Heart Cath... Required?

[pgammo]

Hey all,

I'm a 25 male that is going in for my BAVR on June 1st. I had a question regarding the heart cath procedure. Does EVERY valve replacement patient NEED to get it? My surgeon said that he will not have me do it; I believe that he said that I shouldn't need it based on my age and the CT w/ IV contrast that I did. Aside from the EKG's and CT w/ IV contrast, I have also done a TEE, Echo's, holter monitor, stress test, x-rays, and blood work. Also, I just did a staph infection nose swab today, is that normal? The nurse said that around 30% of the population has staph present in their nose and don't know it.

Thanks all!

 

[dfelder]

The CT & TEE probably showed everything he needed to know. I didn't have a cath before any of mine. The staph thing must be new. I've never had that test.

 

[epstns]

Peter,
I had a cath done prior to my surgery. When I questioned the need, I was told that for patients over the age of 50, they always do one to rule out any occluded arteries. Good thing I had it done, as I ended up with a bypass in addition to my valve. For patients under age 50, unless there is another driving need, my hospital didn't do a cath because the likelihood of arterial blockages is so low in younger patients.

 

[ejc61]

I concur with epstns. I had one at 47 basically to rule out surprises.

 

[AgilityDog]

I had the cath at 46. If you have to do a bypass, best to do it all while the chest is cracked. but at 25, unless you are very overweight, you probably don't have blockages yet.
And the staph test seems to be routine, as well.

 

[pem]

The guidance you've received is consistent with what I've heard. They told me 40 years old was the cutoff and I was on the cusp, but they preferred to do it anyway in my case to avoid surprises. I regret having done it. I've always had low cholesterol, so I was a low risk for surprises. I ended up with complications (deep vein thrombosis), a trip back to the ER, numerous trips to the vascular specialist, etc. That outcome tends to be the exception rather than the rule, but I happened to have the misfortune of being exceptional in this case

I think the nose check is for antibiotic-resistant staph and determines whether or not they'll give you antibiotic ointment to stick up your nose before surgery. Some surgical centers just require it for everyone. I even had a nurse tell me that she and her colleagues routinely use that ointment in their noses. Not a big deal think.

Best,
pem

 

[pgammo]

Thanks for the information guys! I'm not overweight, so I hope there are no surprises for me!

 

[Mom2izzy]

My surgeon wasn't going to order one for me (age 40), but then realized I had been a smoker up until 4 years ago. I'm not overweight and have great numbers as far as cholesterol, so must be smoking is another criterion.

 

[Jkm7]

The nose swab is very common. My nurses at Mass General did a nose swab at least my first two or three days I was there.

 

[Debbrn]

The nose swab is very common. They are checking to see if you are a MRSA carrier. Luckily I came back negative. I suspect it was a false negative though because I am a nurse and have taken care of hundreds of patients with active MRSA infections.

Debbie

 

[Bina]

Yes, I had the heart cath at age 46 and my arteries were clear.
Yes, had the nasal swab as well.

 

[Boston Tiger]

I was 50 when I went in, but had the CT scan with injection rather than a cath, mainly because the surgeon saw the way my eyes bulged out (and blood pressure shot up) when he mentioned a heart cath. I was one of the textbook cases of someone with white coat syndrome for even simple visits to my GP, so the early visits to the cardiologist and cardiac surgeon had me off the wall. The main positive I can say for my beta blockers is that they have toned that down significantly, but I'd still love to get off of Toprol.

 

[Bill B]

The new high resolution, rapid (10 seconds) CAT scans with contrast as so good you can do just about anything that a cath can do but measure pressures. That's what I had. The coronaries and the minutest of vessels throughout your thorax are completely visible. So, I don't think there will be any surprises.

 

[clfhangr]

Peter,
Just had all my pre op testing done this week. for my Monday may 7thy surgery. The did a heart cath on me to rule out any coronary artery disease and get the full lay of the land before the surgery. As for the staph test they did that as well. I thought that was worse than the cath (hate things up my nose). :thumbd: and Yeah I know I am a little off. The nurse that did mine said the same thing and that they to a pre treat if it is positive just for safety sakes.

Good luck and God bless.
Keith

 

[Madsometimes]

I think swabs for MRSA are standard now for most kinds of surgery. I had them for my surgery, my mum had them for a knee replacement. If it is positive, there are treatments available, and you also may get a private room (which is uncommon in the UK).

I had an angiogram before my surgery, and I'm a 39 year old female. For me, I was admitted on the Monday, the angiogram was done that day, and the surgery was on the Tuesday. I was low risk, and my test was fine, but my surgeon wanted it done.

 

[DanielB]

I also had the CT with contrast (at the age of 53). I agree with those above who mention the CT with contrast, is a very accurate method, especially when other factors are considered, such as your TEE, age, weight and especially the stress test. If all those passed, I can see where they would not feel the need to do a heart cathater.

 

[carolinemc]

What the cath is generally used for is to make sure the major arteries are clear, not blocked. It is just a procedure that is best left up to the cardio or heart surgeon to decide on. It is nothing to it and I was glad when I had mine, had not had one for over 20 years. And was glad when the doctor said that the arteries were clear. So good luck with the other preps for surgery. Keep coming in, we all have experiences and war stories. Hugs for today.

 

[pgammo]

Thanks for all the information guys! Appreciate it!

Clfhangr, I pray you have a comfortable experience! God bless you, brother.

 

[ElectLive]

They told me 40 years old was the cutoff and I was on the cusp, but they preferred to do it anyway in my case to avoid surprises. I regret having done it. I've always had low cholesterol, so I was a low risk for surprises. I ended up with complications (deep vein thrombosis), a trip back to the ER, numerous trips to the vascular specialist, etc. That outcome tends to be the exception rather than the rule, but I happened to have the misfortune of being exceptional in this case

Well, I was 35 and had a cath, so guess I'm kind of glad now I didn't read about this the day before! I didn't even think to ask at the time (I was more concerned about the surgery a few weeks later!) but I would guess that the fact that I am diabetic and more prone to atherosclerosis may have been the indication to go ahead and do, even though my cholesterol was perfect. Thankfully mine went well, no problems.

 

[DavesMom]

I was 42 when I got my AVR and had both a TEE and cath. I think they did my cath to see if my arteries were clean and yup, they were. What surprised me is that despite these tests the surgeon was still caught unprepared when I turned out to have a LOT of scar tissue from my first OHS that gave him a lot of problems.

The cath wasn't too bad - a huge difference from my first one when I was eight and had to stay in the hospital for a week. I hope it goes smoothly for you.

Best of luck!