Cardiac Catheterization

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Cardiac catheterization procedures help your doctors diagnose, evaluate, and treat heart conditions like coronary artery disease, valve disease, vascular disease, heart failure, arrhythmias, and congenital heart defects, among others. This minimally invasive approach can help manage your heart disease, inform next steps, and improve your quality of life.

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About Cardiac Catheterization

During a cardiac catheterization, an interventional cardiologist inserts a small, flexible tube called a catheter into a blood vessel (usually in your groin or wrist) and guides it toward your heart. Using small tools that can be passed through the catheter, your doctor may be able to diagnose and/or treat your condition. Some catheterization procedures use dye injected into your coronary arteries to create images. Heart catheterizations are performed in a sterile procedure room, similar to an operating room, called a cardiac catheterization lab. While more complicated procedures may require general anesthesia, many others do not.

Our Cardiac Cath Labs

Duke has cardiac catheterization labs in all three of our hospitals. The cardiac cath labs at Duke University Hospital and Duke Regional Hospital operate 24/7 for emergencies such as heart attacks.

Treatments

Angioplasty with Stenting

Also called percutaneous coronary intervention (PCI). If coronary artery blockages are detected during catheterization, an interventional cardiologist can treat these by inflating a small balloon at the tip of the catheter to open the narrowed artery. A small, cylindrical, mesh tube called a stent is placed in the artery to keep it open. Some stents are coated with a medication that is released slowly to prevent future narrowing of the artery.

Carotid Stenting

In a procedure similar to angioplasty, balloons and stents are used to repair or open carotid arteries leading to the brain, lowering stroke risk.

Atherectomy

A small device that shaves the plaque in the coronary artery can be used to open a blockage.

Balloon Valvuloplasty

People who are not candidates for conventional aortic or mitral valve surgery for stenosis or a blockage may be offered this less-invasive procedure. A balloon is threaded through a catheter to your narrowed heart valve and inflated to open the valve.

Mitral Valve Clip

People with mitral valve regurgitation (a leaking valve) who are not candidates for conventional valve surgery may be treated with this catheterization procedure in which small clips are placed on the widened mitral valve to narrow the opening.

Endovascular Stent Graft

People with a ballooning or enlarged blood vessels -- also called aneurysms -- may be candidates for an endovascular stent graft. This procedure involves strategically placing a fabric tube supported by metal mesh to reinforce the weakened or enlarged blood vessel, often the aorta.

Congenital Heart Defect Repair

Depending on the type and location of the defect, catheterization therapies -- using either balloons to open narrowed vessels or valves, or closure devices to seal abnormal openings -- may be performed instead of more invasive procedures.

Stem Cell Therapy

During this experimental therapy, stem cells are injected into the heart muscle. Studies suggest this procedure may improve the heart’s ability to pump blood when severe heart failure has been diagnosed.

Renal Denervation

This experimental procedure is being tested to determine its effectiveness in lowering blood pressure in people who take multiple medications and have been diagnosed with resistant hypertension. A catheter accesses the renal arteries, and then a pulse of radiofrequency energy is delivered to deaden nerves that can become overactive and contribute to high blood pressure.

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Diagnostic Procedures

Angiogram

A catheter is inserted into a blood vessel and contrast dye is injected to create images. This may be performed on the coronary arteries or on other blood vessels that supply the brain, abdomen, kidneys, or extremities. An angiogram may be performed to diagnose congenital heart defects.

Heart Tissue Biopsy

A biopsy, or sample, of heart tissue may be taken during cardiac catheterization or a separate procedure and analyzed in the lab for signs of diseases that can cause heart failure, including cardiomyopathy (thickening of the heart muscle) and myocarditis (inflammation of the heart). A biopsy may also be used to look for signs of rejection in a transplanted heart.

Best Heart Hospital in North Carolina

When it comes to your heart care, you want the very best. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our cardiology and heart surgery program is nationally ranked, and the highest-ranked program in North Carolina, according to U.S. News & World Report for 2024–2025.

Why Choose Duke

National Leaders
Our cardiac catheterization labs are training centers for interventional cardiologists from across the country, who travel here to learn from our experts about the latest techniques and how to work with new devices and therapies.

Clinical Trials Access
As a Duke patient, you may be eligible to participate in clinical trials testing new therapies or methods that are not yet widely available.

What to Expect

From your arrival to recovery, our cath lab experts are dedicated to giving you the very best care.

Before your heart catheterization, a nurse will record your vitals to ensure you are well enough to proceed and place an IV so your care team can easily administer medications and sedatives to keep you comfortable. Inside the lab, you'll lie flat on a bed under a large X-ray tube used for imaging.

Four or five providers, including your interventional cardiologist, anesthesiologist, technologists, and nurses, will administer either local or general anesthesia, make a small incision to access your artery, and thread a catheter to your heart to perform the specific procedure(s) you need. You shouldn't feel pain. For certain procedures, doctors may ask you to move your arms, cough, or hold your breath at times.

Afterward, you'll recover in another room and may need to lie flat for a while. You may be able to go home the same day.

Risks
Because it is minimally invasive, there are less risks with a catheterization than with open heart surgery, and it is generally very safe. However, common risks include bruising, bleeding, arrhythmias, blood clots, stroke, heart attack, infection, allergic reaction, blood vessel perforation, and damage where the catheter traveled or was inserted.

Watch this video for even more information about cardiac catheterization at Duke.

This page was medically reviewed on 06/28/2024 by