Right heart catheterizations also allow the physician to estimate the cardiac output, the amount of blood that flows from the heart each minute, and the cardiac index, a hemodynamic parameter that relates the cardiac output to a patients body size. Determination of cardiac output can be done by releasing a small amount of saline solution (either chilled or at room temperature) in one area of the heart and measuring the change in blood temperature over time in another area of the heart.Right heart catheterization is often done for pulmonary hypertension, heart failure, and cardiogenic shock. The pulmonary artery catheter can be placed, used, and removed, or it can be placed and left in place for continuous monitoring. The latter can be done an intensive care unit (ICU) to permit frequent measurement of the hemodynamic parameters in response to interventions.Parameters obtainable from a right heart catheterization:
Right atrial pressure
Right ventricular pressure
Pulmonary artery pressure
Pulmonary capillary wedge pressure
Systemic vascular resistance
Pulmonary vascular resistance
Cardiac output
Blood oxygenationImplantation of a CardioMEMS is done during a right heart catheterization. This device is implanted into the pulmonary artery to permit real-time measurement of the pulmonary artery pressure over time. Coronary catheterization
Coronary catheterization is an invasive process and comes with risks that include stroke, heart attack, and death. Like any procedure, the benefits should outweigh the risks and so this procedure is reserved for those with symptoms of serious heart diseases and is never used for screening purposes.
Balloon septostomy
Catheterization can also be used to perform balloon septostomy, which is the widening of a foramen ovale, patent foramen ovale (PFO), or atrial septal defect (ASD) using a balloon catheter. This can be done in certain congenital heart diseases in which the mechanical shunting is required to sustain life such as in transposition of the great vessels. Alcohol septal ablation
Hypertrophic cardiomyopathy is a disease in which the myocardium is thickened and can cause blood flow obstruction. If hemodynamically significant, this excess muscle can be removed to improve blood flow. Surgically, this can be done with septal myectomy. However, it can be done through catheterization and by injecting ethanol to destroy the tissue in an alcohol septal ablation. This is done by selected an appropriate septal artery supplying the intended area and, essentially, causing a localized, controlled myocardial infarction of the area with ethanol. Complications
Complications of cardiac catheterization and tools used during catheterization include, but not limited to:
Death
Stroke
Heart attack
Ventricular ectopy and ventricular arrhythmias
Pericardial effusion
Bleeding: internal and external
Infection
Radiation burn
Contrast induced nephropathy from contrast useThe likelihood of these risks depends on many factors that include the procedure being performed, the overall health state of the patient, situational (elective vs emergent), medications (e.g., anticoagulation), and more. Procedure
"Cardiac catheterization" is a general term for a group of procedures. Access to the heart is obtained through a peripheral artery or vein. Commonly, this includes the radial artery, internal jugular vein, and femoral artery/vein. Each blood vessel has its advantages and disadvantages.