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ETMC Cardiovascular Institute

First in the hearts of East Texas

Cardiac Catheterization

 

Cardiac catheterization is a procedure in which a cardiologist places a small catheter (tube) through an artery (usually in the groin) and threads it up to the heart.

A special dye is injected through this catheter to allow pictures to be taken of the arteries, chambers and valves of the heart. This is a fact-finding (diagnostic) test, and any problems that are identified will be addressed with additional procedures. During this test, the patient is mildly sedated, but remains conscious.

The cardiac catheterization laboratories and cardiac operating rooms of the ETMC Cardiovascular Institute are located adjacent to each other on the first floor of ETMC Tyler and are separated only by a changing area.

This innovative layout is the result of the close collaboration between physicians, architects and other healthcare professionals who worked as a team to develop the center. The ETMC Cardiovascular Institute was the first in East Texas to use this unique arrangement, which provides close proximity for increased safety in treating critical cardiac patients.

What to Expect
When reporting to ETMC for a cardiac catheterization, the patient will check in through the admitting office then proceed to the cath unit where a family history will be obtained and other preparations will be completed.

 

Catheterization Glossary

PTCA:
Percutaneous Transluminal Coronary Angioplasty; also known as balloon surgery. Following cardiac catheterization, PTCA may be performed to open certain types of blockages in coronary arteries. A catheter (tube) is placed in an artery (usually in the groin) and is threaded up to the heart. The catheter is then placed into the affected coronary artery and a small wire is passed through the blocked area. Next, a specialized balloon is passed over the wire to the blockage and inflated. The blockage is pushed against the wall of the artery, making the passage larger. Brief periods of chest discomfort are associated with this procedure when the balloon is inflated. The recovery period is similar to a standard cardiac catheterization.

Coronary Stent:
Small, metal, spring-like devices used during the PTCA procedure to support coronary artery walls. After the narrowed area has been expanded, a stent(s) is advanced to the affected area and inflated over another type of balloon. The balloon is then deflated and removed, but the stent remains behind, embedded into the wall of the previously narrowed artery. The recovery routine is the same as for PTCA. Once the stent is placed, it will gradually become a part of the artery wall. A platelet inhibitor (blood thinner) is usually taken for three months while this process takes place. MRI testing in not allowed during this three-month period to prevent dislodging the stent. A stent may help a narrowed artery stay open longer, so the cath lab maintains an inventory of the newest stents available.

PTCRA:
Percutaneous Transluminal Coronary Rotational Ablation; procedure in which a small, flexible drill bit is placed in the artery to drill through and pulverize material causing blockage. The small bits of resulting debris are so small (the size of red blood cells) that they are removed from the body by natural means. (This procedure is also known as the rotoblator and affectionately called the "roto-rooter" by our patients.) While this device is not for use in all lesions, it is particularly effective for those that are calcified. Often, a balloon and stent are used in addition to this device for best results. The ETMC Cardiovascular Institute was the first in East Texas to offer PTCRA.

TEC:
Transluminal Extraction Catheter; device similar to that used for PTCRA that is superior for use on soft blockages such as those within bypass grafts. Removal of debris from this device is accomplished by using an external suction bottle. The ETMC Cardiovascular Institute was the first in East Texas to offer TEC.

IVUS:
Intravascular Ultrasound; device allowing the cardiologist to see the vessel from the inside. IVUS uses a small catheter containing an ultrasound chip that is passed into the coronary artery to be evaluated. The unique perspective afforded by IVUS allows the cardiologist to obtain special information to improve care. IVUS can be used in addition to any of the above procedures.

Doppler Flow Wire:
This device uses a combination of sound waves and medication to simulate stress on the heart. Special measurements are taken before and after the drug is administered to decide if a lesion is dangerous or not. The ETMC Cardiovascular Institute was the first in East Texas to offer doppler flow wires.