Whilst the first heart catheterization was performed by Werner Forssmann on himself in 1929, the advent of catheter-based intervention in the late 1970s has driven an exponential expansion of cardiac catheterization techniques. Not only have catheters become smaller and more manoeuvrable, but the use of hydrophilic intravascular sheaths or a sheathless approach can reduce vascular complications and improve patient comfort. Advances in haemostasis devices limit or eliminate post-procedure bleeding, increase patient safety and allow more rapid patient mobilisation and faster discharge. As a result, most diagnostic catherisation can be a day case procedure. Simultaneous advances in digital technology in the catheterisation laboratory such as the advent of flat-panel technology mean improved image quality and lower X-ray dose.
Ongoing cardiologist education has driven a significant uptake in the transradial approach, with consequent benefits in reducing patient bleeding and vascular complications. Similarly, downsizing catheters reduces contrast while application of intracoronary physiology or intracoronary imaging aids diagnosis prior to intervention.
The most common test using the cardiac catheter is coronary angiography. Other functions include measuring the pressure within the heart chambers, finding out how well the ventricles of the heart contract, sampling blood within the heart, performing procedures such as heart stenting and catheter ablation, where the catheter tip selectively attenuates parts of heart tissue that are arrhythmias.
Evidence for Benefit of Percutaneous Coronary Intervention for Chronically Occluded Coronary Arteries (CTO) – Clinical and Health Economic OutcomesJohn Rawlins, James Wilkinson, Nick Curzen, et alInterventional Cardiology Review 2014;9(3):190–4
Round Table Discussions
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