Cardiac Catheterization

[bbb]

Hello,
Just read Lorie's post about her CT scan which included this:

I think part of the reason that those of us with aortic aneurysms have to avoid cardiac catheterization is that some of us have connective tissue disorders so the tissues are delicate and catheterizations can be too invasive.

Can anyone weigh in on this? I have not heard people with aortic aneurysms should avoid cardiac catheterization...where is this information from, Lorie?

I ask because I had a cardiac catheterization at Cleveland Clinic about 3 weeks ago, two days before my OHS for aortic aneurysm repair and bicuspid valve replacement with tissue valve. It was pretty rough for me afterwards. I should have been released at 2pm after the procedure, but they kept me until 8pm. I had a lot of pain, a twisted, pulling muscle type of pain, not at the site they went in, but in an area nearby. Then when they tried to sit me up, I got faint and my blood pressure was very low. So they put saline IV in for a while and I slowly got better. But afterwards, walking was tough and I got two huge bruises in nearby areas to the entry site. The doc said (my understanding...)this could be because there are different tissue planes and the bleeding can go across the planes?? Also, that maybe during the OHS, if heparin was used, that could cause the bruising in that area. But I definitely had an unusual reaction to that procedure, as the recovery nurse said in 13 years she had not seen someone had the pain I had.

Any thoughts?

Thanks, Betsy

 

[Bina]

I couldn't even go home until the next morning....very dizzy. It was lucky for me that my surgeon wanted the cath done 10 days before my OHS. I walked funny for a few days after. Spectacular bruises!

 

[Ross]

I don't know if they've established a protocol or not. They did me aneurysm and all and in fact, missed my aneurysm completely on the scan. This was in 95, so things may have changed, but I doubt it. I've ben cathed 3 times now. Never had any problems, but bruising is another thing. I looked like I walked straight into a moving bus and was black and blue for a couple weeks after.

 

[marie]

I'll add my experience from yesterday. I had my heart cath yesterday and had no pain at all. Had to lay flat for 5 hours and I guess that was the worst part. They did apply pressure after the procedure which I guess is standard.

My instructions were to not drive, lift, etc and take it easy for 48 hours. I am not to lift anything heavier than 10 pounds for a week.

Is that standard after procedure? Yes I am following my cardio/hospital instructions just wondered if everyone gets the same instructions. Also did anyone experience any problems at all after?
Any comments, suggestions?
Thanks
Earline

 

[tobagotwo]

I didn't get those instructions, but I was having my surgery in the morning, so I guess they figured things were under control.

I really didn't have any bruising or pain to speak of afterwards, and they used a patch on me, so I didn't have to lie still for five hours.

I did find that I have nerve nexus right where they have to apply and hold all that pressure right afterwards. It was like someone banging on your funnybone with a frying pan continuously for ten minutes, and was very difficult to bear. I understood most people don't have their nerves set up that way, fortunately. I note that I took the very lightest dose of anesthesia, as I wanted to see and remember everything. You can ask for the level of drugs that you want when they start.

I can't help but be struck by the notion that no one should be doing a cath on someone that they know has an aneurysm. It just makes so much sense. It doesn't take much for it to dissect. I suppose the interventional cardiologists feel it's not that invasive, but I could actually feel the catheter banging around in there (not painful - just odd). If I had an aneurysm, I think I would refuse the cath.

Best wishes,

 

[Praline]

I had an angiogram 2 years ago before my surgery. I was amazed at how little I felt. I had to lay on my back for hours, I forget how many. BUT they let me have a pillow under my head. it put my head up enough that if I leaned a book on bed table, I could read. Now there is nothing I like better than a good book!!! so I was just fine.
The next day, I had no pain, no redness, no swelling... If I looked really hard, I could see 2 tiny pin pricks where they went in.

 

[briansmom]

I too am very curious about this issue. We recently found out that the arteries to one of Brian's kidneys were scarred over and killed a kidney. I don't really understand how that could be from his original dissection when they only replaced his ascending aorta. My "assumption" is that the scarring was caused by a catheterization or something. I will certainly be talking about this with his cardiologist. It sounds logical that anyone with a connective tissue disorder should be treated differently.

 

[ALCapshaw2]

I'll add my experience from yesterday. I had my heart cath yesterday and had no pain at all. Had to lay flat for 5 hours and I guess that was the worst part. They did apply pressure after the procedure which I guess is standard.

My instructions were to not drive, lift, etc and take it easy for 48 hours. I am not to lift anything heavier than 10 pounds for a week.

Is that standard after procedure? Yes I am following my cardio/hospital instructions just wondered if everyone gets the same instructions. Also did anyone experience any problems at all after?
Any comments, suggestions?
Thanks
Earline

I've had UMPTEEN Heart Catheterizations (I deliberately lost count so I wouldn't know which one was #13 but never received those specific instructions, just to "take it easy for a 'few' days".

The ONLY problem I ever had was a huge Hematoma (about the size and shape of a Hostess Twinky if you are old enough to remember those). That came about when I went back to work only 2 days later and was sitting / leaning over a desk all day. That was a LONG time ago.

Bottom Line: I think those are EXCELLENT instructions, i.e. to take it easy for 48 hours AND to NOT lift anything over 10 lbs. for a week.

When I had an angioplasty, my BACK started 'Killing Me' and they sedated me for the discomfort. Ever since, I have asked for a Hand Towel to be folded lengthwise a couple of time and pulled under the small of my back. I also ask for a (medium sized) pillow to be placed under my knees. I don't understand why that is not standard procedure. It sure makes it MUCH more comfortable for ME.

IF I had an aneurism, I would certainly wish to avoid having a Cath if at all possible.

We in North Alabama are fortunate to have an OUTSTANDING Cath Lab at Huntsville Hospital. It is possibly the Best and Most Efficient in the State. There are 6 Cardiologists whose primary duty is in the Cath Lab. They can do a 'Standard Cath' in about 20 minutes once the Cardiologist approaches the patient. As I recall from several years ago, their 'event rate' was 1 'undesired event' per 1000 caths. These guys are GOOD !

'AL Capshaw'

 

[tobagotwo]

Point taken, Rachel. You're not always presented with the choices you feel you need at the time you need them, and you're certainly not at fighting strength by the time you're at that point.

It may help to have an advocate. Of course, you don't always have time to duke it out, or to find a different surgeon, even if you do have a tiger in your corner.

Best wishes,

 

[marie]

I've had UMPTEEN Heart Catheterizations (I deliberately lost count so I wouldn't know which one was #13 but never received those specific instructions, just to "take it easy for a 'few' days".

The ONLY problem I ever had was a huge Hematoma (about the size and shape of a Hostess Twinky if you are old enough to remember those). That came about when I went back to work only 2 days later and was sitting / leaning over a desk all day. That was a LONG time ago.

Bottom Line: I think those are EXCELLENT instructions, i.e. to take it easy for 48 hours AND to NOT lift anything over 10 lbs. for a week.

When I had an angioplasty, my BACK started 'Killing Me' and they sedated me for the discomfort. Ever since, I have asked for a Hand Towel to be folded lengthwise a couple of time and pulled under the small of my back. I also ask for a (medium sized) pillow to be placed under my knees. I don't understand why that is not standard procedure. It sure makes it MUCH more comfortable for ME.

IF I had an aneurism, I would certainly wish to avoid having a Cath if at all possible.

We in North Alabama are fortunate to have an OUTSTANDING Cath Lab at Huntsville Hospital. It is possibly the Best and Most Efficient in the State. There are 6 Cardiologists whose primary duty is in the Cath Lab. They can do a 'Standard Cath' in about 20 minutes once the Cardiologist approaches the patient. As I recall from several years ago, their 'event rate' was 1 'undesired event' per 1000 caths. These guys are GOOD !

'AL Capshaw'

I am certainly old enough to remember the twinky Did the hemotoma take care of itself or did you have to go in. That is one the things they are making me watch for.

I learn so much from this site everyday. Somedays I am ready for this to me over and some days I want to chicken out.
Thanks everyone

 

[ALCapshaw2]

I am certainly old enough to remember the twinky Did the hemotoma take care of itself or did you have to go in. That is one the things they are making me watch for.

I learn so much from this site everyday. Somedays I am ready for this to me over and some days I want to chicken out.
Thanks everyone

My cardiologist examined the Hematoma, listened to it with his stethoscope, and told me to go home and lay down as much as possible for a WEEK with NO strenuous activity.

As I recall it eventually receeded on it's own without further incident. I was always more 'careful' for a few days following later cath's and had no more incidents. Most of the time, there was only mild to moderate bruising around the site. Once I had a fairly large bruise, but no hematoma, and it resolved in time.

It has been interesting to note the changes in post-cath treatment and care. I have witnessed the change from Hand Pressure (hard on the nurse/technician) with sandbags an bed rest for several hours, to Giant C Clamps (I hated those things...now that I think about it, repositioning the C-Clamp may have played a role in my Hematoma...I'm not sure), and back to Hand Pressure (for ~30 minutes) as the BEST way to control leakage with a technician and nurse monitoring the patient, followed by application of a Pressure Bandage.

Inserting a "Plug" and/or Stitches is an option which allows almost immediate mobility (think Vice President Chaney).

'AL Capshaw'



'AL Capshaw'

 

[Tina]

When I had my Cath they "plugged" me afterwards and I was mobile in just a few hours - I had very little bruising and was just a little sore for a day or so... guess I was lucky

 

[Faye]

When I had my cath, I barely felt the pinch for the numbing shots. I was awake (although slightly sedated) for the whole procedure. I didn't feel a thing, other than the warmth when the dye was injected. I was very happy I had been warned (thanks to VAR.com members) about the warmth or I would have sworn that I wet myself

I had a BAB as well as an ascending aortic aneurysm - My card did both a right and left cath but did not cross the valve. He said he didn't want to risk knocking some calcium loose or damaging the tissue. He didn't seem worried at all about the aneurysm.

I was told to avoid stairs for 24 hours and lie down as much as possible during that 24 hours, take it very easy for the next 48 hours and then to resume activities but keep lifting to less than 10 lbs. I followed orders and had no problems and just a little bruising.

I sure worried about the procedure but can say it wasn't nearly as bad as I had imagined!

 

[briansmom]

I talked to the docs today about whether Brian's caths could have caused the loss of kidney. Well, bottom line, I did not understand my anatomy very well. According to them, a heart cath goes through the femoral artery which enters the aorta above the renal arteries; so it is not possible that the caths caused his kidney problem. They are assuming that it was during the original ascending aorta dissection which in his case occurred over a minimum of 2 weeks. They think that he had a blood clot or something that blocked the renal arteries. Anyway, that made me feel a bit better, but I still agree that they don't seem like a good idea with an aneurysm.

 

[frank10b]

I had a cath done in 2001 and it was terrible, pain, sharp piercing that forced me into an overnite stay in the hospital. Maybe i had an Pulminary embolism, they checked CPK and cardiac enzymes and they came out negative however shortly after that my aortic stenosis turned into mitro valve problems too. Is it posible that the mitro valve was damaged also during the proceedure. What could have caused my problems with the first cath, the second cath I had at clevland clinic was fine in 2002.