Generally, coronary arteries are invisible under X-rays. A developer must be injected into the coronary artery via a cardiac catheter before being developed under an X-ray. Cardiac catheterization is invasive. A cardiologist inserts a small tube that is about 100-150 cm in length (as thin as an atomic pen) into the femoral artery through the wrist or the iliac crest. The tube is inserted through large blood vessels and into the chambers of the heart where the developer is injected. Using a monitor, the location and severity of the vascular occlusion can be seen and the most appropriate treatment determined. The examination time is about 40 minutes to an hour. When a stent or balloon dilation is required, 1-2 hours is needed.
Need for a cardiac catheter
The heart, the most important organ of the human body and just the size of a fist, supplies oxygen and nutrients to itself through three main coronary arteries to maintain normal functioning.
Cardiac catheterization or further interventional surgery is required if the following conditions are met:
Chest pain, coronary heart disease, valvular heart disease, myocardial disease, heart failure, pericarditis, congenital heart disease, aortic and peripheral vascular disease, or pre-operative examination.
Check the structure of the heart and whether the heart is functioning abnormally.
Check the condition of vascular stenosis.
Treatment of vascular stenosis with balloon dilatation or vascular stent placement.
Assessment of cardiac vascular function and structure before surgery.
Cardiac catheter coronary intervention treatment
Cardiac catheterization is performed under local anesthesia and the patient remains awake throughout the procedure. During examination, there is no discomfort except for a slight pain during the initial insertion of the vascular sheath and a slight burning sensation in the chest when the developer is injected. The treatment procedure is as follows:
Disinfect the skin around the puncture site (left wrist or groin). Then cover with a sterile cloth for local anesthesia.
Insert and place the vascular sheath hose.
Place the catheter through the vascular sheath and follow the blood vessel to the coronary artery opening.
Guided by an X-ray of the cardiac catheter, place the guidewire through the catheter into the lumen of the coronary artery to be treated.
Place a balloon catheter or vascular stent along the guidewire at the stenotic lesion for vasodilation.
Side effects of cardiac catheter coronary interventional treatment
Since the first successful implementation of coronary balloon dilatation in the human body in 1977, the interventional treatment of blood vessels has evolved. Various new and safer tools are now available, making the treatment of coronary heart disease very common, although any surgery or medical treatment is not completely risk-free. Possible complications include acute myocardial infarction, stroke, arrhythmia, vascular injury, emergency surgery, arterial or cardiac rupture, adverse reactions caused by the developer, heart failure, infection, etc. Therefore, cardiac catheterization requires considerable care and post-operative care cannot be underplayed.
Hemostasis after cardiac catheterization
Most wounds due to cardiac catheterization are less than 0.5 cm. After examination, medical staff will pressurize the wound to stop bleeding. Methods to stop bleeding depend on where the wound is positioned:
Brachial artery (wrist)
A tourniquet is pressurized for 2 hours, and the wrist joint is not bent. If the wound feels numb, cold, or turns black, a healthcare provider should be notified immediately.
Femoral artery (groin)
After partial hemorrhage, continue to pressurize the wound with gauze and a hemostatic device (2 kg sandbag) for about 6 hours. When pressurizing, the operated limb must be kept flat and not bent, and the patient is not allowed to get out of bed.
In addition to the traditional hemostasis method, there is a new type of pressurized hemostat which combines hemostatic materials and a pressurizer and is suitable for use on post-operative catheter wounds, arteries and large veins to stop bleeding. Easy to operate, the hemostasis pressure knob can be adjusted at any time to reduce the symptoms of pressure and discomfort on the patient. Hemostasis time is shortened to 2-4 hours, reducing the patient's required bed rest and medical staff's care time.