockages or abnormalities.
6. The catheter is then removed, and pressure is applied to the insertion site to prevent bleeding.

Tools used include catheters, contrast dye, fluoroscopy equipment, and various imaging tools. The procedure is typically performed with local anesthesia and sometimes mild sedation.

Duration

The procedure usually takes about 1-2 hours.

Setting

It is performed in a hospital's cardiac catheterization lab (cath lab).

Personnel

The procedure involves a cardiologist, nurses, a radiologic technologist, and sometimes an anesthesiologist if sedation is required.

Risks and Complications

Common risks include bleeding or bruising at the insertion site, allergic reactions to the contrast dye, and arrhythmias (irregular heartbeats). Rare complications can include heart attack, stroke, arterial damage, or severe allergic reactions.

Benefits

The main benefits are accurate diagnosis and assessment of coronary artery disease and heart function. This can lead to timely and appropriate treatment, potentially preventing heart attacks or worsening of the disease.

Recovery

After the procedure, patients are monitored in a recovery area for a few hours. Instructions include keeping the insertion site clean and dry, avoiding strenuous activities for several days, and attending follow-up appointments. Recovery time varies, but most patients can resume normal activities within a week.

Alternatives

Alternatives include non-invasive tests such as stress tests, echocardiograms, and CT angiography. However, these may not provide as detailed information as a coronary angiography. Each alternative has its pros and cons, mainly regarding the level of detail and the risks involved.

Patient Experience

During the procedure, patients may feel pressure at the catheter insertion site but should not feel pain due to local anesthesia. Post-procedure, they might feel groggy from sedation and have some discomfort or bruising at the insertion site. Pain management and comfort measures include local anesthesia and mild sedatives if needed.