Re: catherization

Posted By CCF CARDIO MD - MTR on February 17, 1999 at 16:41:40:

In Reply to: catherization  posted by Rahcel on February 17, 1999 at 12:30:53:






Dear doctor,
My grandfather had bi-pass surgery three years ago. He recently had a heart attack and now was told that he needs a catherization. He is not at home, since he lives somewhere else during the winter. The doctors told him that it would be a serious risk if he tried to come home in order to have the test by doctors that he knows.
What is the likelihoood that the catherization will be successful? I was wondering what exactly this procedure is because everyone keeps saying that it is very serious and can even be fatal. If he has already had the bi-pass surgery, can he have it again?
Thanks
Rachel





Dear Rachel, thank you for your question.  A cardiac catheterization is also known as coronary angiography.  During this procedure, catheters are inserted into the arterial bloodstream through an artery in the groin.  These catheters are used to engage the native coronary arteries and the bypass grafts to inject contrast dye into these vessels.  The dye opacifies the arteries and grafts to allow the cardiologist to determine where blockages are and how such blockages can be treated.   Without contrast dye, the arteries do not show up on the x-ray screen.  It is usual clinical practice to perform a cardiac cath after a heart attack so that the coronary arteries can be directly imaged.  The risks of a catheterization are very small unless a patient has multiple other medical problems.  Based  on the results of a cath, one of three options is usually recommended: medical therapy, angioplasty, or bypass surgery.  Since your grandfather had a heart attack after bypass surgery, a cath is needed to determine if one of his native arteries or one of his bypass grafts has a severe blockage that caused the heart attack.  This test should be performed at the hospital which he's at now, since moving a patient with a recent heart attack to another hospital could be dangerous.  Most likely, the cath will be successful, but the results will need to be used to decide what course of treatment to pursue.  I can't speculate on this topic without knowing the results of the cath.  Redo bypass surgery can usually be accomplished successfully depending on the patient and the severity of blockages found on the cath.  Again, the answer to this question depends on the results of his cath.  I suggest that you have his cardiologist from his home town communicate with the cardiologist(s) who is caring for him now before the cath is performed.  

I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.  Good luck.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.   The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.