RIGHT HEART CATHETERIZATION

DR. GOURANGA KUMAR SAHA

MBBS,MD,FESC,FACC ASSOCIATE PROFESSOR CARDIOLOGY NICVD,DHAKA.

Cardiac catheterization (also called heart catheterization) is a diagnostic procedure which does a comprehensive examination of how the heart and its blood vessels function.

One or more catheters is inserted through a peripheral blood vessel in the arm (antecubital artery or vein) or leg (femoral artery or vein) with x-ray guidance. This procedure gathers information such as adequacy of blood supply through the coronary arteries, blood pressures, blood flow throughout chambers of the heart, collection of blood samples, and x rays of the heart's ventricles or arteries.

 Right-sided cardiac catheterization

Evaluate tricuspid and pulmonary valve function, and measure pressures of different chambers and take blood samples from the right atrium and ventricle, and pulmonary artery and can detect Pulmonary HTN, pulmonary valve stenosis, tricuspid valve stenosis, atrial and ventricular septal defects.

Left-sided cardiac catheterization

Evaluate function of mitral and aortic valves, and coronary arteries Abnormalities, left side Aortic valve regurgitation, CADstenosis or occlusion, mitral valve stenosis or regurgitation, ventricular hypertrophy or aneurysm

Right heart catheterization

When testing the heart's right side, tricuspid and pulmonary valve functions are evaluated, in addition to measuring pressures and collecting blood samples from the right atrium, ventricle, and pulmonary artery. Also see abnormal trajectory ,do right ventriculography, evaluate normal and abnormal venous system.

Indication
Congenital heart defects, or heart problems that originated from birth A diagnosis of valvular-heart disease Meaasurement of pulmonary pressure Measurement of PVR, PCW

RISKS:
Most people do not have problems having a right heart cath. Injury to surrounding structure . Sore area or bruise where the catheter was put in. Bleed too much or need surgery. Arrhythmia . Pulmonary oedema , Infection. Embolismcerebral, pulmonary, Pericardial tamponade.

Stroke (CVD). Peripheral thromboembolism. Allergic reaction Renal failure from the dye. Hypotension

Precaution Before Your Right Heart Cath :

if patient have bleeding problems, need special precaution.

If patient is diabetic , omit morning dose of anti diabetic medication. A dye used during right heart cath to visualized cardiac chamber. People who are allergic to shellfish (lobster, crab, or shrimp) may also be allergic to this agent.

 A diagnosis of a bleeding disorder, poor kidney function, or debilitation. Any of these pre-existing conditions typically raises the risk of the catheterization procedure and may be reason to cancel the procedure.

Antibiotics and may be given before the test

Before procedure :

A mild sedative. An intravenous line. ECG Monitoring. Local anesthetic.

Parameter seen during cath:

Pressure study : During the cath, check the pressure and blood flow in the chambers. Detecting the difference in pressure above and below the heart valve can verify heart valve disease. The greater narrowing correlates with the higher pressure difference.

Oxymetry: see the oxygen saturation and step up.

Catheter trajectory: To see shunt anomalies and congenital defects. Graphy of different chamber : check the valves and blood vessels and chamber.

Aftercare While cardiac catheterization may be performed , patient may require close monitoring following the procedure while remaining in the hospital for at least 24 hours. The patient will be instructed to rest in bed for at least eight hours immediately after the test. If the catheter was inserted into a vein or artery in the leg or groin area, the leg will be kept extended for four to six hours. If a vein or artery in the arm was used to insert the catheter, the arm will need to remain extended for a minimum of three hours.

Thanks