Cardiac Catheterisation

What is Cardiac Catheterisation?

In the past when a patient had an issue with the heart that needed to be looked at in more detail, often open heart surgery would be used. Now small cuts in this skin (usually in the groin or arm) can be made through which thin flexible tubes can be passed into the body.

This is known as Cardiac Catheterisation and is guided by images collected through fluoroscopy . This can often provide the same kind of information as open heart surgery and can even be used for treatment. This procedure is associated with less risk and shorter healing times than open heart surgery.

Once the flexible tube (catheter) is in place in the heart different procedures can be carried out such as:

  • The injection of a liquid (contrast) to better image any issues with the heart or surrounding vessels.

  • Balloons can be used to open up vessels and improve blood flow.

  • Stents can be inserted to make sure that the vessels remain open long term.

  • Areas of the heart that trigger irregular heart beats can be stopped.

  • Other procedures can be carried out such as the closing of holes.

Pacemaker insertion is also carried out in cardiac catheter labs.

The doses received with cardiac catheter procedures are related to the difficulty of the procedure.

What do I need to know?

This video discusses the process involved in cardiac catheter procedures.

Take away points:

  • You should tell the person doing your test if you are, or think you could be, pregnant.

  • The lifetime risk of cancer induction for cardiac catheterisation depends on the procedure but is usually between 1 in 1000 and 1 in 10 000.

  • This risk has been assessed by a healthcare professional to be less than the risk of not having the procedure (the risk is justified).

Skin burns

The Radiographer and the doctor who specialises in imaging (Radiologist) will be aware of the radiation dose that you are receiving. They will make sure that the dose is as low as possible. While it is rare, sometimes you may be at risk of skin reddening and burns after the procedure. You will be given information on what to do if this happens. However, some simple steps you can take that may ease the burn are:

  • Apply a moisturiser to the reddened area 2 times a day. For example, E45 cream.

  • Take a bath or shower every day if possible, using baby soap or unperfumed soap or unperfumed shower gel.

  • Pat the area dry with a soft towel, being very gentle with folds of skin, taking care not to rub.

  • Do not swim if you have visibly red skin.

  • Do not use a sun bed.

Patient shielding

In the past, you may have been given a lead apron or shielding like gonad shields during an X-ray. Recent evidence shows that this is not necessary due to improvements in technology and scientific knowledge.

Therefore, you may notice that you are no longer offered shielding. If you would like more information on why this change has happened you can find it here.

Summary

  • Cardiac catheterisation using fluoroscopy will only be used if a healthcare professional can show that the benefit to you is greater than the risk (justified).

  • The X-rays used for cardiac catheterisation do not hurt though other parts of the procedure may cause discomfort. Usually, this is much less than if the procedure were carried out with open surgery.

  • The fluoroscopy equipment will be maintained to reduce the dose to keep the dose and risk to you as low as possible.

  • The individual carrying out the imaging will be trained to keep the dose and risk to you as low as possible.

  • If you have any more questions, please ask a healthcare professional.

If you'd like to find out more about the risks of cardiac catheterisation, there is more information within the 'Radiation Risk' section.