CATH LAB

The Cardiac Catheterization Laboratory, also known as the “Cardiac Cath Lab,” is a special room where doctors can perform minimally invasive tests and procedures to diagnose and treat cardiovascular disease. 

Surgery performed in a cardiac catheterization laboratory almost always involves small flexible tubes called catheters, which can be used in place of surgery to access the heart and blood vessels. 

The catheter lab has special imaging equipment that is used to view the arteries and check the flow of blood in and out of the heart. This information helps the care team diagnose and treat blocked arteries and other problems.

 CATH LAB

Cardiac Catheterization is Used to:-

• Assess or confirm the presence of coronary artery disease, valvular heart disease, or aortic disease 
• Assess myocardial function 
• Determine if additional treatment is needed (for example, interventional surgery or coronary artery bypass graft, or CABG, surgery

During cardiac catheterization, an elongated tube called a catheter is inserted into a plastic introducer sheath (a short hollow tube inserted into a blood vessel in the leg or arm). With the help of a special X-ray machine, the catheter passes through the blood vessel to the coronary artery. 

A contrast agent is injected through a catheter as it passes through the heart chambers, valves, and main vessels. This part of the procedure is called coronary angiography. Coronary artery disease is narrowing or blockage of the coronary (heart) arteries. After interventional surgery, the coronary arteries are opened, increasing blood flow to the heart. 

The digital photo of the contrast material is used to identify the location of coronary artery stenosis or blockage. Additional imaging procedures called intravascular ultrasound (IVUS) and fractional flow reserve (FFR), can in some cases be performed in conjunction with cardiac catheterization to obtain detailed images of the vessel wall. Currently, these two imaging procedures are only available in specialty hospitals and research centers. 

Using IVUS, place a miniature sound probe (transducer) on the tip of the coronary catheter. The catheter passes through the coronary arteries and uses high-frequency sound waves to generate detailed images of the inner walls of the arteries. IVUS produces accurate images of the location and extent of the patches. 

Uses FFR to pass a special wire through the artery and administer a vasodilator. This test functionally performs a very high-quality stress test on a small section of arteries.

Cardiac Cath Lab Procedures.

1. Cardiac Implant Closure Device:- The percutaneous closure of the patent foramen ovale (the opening between the heart chambers) is done using a special closure device connected to the catheter.

Cardiac Implant Closure Device

2. Cardiac Stent:- A small wire mesh tube (stent) is inserted into the blocked artery to restore blood flow to the heart muscle.

Cardiac stent

3. Cardioversion:- A catheter is placed in the heart to locate and map small clusters of heart cells that cause the abnormal rhythm. Send a signal along the catheter to silence the cells, which results in an abnormal rhythm.

Cardioversion

4. Catheter Ablation:- A catheter placed in the heart locates and maps the small groups of heart cells that cause abnormal rhythms. The signal is sent along the duct, silencing the cells and causing the abnormal rhythm.

Catheter Ablation

5. Coronary Arteriogram:- A coronary arteriogram is an operation in which a very thin catheter or tube is passed from the groin, neck, or arm through the artery to the coronary arteries that surround the heart. The doctor uses the catheter to inject a contrast medium into the blood of the coronary arteries. The dye shows up on the x-ray and highlights the coronary arteries. X-rays are called angiography. It’s an X-ray examination of the coronary arteries. The catheter is placed in the coronary arteries to evaluate the arteries and pumping chambers of the heart.

Coronary Arteriogram

6. Electrophysiology Evaluation:- A study to understand the origin of heart rhythm disorders. The small catheter enters the heart through the femoral artery or brachial artery and is used to test the electrical system of the heart. It can induce the patient’s abnormal heartbeat for diagnosis and treatment.

Electrophysiology Evaluation

7. Electrophysiology Syncope Study:- A test to diagnose the cause of syncope. While monitoring the ECG and blood pressure, the patient’s bed is tilted from a flat position to an upright position. Once the individual’s response is recorded, treatment can begin to prevent a recurrence.

8. Internal Cardioverter Defibrillator Implant:-  A small device implanted in the chest that can be used as a pacemaker or to generate a slight electric shock when needed to restore a normal heart rhythm.

9. Angioplasty:-  The healthcare provider uses fluoroscopy during surgery. It is a special type of X-ray, just like X-ray “film.” When the contrast dye passes through the artery, it can help the doctor find the blockage in the heart artery. This is called coronary angiography. 

10. Rotoblation:- Rotablation (Rotational atherectomy) may be a complex and also the most challenging technique in coronary intervention utilized in patients with heavy calcification in coronary arteries (hardened arteries) to deliver stents in position to enhance blood flow. it's essentially a drilling technique with the assistance of a special diamond tip burr, which rotates at a speed of 150,000 to 200,000 rotations per minute. This drilling technique clears the within of the arteries to assist pass the balloon and stent easily. The tubes or catheters employed in this method are bigger than the conventional catheter.

Cardiac Catheterization Risks

Cardiac catheterization is usually safe. But as with any procedure that involves getting into your body, there are risks. Your doctor will discuss the risks with you and will carefully reduce your chances of developing these risks. Risks may include: 

• Blood vessel perforation 
• Air embolism (when air enters the blood vessel; this can be fatal) 
• Allergic reaction to the dye 
• Bleeding 
• Thrombus 
• Contusion 
• Seizure 
• Kidney infection from dye 
• Stroke 
• Uneven or irregular heart rhythm (arrhythmia)

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