Cardiac catheterization

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Cardiac catheterization lab

Cardiac catheterization (heart cath) is the insertion of a catheter into a chamber or vessel of the heart. This is done both for diagnostic and interventional purposes. Subsets of this technique are mainly coronary catheterization, involving the catheterization of the coronary arteries, and catheterization of cardiac chambers and valves of the Cardiac System.

Coronary catheterization[edit]

Procedure[edit]

"Cardiac catheterization" is a general term for a group of procedures that are performed using this method, such as coronary angiography and left ventricle angiography. Once the catheter is in place, it can be used to perform a number of procedures including angioplasty, PCI (percutaneous coronary intervention) angiography, balloon septostomy, Electrophysiology study or catheter ablation.

Indications for diagnostic use[edit]

This technique has several goals:

Investigative techniques used with coronary catheterization[edit]

  • to measure intracardiac and intravascular blood pressures
  • to take tissue samples for biopsy
  • to inject various agents for measuring blood flow in the heart; also to detect and quantify the presence of an intracardiac shunt
  • to inject contrast agents in order to study the shape of the heart vessels and chambers and how they change as the heart beats

Catheterization of chambers and valves[edit]

Catheterization of cardiac chambers and valves may be performed at the same time as a coronary catheterization, and may also involve nearby major vessels, such as the aorta. It is the main method of cardiac ventriculography (another being radionuclide ventriculography, whose use has largely been replaced by echocardiography).

It has the ability to measure the pressure gradient across a valve and derive valve area from it. Thereby, it can assist in diagnosis of, for example, aortic stenosis.[1]

This is also the procedure used in balloon septostomy, which is the widening of a foramen ovale, patent foramen ovale (PFO), or atrial septal defect (ASD) using a balloon catheter.

History[edit]

The history of cardiac catheterization dates back to Claude Bernard (1813-1878), who used it on animal models. Clinical application of cardiac catheterization begins with Werner Forssmann in the 1930s, who inserted a catheter into the vein of his own forearm, guided it fluoroscopically into his right atrium, and took an X-ray picture of it. Forssmann won the Nobel Prize in Physiology or Medicine for this achievement, though hospital administrators removed him from his position owing to his unorthodox methods. During World War II, André Frédéric Cournand, a professor at Columbia University College of Physicians and Surgeons who also shared the Nobel Prize, and his colleagues developed techniques for left and right heart catheterization.

References[edit]

  1. ^ Elizabeth D Agabegi; Agabegi, Steven S. (2008). Step-Up to Medicine (Step-Up Series). Hagerstwon, MD: Lippincott Williams & Wilkins. ISBN 0-7817-7153-6. 

External links[edit]