Cardiac catheterization

Cardiac catheterization lab in Idaho Falls

The cardiac catheterization lab at Eastern Idaho Regional Medical Center (EIRMC) provides diagnostic and therapeutic services by cardiologists that excel in their field. We have the full capacity and support to treat patients 24/7 who are experiencing chest pain or complications due to coronary artery disease.

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Recognized cardiac cath care

EIRMC was named a "Top 50 Cardiovascular Hospital" in the U.S. by IBM Watson Health™. This designation was awarded as a result of the level of care displayed by our inpatient cardiovascular team.

Healthgrades has also recognized EIRMC with a five-star rating, ranking us in the nation's top 10 percent for coronary intervention excellence.

Our cardiac catheterization lab provides diagnostic and therapeutic services by highly experienced critical care specialists who excel in their field, including cardiologists, interventional radiologists, licensed radiologic technologists, registered nurses, certified nursing assistants, and registered cardiovascular physician technicians.

What is a cath lab procedure?

Cardiac catheterization is when a cardiovascular doctor places a catheter into a blood vessel in the groin, arm or neck, into the aorta, then to the heart. Once in place, the catheter allows for numerous cardiac tests to be performed.

These procedures are often done on an emergency basis when it is suspected that symptoms such as chest pain may indicate heart problems. We perform an average of over 1,800 cath lab procedures every year, which is more than any other in our region and rivals the amount done in major metropolitan communities.

No matter the procedure, cardiac catheterizations allow our physicians to decide appropriate treatments while measuring blood pressure within the heart, evaluating heart valve and chamber function, identifying narrowed or clogged arteries and checking for congenital heart abnormalities.

What procedures are done in a cardiac cath lab?

The cardiac cath lab at EIRMC offers both diagnostic and interventional catheterization procedures. Available options include:

Diagnostic procedures

Diagnostic procedures are performed to help diagnose potential heart complications. Procedures performed through our cath lab include:

• Coronary angiography
• Intravascular ultrasound
• Left and right heart catheterization
• Myocardial biopsy
• Pacemaker insertion, permanent and temporary
• Pacing studies, overdrive pacing, cardioversions
• Pericardiocentesis
• Peripheral vascular angiography studies

Interventional procedures

Minimally invasive interventional cath procedures are typically employed in place of traditional surgery. These interventional procedures are often easier on patients, require less recovery time and are less painful. We offer:

• Intra Aortic balloon placement
• Intracoronary rotational atherectomy
• Intracoronary stent placement
• Intracoronary thrombectomy
• Percutaneous transluminal coronary angioplasty (PTCA)
• Percutaneous transluminal peripheral vascular angioplasty
• Valvuloplasty

Transradial catheters

EIRMC is proud to offer patients the option of a transradial catheter, an alternative to a traditional groin catheter that is placed in the wrist. Fewer than 15 percent of heart programs in the U.S. offer this option, leading to us having the highest volume of transradial catheterizations in southeast Idaho, western Wyoming and southern Montana. Additionally, we routinely train physicians from across the country on this technique.

Benefits include:

• Decreased postoperative bed rest, even if the catheter is coupled with a stent procedure
• Fewer activity limitations, with patients able to move normally, including lifting, pushing and pulling, as long as they don't use the affected wrist
• Less risk for bleeding, with some cases having no bleeding at all
• More options for positioning during the procedure

Angioplasty

EIRMC's cardiac cath lab also offers angioplasty procedures — a nonsurgical treatment designed to open clogged arteries. We also specialize in balloon angioplasty, when a balloon is used to widen the area of the vessel blockage, improving blood flow.

A coronary stent is a small, expandable mesh metal tube that acts as scaffolding to hold the artery open and improve blood flow. Stents come in various sizes, strengths, and textures and are frequently inserted after balloon angioplasty. Our team also uses drug-eluting stents, stents coated with medications that decrease the potential for an arterial re-blockage.

Before the procedure

While your doctor will be able to definitively tell you how long you may expect to be in the hospital, usually patients stay for a day or two. Here are some general guidelines:

• Generally, you may not have anything to eat or drink for six to eight hours before the procedure.
• You may be asked to start taking certain medications, so let your doctor know if you have any drug allergies.
• Make arrangements for someone to drive you to and from the hospital.
• Pack a small bag for your hospital stay, including a robe, pajamas, slippers, and toiletries.
• Bring a list of all medications and/or herbs, including exact names, frequency, and dosages.
• Do not bring valuables or money to the hospital, but you may wear your dentures, hearing aids, or glasses.
• Be sure to tell your nurse or doctor if you are allergic to iodine, shellfish, or contrast.
• In addition to examining your medical history, an electrocardiogram (EKG), blood tests and chest X-ray are usually done before the procedure.
• The nurse will clean and shave the area where the catheter will be inserted.
• An IV will be put in your arm or hand to administer fluids and medications, some of which may be used to relax you.

During the procedure

The procedure is done in one of our two catheterization laboratories. A fluid called contrast is injected into the catheter, allowing your doctor to view your coronary arteries. Blood-pressure recordings may be made in the various chambers of your heart, as well as an examination of valve function. Pictures will be taken with specialized cameras.

When the blockage is located, the balloon catheter is placed in the narrowed artery and slowly inflated to press fatty deposits against the artery walls, allowing blood to flow freely to the heart muscle.

After the procedure

After angioplasty, you will report to the fourth floor, where you will be asked to lie down and drink plenty of fluids to flush the contrast out of your system. A collagen closure device may be placed at the insertion site, where it works as a plug and prevents bleeding.

Your doctor will talk to you about healing at the insertion site, the possibility of your symptoms returning, medications and restrictions and changes in daily habits to reduce the risk of more arteries narrowing. Cardiac rehabilitation will further instruct you on the cardiac risk factors and answer your questions. The doctor will inform you when to make follow-up visits.

Stent procedure

Typically, after balloon angioplasty is performed, a stent is placed on another balloon catheter and guided to the area of blockage. The stent is then expanded in the artery through inflation of the balloon, which usually takes anywhere from several seconds to a few minutes. The stent will adhere to the artery wall and be left in place to become part of your artery.

After stent insertion

After the procedure, you will go to the fourth floor and be asked to lie still with your legs straight. You will remain connected to a heart monitor while a nurse checks your catheter insertion site and takes frequent measurements of your blood pressure. You will most likely still have the IV in for fluids and medications.

A thin layer of the artery’s inner lining cells will cover the stent within about a month. With drug-eluting stents, this process may take up to a year. This is why you need to take an antiplatelet drug prescribed by your physician. Aside from the time required for cardiac catheterization recovery, you will not need to worry about mechanical medical devices or metal detectors affecting you due to your implanted stent.

Cardiac catheterization risks

There can be some risk involved with specific diagnostic procedures. With stents, specifically, there can be damage to the vessel when the stent is implanted. You could also experience blood clots or restenosis when the artery builds up again with plaque either in the stent or at one end of it.

Please speak with your doctor to discuss the risks and benefits before any catheterization procedure. After the procedure, call your doctor or seek immediate medical treatment if:

• The insertion site begins to bleed.
• You feel chest pain or discomfort.
• Your arm or leg feels numb or cold.
• The bruising or swelling gets worse or increases.
• You have a fever of 101ºF or more.
• You see signs of infection (redness, oozing, hot to the touch) at the insertion site.
• You see any other unusual symptoms.