What is a heart catheterization?

A heart catheterization is an invasive heart test performed by a cardiologist using your arteries or veins to obtain information about your heart and its function. It may involve a left heart catheterization, a right heart catheterization, or both.

Left Heart Catheterization and

Coronary Angiogram

A left heart catheterization allows your doctor to actually see how the blood flows through your heart and coronary arteries. When dye is injected into your coronary arteries to take an x-ray movie picture, it is called a coronary angiogram. This is the best way to evaluate the coronary arteries for any potential blockage problems.

After carefully cleaning and sterilizing the area, a cardiologist inserts a catheter (a small, fine, hollow tube) into an artery on the side of your groin and uses an x-ray camera to guide the catheter up to your heart. From the tip of the catheter, the doctor can inject a small amount of dye into each coronary artery and take an x-ray movie picture of all your coronary arteries. These pictures show up on the monitor screens and are recorded digitally. Pictures of your heart’s pumping function can also be obtained to measure your ejection fraction.

You are awake but sedated during this routine procedure, which takes approximately 1 hour. The procedure takes place in the cardiac catheterization laboratory, and you can go home several hours after the test is completed.

It is likely that you will have a left heart catheterization at some time before you undergo a heart transplant. After your transplant, you will also have this procedure as a part of your annual posttransplant check-up. A left heart catheterization is often accompanied by a right heart catheterization (see below).

Right Heart Catheterization

A right heart catheterization is an invasive test that is performed to measure the pressures inside the right side of your heart. It is done to check for the presence of pulmonary hypertension (elevated pressure in the lungs).

After carefully cleaning the side of your neck, a cardiologist inserts a small catheter (a fine, hollow tube) into the large vein on the side of your neck (the jugular vein). This special catheter has a soft inflatable balloon on the tip, known as a Swan-Ganz catheter or a pulmonary artery catheter. The tip of this catheter is then advanced into the right-sided chambers of the heart (atrium and ventricle) and then advanced out into the pulmonary artery, which is the main artery that leaves the heart and delivers blood to the lungs (this is why it is called a pulmonary artery catheter). The pressures in each of your heart chambers and in your lungs (pulmonary artery pressure) are carefully measured and recorded. These pressures are also known as your hemodynamics.

This test is performed before you are considered for a heart transplant. It is also scheduled periodically (usually every 6 months) while you are waiting on the transplant list to make sure no changes have occurred.

Some patients are so sick while waiting for a heart transplant that they require a long-term pulmonary artery catheterization, whereby the Swan-Ganz catheter is left in their neck until they receive a new heart. Their tenuous medical condition may require continual monitoring of their heart pressures to prevent their clinical status from deteriorating while they await a new heart. Because they are so sick, these patients have a preferred status on the heart transplant waiting list.