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Cardiac Catheterisation

Determines

  1. Anatomy
  2. Pressures within cardiac chambers
  3. Oxygenation

 

Indications

Side Method Indications
Left
  • Femoral artery
  • Radial artery
  • Brachial artery
  • Define arterial anatomy - coronary circulation, internal mammary arteries, previous graft surgery
  • Determining LV function
  • Aortic and mitral valve function
  • Anatomy of the aortic root, ascending aorta and arch vessels 
Right
  • Femoral vein
  • Determine information about right atrium and ventricle
  • Tricuspid and pulmonary valve function

 

In suspected coronary artery disease:

  • Selected patients (PM female, risk factors for IHD) undergoing valve replacement surgery
  • Aortic dissection (when possible)
  • Acute Mitral regurgitation or ventricular septal defects
  • Subacute free wall rupture

 

Other cardiac applications

  • Accurately define shunts
  • Assessment of LV, RV, LA, RA pressures in patients with possible constrictive pericarditis

 

 

Contraindications

  • "Too unwell" - type A dissection
  • Patients with known severe calcific aortic stenosis should not have ventriculograms or pull-back gradients - crossing the aortic valve carries 3-5% risk of stroke (this information can be obtained more safely with echocardiograms)
  • Caution in renal impairment

 

 

Performing a cardiac catheterisation

  • Patient is (usually awake), performed under LA
  1. Contrast is injected into coronary ostia
  2. X-ray tube and camera is rotated around the patient to capture the images: biplane imaging using two cameras can reduce the radiation exposure
  3. Moving images are captured digitally and transported on CD

 

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