Left heart catheterization
Left heart catheterization is the passage of a thin flexible tube (catheter) into the left side of the heart. It is done to diagnose or treat certain heart problems.
Video: Cardiac catheterization - indications
Catheterization - left heart
How the Test is Performed
You may be given a mild medicine (sedative) before the procedure starts to help you relax. The health care provider will place an IV into your arm so that you can get medicine during the procedure.
You will lie on a padded table. Your doctor will make a small surgical cut on your body. A flexible tube (catheter) is inserted through the cut into an artery. It is most often inserted through the groin, but may be placed in your arm or wrist. You will be awake during the procedure.
Live x-ray pictures are used to help guide the catheters up into your heart and arteries. Dye will be injected into your body to highlight blood flow through the arteries. This helps show blockages in the blood vessels that lead to your heart.
The catheter is then moved through the aortic valve into the left side of your heart. The pressure is measured in the heart in this position. Other procedures, such as ventriculography to check the heart's pumping function and coronary angiography to look at the coronary arteries can be done at this time. Sometimes procedures to correct blockages in the arteries are then performed, such as angioplasty with or without stenting.
The procedure may last from less than 1 hour to several hours.
How to Prepare for the Test
In most cases, you should not eat or drink for 8 hours before the test. (Your health care provider may give you different directions.)
The procedure will take place in the hospital. You may be admitted the night before the test, but it is common to come to the hospital the morning of the procedure.
Your health care provider will explain the procedure and its risks. You must sign a consent form.
How the Test will Feel
You will be given medicine (a sedative) to help you relax before the procedure. However, you will be awake and able to follow instructions during the test.
You will be given local numbing medicine (anesthesia) before the catheter is inserted. You will feel some pressure as the catheter is inserted, but you should not feel any pain. You may have some discomfort from lying still for a long period of time.
Why the Test is Performed
The procedure is done to look for:
- Cardiac valve disease
- Cardiac tumors
- Heart defects (such as ventricular septal defects)
- Problems with heart function
The procedure may also be done to repair certain types of heart defects, or to open a narrowed heart valve.
When this procedure is done with coronary angiography, it can open blocked arteries or bypass grafts.
Video: Cardiac cathertization - uses in diagnosis, evaluation and treatment
The procedure can also be used to:
- Collect blood samples from the heart
- Determine pressure and blood flow in the heart's chambers
- Examine the arteries of the heart (coronary angiography)
- Take x-ray pictures of the left side of the heart (ventriculography)
A normal result means the heart's size, motion, thickness, pressure, and arteries appear to be normal.
What Abnormal Results Mean
Abnormal results may be a sign of cardiac disease or heart defects, including:
- Coronary artery disease
- Heart enlargement
- Heart valve disease
- Mitral regurgitation
- Mitral stenosis
- Ventricular aneurysms
Complications may include:
- Cardiac arrhythmias
- Embolism from blood clots at the tip of the catheter to the brain or other organs
- Injury to the artery
- Low blood pressure
- Reaction to the contrast material
Davidson CJ, Bonow RO. Cardiac catheterization. In: Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 19.
Goff DC Jr, Lloyd-Jones DM, Bennett G, et al. 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013 Nov 12. pii: S0735-1097(13)06031-2.
Kern M. Catheterization and angiography. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 55.
Popma JJ, Kinlay S, Bhatt DL. Coronary arteriography and intracoronary imaging In: Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 20.