These methods have drawbacks, but give invasive estimations of the cardiac output, which can be used to make clinical decisions (e.g., cardiogenic shock, heart failure) to improve the persons condition.Cardiac catheterization can be used as part of a therapeutic regimen to improve outcomes for survivors of out-of-hospital cardiac arrest.Cardiac catheterization often requires the use of fluoroscopy to visualize the path of the catheter as it enters the heart or as it enters the coronary arteries. The coronary arteries are known as "epicardial vessels" as they are located in the epicardium, the outermost layer of the heart. The use of fluoroscopy requires radiopaque contrast, which in rare cases can lead to contrast-induced kidney injury (see Contrast-induced nephropathy). People are constantly exposed to low doses of ionizing radiation during procedures. Ideal table positioning between the x-ray source and receiver, and radiation monitoring via thermoluminescent dosimetry, are two main ways of reducing a persons exposure to radiation. People with certain comorbidities (people who have more than one condition at the same time) have a higher risk of adverse events during the cardiac catheterization procedure. These comorbidity conditions include aortic aneurysm, aortic stenosis, extensive three-vessel coronary artery disease, diabetes, uncontrolled hypertension, obesity, chronic kidney disease, and unstable angina. Left heart catheterization
Left heart catheterization (LHC) is an ambiguous term and sometime clarification is required:
LHC can mean measuring the pressures of the left side of the heart.
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.