Thanks to advances in technology and technique, diagnosing and treating heart disease have never been more precise and effective. One of the most impactful developments in this field is cardiac catheterization, a minimally invasive procedure that allows physicians to access the heart through a tiny incision.
This technique avoids the need for open-heart surgery, making it much more patient-friendly than previous types of invasive procedures. What once required large incisions and long recovery times can now be accomplished with tiny incisions, less pain and faster recovery.
What Is Cardiac Catheterization?
Cardiac catheterization involves threading a thin, flexible tube (called a catheter) into a blood vessel, typically in the arm or groin, and guiding it to the heart.
Why would you need a heart catheterization? Doctors use cardiac cath to diagnose or treat conditions like coronary artery disease, heart valve disease, congenital heart defects or heart failure. It provides critical insights into blood flow and heart health.
Cardiac catheterization allows physicians to:
- Detect blockages in the arteries
- Evaluate a patient’s heart function
- Examine valve performance
- Measure pressures in the heart chambers and arteries in the lungs
- Treat blockages in the arteries
Cardiac catheterization is typically performed under light sedation and local anesthesia. Most patients remain awake but comfortable and can return home the same day. The recovery time is quick, permitting early return to work and/or regular activity.
What Can Cardiac Catheterization Diagnose or Treat?
A cardiac catheterization can be used for both diagnostic and therapeutic purposes (or in other words, to diagnose and treat heart conditions). It helps doctors identify and manage conditions such as:
- Coronary artery disease (clogged or narrowed arteries): A buildup of plaque in the arteries that supply blood to the heart, reducing blood flow and increasing the risk of chest pain, heart attacks and other complications.
- Congenital heart defects like atrial septal defects: Openings in the heart’s wall that can allow blood to flow between heart chambers abnormally.
- Heart valve disease: Malfunctioning heart valves that don’t open or close properly, which can disrupt blood flow through the heart.
- Cardiomyopathy or heart failure: A disease of the heart muscle that makes it harder for the heart to pump blood effectively.
- Structural problems with the heart muscle: Abnormalities in the shape, thickness or function of the heart muscle (such as from scarring or thickening).
- Pulmonary hypertension: High blood pressure in the arteries of the lungs that can cause people to be shortness of breath.
Types of Catheter-Based Interventions
In addition to cardiac catheterization, other coronary catheter-based interventions may include:
- Angioplasty: A balloon-tipped catheter is used to open narrowed or blocked arteries.
- Stenting: A tiny metal coil (stent) is placed inside a narrowed artery to keep it open long-term.
- Intravascular ultrasound: High-frequency sound waves are used to create detailed images of blood vessel walls from the inside.
- Optical coherence tomography: Near-infrared light is used to produce high resolution imaging to visualize inside the coronary artery.
- Laser atherectomy: A laser catheter is used to vaporize blockages in blood vessels.
- Rotational/orbital atherectomy: A diamond-coated burr/orbit is spun to debulk and/or sand away calcified plaque in blood vessels.
Non-Coronary Catheter-Based Interventions
Types of non-coronary catheter-based interventions may include:
- Impella® support: A pump placed in the heart to help circulate blood in patients with severe heart failure or during high-risk procedures.
- PFO/ASD closure: Small plugs are used to close abnormal openings in the heart.
- Transcatheter valve interventions:
- Balloon aortic valvuloplasty (BAV)
- Transcatheter aortic valve replacement (TAVR)
- Balloon mitral valvuloplasty (BMV)
- Mitral transcatheter edge-to-edge repair (M-TEER)
- Transcatheter mitral valve replacement (TMVR)
- Paravalvular leak (PVL) closure
- Tricuspid transcatheter edge-to-edge repair (T-TEER)
- Transcatheter tricuspid valve replacement (TTVR)
- Transcatheter pulmonic valve replacement (TPVR)
Why Choose Cardiac Catheterization?
One of the biggest advantages of catheterization is that it’s minimally invasive and accurate.
Catheter-based procedures typically result in:
- Small incisions
- Low risk of infection
- Fast recovery
- Same-day or next-day discharge
What to Expect
Most patients can resume light activity within a few days after cardiac catheterization, depending on their overall health and the complexity of the procedure. Here’s more about what to expect from a cardiac catheterization:
- Procedure time: Typically around 30 to 60 minutes, with additional time for prep and recovery.
- Sedation: Local anesthesia and mild sedation, meaning you’ll be awake but relaxed.
- Recovery: Most patients return home the same day and recover fully in about a week.
- Risks: Generally low, with minor side effects like bruising or mild allergic reactions in rare cases.
Preparing for Cardiac Catheterization
Cardiac catheterization is a common, minimally invasive procedure that helps diagnose and treat many heart conditions. Here’s what to expect before, during and after the procedure.
Before the Procedure:
- You’ll receive specific instructions from your care team, including when to stop eating or drinking.
- Your doctor may adjust or pause certain medications, especially blood thinners or diabetes medications.
- Pre-procedure testing, like bloodwork or an EKG, may be done to ensure you’re ready.
- Arrange for someone to drive you home afterward, as you won’t be able to drive yourself.
During the Procedure:
- You’ll be awake but sedated for comfort.
- A local anesthetic is used to numb the insertion site, usually in the wrist or groin.
- A thin, flexible catheter is gently guided through your blood vessels to your heart using imaging guidance.
- The procedure typically takes 30 to 60 minutes, depending on what needs to be done (diagnostic vs. therapeutic).
After the Procedure:
- You’ll be monitored in a recovery area, often for several hours, to be sure there’s no bleeding or complications.
- You may need to lie flat for a few hours if the catheter was inserted through the groin.
- Most patients go home the same day and recover fully within a few days to a week.
- Avoid strenuous activity for at least 24 to 48 hours, or longer if instructed.
Frequently Asked Questions About Cardiac Catheterization
How serious is a heart catheterization procedure?
It’s considered low-risk and minimally invasive, but like all medical procedures, it carries small risks such as bleeding, allergic reactions to contrast dye or blood vessel damage.
Can heart catheterization clear a blockage?
Yes. If a blockage is found, the doctor may perform angioplasty (ballooning) and place a stent during the same procedure to restore blood flow.
How long does it take to recover from a heart catheterization?
Most people recover within 24 to 72 hours. Full return to activity typically happens within a week, depending on your health and whether any interventions (like stenting) were performed.
How painful is cardiac catheterization?
The procedure is usually not painful. You might feel pressure at the catheter site, but sedation and local anesthesia keep you comfortable. Mild soreness or bruising afterward is normal.
How long is bed rest after cardiac catheterization?
If the catheter was inserted through the groin, bed rest may last 4 to 6 hours. For wrist insertions, recovery time is shorter, often just 1 to 2 hours.
Can you go home the same day after a heart catheterization?
Yes, most patients return home the same day, especially if the procedure is diagnostic and no complications arise. If additional interventions are done, an overnight stay may be recommended.
Can you drive yourself home after a heart cath?
No, you’ll need someone to drive you. Sedation and the procedure itself can impair your ability to drive safely for several hours afterward.
Stony Brook Medicine is the only academic-based cardiac catheterization facility in Suffolk County, providing expert-led, research-informed care. Our team performs over 1,500 interventional procedures annually and handles some of the most complex cardiac cases in the region.
Stony Brook has been named one of America’s 100 Best Hospitals in Coronary Intervention™ for five consecutive years by Healthgrades. Our advanced catheterization labs at Stony Brook University Hospital and Stony Brook Southampton Hospital offer a full range of interventional services. We also coordinate closely with your cardiologist and primary care doctor to ensure seamless care before, during and after your procedure.
If you have symptoms of heart disease or your doctor has recommended further evaluation, a cardiac catheterization may be the safest and most effective next step. Our specialists are here to guide you every step of the way. To schedule an appointment or learn more, call (631) 44-HEART (444-3278) or visit heart.stonybrookmedicine.edu.
