Generally, coronary arteries are invisible under X-rays, and developer must be injected into the coronary artery via a cardiac catheter before being developed under an X-ray making cardiac catheterization is invasive. A cardiologist inserts a small tube that is about 100-150 cm in length, as thin as an atomic pen, into the femoral artery through the wrist or the iliac crest. The tube is inserted through the large blood vessels and into the chambers of the heart where the developer is injected. Through a monitor the location and severity of the vascular occlusion is seen and the most appropriate treatment is determined. The examination time is about 40 minutes to an hour. When a stent or balloon dilation are required, 1-2 hours is needed.
1. Need to do a cardiac catheter
The heart, the most important organ of the human body and just the size of a fist, supplies oxygen and nutrients to itself through three main coronary arteries to maintain its normal functioning. Cardiac catheterization or further interventional surgery is required if the following conditions are met.
Chest pain, coronary heart disease, valvular heart disease, myocardial disease, heart failure, pericarditis, congenital heart disease, aortic and peripheral vascular disease, or pre-operative examination.
Check the structure of the heart and whether the heart function is abnormal.
Check the condition of vascular stenosis.
Treatment of vascular stenosis with balloon dilatation or vascular stent placement
Assessment of cardiac vascular function and structure before surgery
2.Cardiac catheter coronary intervention treatment
Cardiac catheterization is performed under local anesthesia and the patient remains awake throughout the procedure. During the examination, there is no discomfort except slight pain during the initial insertion of the vascular sheath and a slight burning sensation in the chest when the developer is injected. The treatment procedure is:
(1) Disinfect the skin around the puncture site (left wrist or groin), then cover with a sterile cloth for local anesthesia.
(2) Insert and place the vascular sheath hose.
(3) Place the catheter through the vascular sheath and follow the blood vessel to the coronary artery opening.
(4) Guided by an X-ray of the cardiac catheter, place the guidewire through the catheter into the lumen of the coronary artery to be treated.
(5) Place a balloon catheter or vascular stent along the guidewire at the stenotic lesion for vasodilation
3. The side effect of cardiac catheter coronary interventional treatment:
Since the first successful implementation of coronary balloon dilatation in the human body in 1977, the interventional treatment of blood vessels has been changing with each passing day. Various new and safer tools have been released, making the treatment of coronary heart disease very common, yet any surgery or medical treatment is not completely risk-free. Possible complications include acute myocardial infarction, stroke, arrhythmia, vascular injury, emergency surgery, arterial or cardiac rupture, adverse reactions caused by developer, heart failure, infection, etc. Therefore, cardiac catheterization requires considerable care, and post-operative care cannot be ignored.
4. Hemostasis after cardiac catheterization
Most of the wounds of cardiac catheterization are less than 0.5 cm. After the examination, the medical staff will pressurize the wounds to stop bleeding. The wounds in different positions have slightly different ways of stopping bleeding.
(1) Brachial artery (wrist):
The tourniquet is pressurized for two hours and the wrist joint is not bent. If you feel numb, black, or cold, you should inform your healthcare provider immediately.
(2) Femoral artery (groin):
After partial hemorrhage, continue to pressurize the wound with gauze and a hemostatic device (2 kg sandbag) for about 6 hours. When pressurizing, the unilateral limb of the operation must be kept flat and not bent, and the patient is not allowed to get out of bed.
In addition to the traditional hemostasis method, there is a new type of pressurized hemostat, combined with hemostatic materials and a pressurizer, which is suitable for postoperative catheter wounds, arteries and large veins to stop bleeding. Easy to operate, the hemostasis pressure knob can be adjusted at any time to reduce the symptoms of pressure and discomfort of the patient; the hemostasis time is also shortened to 2-4 hours, and the patient's bed rest and medical staff's care time is reduced.