Types of Cardiac Catheterization
Mayo Clinic doctors trained in heart disease (cardiologists) have expertise in many cardiac catheterization procedures for diagnosis and treatment including:
- Angiography or angiogram. In this test, your doctor injects contrast dye into blood vessels and uses X-ray images to diagnose blockages in coronary arteries and coronary artery bypass grafts. Doctors also use angiography to diagnose blockages in arteries to the kidneys, limbs, brain and other organs and to guide instruments during treatment.
- Angioplasty and stenting. In an angioplasty, your doctor inserts a small balloon through the catheter into a blocked artery and expands the balloon, opening the artery. Your doctor may then place a small, wire mesh tube (stent) in the opening to keep the blood vessel open permanently.
- Atherectomy. In rotational atherectomy, your doctor may use a high-speed, drill-like device to clear highly calcified material that has built up inside an artery (plaque) before doing an angioplasty and stent placement.
- Balloon valvuloplasty. Your doctor may treat tight (stenotic) heart valves by dilating these with a balloon in a technique similar to angioplasty.
- Cardiac assist devices (also called ventricular assist device or heart pump). Doctors implant ventricular assist devices in some people who have congestive heart failure. They may use temporary heart support systems during catheterization procedures if your heart's pumping function (left ventricular function) is poor.
- Cell and gene therapy. Your doctor injects genes, growth factor proteins or cells through a catheter to stimulate growth of new blood vessels (angiogenesis) and help restore blood flow to your heart. These therapies occasionally are available as part of approved research studies. These are still under investigation and aren't available for everyone.
- Closure of leaks next to replacement heart valves (periprosthetic valve leaks). Doctors sometimes can seal leaks that have developed next to replacement heart valves during a catheter-based procedure.
- Coronary spasm study. Your doctor performs this test to assess the blood flow in your heart arteries if you have a long history of chest pain but your coronary arteries appear normal during angiography.
- Endomyocardial biopsy. Your doctor collects tissue samples from within your heart (endomyocardial biopsy) to test for a weak heart (cardiomyopathy) or check for signs of organ rejection if you have had a heart transplant (surveillance biopsy).
- Hemodynamic assessment. In this test, your doctor places sensors inside your heart and major arteries to the body and lungs to measure blood pressure, blood flow and oxygen levels. Doctors often use this test to diagnose pulmonary hypertension, heart valve disease or congenital heart disease.
- Septal ablation. If you have hypertrophic cardiomyopathy, your doctor may use a catheter to inject a very small amount of alcohol into an artery supplying blood to a thickened area of your heart (septal muscle) when the muscle obstructs blood flow. The alcohol causes a small localized heart attack and scar tissue formation which thins the septal muscle, leading to improved blood flow.
- Nonsurgical closure of a hole between your heart chambers. To close an abnormal opening in the wall (septum) between your heart chambers, through a catheter your doctor may insert a coil or a patch (usually resembling a small umbrella) called a septal occluder. This procedure treats congenital heart defects such as ostium secundum atrial septal defects, patent foramen ovale and patent ductus arteriosus.
- Thrombectomy. In this procedure, your doctor inserts a catheter into an artery and guides it to the location of a blood clot in a blood vessel. Attachments on the catheter mechanically remove the blood clot.
- Ultrasound. Your doctor may use angiography along with ultrasound to check the severity of your coronary artery blockages and guide other surgical procedures.
- Valve replacement. Your doctor may use cardiac catheterization during heart valve replacement surgery. Aortic valve replacement through a catheter-based approach is currently being investigated.
Catheterization procedures can help to diagnose or treat many cardiovascular and vascular conditions, including: