Health Dictionary
Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.
Complications during and following cardiac catheterization
Introduction
Editors-In-Chief: Alexandra Almonacid M.D.[1] and Jeffrey J. Popma M.D.[2]
- Patients at Increased Risk for Complications after Coronary Arteriography
- Increased Medical Risk
- Age >70 years
- Complex congenital heart disease
- Morbid obesity
- General debility or cachexia
- Uncontrolled glucose intolerance
- Arterial oxygen desaturation
- Severe chronic obstructive lung disease
- Renal insufficiency with creatinine greater than 1.5mg/dl
- Increased Cardiac Risk
- Three-vessel coronary artery disease
- Left main coronary artery disease
- Functional class IV
- Significant mitral or aortic valve disease or mechanical prosthesis
- Ejection fraction less than 35%
- High-risk exercise treadmill testing (hypotension or severe ischemia)
- Pulmonary hypertension
- Pulmonary artery wedge pressure greater than 25mmHg
- Increased vascular Risk
- Anticoagulation or bleeding diathesis
- Uncontrolled systemic hypertension
- Severe peripheral vascular disease
- Recent stroke
- Severe aortic insufficiency
- Risk of Death
- Death rates: 0.08 – 0.14%
- Age : < 1 years and > 60 years
- Class IV CHF 10 x higher than I or II
- Left main 10 x higher than single vessel patients
- Screening shots, minimize the views
- LV dysfunction <30% 10x risk compared to >50%
- Valvular heart disease
- Severe non-cardiac disease
- Increased Medical Risk
- Major Complications
- Major Complications
- Mortality
- Myocardial infarction
- Cerebrovascular accident
- Arrhythmias
- Vascular complications
- Contrast reaction
- Hemodynamic complications
- Perforation of heart chamber
- Major Complications
- Minor Complications
- Uncommon (< 2Â %).
- Air embolus (0.1%)
- Ventricular arrhythmias associated can be treated with lidocaine and direct-current cardioversion.
- Cholesterol embolization
- Nerve pain
- Lactic acidosis may develop in diabetic patients taking metformin
- Tips for Cardiac Catheterization
- Be careful with the vascular puncture method
- Always advance catheters over a guidewire around the aortic arch – keep the guidewire in place in the aorta during catheter exchanges
- Flush catheters fully with saline to avoid bubbles within the manifold or the contrast line
- Watch the arterial pressure at all time – never inject if the catheter has a damped pressure
- Make certain the catheters are co-axial
- Make certain to demonstrate evaluate each segment of each coronary artery