What Right Heart Catheterization is for?

Right Heart Catheterization is performed to diagnosis and the type of treatments needed for the right side of heart and Lungs. Your doctor may recommend a Right Heart Catheterization if you have:

1. Pulmonary Hypertension: Raised pressures in the lungs.
2. Congenital heart disease: For patients who are born with heart defects. For example hole in the heart.
3. Heart Valve disease: This is to assess the malfunction valves ( doors inside heart).
4. Cardiomyopathy: To assess the enlargement and weekend heart.
5. Heart Failure: To assess the causes or heart failure (weekend heart) resulting in accumulation of fluids in the lungs or legs.
6. Cardiogenic shock: Right heart catheterization, is used to guide management of extreme weekend heart. This occurs in acute heart failure.
7. Heart Transplant: To assess the failing heart and to take sample of heart (Biopsy). The doctor will assess heart for the need for transplant. This procedure is also needed to assess heart function of the transplanted heart.

What to expect before the procedure?

1. Before your procedure, your doctor will review your medical history, including allergies and medications you take. The team may perform a physical exam and check your vital signs including blood pressure and pulse.
2. The doctor will obtain verbal and written consent (after explaining procedure and potential complications)
3. You will be asked not to drink or eat anything for at least 4-6 hours before the procedure.
4. An IV line is inserted into a vein in your arm for IV fluids and other medications

Possible Complications

As with any invasive procedures, there are some risks associated with the procedures. Although risks are there but the benefits of finding the underlying conditions of the vessels are important. The Potential complications include:

1. Bruising at the site of catheter entry into body
2. Injury to the catheterized artery (pulmonary artery)
3. Irregular heart rhythms (arrhythmias)- Rare
4. Allergic reactions to the dye or medications used during the procedure
5. Excessive bleeding-rare
6. Infection- Rare

What to expect during the procedure

1. For the procedure, you will be transferred inside a catheter lab
2. You will then lie on x-ray table. The team will adjust the table height and position. The X-ray cameras may move over and around your head and chest to take pictures from many angles.
3. The doctor may give you medications including pain killers and sedatives ( to help you relax). You may feel sleepy but you'll still be able to be easily awakened to follow any instructions.
4. You will be attached to heart monitor, blood pressure cuff and Oxygen monitor.
5. A small amount of hair may be shaved from your groin or arm where a flexible tube (catheter) will be inserted. The area is washed and disinfected and then numbed with an injection of local anesthetic.
6. You will be completely covered with sterile drape sheets during the procedure.

Procedure

A small incision is made at the entry site (Right or left groin), and a short plastic tube (sheath) is inserted into your artery. The catheter is inserted through the sheath into your blood vessel and carefully threaded to your heart vessels.

You shouldn’t feel any movement of catheters inside your body. Tell your health care team if you have any discomfort.

Dye (contrast material) may be injected through the catheter. When this happens, you may have a brief sensation of flushing or warmth.

The dye is easy to see on X-ray images. As it moves through your blood vessels, your doctor can observe its flow and identify any blockages or constricted areas.

The Doctor will check pressures in various parts (chambers) of heart and lung.

Having a Right Heart Catheterization takes about one hour, although it may be longer, especially if combined with other cardiac catheterization procedures. Preparation and post-procedure care can add more time.

After discharge from hospital

1. You may see some bruise at the puncture site (groin), which will improve itself. If you feel some discomfort, you can use paracetamol or other simple painkillers.
2. Avoid heavy lifting for 7 days after the procedure.
3. A lump may develop around your wound site. If it is the size of a pea, then do not worry – this is just the scar. If, however, a large lump develops, which is bigger than a 10 pence coin, or the site starts to bleed you must seek immediate medical advice.
4. If the bleeding is from the groin you should then lie down and apply pressure. If it is from the wrist you should apply pressure and elevate the arm.
5. You must seek immediate medical advice. If you experience numbness, coldness or pain in the affected leg or arm

Driving after procedure

1. Although it is generally not recommended to take a long haul flight shortly after a Right Heart Catheterization
2. You may be able to fly after 2-3 days.

Traveling by Aircraft

After a Right Heart Catheterization do not drive for 3 days.

Working

Return to work will depend on your occupation. In general, you may return to work 3 days after procedure.

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