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left heart catheterisation

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Coronary arteries

Normal Heart

Alternative Names 
left-sided heart catheterisation

Definition
Left heart catheterisation describes the placement of a tube into the heart. It is most commonly done to examine the arteries that supply the heart. It may also used to examine the structure and function of the left side of the heart.

Who is a candidate for the procedure? 
Most people undergo this procedure because a blockage in the heart arteries, known as coronary artery disease, is suspected. These blockages may increase the risk of, or cause, heart attacks.

Sometimes the procedure is done to: How is the procedure performed? 
The most common method of left heart catheterisation is described below.

An intravenous or IV line is put in a vein in the person's arm and a sedative is usually given. The person is asked to lie on a flat table in the procedure room.

Skin on one side of the groin is cleaned. A needle is placed into the artery and a guide wire advanced through the needle. A tube, or catheter, is inserted into the artery. The tube is then advanced into the artery and up toward the heart. A special X-ray machine can follow the tube as it moves forward. The tube eventually reaches the heart.

Once the tube is in the right place, dye is squirted through it. This dye shows up well on the X-rays giving clear pictures of the arteries of the heart and the heart itself.

Any blockage or defects in the heart or arteries can be seen, too. If certain blockages or heart valve problems are seen, the doctor may try to correct them with tiny instruments that can be inserted through the tube.

For example, a balloon can be inserted through the tube into a blocked artery. The balloon can be inflated to open the blockage. This is known as angioplasty. A rigid tube, or stent, may be placed into the artery to keep it from becoming blocked again. Sometimes a blood clot is seen and a "clot-dissolving" medication is given to dissolve the clot.

After the pictures are taken and any corrections done, the tube is removed from the body. Pressure is applied over the incision to prevent bleeding.

What happens right after the procedure? 
The person is taken to the surgery recovery room until the sedative wears off. Usually, the person is asked to lie flat on his or her back for a few hours. This prevents bleeding in the groin area. If everything is stable, the person may be able to go home later that day.

If multiple blockages were found, the person may need heart bypass surgery.

What happens later at home? 
Usually a person can usually return to normal activities the next day unless surgery was indicated.

What are the potential complications after the procedure? 
The risks of this procedure are:
  • bleeding
  • reaction to the dye
  • infection
  • stroke
  • heart attack
  • death, though this is uncommon
When a balloon is used to open a blockage, the artery may be damaged or even rupture. This may require immediate surgery.

Allergic reactions to the dye that is used can also occur. These include:
  • flushing of the skin, in which the skin becomes hot and red
  • itching of the skin
  • rash
  • kidney failure, known as acute renal failure
  • anaphylactic shock, which is severe difficulty breathing and a drop in blood pressure. This may cause death.
Author: 
Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne
Last Updated: 9/11/2004
Contributors
Potential conflict of interest information for reviewers available on request
 


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