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By Mayo Clinic staff
During the procedure
Cardiac catheterization is often done in a special operating room called a catheterization lab. The catheterization lab has special X-ray and imaging machines that normal operating rooms don't have.
Cardiac catheterization is usually performed while you're awake, but sedated. An intravenous (IV) line will be inserted in your hand or arm, and will be used to give you any additional medications you might need during your procedure. You may also have monitors (electrodes) placed on your chest to check your heartbeat during the test.
Just before the procedure, a nurse or technician may shave the hair from the site where the catheter will be inserted. Before the catheter is inserted in your artery, you'll be given a shot of anesthetic to numb the area. You may feel a quick, stinging pain before the numbness sets in.
After you feel numb, the catheter will be inserted. A small cut is made, usually in your leg, to access an artery. A plastic sheath will be inserted in the cut to allow your doctor to insert the catheter.
What happens next depends on why you're having a cardiac catheterization:
- Coronary angiogram. If you're having this test to check for blockages in the arteries leading to your heart, a dye will be injected through the catheter, and X-ray images of your heart arteries will be taken. In a coronary angiogram, the catheter is usually placed in the artery in your groin or wrist.
- Right heart catheterization. This procedure checks the pressure and blood flow in the right side of your heart. For this procedure, the catheter is inserted in the artery in your neck or groin. The catheter has special sensors in it to measure the pressure and blood flow in your heart.
- Heart biopsy. If your doctor is taking a sample of heart tissue (biopsy), the catheter will usually be placed in the artery in your neck. A catheter with a small, jaw-like tip is used to cut a small sample of tissue from your heart. You may feel pressure as this catheter is being used, but you likely won't feel the actual tissue being snipped.
- Balloon angioplasty, with or without stenting. This procedure is used to open a narrowed artery in or near your heart. The catheter will likely be inserted in the artery in your groin for this procedure. A long, flexible catheter will be thread through your arteries to the narrowed artery. Then, a smaller balloon catheter will be led through the flexible catheter and inflated at the narrowed area to open it. In many cases, your doctor will also place a mesh coil called a stent at the narrowed portion to help keep the artery open.
- Closure of heart defects. If your doctor is closing a hole in your heart, such as an atrial septal defect or patent foramen ovale, you will often have catheters inserted in both the arteries and veins of the groin and neck. A device is then inserted into your heart to close the hole.
- Balloon valvuloplasty. This procedure is done to open up narrowed heart valves. The placement of your catheters will depend on which valve problem you have. A catheter is threaded across the valve. A balloon is then blown up to make the valve open more easily. You may feel pressure as the catheters are inserted into your body, but you should not feel discomfort from the balloon treatment itself.
Although you may be sedated, you'll be awake during the procedure so that you can follow instructions. Throughout the procedure you may be asked to take deep breaths, hold your breath, cough or place your arms in various positions. Your table may be tilted at times.
Threading the catheter shouldn't be painful, and you won't feel it moving through your body. Tell your health care team if you do experience any discomfort.
After the procedure
It usually takes several hours to recover from a cardiac catheterization. After your procedure is finished, you'll be taken on a gurney to a recovery room while the anesthesia wears off. This usually takes about an hour.
After you leave the recovery room, you'll go to a regular hospital room. The plastic sheath inserted in your groin, neck or arm will be removed soon after unless you've had a blood-thinning medication during your procedure. It's very important not to move the limb that your catheter's been inserted in, or to lift your head if your catheter is in your neck, so as not to cause serious bleeding.
After your catheter has been removed, the technician or nurse who has removed your sheath will apply pressure to the insertion sites, and you'll need to lie flat for one to six hours after the procedure to avoid serious bleeding and to allow the artery to heal.
You'll be able to eat and drink after the procedure. The length of your stay in the hospital will depend on your condition. You may be able to go home the same day as your catheterization, or you may need to stay overnight or longer. Longer stays are common if you have a more serious procedure immediately after your catheterization, such as angioplasty.
- Eastwood J. Nurse's role in the cardiac catheterization laboratory. In: Moser DK, et al. Cardiac Nursing: A companion to Braunwald's heart disease. Philadelphia, Pa..: Saunders Elsevier; 2007339.
- Barbara Woodward Lips Patient Education Center. About your heart-catheter procedures. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2005.
