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Left heart catheterization
Definition
Left heart catheterization is the passage of a thin flexible tube (catheter) into the left side of the heart to diagnose or treat certain heart problems.
Alternative Names
Catheterization - left heart
How the Test is Performed
You may be given a mild sedative before the procedure starts to help you relax. The health care provider will place an IV into your arm so that you can receive medication during the procedure.
You will lie on a padded table. Your doctor will make a small surgical cut on your body, usually near the groin. Then your doctor will insert a flexible tube (catheter) through the cut into an artery. Sometimes the catheter will be placed in your arm or wrist. You will be awake during the procedure.
The doctor will use live x-ray pictures to carefully 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 the doctors see any blockages in the blood vessels that lead to your heart.
The catheter is the moved through the aortic valve into the left side of your heart. When in place, a special dye (contrast) flows through the tube. This helps the doctor better see your heart.
The procedure may last from less than 1 hour to several hours.
How to Prepare for the Test
You should not eat or drink for 8 hours before the test. (Your doctor or nurse 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 sedation to help you relax before the procedure, but 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 evaluate:
- Cardiac valve disease
- Cardiac tumors
- Heart defects (such as ventricular septal defects)
- 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.
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)
Normal Results
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:
- Aortic insufficiency
- Aortic stenosis
- Coronary artery disease
- Heart enlargement
- Heart valve disease
- Mitral regurgitation
- Mitral stenosis
- Ventricular aneurysms
Risks
Complications may include:
- Cardiac arrhythmias
- Cardiac tamponade
- Embolism from blood clots at the tip of the catheter to the brain or other organs
- Heart attack
- Injury to the artery
- Infection
- Low blood pressure
- Reaction to the contrast material
- Stroke
References
Davidson CJ, Bonow RO. Cardiac catheterization. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders; 2011:chap 20.
Kern M. Catheterization and angiography. In: Goldman L,Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier;2011:chap 55.
Popma JJ. Coronary angiography. In: Bonow RO, Mann DL, ZipesDP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders; 2011:chap 21.
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
