Cardiac Catheter - Methods

For the vital maintenance of the function of our organs, a corresponding blood supply is necessary. Several conduit arteries convey blood to the organs and supply them with oxygen and nutrients, among other things.
In the case of the heart, the blood supply is effected via the coronaries or the coronary blood vessels, i.e. the vessels which lie directly around the heart in the shape of the wreath and convey enriched blood to the main arteries (aorta). Constrictions (stenoses) in the coronaries can have fatal consequences, such as when only one conduit is available to supply sufficient oxygen to the heart muscle in an adequate manner. Causes for constrictions of the blood vessels include long-term nicotine abuse, extended high blood pressure, or lipometabolic and diabetic diseases. All this can lead to the accumulation of tissue, fat, and calque on the arterial walls, which reduces their interior diameter.

The symptoms of such stenoses are primarily painful anxious conditions (angina pectoris) which first appear during times of physical stress, then later also when at rest. Should the constriction progress to total closure of the blood vessel, initial angina pectoris can result in a heart attack.
A left heart catheter examination illustrates the coronary blood vessels (coronary angiography) and shows the exact extent as well as localisation of the constriction(s). A guiding tube is then introduced, usually through a leg artery in the area of the groin or less commonly through an arm artery, through which a flexible, thin, plastic tube (catheter) is inserted up into the outflows of the coronaries near the heart. After the injection of the contrast agent through the catheter, the coronary arteries including possible existing constrictions are made visible on the attached monitors through simultaneous radiography. Another catheter is used in an attempt to penetrate into the affected blood vessel with turning movements. On the tip of the catheter a small balloon is located, which is pumped up at the constricted spot through the diluted contrast agent, thereby expanding the blood vessel outward. Such expansion or dilatation of a coronary blood vessel is also referred to as a percutaneous transluminal coronary angioplasty or PCTA for short.

If the blood vessel cannot be expanded sufficiently despite balloon inflation, there is the additional possibility of setting a blood vessel support in place; this is known as a stent. A stent is a small, cylindrical frame bar made of metal or plastic which is transported via catheter to the point of constriction. The stent then unfolds itself and holds the artery open from the inside. The stent can remain in place and grows into the arterial wall over time. In addition to medication-free stents, there are stents that release medications which inhibit the new formation of cells. This allows for the prevention of repeated constriction due to the new formation of tissue at the same spot (restenosis).
Through balloon dilatation, an imminent heart attack can be avoided in most cases. Balloon expansion as well as stretching with the aid of a stent can also be performed in the case of an acute heart infarction.^1,2,3

Very stubborn blood vessel deposits can be treated using a method called rotablation. A tiny trephine replaces the balloon at the end of the catheter and bores the blood vessel free.⁴

Your doctor will gladly clarify the various methods in a preliminary conversation.