Cardiac Catheterization, Cardiac Stents, and Open Heart Surgery

Some cardiac patients may require more diagnostic testing and procedures depending on their level of coronary artery disease. One specific diagnostic test Dr. Nadar and the team at Capital Area Cardiovascular Associates uses is cardiac catheterization, also known as a cardiac cath.

Based on the results of the heart catheterization, your physician may recommend a cardiac stent or in some rare cases, open heart surgery.

If your primary care physician wants you to undergo a cardiac cath, reach out to the team to schedule an appointment.

What Is a Cardiac Catheterization?

Cardiac catheterization is a diagnostic procedure where a thin, flexible tube called a catheter is guided through the blood vessels of the legs or arms to the heart. Cardiac caths give our doctors the ability to gather important information about the heart muscle, heart valves, and blood vessels in the heart.

Cardiac catheterization is a common procedure that helps to diagnose or treat various types of heart conditions and heart disease including arrhythmias (irregular heartbeats), chest pain, and heart valve issues.

During the procedure. your physician can:

Locate any narrowing or blockages in blood vessels
Measure the pressure of the heart and the oxygen level of different parts of the heart
Examine how well the heart pumps blood
Take a tissue sample of the heart muscle
Identify and diagnose congenital heart issues (heart problems present from birth)
Examine the heart valves for disease
Look for blood clots

In addition to using cardiac catheterization as a diagnostic tool, heart caths can also be done at the same time as other interventional procedures (percutaneous coronary intervention or PCI). Interventional procedures include cardiac angioplasty, either with or without a cardiac stent. Cardiac angioplasty is a procedure that opens narrowed arteries to improve blood flow to the heart. Angioplasty may be performed either with or without a stent.

For patients who need a cardiac angioplasty without the use of a stent, a small balloon on the end of the catheter is inflated at the site of the blocked blood vessel. This causes the plaque or blood clot to push against the sides of the artery, making more room for blood flow.

In some cases, a stent will need to be placed during the angioplasty, or cardiac catheterization. What is a cardiac stent?

Cardiac Stents

A cardiac stent is a small wire mesh tube that widens a clogged artery. The stent, which is left in place, restores adequate blood flow to the heart. The procedure is performed by placing the stent over a long, thin tube with a balloon tip (catheter). The catheter and stent are inserted into an artery in your leg or arm and once it reaches the clogged artery, the doctor will inflate the balloon.

When the balloon is inflated, the stent also inflates and pushes against the side of the clogged blood vessel. Your doctor will then deflate the balloon and remove the catheter. The stent will stay in place permanently and help keep the artery propped open, improving blood flow.

There are two types of cardiac stents:

Bare-Metal Stents: Bare metal stents are not coated with polymer or drugs to help prevent the artery from re-clogging. This type of stent is often used in patients who are allergic to polymers or the drugs used in drug-eluting stents.
Drug-Eluting Stents: Drug-eluting stents are a type of bare-metal stents, however they are coated with a polymer that releases a drug over time. The drug helps arteries from re-clogging with plaque and buildup.

Depending on the outcomes of your diagnostic tests, your doctor may recommend a cardiac stent to keep your artery open. If you have questions about the procedure, talk to your doctor during your next appointment.

Open Heart Surgery

When heart disease cannot be addressed with angioplasty (either with or without a stent), open heart surgery may be recommended. Open heart surgery helps repair damage to the heart. The most common type of open heart surgery is a coronary artery bypass surgery. Other reasons you may need open heart surgery include:

Arrhythmias
Congenital heart defects
Heart failure
Heart valve issues
Thoracic aortic aneurysm

Patients undergoing open heart surgery may either be "on-pump" or "off-pump." When a patient is "on-pump", they are placed on a heart lung bypass machine. This machine circulates blood through the body and away from the heart chamber. After the surgery is finished, the patient is taken off of the machine and the heart begins to pump again on its own. When a patient is "off-pump" the surgery is performed on the beating heart. Patients who undergo open heart surgery will often spend at least a week recovering in the hospital and may spend the first few days in the intensive care unit (ICU). If you are scheduled for open heart surgery and have questions, talk to your physician at your next appointment.