Catheterization - left heart

Alternative names
Left heart catheterization

Definition

Left heart catheterization is the passage of a catheter (a thin flexible tube) into the left side of the heart. The procedure may be performed to obtain diagnostic information about the left side of the heart or to treat certain types of heart conditions.

The procedure can also be used to determine pressure and blood flow in the heart’s chambers, to collect blood samples from the heart, and to examine the arteries of the heart by a type of X-ray called fluoroscopy.

How the test is performed

You will be given a mild sedative prior to the test. An intravenous (IV) catheter is started in your arm to allow medication to be administered during the procedure. A radiologist or cardiologist inserts the catheter through a small incision in the femoral or brachial artery after cleansing the site and numbing the site with a local anesthetic.

The catheter is then carefully threaded into your heart through the aorta and aortic valve and then into the left ventricle using X-ray images called fluoroscopy to guide the insertion. When the catheter is in place, dye is injected to allow the health care provider to visualize the structures and vessels within the heart.

How to prepare for the test

Adults:
Food and fluid is restricted for 6 to 8 hours before the test.

The procedure takes place in the hospital. Sometimes, admission the night before the test is required. Otherwise, admission as an outpatient or inpatient the morning of the procedure is required.

A health care provider must explain the procedure and its risks. You must sign a consent form for the procedure.

You are given a mild sedative 1/2 hour before the procedure. The procedure may last from 1 to several hours. You will wear hospital clothing.

Infants and children:
The physical and psychological preparation you can provide for this or any test or procedure depends on your child’s age, interests, previous experience, and level of trust. For specific information regarding how you can prepare your child, see the following topics as they correspond to your child’s age:

     
  • Infant test or procedure preparation (birth to 1 year)  
  • Toddler test or procedure preparation (1 to 3 years)  
  • Preschooler test or procedure preparation (3 to 6 years)  
  • Schoolage test or procedure preparation (6 to 12 years)  
  • Adolescent test or procedure preparation (12 to 18 years)

How the test will feel

The procedure takes place in a radiology department or cardiac diagnostic laboratory. You are given sedation to relax prior to the procedure, but you are awake and able to follow instructions during the test. You will remain on a stretcher for the duration of the test.

An insertion is made into an artery for threading the catheter into the left side of your heart. You are given local anesthesia to insert the catheter, and generally the only sensation is one of pressure at the site. You may experience some discomfort due to lying still for a prolonged period of time.

Why the test is performed
The procedure is performed to evaluate cardiac valvular disease, heart function and blood supply, congenital heart anomalies, and to determine the need for cardiac surgery. Therapeutic catheterization may be used to repair certain types of heart defects, open a stenotic heart valve, and dilate obstructed arteries or grafts in the heart.

Normal Values
Normal heart size, normal heart motion and thickness, normal heart blood supply (if coronary angiography is also performed), normal heart pressures are found.

What abnormal results mean

Cardiac defects or disease may be present. These could include

     
  • Coronary artery disease  
  • Valvular heart disease (see below)  
  • Ventricular aneurysms  
  • Enlargement of the heart.

Additional conditions under which the test may be performed:

     
  • Aortic insufficiency  
  • Aortic stenosis  
  • Mitral regurgitation; acute  
  • Mitral stenosis

What the risks are
Risks of the procedure are trauma to the artery, local hematoma at the access site, cardiac arrhythmias, Cardiac tamponade, low blood pressure, infection, embolism from blood clots at the tip of the catheter, reaction to contrast medium, stroke, and heart attack.

Johns Hopkins patient information

Last revised: December 6, 2012
by Simon D. Mitin, M.D.

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.