cardiac catheterization risk

[windsurfer]

I have aortic stenosis (AVA 0.7 - 0.8 cm2, peak gradient at 70mmHg) and one surgeon said Friday I should proceed with plans for surgery. First I need to get a cardiac catheterization but understand it has some risks. How do you know if your doctor is good at it or how to find one that is? Is an MRI/MRA or some other test a safer substitute?

Windsurfer

 

[Ross]

As with any invasive procedure, there is a risk of anything going wrong, but honestly, don't sweat it. It's not a big deal at all. I haven't heard of anyone having any major problems from one here. A Cath is by far one of the best diagnostic tools available as they can get right in there and measure pressures and see problems first hand.

 

[T-Money]

Hi.
Catheterization is usually considered a big deal for people who haven't had or won't ever have to have heart surgery. The catheter is nothing compared to OHS. They probably won't be insertng any stents or doing an angio so you will go home the same day of the cath. (unless there is some kind of difficulty). I wouldn't worry about it too much. They can knock you out pretty good if you don't like things of that nature. I don't and told them I wanted to sleep through it. It can be rough procedure for folks who are really up in age. Sounds like you will be fine. It is routine for folks like us who are in the preoperative phase.

 

[Nancy]

As Ross said, any invasive procedure can have some risks. Most doctors who do caths do them a LOT and are very good at it. The larger hospitals have invasive procedure suites which are run like assembly lines and cardiologists who specialize in invasive procedures.

Joe recently had a right and left heart cath. He has many very serious cardiac and pulmonary problems in addition to other medical problems. He tolerated the procedures well. He has had many caths in his lifetime.

It is a valuable test which shows many important things.

 

[Debrinha GT]

I can still remember..

I can still remember..

I've had two, one at the age of ten back in 1975, just two days before my first mitral valve replacement, and the other, one month before my second OHS, five ears later. I was an extreme case and weighed only 21kgs, and that included a lot of fluid retention. I went to ICU for a couple of hours. Then, the next time it was no big deal, but since I had to go to another city for it, they kept me in hospital for a day. I didn't get one before my third surgery ten years ago, but they did a TEE instead. Hope it all goes well for you.
Débora

 

[Marty]

5 Mgm Valium?

5 Mgm Valium?

Just before the interventional cardiologist was to begin my cath in the X-ray suite the nurse remembered I had had no premedication. She hastened to give me a little pill which I took and only later found out was Valium. I never felt any effect from it and the cardiologist began immediately. I was glad I was not sedated because I watched the TV monitor throughout. When the cardiologist injected the first bolus of dye he said " this will warm you up." The sensation of warmth was not unpleasant at all. The coronaries fill out right away. I was even happier when he said " you have the coronaries of a 20 year old". ( I was 72 at the time). After he pulled the catheter out he plugged the hole in the artery. I did not have to lay in the recovery room 4 hours with a heavy weight on my leg. I went home in two hours and never had any problems. Had the mitral valve surgery two weeks later.Ask your cardiologist who he would have cath him and then get that fellow to do yours.

 

[ALCapshaw2]

As with any invasive procedure, there are some risks.

The best way to minimize those risks is to find a cardiologist who does catheterizations regularly at a hospital that does them in high volume. My cardiology group has 5 or 6 cardiologists that specialize in caths. They run the most efficient cath lab in the state and probably have the best record in the state. I'm thinking their risk of complication is on the order of 1 in 1000.

I recall being terrified of my first cath. When it was over, I had one of those "is that all there is" kind of reactions. I've lost count of the number of caths I've had (I didn't want to know which one was #13) and have had only one minor problem, a hematoma (bleeding under the skin) formed when I went back to work too soon afterward and was sitting hunched forward too long.

FWIW, I've always opted to stay alert through the procedure to watch the monitor as they cardio did his thing. It's pretty interesting to watch!

'AL Capshaw'

 

[Michaelena]

I have aortic stenosis (AVA 0.7 - 0.8 cm2, peak gradient at 70mmHg) and one surgeon said Friday I should proceed with plans for surgery. First I need to get a cardiac catheterization but understand it has some risks. How do you know if your doctor is good at it or how to find one that is? Is an MRI/MRA or some other test a safer substitute?

Windsurfer

I had two caths. The second one I had an allergic reaction to the cath dye. The staff were pros, very matter of fact, and handled it like it was an everyday occurance, (benadryl through the IV line). Immediately, all symptoms began to subside. I must agree with everyone else, it is no big deal. I too was awake and watched the procedure. I was also able to communicate what I felt when I had the reaction.

Michaelena

 

[Big-Chuck]

catherization

catherization

I didnt even know they did mine and I was wide awake the whole time. Only thing I felt was the collagen plug they stuck in my artery in my leg/groin area.

 

[Joel]

Catheterization

Catheterization

I had one when I was eight years old. Addmitted to the hospital for three days, was put out (sleep) woke up burning hot. Climbed out of the hospital bed and laid on the cool floor. Nurses were very upset. That was in the early 1970s.

I had one two weeks ago. Outpatient procedure, got to see it all on the tv screen. (Really cool!) They gave me valium, but I honestly couldn't tell the difference. Felt the warm sensation from the dye. It dissipated very quickly.

They then moved me to the recovery area where a nurse monitored me for 30 minutes for problems, then back to the outpatient area to wait until I was released. The recovery nurse explained what he was looking for. I was told any of those things were extremely rare, but the nurse was by my side the whole time.

1. Drop in blood pressure (Could be caused by a hole near the heart leaking blood into the heart sack.)
2. Allergic reaction to the dye.
3. Bleeding from the puncture site (Femoral Artery.) It was bruised (normal), but they would check it to see if it got Hard, or swollen.
4. Feet swelling up or loss of feeling in the feet (Blood clot/Ischema?)

When I was released I was given instructions not to do too much over the next 24 hrs.(Skipped work.) and check the area for bleeding. If it was internal or a lot of bleeding, call 911.

I had some small surface bleeding the next morning, I put some pressure on it and it stopped. All was well, by the way, my arteries were clean.

 

[Jewel]

Cath is very important

Cath is very important

Hi Windsurfer - you can read about my surgery postponement on "post surgery" due to an exhaustive Cath Procedure. In answer to your questions, I agree with Al - and you should look at someone who does many of these.

While most of what everyone said above is true, there are risks and - in my case - difficulties with the procedure - I said a prayer of thanks that I was in that room for 90 minutes with a man who has done 100s of these (not just a few). It turns out congenitally my defect turns the valve in an opposite direction so it was difficult getting the wires in. Don't want to be in this situation with an amatuer.

By the way - the 'warm feeling' everyone describes was "FIRE in the HOLE" to me But I did like watching the screen. It is an awesome procedure

Also -I had no medicine and no dye reaction, but did have a "ticklish" heart - which is an annoyance to the surgeon and made the team "laugh" but is VERY wierd to the paitent! I just stayed as calm as I could and talked to my heart and did not need benedryl nor defib!

Best to you -
this is an important procedure

Jewel

 

[lance]

No old codgers for catheterization.

No old codgers for catheterization.

It's funny. A person needs a cardiologist that's done 100' or 1000's of them, and I might add won't hit the retirement age any time soon.

Conversely a patient (this one) doesn't want the cardiologist doing his 5th or 6th catheterization.

We have to meet the happy medium --not too old nor too young, not his 1000th and not his 1st.

 

[windsurfer]

vascular sealing - hematoma

vascular sealing - hematoma

I had the cath done July 24th and it went smoothly with good news that there were no coronary problems so a simple AVR is all that is needed. They used a vascular sealing product called Duet Pro (www.vascularsolutios.com) which seemed to work until recently. On August 5th (11 days later) just after flying north for a 5 day family visit I noticed a hard lump forming under the skin. It caused some discomfort. Today I'm back home and the hematoma seems to have stabilized though still bothers me. I'll call the cardiologist to see what he recommends. I'm concerned that the pressure from the hematoma when I sit or crouch in certain positions may cause more internal bleeding. Also wondering why there was bleeding so long after the procedure and if could happen again. Is it related to the new vascular sealing system used? Has anyone else had experiences with the Duett Pro sealing technology?

Bob

 

[Der Biermeister]

Has anyone else had experiences with the Duett Pro sealing technology?

Bob

I just had and Angio-Seal -- uses a collegen sponge and suture. Supposed to carry a card with me for 90 days.

 

[ALCapshaw2]

Bob,

Call your Cardiologist FIRST THING this morning. If you cannot be seen immediately, then you may want to go to the ER to have your hematoma evaluated. It would probably be best to have someone ELSE do the driving.

'AL Capshaw'

 

[windsurfer]

resolving hematoma

resolving hematoma

They did a sonagram and said it was a resolving hematoma and not a false aneurysm. It seems to be shrinking so hopefully will go away. I'm still wondering why the bleeding started 11 days after the cath. If a new hematoma starts up again then we'll try to get answers. Perhaps the plug used creates leverage at one end of the plug when you bend at the waist - but then others should have had the same problem. The other possiblity is that I don't clot well due to my celiac disease - can't absorb fat soluable vitamins like K. If this is the case then we need to figure out a solution before AVR since there will be more places to bleed. Saving some of my own blood may be a good precaution even though blood is rarely needed in AVR.
Bob