Cardiac Catheterization Procedure in India - Types, Procedure, why it is done, Costs and Aftercare

Cardiac Catheterization, also known as Coronary Angiogram, Cardiac Cath, Cardiac heart cath, Heart Catheterization, or Cardiac Heart Catheterization is a diagnostic technique that is used to evaluate heart health. In this procedure, a narrow, thin, flexible, and hollow tube called a catheter is inserted from the leg, arm, or groin of the patient, and it is moved to the coronary artery.

Once the catheter reaches the heart, a dye is injected through the catheter. The movement of dye within the arteries is captured by the X-ray images that show its movement and it highlights any constriction in the arteries. This is known as Cardiac Angiogram. This procedure is performed to evaluate any damage in the heart muscles, blood vessels, or heart valves. During this process, the patient’s heart rate and blood pressure are continuously monitored throughout the procedure.

Types of Cardiac Catheterization

Cardiac heart catheterization are of 2 types: The Right Heart Catheterization (RHC) and the Left Heart Catheterization (LHC). During the right heart catheterization, the doctor will insert the catheter into the blood vessel from the elbow, neck, or leg and it is done to examine the right-side of heart whereas during the left heart catheterization, the catheter is inserted in the blood vessel from the arm, the wrist, or the leg and is performed to examine the left-side of heart.

What is the Cardiac Catheterization cost in India?

The cost of this procedure depends upon what procedure is performed, the hospital you select and its location, the charges of your selected doctor, the patient’s condition, etc. However, the average cost of cardiac cath in India ranges between 400 to 500 USD.

Why Should You Travel to India to Get Your Treatment Done?

A survey shows that out of 33 participating countries in Africa, 18% of them don’t have registered cardiologists. For a population of 1.2 billion, only 2000 cardiologists are there in Africa. Whereas, there are 5500 cardiologists in India. Also, the success rates of treatment in India have increased drastically.

India’s cardiology hospitals have the most up-to-date infrastructure and equipment, which boosts the treatment process. The treatment in India is approved by international health organizations. In addition to this, the medical cost is much cheaper in India as compared to other countries such as the UK and US. The cardiac catheterization cost in different countries are:

• UK: 1922.81 USD
• US: 8,118 USD
• India: 400 USD

Best Cardiac Catheterization Doctors in India

1. Dr. T S Kler

2. Dr. Ashok Seth

3. Dr. Naresh Trehan

4. Dr. Kewal Krishan

When Will Your Doctor Suggest You for Heart Catheterization?

Catheterization is performed to diagnose various heart-related problems such as blood vessel constriction, poor heart muscles, damaged heart valves, etc. Your doctor may suggest you for arterial cardiac catheterization to examine the following conditions.

• Determine the root cause of your chest discomfort or irregular heartbeat.
• Examine the health of cardiac muscles known as myocardium.
• Diagnosis or confirmation of coronary artery disease, valve disease, or aortic disease. This may be done regularly or just after a heart attack.
• Look for problems in your pulmonary arteries.
• Examine your heart's oxygen saturation, blood pressure, and blood flow.
• Find out whether additional therapy is required.
• Determine if a patient has pulmonary hypertension, aortic stenosis, mitral valve regurgitation, or cardiomyopathy.
• Insert a stent to prop open an obstructed artery.
• Facilitate the preparation for a heart transplant.

A Brief Idea About How this Procedure is Performed

Before the exam, you will be given medication to assist you in calming down. Care providers often prepare an area on the patient's arm, neck, or groin by cleaning and sterilizing the area before inserting an intravenous (IV) line. First, the sheath (bigger, thinner plastic tube) is inserted into the patient’s artery (leg or arm), and then the catheter (longer plastic tube) is placed in the sheath and guided by fluoroscopy so that the doctor can move the catheter to the heart. After that, the doctor is ready to perform the diagnosis mentioned below:

• Retrieve samples of cardiac blood for testing.
• Take readings of the pressure and blood flow in each chamber of the heart and the major arteries surrounding it.
• Check how much oxygen is getting to your heart muscle.
• Check out the coronary arteries.
• Take a tissue sample from the heart muscle.
• Sometimes, a dye is injected into a patient to aid in visualizing the heart's structures and veins during an operation.
• Perform catheter ablation therapy where cold or heat energy is used to normalize the heartbeat.

A stent may be implanted when angioplasty is performed to clear a blockage. The exam might run anywhere between 30 and 60 minutes. The test duration might be extended if additional, non-standard processes are required.

Steps to follow after the Tests for Cardiac Catheterization

• Once the diagnosis is completed, your doctor will contact you and arrange an appointment after the reports are generated. He/she will discuss your condition and its possible treatments with you.
• Results from the examination will be discussed with the attending physician. The test findings will also be sent to your primary care physician via mail.
• Take a few hours off after the exam to recuperate. It's a good idea to have someone drive you home safely, such as a family or close friend. The majority of patients folks are back to normal the day after.
• The area where the catheter was placed may become bruised and sore once the anesthesia anaesthetic wears off. Analgesics, such paracetamol, may assist with the pain.
• If you need minor surgical intervention (such as a cut) to install the catheter, you may need to have your sutures removed after around seven days.

Performing an angiography using a cardiac cath takes around 20-30 minutes on average. It is often performed as an outpatient operation on the same day it is planned. Some cardiac cath procedures may take more time, and some patients may need a brief hospital stay.

Preparation Before the Cardiac Catheterization Procedure

Even while the actual procedure only takes around 30 minutes, the time spent getting ready for it and recovering may easily exceed several hours. Expect to spend the whole day in the hospital and have a ride home arranged after the surgery. Instructions on what you may and cannot consume in the 24 hours before your heart catheterization will be provided. You will likely be advised to fast for at least six to eight hours before the procedure.

Tell your doctor about all the drugs you're taking, including the ones you get from the drugstore. Please don't stop taking them until told to by your doctor; you may be asked to hold off until after your heart catheterization. If you have any known allergies, the nurse doing your operation will want to know about them, especially to iodine, rubber, latex, or any medications. Do not skip wearing your hearing aid if you normally do so. Bring your glasses with you if you need to use them.

There is a small but real risk that a cardiac cath might harm an unborn child, so it's important to discuss your pregnancy status with your doctor. Pregnancy-related radiation exposure has been linked to a higher risk of congenital anomalies. If you are nursing, you should also let your doctor know.

In rare cases, a patient undergoing a cardiac cath may have an allergic response to the dye used in the procedure. Make sure your doctor knows if you have any allergy or sensitivity, including medications, contrast dye, iodine, or latex. Furthermore, you should inform your doctor if you have renal failure or any other kidney issues.

Some patients experience discomfort or agony from having to remain immobile on the cardiac cath table for the duration of the procedure. Depending on your unique health situation, there may be additional side effects and dangers. Talk to your doctor about your worries before the operation.

During the Cardiac Catheterization Procedure

During the cardiac heart cath procedure, the nurse will place an IV (Intravenous Line) into the vein in your arm, to give you medication. This medication will keep you sedated to make sure the procedure is comfortable. The amount of sedation you may need depends upon the reason for doing this procedure. The nurse will then shave and sanitize the area from where the catheter is to be inserted.

Now, First, the doctor will insert a needle in your blood vessel, place a guidewire in that needle, and take the needle out. Then, the doctor places a sheath which is a small tube around the guidewire into the blood vessel and removes the guidewire. After that, a catheter is placed into that sheath. Now, the doctor will carefully guide the catheter and move it towards the heart.

Different kinds of instruments may be attached to the tip of the catheter which is used to perform various procedures such as monitoring blood pressure within every heart chamber and in the veins connecting to the heart, seeing the interior of the vessels, drawing blood from different parts of the heart, and performing a biopsy stent placement, angioplasty, etc.

After the Cardiac Catheterization Procedure, What Should You Anticipate?

After the completion of the procedure, your doctor will carefully remove the catheter, the sheath, and the guidewire. After that, some amount of pressure may be applied at the site from where the catheter was inserted to stop the bleeding. Then you will be shifted to the recovery room where you may relax until the effects of anesthesia wear off and your blood pressure and heart rate will be monitored for a few hours to make sure there are no side effects of the procedure.

In case the catheter was inserted from your groin, you will need to lie flat on your back while keeping your legs straight for 3 to 6 hours to make sure there is no excessive bleeding. Your doctor will inform you to drink plenty of water so that the contrast agent/dye used in this procedure is cleared up and eliminated easily from the body. You may need to urinate frequently because of this reason.

Side Effects After Catheterization

The possibility of side effects or any complications after diagnostic catheterization is less than 1%. However, any possible side effect that may occur depends upon the patient’s condition, the expertise of the doctor, and what procedure is being performed. Some of the after-effects are listed below:

The potential hazards of cardiac catheterization include the following:

• Discomfort, bleeding, or discomfort at the site of catheter insertion.
• Infection at the catheter insertion site that might cause blood clots or rupture of the blood artery.
• Pain in the chest, Shortness of breath, lack of oxygen supply or blood supply in the heart muscle.
• Damage or tear in the lining of the arterial wall.
• Damage in the kidney due to the dyes used in this procedure.
• Allergic reaction due to the dye used in this procedure.
• Mild sunburn-like reaction on the skin due to X-ray exposure.
• Catheter insertion site bleeding or bruising.
• Infection at the site where the catheter was inserted might cause a blood clot or rupture of the blood artery.
• Discomfort at the insertion site of the catheter.
• Rhythm disturbances.

Among the most severe but infrequent problems are:

• Pain in the chest, shortness of breath, and a lack of oxygen in the heart muscle all point to ischemia or a lack of blood supply.
• A tear in the lining causes damage to the arterial wall.
• Coronary artery occlusion occurs suddenly.
• Stroke.
• Harm to the kidneys from the dye.

There is a small but real danger that a cardiac cath might harm an unborn child, so it's important to discuss your pregnancy status with your doctor. Pregnancy-related radiation exposure has been linked to a higher risk of congenital anomalies. If you are nursing, you should also let your doctor know.

In rare cases, a patient undergoing a cardiac cath may have an allergic response to the dye used in the procedure. Make sure your doctor knows if you have any allergy or sensitivity, including medications, contrast dye, iodine, or latex. Furthermore, you should inform your doctor if you have renal failure or any other kidney issues.

Some patients experience discomfort or agony from having to remain immobile on the cardiac cath table for the duration of the procedure. Depending on your unique health situation, there may be additional dangers. Talk to your doctor about your worries before the operation.

What Are the Chances of Success in the Heart Catheterization Procedure?

It is estimated that the risk of death and significant complications after diagnostic cardiac cath operations are less than 0.05% and less than 1%, respectively. The hazards and consequences of heart catheterization have been greatly reduced because of the development of smaller catheters, the widespread adoption of the trans-radial technique, and the rising technical proficiency of the operators. Complications from this often-performed life-saving treatment may be avoided with careful attention to detail.

Guidelines to Follow After Discharging from the Hospital

You should follow the instructions that your healthcare provider will give you. Maintaining a healthy lifestyle plays a crucial role in overall good health. Your healthcare provider may give you some guidelines mentioned below to follow after getting discharged from the hospital:

• Arrange for a friend or relative to give you a ride home.
• There will be a two-day period when you can't drive.
• Once you go home, you should have an adult with you for at least 12 hours.
• Before leaving the hospital, patients will get thorough instructions on how to take their medicines, what to eat, and how to care for any wounds or surgical sites, as well as any recommended physical therapy or other post-hospital care.
• Following most surgical procedures, patients have to take it easy for three to five days before they may resume heavy lifting and other physically demanding activities.

Cardiac Catheterization FAQs