What are cardiac catheterization and angiography, why are these procedures needed?
Heart catheterization and angiography are not treatment, but diagnosis methods. It is based on imaging the heart chambers and coronary arteries during the administration of contrast material (a type of medical dye) and taking moving movies using "X" rays. The data obtained are very valuable in directing the treatment and are the main determinant in choosing the treatment strategy in most patients.
How are cardiac catheterization and angiography performed?
Cardiac catheterization and angiography It is necessary to fast for 4-12 hours beforehand (medicines can be taken with a very small amount of water). Before the patient is taken to the catheterization laboratory, the groin area must be shaved to ensure better sterilization. If necessary, a sedative medication is administered. The groin or arm area where the procedure will be performed is anesthetized and a cannula is inserted into the artery in this area (access route is opened). The heart cavities are reached with a thin tube (catheter) made of plastic-like material and the pressure is recorded; Contrast material is administered, coronary arteries are visualized and film recordings are taken.
This process takes about 20-30 minutes. After the procedure is completed, the cannula in the groin is removed and pressure is applied to this area for 15-20 minutes. After it is seen that the bleeding has stopped, it is covered with a very tight bandage. However, in some cases of medical necessity, this practice can be changed as the cannula in the groin may need to be kept in place for a longer period of time. Except for exceptional cases, the patient is allowed to return to daily life 24 hours after the procedure.
Can there be undesirable events associated with cardiac catheterization and angiography?
Although rare, procedure-related problems and undesirable events may occur during or immediately after cardiac catheterization. events (complications) may be encountered. After coronary angiography, pain, slight swelling and bruising (hematoma, ecchymosis, pseudo-aneurysm) may occur less frequently in the treated vascular area. Rarely, there is a possibility of stroke (paralysis) and myocardial infarction. Apart from these, some complications that may occur (emergency surgery, cardiac arrest) Perforation in the blood vessels and cavities, low blood pressure due to severe allergic reaction, some rhythm disorders, need for a temporary pacemaker, etc.) can be seen, although very rarely. Most of these complications can be compensated with treatment. Depending on the drugs used during the procedure, especially iodinated contrast material, renal failure may develop. Although most patients who develop kidney failure recover, rarely, patients may need dialysis treatment later in life.
What kind of problems may be encountered if cardiac catheterization and angiography are not performed even though they are necessary?
If cardiac catheterization and angiography are not performed, sufficient information about the patient's disease cannot be obtained. Planning of possible interventions and treatments may not be carried out in a healthy way.
Are there alternative examination methods that can replace cardiac catheterization and angiography?
In parallel with the developments in technology, there have been great developments in heart-related imaging methods. There are no non-invasive (bloodless) diagnostic methods (examinations with computerized tomography or magnetic resonance methods, etc.) that can replace cardiac catheterization and angiography and provide as accurate information as these methods.
Can or should balloon angioplasty and heart surgery, which is decided according to the results of cardiac catheterization and angiography, be performed immediately?
Due to a complication of the catheterization and angiography procedure or should it be performed immediately? It should be known that in case of detection of the need for urgent intervention for the underlying disease that caused the patient to be examined, there may be a need for coronary therapeutic intervention (coronary balloon angioplasty, coronary stent applications, etc.) or emergency cardiac surgery in the same session. Except for the emergencies mentioned above, a decision is made about the further examination or treatment method by evaluating the angiography, and the patient is informed about this and the necessary interventions and treatments are planned.
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