Heart catheter lab

What is a heart catheter examination?

A heart catheter examination is a method of examining the heart. This usually means the “left heart catheter” (also referred to as the “large catheter”) when talking about the heart catheter. The “right heart catheter” (also referred to as the “small catheter”) is falling out of use due to modern ultrasound technology, and is used for the clarification of acute or chronic right heart stress or in the case of heart rhythm disorders. The left heart catheter is often equated to coronary angiography, and is carried out for further clarification of suspicion of a coronary heart disease.

In the case of a heart catheter examination, an artery is punctured under local anaesthetic, and a thin guide wire inserted into the vessel. The heart catheter is then pushed to the heart along this guide wire. Contrast agent, which is injected into the coronary arteries, shows up constrictions or obstructions in the coronary arteries on the X-ray image as blank areas in the contrast agent, or “vascular breaks”.

In most cases, severe constrictions in the coronary arteries are treated immediately with a special guide catheter, such as by balloon dilation and the implantation of vascular supports or “stents”.

When is a heart catheter examination necessary?

This invasive examination is as a rule only carried out when the cardiologist, on the grounds of the results of non-invasive methods (type and character of the complaints, results of the ECG and the echocardiography or stress-echocardiography following analysis of the existing risk factors of every individual patient) suspects a coronary heart disease, or anticipates a therapeutic consequence which can frequently be carried out immediately following the examination.

A heart catheter examination can also be used for the diagnosis of diseases of the heart muscle, the heart valves or congenital or acquired heart defects.

Procedure

Heart catheter examinations are carried out at the HPK in our own heart catheter lab. The catheter lab is equipped with the latest and most modern heart catheter equipment (both for coronary angiography and for electro-physiology). The HPK also has modern radiography facilities using digital technology, together with measurements and monitoring instruments (monitors for monitoring the ECG, blood pressure, heart rate and oxygen saturation).
General anaesthesia is not necessary for a heart catheter examination. The examination is carried out using a local anaesthetic. At the request of the patient, a mild sedative may be administered.

For the examination, an arterial vessel is punctured, usually in the groin.
Heart catheter examinations are usually carried out on an out-patient basis, as they are in our private clinic. If balloon dilation or stent implantation is required, this necessitates observation for at least 12 hours, which also takes place at the HPK.

If the patient requests that the heart catheter examination should be carried out by the doctors of the HPK on hospital premises, this would also be possible due to the existing cooperations with hospitals in Heidelberg.

Duration

A diagnostic heart catheter examination without therapeutic intervention takes approximately 30 minutes.

Risks

A heart catheter examination, like any medical examination, is not completely free of risks, although complications only actually occur in less than 1% of all heart catheter examinations. Possible complications include: Heart rhythm disorders, heart attack, embolisms and thromboses, and infections.

Note

After the examination, the patient must rest for several hours (usually 4-5 hours) wearing a pressure bandage in order to prevent renewed bleeding at the puncture point or vascular propagation is. The patient is mobile following the examination. Driving a motor vehicle or riding a bicycle should be avoided for the next 2-3 days.