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Interventional Cardiac Catheterization
Heart care in Olean and the surrounding region has taken a significant leap forward with the opening of a state-of-the-art cardiac catheterization laboratory at Olean General Hospital. The new lab is operated in partnership between OGH and Kaleida Health’s Gates Vascular Institute in Buffalo, the largest provider of cardiac services in Upstate New York.
With the opening of the new lab, patients in the region now have access to cardiac catheterization procedures and interventions to quickly diagnose and treat coronary artery disease, significantly reducing both time and distance for residents to travel to receive life-saving heart care. OGH is the only hospital in Southwestern New York to have these capabilities.
Cardiac catheterization is a medical procedure where physicians insert a long, thin, flexible tube called a catheter into a blood vessel in the arm, groin (upper thigh), or neck and thread it to the heart. Through the catheter, doctors can do diagnostic tests and treatments on the heart.
Procedures available at the new catheterization lab include angiography, used to diagnose blood vessel blockage around the heart, and interventional cardiac catheterization, used to repair blocked arteries using balloon angioplasty and stent placement.
Diagnostic Coronary Angiography
What is Angiography?
Angiography is a common diagnostic test used to measure the flow and pressure of blood in the chambers of the heart and determines if the arteries that supply blood and oxygen to the heart muscle are blocked or narrowed. Through angiography, also known as diagnostic cardiac catheterization, doctors can diagnose blood vessel damage around the heart. The test is performed in the cardiac catheterization lab and takes about 45 minutes.
How is Angiography Performed?
A long, thin, flexible tube called a catheter is threaded into a blood vessel in the arm, groin (upper thigh), or neck and threaded to the heart. During angiography, dye is injected through the veins and/or into the heart's chambers. (animation – click here)
This procedure causes areas where blood flows to temporarily darken and create a contrast with surrounding tissue to ensure that images can be created with X-rays (called an angiogram). The movement of the dye through the heart and coronary arteries is recorded as an angiogram and viewed on a television monitor,
What to Expect
Many patients experience a warm sensation throughout their body when the dye is injected. Sometimes the patient is asked to cough vigorously.
If any chest discomfort is experienced during the test, the medical team should be alerted. The procedure may take one to two hours, but preparation and recovery will take an additional two to four hours.
Is Angiography Safe?
Angiography is a safe test and the dye used will cause no harm. Patients should drink plenty of water following the procedure to help rid the body of the dye.
In rare cases, some people may have an allergic reaction to the dye. Tell the doctor before the test of any allergies to iodine, shellfish or strawberries.
Angiography procedures can be performed through the wrist (radial approach) or the more traditional groin (femoral approach) method. Radial angiography allows patients increased mobility after the procedure with a lower risk of bleeding and other complications. Patients can be discharged about two hours after a diagnostic procedure and can ambulate within minutes after a radial angiogram.
Coronary Interventional Procedures
Percutaneous Coronary Intervention
Percutaneous coronary intervention, also known as PCI, is also referred to as interventional cardiac catheterization and includes a variety of procedures used to treat patients with diseased arteries of the heart, such as:
- Chest pain caused by a build-up of fats, cholesterol, and other substances from the blood (referred to as plaque) that can reduce blood flow to a near trickle
- A heart attack caused by a large blood clot that completely blocks the artery
Percutaneous coronary intervention is a non-surgical treatment for blocked or narrowed passages in one or more of the coronary arteries and can be done in several ways, including:
- Balloon angioplasty
Performed by threading a catheter (thin tube) with a balloon on the end through the groin or wrist into the narrowed artery. The balloon is then inflated at high pressure one or more times, depending on the severity of the narrowing or blockage, to widen the artery and allow blood to flow more easily through it.
- Bare metal stent placement
A balloon catheter is used to move a thin metal scaffolding (a stent) into a narrowed coronary artery. The balloon catheter is inflated, which expands the stent to support the arterial wall and keep it dilated. The stent remains in the artery permanently and is effective at preventing re-narrowing of the artery. Over the following weeks, cells form a natural covering that will hold the stent firmly in place. Because the stent is a foreign object in the coronary artery, patients should receive a stent card that describes the type, date and location of the stent. No metal detectors will be set off due to stent implantation.
- Drug-eluting stents
A more recent option in angioplasty, slowly releasing drugs that help prevent scar tissue from forming inside the stent during the healing process. Older stents sometimes caused new blockages to form and a return of symptoms, which often required another stenting procedure.
Preparing for your procedure
Generally, the test takes between one and two hours. However, if an artery blockage is detected, your physician may want to treat it with an additional catheterization procedure.
It is important that your stomach is empty for the test. You should usually not eat or drink after midnight the night before the test. Talk to your doctor about any medications you may be taking, and whether you should or should not take them as normal on the day of the test. In either case, you should bring all your medications, in their original containers, to the test to be sure your physician is aware of them.
Unless otherwise instructed by your doctor, continue to take your medications. Be sure to tell your doctor if you take a blood thinner such as Coumadin® or Plavix®. If you take medication for diabetes, please talk to your doctor about the dose that you should take the morning of the procedure. If you are taking medications, do so with a small sip of water. You will need to have a driver take you home.
You will be asked to change into a hospital gown. You may wear glasses, dentures and hearing aids during the procedure.
Symptoms of a Heart Attack:
CALL 911, if you or someone you know experiences any of the following symptoms of Acute Coronary Syndrome:
- Chest pain
- Shortness of breath
- Fainting or dizziness
- Age greater than 50 years (men) or 55 years (women)
- Family history of heart disease
- High cholesterol
- High blood pressure
- Cigarette smoker
- Being overweight