Cardiac catheterisation

Visualising the invisible

The catheterisation of the heart is a method to display the heart and its vessels and to measure certain pressures. Where other diagnostic techniques are not sufficient, e.g. in case of a suspected dangerous narrowing of the coronary vessels or a suspected cardiac valve disease, the cardiac catheterisation will visualise the invisible.

The cardiac catheter is a thin, flexible plastic tube. It serves to measure the pressure in the chambers of the heart and in vessel sections near the heart. Besides, the physician can inject radiographic contrast medium via the catheter. This way he can display the structures of the heart and/or the vessels on a monitor. Specific catheters also facilitate measuring certain cardiovascular values such as, e.g., the amount of blood pumped out of the heart within one minute.

Left ventricular catheterisation through the arm or leg artery

Basically, we distinguish between two types of examination procedures.

• right ventricular catheterisation, also called venous catheter technique
• left ventricular catheterisation, also called arterial catheter technique

Different techniques for all sorts of issues

The right ventricular catheterisation(catheter infiltration) serves to examine the right cavities of the heart and the pulmonary vessels. This technique will be applied if there is a suspicion of valvular insufficiency, defective septums or a functional disturbance of the heart (e.g. in case of cardiac insufficiency, myocardial disorder or after suffering a heart attack) or if a disease of the pulmonary circulation is supposed.

For right ventricular catheterisation the physician punctures a vein in the groin or in the bend of the elbow, occasionally also a jugular vein. This is done after thorough disinfection and under local anaesthesia. Subsequently, under X-ray observation, the physician inserts the catheter through the vascular system up to the right ventricle and into the pulmonary vessels. After removing the guide probe the physician will be able to inject radiographic contrast medium via the catheter, to take blood samples or to take the blood pressure in the right ventricle and in the pulmonary artery.

The procedure of the left ventricular catheterisation corresponds in principle to the approach of the right ventricular catheterisation. For this, however, instead of the vein it is the artery in the groin or in the bend of the elbow that is punctured. The primary object of the left ventricular catheterisation is the display of the coronary vessels (coronary angiography). For this purpose the cardiac catheter is advanced through the vascular system and the left ventricle up to the outlet of the coronary vessels from the aorta.

As the imaging of the coronary vessels in a standard X-ray photograph, in an ultrasonic examination or even in the more sophisticated examination by means of a magnetic resonance tomograph (MRT) is not sufficiently precise, it is necessary to inject a radiographic contrast medium into the coronary vessels for coronary angiography. Only with this contrast medium injected the fine coronary vessels and their narrow areas become visible on an X-ray monitor.

Picture of the left coronary artery with a narrow area

Safety thanks to the most advanced medical equipment

A cardiac catheterisation is usually performed when the patient is in the waking state. The puncture point is locally anaesthetised so that the needle penetrates the groin or the bend of the elbow without inflicting pain. Before the examination is commenced, the patient must be covered with a large sterile drape for hygienic reasons. During the examination the patient is monitored by means of the most advanced circulatory and respiratory monitoring equipment. On average, a cardiac catheterisation in the Schüchtermann-Klinik takes approx. 15 minutes.

Cardiac catheterisation: definite diagnosis

In Germany every year a total of more than 800,000 left ventricular catheterisationsare performed. Where other diagnostic methods do not suffice for a decision on the therapy, the cardiac catheterisation provides very precise findings.
The complications rate in cardiac catheterisation is very low, but depends also on the severity of a cardiac and/or vascular disease possibly existing in the individual case.

The findings of a cardiac catheterisation enable the attending cardiologists to make an exact diagnosis and to plan the further treatment. Any complex diagnoses are discussed between our cardiologists and cardiac surgeons in the meeting they have every morning. Thus we ensure that every patient will receive the best individual therapy.

The immediate local vicinity and the trans-divisional cooperation of the Cardiology and Cardiac Surgery department mean maximum safety for our cardiological patients.